SNFData - 335476 - 12/1998 - Worksheet S-7, Part I

THE ROCHESTER FRIENDLY HOME
ROCHESTER, NY 14618

Medicare Provider Number: 335476

Cost report status: Settled Without Audit

[Record Code 37684 - 1996]

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NHCMQ DEMONSTRATION AND PPS STATISTICAL DATA					PROVIDER NO: 335476	PERIOD: FROM 01/01/1998 TO 12/31/1998	WORKSHEET S-7 Part I
PART I - NHCMQ DEMONSTRATION STATISTICAL DATA FOR COST REPORTING PERIODS BEGINNING PRIOR TO JULY 1, 1998
	GROUP	M3PI REVENUE CODE	SERVICES PRIOR TO JANUARY 1ST (1)		SERVICES ON OR AFTER JANUARY 1ST (1)		TOTAL (See Instructions)
	GROUP	M3PI REVENUE CODE	RATE	DAYS	RATE	DAYS	TOTAL (See Instructions)
	1	2	3	3.01	4	4.01	5
1	RVC	9044						1
2	RVB	9043						2
3	RVA	9042			###	###	###	3
4	RHD	9041						4
5	RHC	9040			###	###	###	5
6	RHB	9039			###	###	###	6
7	RHA	9038			###	###	###	7
8	RMC	9037			###	###	###	8
9	RMB	9036			###	###	###	9
10	RMA	9035			###	###	###	10
11	RLB	9034			###	###	###	11
12	RLA	9033			###	###	###	12
13	SE3	9032						13
14	SE2	9031						14
15	SE1	9030						15
16	SSC	9029						16
17	SSB	9028						17
18	SSA	9027			###	###	###	18
19	CD2	9026			###	###	###	19
20	CD1	9025			###	###	###	20
21	CC2	9024			###	###	###	21
22	CC1	9023			###	###	###	22
23	CB2	9022						23
24	CB1	9021			###	###	###	24
25	CA2	9020			###	###	###	25
26	CA1	9019			###	###	###	26
27	IB2	9018						27
28	IB1	9017						28
29	IA2	9016						29
30	IA1	9015						30
31	BB2	9014						31
32	BB1	9013						32
33	BA2	9012						33
34	BA1	9011						34
35	PE2	9010						35
36	PE1	9009			###	###	###	36
37	PD2	9008						37
38	PD1	9007						38
39	PC2	9006						39
40	PC1	9005						40
41	PB2	9004						41
42	PB1	9003						42
43	PA2	9002						43
44	PA1	9001						44
45	Other Group	9000			###	###	###	45
46	TOTAL					###	###	46
(1) Calendar Year Providers: Complete columns 1, 2, 4, 4.01, and 5
Fiscal Year Providers - Rate change as of January 1st: Complete ALL columns.
Fiscal Year Providers - Rate DOES NOT change as of January 1st: Complete columns 1, 2, 3, 3.01, and 5.