Page 192 - Financial Workbook August

Facility Code: 1 User: Zach Bell 4 Page 3 of 210 +01/17 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

180 02/17 $1,020.00 $0.00 $0.00 $0.00 $4,606.00 $5,626.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $142.57 $142.57 $0.00 $4,778.48 $0.00 $3,571.48 $3,272.48 $11,622.44

150 03/17 $5,115.00 $0.00 $0.00 $0.00 $380.23 $5,495.23 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $677.25 $677.25 $0.00 $5,290.46 $0.00 $4,083.46 $3,784.46 $13,158.38

120 04/17 $4,950.00 $0.00 $0.00 $0.00 $0.00 $4,950.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $5,119.80 ($44.21) $3,912.80 $0.00 $8,988.39

Resident: All Status: Both Aging Type: A/R Aging Age By: Service Date Buckets: PCC Default Balance Filter Options: All Payers: All

05/17 $3,630.00 $0.00 $0.00 $0.00 $0.00 $3,630.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.10 $0.00 $0.00 $0.10 $0.00 $3,071.88 $894.70 $0.00 $0.00 $3,966.58
90

60 06/17 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ($467.64) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $241.28 $0.00 $0.00 ($226.36) $4,310.80 $0.00 $0.00 $0.00 $0.00 $4,310.80
Towne Square Care of Puryear - SNF A/R Aging Report August 2017 30 Current 07/17 08/17 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $2,796.50 $0.00 $0.00 $0.00 $2,796.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ($81.40) $0.00 $0.00 ($6.00) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $327.37 $0.00 $0.00 $0.00 $951.38 $1,017.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ($483.42) ($4,394.36) $0.00 $0.00 $713.93 ($3,383.36) $4,481.46

Future Cash $0.00 ($4,950.00) ($300.00) $0.00 $0.00 ($5,250.00) ($346.00) ($1,150.05) ($809.00) ($200.00) $0.00 $0.00 ($950.00) ($1,252.90) ($4.00) $0.00 ($832.00) $0.00 ($285.54) ($1,152.29) $0.00 $0.00 $0.00 ($6,981.78) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Total +08/17 $14,715.00 ($4,950.00) ($300.00) $2,796.50 $4,986.23 $17,247.73 ($346.00) ($1,150.05) ($809.00) ($200.00) ($549.04) ($6.00) ($950.00) ($1,252.90) ($4.00) $327.37 ($832.00) $1,968.38 ($285.54) ($1,152.29) $241.38 ($4,877.78) $819.82 ($9,057.65) $13,273.72 $23,551.08 $850.49 $15,651.20 $10,841.40 $64,167.89

Resident Name (ID) Kemp, MARION SUE (KEMPM) D/C: 05/23/2017 Noel, Peggy S (NOEL) RAINEY, BERNICE H (RAINB) Smith, Martha Sue (SMITHM) Wright, Mary Lois (WRIGM) Total Beazley, Rosalie S (BEAZ R) Bell, Elsie L (BELL E) BERKLEY, TREVA J (BERKT) Brunzel, Sandra S (BRUN S) Conaway, Harvey Joe (CONAH) D/C: 06/03/2017 Erwin, Wanda Gray (ERWI W) Fitzgerald, Thomas E (FITZ T) Flanary, Dolores Ilo (FLAND) Hudson, Edith (HUDS E) Jeter, Daisy E. (JETED) Manning,

Date: Sep 15, 2017 Time: 13:47:40 CT PRIVATE PAY (PP) RESIDENT LIABILITY (PL) UNITEDHEALTHCARE

Facility #: F Payer MCO (UMC-TN)