Page 1 of 6 User: Tom Hathaway 7/1/2019 to 6/30/2020 Page # 1 Include Adjustment Periods: NO Include Closing Periods: NO Budget-Income ALF Medicaid 0 368,000-0 368,000 - ALF Private 0 665,000-0 665,000 - NF:Medicaid 0 1,347,960-0 1,347,960 - NF Medicare A 0 1,012,848-0 1,012,848 - NF Medicare B 0 132,453-0 132,453 - Contractual Allowance 0 (70,000) - 0 (70,000) - NF Private Pay 0 41,452-0 41,452 - NF Private Ins 0 20,754-0 20,754 - NF Managed Care 0 126,480-0 126,480 - NF Donations/Gift Revenue 0 100-0 100 - ALF Donations/Gift Revenue 0 100-0 100 - NF Misc. Income:Drug Income 0 150,000-0 150,000 - NF Misc. Income:Interest 0 12,000-0 12,000 - ALF Misc Income:Interest 0 12,000-0 12,000 - NF USB Stock Sales 0 50,000-0 50,000 - ALF USB Stock Sales 0 50,000-0 50,000 - NF Misc. Income:Meals(Staff) 0 5,000-0 5,000 - ALF Misc Income:Meals(Staff) 0 5,000-0 5,000 - NF Misc. Income:Other 0 52,000-0 52,000 - ALF Misc Income: Other 0 50-0 50 - NF Misc.Income: Meals (Guest) 0 1,400-0 1,400 - ALF Misc Income:Meals(Guest) 0 1,900-0 1,900 - NF Misc Income Refunds 0 5,000-0 5,000 - ALF Misc Income:Refunds 0 194-0 194 - ALF Misc. Inc:Transportation 0 1,500-0 1,500 - NF Misc Income: Transportation 0 300-0 300 - NF Tax Revenue 0 161,975-0 161,975 - ALF Tax Revenue 0 161,975-0 161,975 - NF Tax Revenue Interest 0 1,200-0 1,200 - ALF Tax Revenue Interest 0 1,200-0 1,200 - NF Misc Income:Chng Mrkt Value 0 10,000-0 10,000 - ALF Misc Income:Chng Mrkt Valu 0 10,000-0 10,000 - TOTAL Budget-Income 0 4,337,841-0 4,337,841 - Budget Expenses NF Activity Supplies 0 2,000-0 2,000 - ALF Activity Supplies 0 2,000-0 2,000 - ALF Activity Pet Expense 0 10-0 10 - NF Activity Socials 0 500-0 500 - ALF Activity Socials 0 750-0 750 - NF Advertising Admin 0 12,000-0 12,000 - ALF Advertising Admin 0 2,500-0 2,500 - NF Beauty & Barber 0 100-0 100 - NF Auditing 0 3,000-0 3,000 - ALF Auditing 0 250-0 250 - NF Cable TV 0 5,000-0 5,000 - ALF Cable TV 0 4,250-0 4,250 - NF Consultants Admin 0 30,000-0 30,000 - NF Consultants Nursing 0 12,000-0 12,000 - NF Consultants Dietary 0 12,000-0 12,000 - ALF Consultants Admin 0 2,000-0 2,000 - NF Software Fees Business 0 1,200-0 1,200 - NF Software Fees Nursing 0 10,628-0 10,628 - NF Software Fees Maintenance 0 3,300-0 3,300 - ALF Software Fees Maintenance 0 2,652-0 2,652 - ALF Software Fees Nursing 0 5,804-0 5,804 - Depreciation 0 130,000-0 130,000 - NF Drugs--Medicare 0 97,854-0 97,854 - NF Drugs--House Supply 0 10,000-0 10,000 - ALF Drugs: House Supply 0 1,000-0 1,000 - NF Education-Inservice ADMIN 0 1,500-0 1,500 - NF Education PGM MGR 0 398-0 398 - NF Education-Inserv Human Res 0 124-0 124 -
