Page 1 of 2 Assisted Living Program ALP (DSRIP) Analysis of Assisted Living Program Data - SELF ATTESTATION Delivery System Reform Incentive Payment Plan 9/9/2014 Total 63 100.00% Qualified 57 90.48% ALP Condition 1 - Volume Licence # Volumes >= 35% Utilization Result Rate 100.00% TRUE 100.00% TRUE Final Result TRUE TRUE By Appeal TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE By Appeal TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE By Appeal TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE By Appeal TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE By Appeal 97.26% TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE 93.86% TRUE TRUE By Appeal 92.10% TRUE TRUE TRUE TRUE TRUE TRUE By Appeal 1563L001 590-F-322 620-F-081 370-S-132 610-F-064 230-F-82 520-F-153 590-F-309 610-F-037 590-F-328 590-F-321 520-F-105 700- F-921 A331S009 020-F-819 230-F-068 230-F-044 540-F032 530-F-053 540-F-028 670-F-006 770-F-037 510-F-059 420-S-379 0671L002 590-F-319 590-F-309 370-F-208 590-F-320 331-F-270 720-S-004 570-F-049 800-F-129 260-f-016 800-F-990 090-f-003 600-F-250 FACILITY NAME Cedarbrook Village Incorporated Central Assisted Living LLC Chestnut Operating Company LLC dba Hudson Valley Assisted Living Program Famiy Service of Rochester, Inc. Harbor Terrace Adult Home and Assisted Living Hedgewood Home for Adults ALP Highland Park Center, Inc. dba Park Terrace at Radisson Hofgur LLC dba Queens Adult Care Center ALP Lakeside Manor Home for Adults & Assisted Living Program Long Island Living Center LLC Madison York Rego Park LLC Manlius Home For Adults Medford Hamlet LLC Moffat Gardens ALP, Inc. New Fordham Arms Assisted Living Program P&A Reckess dba Avalon Assisted Living & Wellness Center P&A Reckess dba Dutchess Care Promenade Middletown LLC Seneca Lake Terrace The Eliot at Erie Station ALP The New Falls Home LLC The Terrace at Newark Assisted Living Program The Terrace at Woodland Assisted Living Program Village Housing Development Fund Corp dba VillageCare at 46&Ten Underwood Manor ALP Elm York LLC Hofgur LLC dba Queens Adult Care Center Hilton East Madison York Assisted Living Community LLC Oceanview Manor Home for Adults, Inc ElderWood Assisted Living at Waverly Robynwood LLC P&A Reckess dba Crestview Manor ALP Adirondack Manor Home For Adults dba Montcalm Manor HFA Westchester ALP Management LLC dba The Westchester Center for Indepenent and Assited Living Adirondack Manor Home For Adults Troy Crossings LLC dba the Pines at Heartwood Highlighted Facility Names Indicate Medicaid Utlization of 35% or greater 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 99.82% 99.76% 99.64% 99.36% 99.02% 98.34% 97.47% 97.44% 91.57% 91.36% By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal Page 2 of 2 Assisted Living Program Condition 1 - Volume ALP FACILITY NAME Licence # 420-S-391 020-E-133 400-E-295 400-F-325 650-f-078 0690L001 050-F-022 510-f-055 630E 008 020-F-817 240-E-141 650-E-009 331-F-284 240-E-843 750-f-046 370-E-198 240-E-146 580-F-001 530-E-051 580-F-001 650-E-009 400-F-301 N/A N/A Lott Assisted Living Operating Corp. St. Vincent de Paul Residence Newco Alp Inc. dba Island Assisted Living Amber Court of Westbury LLC Adirondack Manor Home For Adults dba Scotia Mansion HFA Briarwood Manor Inc. Northbrook Heights Home For Adults Adirondack Manor Home For Adults dba Willow Park HFA United Helpers Canton Nursing Home, Inc. dba Maplewood Assisted Living Judith Lynn Home For Adults LLC dba Jamber Court of Pelham Gardens Menorah Campus Adult Home, Inc. St. Francis Commons Assisted Living Residence Amber Court of Brooklyn LLC DePaul Adult Care Communities, Inc. dba Kenwell Assisted Living Facility Adirondack Manor Home For Adults dba Adirondack Manor HFA ALP DePaul Adult Care Communities, Inc. dba Woodcrest Assisted Living Facility Good Shepherd Fairview Home. Inc. DePaul Adult Care Communities, Inc. dba Glenwell Assisted Living Facility Clover Lake Management LLC DePaul Adult Care Communities, Inc. dba Horizons Assisted Living Facility Plaza at Clover Lake Baptist Health Enriched Housing Program, Inc. Hempstead ALP dba Long Beach Assisted Living P&A Reckess dba Starlite Assisted Living Robynwood LLC Wallkill Hamlet LLC Highlighted Facility Names Indicate Medicaid Utlization of 35% or greater Volumes >= 35% Utilization Result Rate 89.45% TRUE 87.95% TRUE 86.76% TRUE 85.67% TRUE Final Result TRUE TRUE TRUE TRUE By Appeal TRUE TRUE TRUE By Appeal 81.71% TRUE TRUE TRUE 76.94% TRUE TRUE By Appeal 70.48% TRUE TRUE By Appeal 68.44% TRUE TRUE TRUE TRUE By Appeal 62.15% TRUE TRUE TRUE TRUE 62.05% TRUE TRUE By Appeal 61.33% TRUE TRUE By Appeal 59.84% TRUE TRUE TRUE TRUE By Appeal TRUE TRUE TRUE TRUE By Appeal TRUE FALSE FALSE FALSE FALSE FALSE By Appeal 0.00% TRUE FALSE FALSE FALSE FALSE FALSE 0.00% FALSE FALSE 84.58% 82.36% 66.01% 64.64% 46.92% 43.69% 39.72% 38.25% 24.46% 13.89% 0.00% 0.00% By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal By Appeal
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