SNFData - 335382 - 12/2001 - Worksheet S-7, Part I

MERCY HEALTH & REHAB CENTER
AUBURN, NY 13021

Medicare Provider Number: 335382

Cost report status: Settled Without Audit

[Record Code 153125 - 1996]

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NHCMQ DEMONSTRATION AND PPS STATISTICAL DATA					PROVIDER NO: 335382	PERIOD: FROM 01/01/2001 TO 12/31/2001	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.