Page 2 of 6 User: Tom Hathaway 7/1/2019 to 6/30/2020 Page # 2 NF Education-Inservice Nursing 0 1,000-0 1,000 - NF Education-Inservice Dietary 0 1,000-0 1,000 - ALF Education-Inservice Dietar 0 202-0 202 - NF Education-Inserv Maint 0 136-0 136 - ALF Education-Inservice Admin 0 500-0 500 - ALF Education-Inserv Human Res 0 54-0 54 - ALF Education-Inserv Nursing 0 330-0 330 - NF Electricity & Gas 0 36,000-0 36,000 - ALF Electricity & Gas 0 31,814-0 31,814 - NF Employee Incentive Admin 0 5,000-0 5,000 - NF Employee Incentive Nur 0 3,900-0 3,900 - ALF Employee Incentive ADM 0 5,500-0 5,500 - ALF Employee Incentive Nurs 0 200-0 200 - NF Nursing Equipment Rental 0 36,000-0 36,000 - NF Minor Equip Purchase <5,000 0 10,000-0 10,000 - ALF Minor Equip Purchase<5,000 0 5,000-0 5,000 - NF Food 0 71,000-0 71,000 - ALF FOOD 0 67,000-0 67,000 - NF Food: Dairy 0 6,000-0 6,000 - ALF Food: Dairy 0 6,200-0 6,200 - NF Food: Bread 0 3,500-0 3,500 - ALF Food: Bread 0 3,500-0 3,500 - NF Food: Utensils/Dishes 0 2,000-0 2,000 - ALF Food: Utensils/Dishes 0 2,000-0 2,000 - NF Food: Dietary Supplies 0 3,000-0 3,000 - ALF Food: Dietary Supplies 0 2,398-0 2,398 - NF Food:Supplement 0 4,900-0 4,900 - ALF Food:Supplement 0 222-0 222 - NF Food: Menu Charges 0 600-0 600 - ALF Food: Menu Charges 0 250-0 250 - NF Food: Gloves 0 1,200-0 1,200 - ALF Food: Gloves 0 1,200-0 1,200 - NF Food: Paper Products 0 1,100-0 1,100 - ALF Food: Paper Products 0 1,000-0 1,000 - NF Food: Chemicals 0 1,700-0 1,700 - ALF Food: Chemicals 0 1,700-0 1,700 - NF Nursing Equip. Repair 0 700-0 700 - NF Kitchen Equip Repairs 0 1,000-0 1,000 - ALF Nursing Equip Repair 0 264-0 264 - NF Food: Trash Liners 0 270-0 270 - ALF Food: Trash Liners 0 270-0 270 - NF Laundry Equip Repair 0 300-0 300 - ALF Laundry Equip Repair 0 300-0 300 - NF Housekeeping: Supplies 0 10,000-0 10,000 - ALF Housekeeping: Supplies 0 7,000-0 7,000 - NF Housekeeping: Equipment 0 100-0 100 - ALF Housekeeping: Equipment 0 100-0 100 - NF Liability Insurance 0 25,000-0 25,000 - NF Insurance, Property, Auto 0 12,350-0 12,350 - ALF Liability Insurance 0 20,000-0 20,000 - ALF Insurance, Property, Auto 0 9,000-0 9,000 - NF Laundry Supplies 0 1,100-0 1,100 - ALF Laundry Supplies 0 690-0 690 - NF Laundry, Linen & Bedding 0 1,500-0 1,500 - ALF Laundry, Linen & Bedding 0 274-0 274 - NF Legal Fees 0 10,000-0 10,000 - ALF Legal Fees 0 10,000-0 10,000 - NF License & Dues ADMIN 0 14,000-0 14,000 - NF License & Dues Nursing 0 1,176-0 1,176 - NF License & Dues Dietary 0 12-0 12 - ALF License & Dues Dietary 0 8-0 8 - ALF License & Dues Admin 0 6,500-0 6,500 - ALF License & Dues Nursing 0 160-0 160 - NF Maint Building Repairs 0 4,000-0 4,000 -
