KRISTI LEE MANOR INC.
COLORADO CITY, TX  79512-3099

Medicare Provider Number: 676027
Cost report status: Settled Without Audit
[Record Code 381786 - 1996]

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ANALYSIS OF CHANGES DURING COST REPORTING PERIOD IN CAPITAL ASSET BALANCES
PROVIDER NO:
676027
PERIOD:
FROM 01/01/2009
TO 12/31/2009
WORKSHEET A-7
  Description
Beginning
Balances
Purchases
Acquisitions
Donation
Total
Disposals
and
Retirements
Ending
Balance
 
1 2 3 4 5 6
1 Land ### ### ### 1
2 Land Improvements 2
3 Buildings and Fixtures ### ### ### ### 3
4 Building Improvements 4
5 Fixed Equipment ### ### ### 5
6 Movable Equipment ### ### ### 6
7 TOTAL ### ### ### ### 7