PILGRIM MANOR
CROMWELL, CT  06416

Medicare Provider Number: 075306
Cost report status: Settled Without Audit
[Record Code 15990 - 1996]

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SKILLED NURSING FACILITY AND SKILLED NURSING FACILITY HEALTH CARE COMPLEX STATISTICAL DATA
PROVIDER NO:
075306
PERIOD:
FROM 02/01/2000
TO 01/31/2001
WORKSHEET S-3 Part I
Component
Number
of
Beds
Bed
Days
Available
Inpatient Days Discharges Average Length of Stay Admissions
Full Time
Equivalent
 
Title
V
Title
XVIII
Title
XIX
Other Total
Title
V
Title
XVIII
Title
XIX
Other Total
Title
V
Title
XVIII
Title
XIX
Total
Title
V
Title
XVIII
Title
XIX
Other Total
Employees
on Payroll
Nonpaid
Workers
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
1 Skilled Nursing Facility ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### 1
2   2
3 Nursing Facility         3
3.01 ICF/MR                 3.01
4 Other Long Term Care                         4
5 Home Health Agency                                           5
6   6
7 SNF-Based Outpatient Rehabilitation Providers                                           7
8 Hospice 8
9 Total (Sum of lines 1-8) ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### ### 9
10 Ambulance Trips                                             10