Page 3 of 6 User: Tom Hathaway 7/1/2019 to 6/30/2020 Page # 3 ALF Maint Building Repairs 0 6,554-0 6,554 - NF Maint Contract Services 0 11,000-0 11,000 - ALF Maint Contract Services 0 12,000-0 12,000 - NF Maintenance Supplies 0 3,500-0 3,500 - ALF Maintenance Supplies 0 2,000-0 2,000 - NF Maintenance Technology 0 1,500-0 1,500 - ALF Maintenance Technology 0 1,044-0 1,044 - NF Maint Outside Landscaping 0 2,348-0 2,348 - ALF Maint Outside Landscaping 0 2,304-0 2,304 - NF Medical Director 0 36,000-0 36,000 - NF Misc Operating Expense 0 500-0 500 - ALF Misc Operating Expense 0 300-0 300 - NF Company Picnics & Parties 0 1,500-0 1,500 - ALF Company Picnics & Parties 0 1,500-0 1,500 - NF Medicaid Cost Report 0 4,700-0 4,700 - NF Medicare Cost Report 0 4,000-0 4,000 - NF Nursing Services:Lab 0 20,000-0 20,000 - NF Nursing Services: Oxygen 0 19,296-0 19,296 - NF PT/OT/Speech Therapy 0 333,000-0 333,000 - NF Therapy Equipment Rental 0 300-0 300 - NF Therapy Supplies 0 3,000-0 3,000 - NF Nursing Supplies 0 69,000-0 69,000 - ALF Nursing Supplies 0 3,500-0 3,500 - NF Nursing Suppl, Incon Suppl 0 20,000-0 20,000 - ALF Nursing Supp. Incon.Suppl 0 2,000-0 2,000 - NF Bus Equipment Lease 0 252-0 252 - ALF Bus Equipment Lease 0 252-0 252 - NF Office Supplies Admin 0 5,700-0 5,700 - NF Office Supplies Nursing 0 3,500-0 3,500 - NF Office Supplies Dietary 0 500-0 500 - ALF Office Supplies Dietary 0 500-0 500 - NF Office Supp Maintenance 0 24-0 24 - NF Office Supplies Activity 0 150-0 150 - ALF Office Supplies Activity 0 100-0 100 - ALF Office Supplies Admin 0 3,113-0 3,113 - ALF Office Supplies Nursing 0 200-0 200 - NF Postage & Shipping 0 700-0 700 - ALF Postage & Shipping 0 450-0 450 - NF Copy Machine Lease 0 3,200-0 3,200 - ALF Copy Machine Lease 0 3,170-0 3,170 - ALF Office Copier Useage ALF 0 1,750-0 1,750 - NF Promotional 0 1,500-0 1,500 - ALF Promotional 0 500-0 500 - NF Provider Tax 0 180,000-0 180,000 - NF Resident Replacement Items 0 1,000-0 1,000 - NF Telephone 0 9,000-0 9,000 - ALF Telephone 0 3,500-0 3,500 - NF Transport Purchase Serv 0 300-0 300 - NF Travel ADMIN 0 530-0 530 - NF Travel PGM MGR 0 132-0 132 - NF Travel Soc Serv 0 48-0 48 - NF Travel Nursing 0 300-0 300 - NF Travel Maintenance 0 366-0 366 - ALF Travel Maintenance 0 168-0 168 - NF Travel Activity 0 46-0 46 - ALF Travel Admin 0 486-0 486 - ALF Travel Nursing 0 70-0 70 - NF Uniforms Nursing 0 350-0 350 - NF Uniforms Dietary 0 366-0 366 - ALF Uniforms Dietary 0 244-0 244 - NF Uniforms Housekeeping 0 40-0 40 - ALF Uniforms Housekeeping 0 28-0 28 - ALF Uniforms Nursing 0 66-0 66 - NF Van Repairs 0 2,000-0 2,000 -
