WOODCARE V INC
BRIGHTON, MI  48116

Medicare Provider Number: 235615
Cost report status: Settled Without Audit
[Record Code 385432 - 1996]

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STATEMENT OF REVENUES AND EXPENSES
PROVIDER NO:
235615
PERIOD:
FROM 01/01/2009
TO 12/31/2009
WORKSHEET G - 3
1 Total patient revenues (From Wkst. G - 2, Part I, col. 3, line 14) ### 1
2 Less: contractual allowances and discounts on patients accounts ### 2
3 Net patient revenues (Line 1 minus line 2) ### 3
4 Less: total operating expenses (From Worksheet G-2, Part II, line 15) ### 4
5 Net income from service to patients (Line 3 minus 4) ### 5
6 Other income:   6
7 Contributions, donations, bequests, etc 7
8 Income from investments ### 8
9 Revenues from telephone and telegraph service 9
10 Revenue from television and radio service 10
11 Purchase discounts 11
12 Rebates and refunds of expenses 12
13 Parking lot receipts 13
14 Revenue from laundry and linen service 14
15 Revenue from meals sold to employees and guests 15
16 Revenue from rental of living quarters 16
17 Revenue from sale of medical and surgical supplies to other than patients 17
18 Revenue from sale of drugs to other than patients 18
19 Revenue from sale of medical records and abstracts 19
20 Tuition (fees, sale of textbooks, uniforms, etc.) 20
21 Revenue from gifts, flower, coffee shops, canteen 21
22 Rental of vending machines 22
23 Rental of skilled nursing space 23
24 Governmental appropriations 24
25 25
26 Total other income (Sum of lines 7 - 25) ### 26
27 Total (Line 5 plus line 26) ### 27
28 Other expenses (specify)   28
29     29
30     30
31 Total other expenses (Sum of lines 28 - 30) 31
32 Net income (or loss) for the period (Line 27 minus line 31) ### 32