Worksheet A-7
- Return to Cost Report Summary
- Form A700
- INSTRUCTIONS AS PUBLISHED IN CMS PUB. 15-II, , REV
CARIBOU NURSING HOME
CARIBOU, ME 04736-
CARIBOU, ME 04736-
Medicare Provider Number: 205117
Cost report status: Settled Without Audit
[Record Code 197221 - 1996]
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ANALYSIS OF CHANGES DURING COST REPORTING PERIOD IN CAPITAL ASSET BALANCES |
PROVIDER NO: 205117 |
PERIOD: FROM 10/01/2002 TO 09/30/2003 |
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 | |