Page 4 of 6 User: Tom Hathaway 7/1/2019 to 6/30/2020 Page # 4 ALF Van Repairs 0 2,000-0 2,000 - NF Van License 0 1,000-0 1,000 - ALF Van License 0 650-0 650 - NF Van Gas 0 3,000-0 3,000 - ALF Van Gas 0 1,256-0 1,256 - NF Water, Sewer & Garbage 0 25,000-0 25,000 - ALF Water, Sewer & Garbage 0 8,700-0 8,700 - NF Administrator 0 98,280-0 98,280 - NF Program Manager 0 48,500-0 48,500 - NF Business Manager 0 36,301-0 36,301 - ALF Business Manager 0 15,560-0 15,560 - NF Business Office Assistant 0 14,550-0 14,550 - ALF Business Office Assistant 0 14,550-0 14,550 - NF Human Resource 0 29,100-0 29,100 - ALF Human Resource 0 12,500-0 12,500 - NF Social Services 0 50,350-0 50,350 - NF Medical Records 0 25,400-0 25,400 - ALF Administrator 0 57,000-0 57,000 - ALF PSA/CNA 0 360,000-0 360,000 - ALF Registered Nurse 0 60,500-0 60,500 - NF Director of Nursing 0 97,000-0 97,000 - NF RN Care Manager 0 76,000-0 76,000 - NF RN Supervisor 0 88,500-0 88,500 - NF Registered Nurse 0 46,000-0 46,000 - NF Licensed Practical Nurses 0 184,000-0 184,000 - NF Certified Nurse Aides 0 394,000-0 394,000 - NF Contract Registered Nurse 0 50,000-0 50,000 - NF Driver 0 10,400-0 10,400 - ALF Driver 0 3,500-0 3,500 - NF Dietary Supervisor 0 16,000-0 16,000 - ALF Dietary Supervisor 0 16,000-0 16,000 - NF Dietary Cook 0 39,500-0 39,500 - ALF Dietary Cook 0 26,000-0 26,000 - NF Dietary Aide/Dishwasher 0 65,000-0 65,000 - ALF Dietary Aide/Dishwasher 0 45,500-0 45,500 - NF Maintenance Supervisor 0 32,300-0 32,300 - ALF Maintenance Supervisor 0 14,000-0 14,000 - NF Maintenance Assistant 0 14,800-0 14,800 - ALF Maintenance Assistant 0 14,800-0 14,800 - NF Laundry 0 35,000-0 35,000 - NF Housekeeping 0 47,000-0 47,000 - ALF Housekeeping 0 32,300-0 32,300 - NF Activity Supervisor 0 25,000-0 25,000 - ALF Activity Aide 0 25,000-0 25,000 - NF Employee Bene:IRA Admin 0 3,000-0 3,000 - NF Employee Bene:IRA Bus Off 0 1,656-0 1,656 - NF Employee Bene:IRA Human Res 0 950-0 950 - NF Emp Bene:IRA Med Rec 0 642-0 642 - NF Employee Bene:IRA Nursing 0 3,700-0 3,700 - NF Employee Bene:IRA Dietary 0 700-0 700 - NF Emp Bene:IRA Maintenance 0 852-0 852 - NF Emp Bene:IRA Housekeeping 0 1,150-0 1,150 - NF Emp Bene:IRA Laundry 0 180-0 180 - ALF Employee Bene:IRA Admin 0 1,700-0 1,700 - ALF Employee Bene:IRA Bus Off 0 1,100-0 1,100 - ALF Employee Ben:IRA Human Res 0 405-0 405 - ALF Employee Bene:IRA Dietary 0 300-0 300 - ALF Emp Bene:IRA Maintenance 0 550-0 550 - ALF Emp Bene:IRA Houskeeping 0 750-0 750 - ALF Employee Bene:IRA Nursing 0 3,900-0 3,900 - NF Employee Holidays PGM MGR 0 500-0 500 - NF Emp Bene:Holiday Bus Off 0 2,000-0 2,000 - NF Emp Bene:Holiday Human Res 0 1,000-0 1,000 - NF Employ:Holidays Med Rec 0 1,000-0 1,000 -
