Adult Care Facilities
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ACF (DSRIP)
Analysis of Adult Care Facilities Data - SELF ATTESTATION
Delivery System Reform Incentive Payment Plan
9/9/2014
280-E-002
360-F-008
520-F-041
400-E-117
710-F-064
700-F-287
230-F-82
620-F-036
331-F-266
050-E-010
331-F-278
620-F-071
420-S-391
370-F-025
510-f-028
230-F-272
AF0519A
050-F-022
610-F-066
331-E-125
331-f-022
070-F038
540-E-050
030-E-039
240-S-004
620-f-076
700-893F
27
100.00%
Qualified
25
92.59%
Condition 1 - Volume
ACF
License #
Total
FACILITY NAME
David & Helen Getman Memorial Home
Hamilton Manor
Highland Home for Adults
Jones Manor on the Sound
Narrowsburg Manor LLC
New Brookhaven Town House for Adults
Hedgewood Home for Adults LLC
Green Hills Estate
New South Shore Manor
Central New York Adult Homes, Inc. dba Evergreen
Heights
Brooklyn Adult Care Center
Springvalley Rest Home
Lott Assisted Living Operating Corp./ dba Lott Assisted
Living Residence
Shire At Culverton
Adirondack Manor Home For Adults
Crystal House Manor, Inc.
Johnson Adult Homes - Forestville
Northbrook Heights Home For Adults
Mariners Residence, Inc.
St. Nicholas Home
Signature Senior Living (Formerly Scharome Manor)
JJM Health LLC
Elant at Goshen Adult Home
Ideal Senior Living Center
The Bristol Home, Inc.
L'Dor
The Lake Shore Adult Home
Highlighted Facility Names Indicate Medicaid Utlization
of 35% or greater
Volumes >= 35%
Utilization
Result
Rate
100.00% TRUE
100.00% TRUE
100.00% TRUE
100.00% TRUE
100.00% TRUE
100.00% TRUE
98.34% TRUE
97.22% TRUE
96.97% TRUE
Final
Result
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
By Appeal
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
By Appeal
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
FALSE
FALSE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
FALSE
FALSE
By Appeal
94.83%
94.53%
93.55%
90.91%
90.60%
90.23%
88.04%
85.83%
81.72%
77.86%
75.00%
66.67%
53.34%
49.53%
47.33%
44.44%
0.00%
0.00%
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