Page 5 of 6 User: Tom Hathaway 7/1/2019 to 6/30/2020 Page # 5 NF Employee:Holidays Soc Serv 0 2,500-0 2,500 - NF Employee:Holidays Nursing 0 15,148-0 15,148 - NF Employee: Holidays Dietary 0 2,638-0 2,638 - NF Emp:Holidays Maintenance 0 500-0 500 - NF Emp:Holidays Housekeeping 0 1,286-0 1,286 - NF Emp:Holidays Laundry 0 474-0 474 - NF Employee:Holidays Activity 0 450-0 450 - ALF Employee:Holidays Activity 0 450-0 450 - ALF Emp Bene:Holiday Bus Off 0 1,274-0 1,274 - ALF Emp Bene:Holiday Human Res 0 600-0 600 - ALF Employee:Holidays Dietary 0 1,500-0 1,500 - ALF Emp:Holidays Maintenance 0 400-0 400 - ALF Emp:Holidays Housekeeping 0 858-0 858 - ALF Employee:Holidays Nursing 0 10,720-0 10,720 - NF Employee:Life Ins Group 0 2,640-0 2,640 - NF Employee:Insurance Admin 0 5,850-0 5,850 - NF Employee Insurance PM 0 5,800-0 5,800 - NF Employee:Insurance Bus Off 0 7,700-0 7,700 - NF Employ:Insurance Human Res 0 4,100-0 4,100 - NF Employ:Insurance Med Rec 0 4,400-0 4,400 - NF Employee:Insurance Soc Serv 0 6,925-0 6,925 - NF Employee:Insurance Nursing 0 110,000-0 110,000 - NF Employee:Insurance Dietary 0 20,100-0 20,100 - NF Emp:Insurance Maintenance 0 6,000-0 6,000 - NF Emp:Insurance Housekeeping 0 7,100-0 7,100 - NF Emp:Insurance Laundry 0 500-0 500 - NF Employee:Insurance Activity 0 1,900-0 1,900 - ALF Employ:Insurance Activity 0 5,850-0 5,850 - ALF Employee:Insurance Admin 0 5,850-0 5,850 - ALF Employee:Insurance Bus Off 0 5,150-0 5,150 - ALF Employ:Insurance Human Res 0 1,750-0 1,750 - ALF Employee:Insurance Dietary 0 11,000-0 11,000 - ALF Emp:Insurance Maintenance 0 3,950-0 3,950 - ALF Emp:Insurance Housekeeping 0 4,750-0 4,750 - ALF Employee:Insurance Nursing 0 86,700-0 86,700 - NF Employee:Sick Nursing 0 2,100-0 2,100 - NF Employ Bene:PTO Bus Off 0 1,900-0 1,900 - NF Employ Bene:PTO Human Res 0 1,700-0 1,700 - NF Employee Bene:PTO Med Rec 0 1,800-0 1,800 - NF Employee Bene:PTO Soc Serv 0 2,600-0 2,600 - NF Employee Bene:PTO Nursing 0 30,000-0 30,000 - NF Employee Bene:PTO Dietary 0 9,000-0 9,000 - NF Emp Bene:PTO Maintenance 0 300-0 300 - NF Emp Bene:PTO Housekeeping 0 3,700-0 3,700 - NF Emp Bene:PTO Laundry 0 400-0 400 - NF Employee Bene:PTO Activity 0 500-0 500 - ALF Employee Bene:PTO Activity 0 1,100-0 1,100 - ALF Employ Bene:PTO Bus Off 0 1,200-0 1,200 - NF Employ:Lab/Fingerprt Admin 0 400-0 400 - ALF Employ:Lab/Fingerprt Admin 0 300-0 300 - NF FICA/Medicare Admin 0 7,624-0 7,624 - NF FICA/Medicare PGM MGR 0 3,500-0 3,500 - NF FICA/Medicare Bus Off 0 4,790-0 4,790 - NF FICA/Medicare Human Res 0 2,400-0 2,400 - NF FICA/Medicare Med Rec 0 1,596-0 1,596 - NF FICA/Medicare Soc Serv 0 4,000-0 4,000 - NF FICA/Medicare Nursing 0 68,000-0 68,000 - NF FICA/Medicare Dietary 0 11,000-0 11,000 - NF FICA/Medicare Maintenance 0 3,500-0 3,500 - NF FICA/Medicare Housekeeping 0 4,000-0 4,000 - NF FICA/Medicare Laundry 0 2,800-0 2,800 - NF FICA/Medicare Activity 0 1,600-0 1,600 - ALF FICA/Medicare Activity 0 2,000-0 2,000 - ALF FICA/Medicare Admin 0 4,300-0 4,300 -
Page 6 of 6 User: Tom Hathaway 7/1/2019 to 6/30/2020 Page # 6 ALF FICA/Medicare Bus Off 0 3,050-0 3,050 - ALF FICA/Medicare Human Res 0 1,025-0 1,025 - ALF FICA/Medicare Dietary 0 6,000-0 6,000 - ALF FICA/Medicare Maintenance 0 2,300-0 2,300 - ALF FICA/Medicare Housekeeping 0 2,700-0 2,700 - ALF FICA/Medicare Nursing 0 32,000-0 32,000 - NF Workman's Comp Admin 0 650-0 650 - NF Workman's Comp PGM MGR 0 650-0 650 - NF Workman's Comp Bus Off 0 946-0 946 - NF Workman's Comp Human Res 0 464-0 464 - NF Workman's Comp Med Rec 0 426-0 426 - NF Workman's Comp Soc Serv 0 684-0 684 - NF Workman's Comp Nursing 0 16,552-0 16,552 - NF Workman's Comp Dietary 0 5,300-0 5,300 - NF Workman's Comp Maintenance 0 796-0 796 - NF Workman's Comp Housekeeping 0 1,650-0 1,650 - NF Workman's Comp Laundry 0 872-0 872 - NF Workman's Comp Activity 0 400-0 400 - ALF Workman's Comp Activity 0 350-0 350 - ALF Workman's Comp Admin 0 900-0 900 - ALF Workman's Comp Bus Off 0 650-0 650 - ALF Workman's Comp Human Res 0 200-0 200 - ALF Workman's Comp Dietary 0 2,000-0 2,000 - ALF Work Comp Maintenance 0 450-0 450 - ALF Workman's Comp Housekeep 0 900-0 900 - ALF Workman's Comp Nursing 0 10,500-0 10,500 - NF ADP Payroll Fees 0 6,610-0 6,610 - ALF ADP Payroll Fees 0 6,610-0 6,610 - NF Bank Fees 0 1,100-0 1,100 - ALF Bank Fees 0 1,100-0 1,100 - NF LGIP Bank Fees 0 148-0 148 - ALF LGIP Bank Fees 0 148-0 148 - NF Financial Charges 0 800-0 800 - ALF Financial Charges 0 800-0 800 - NF Bond Payment 0 139,738-0 139,738 - ALF Bond Payment 0 139,737-0 139,737 - NF Misc Expense 0 31,268-0 31,268 - TOTAL Budget Expenses 0 4,824,676-0 4,824,676 - Budget Days Medicaid Days 0 (5,245) - 0 (5,245) - Medicare A Days 0 (2,555) - 0 (2,555) - Managed Care Days 0 (170) - 0 (170) - ALF - Private 0 (6,754) - 0 (6,754) - ALF - ALF - Medicaid 0 (3,831) - 0 (3,831) - TOTAL Budget Days 0 (18,555) - 0 (18,555) -