ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY …illinois department of healthcare and family...

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Page 1 ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES BUREAU OF RATE DEVELOPMENT AND ANALYSIS MEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015 Building Facility Rate Capital Support Nursing Total Effective Capital Rate ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date 6000012 A MERKLE C KNIPPRATH N H 4 4 CLIFTON $9.07 $46.85 $68.81 $124.73 4/1/2015 6000020 ABBINGTON REHAB NURSING CENTER 7 7 ROSELLE $13.19 $49.47 $85.03 $147.69 4/1/2015 6000038 ABBOTT HOUSE 8 HIGHLAND PARK $11.47 $49.04 $55.09 $115.60 7/1/2014 Eligible for Provisional Licensure as SMHRF 6000046 ADDOLORATA VILLA 7 7 WHEELING $13.92 $55.98 $98.29 $168.19 4/1/2015 6007959 ALBANY CARE INC 7 EVANSTON $15.70 $33.26 $55.95 $104.91 7/1/2014 Eligible for Provisional Licensure as SMHRF 6000103 ALDEN ALMA NELSON MANOR 1 1 ROCKFORD $14.99 $49.65 $87.03 $151.67 4/1/2015 6014757 ALDEN DES PLAINES REHAB HHC 7 7 DES PLAINES $22.20 $55.98 $108.73 $186.91 4/1/2015 6003735 ALDEN ESTATES OF BARRINGTON 7 7 BARRINGTON $23.27 $55.98 $145.85 $225.10 4/1/2015 6013429 ALDEN ESTATES OF EVANSTON 7 7 EVANSTON $19.32 $55.98 $114.25 $189.55 4/1/2015 6007033 ALDEN ESTATES OF NAPERVILLE 7 7 NAPERVILLE $16.88 $53.32 $114.76 $184.96 4/1/2015 6016695 ALDEN ESTATES OF SHOREWOOD 9 9 SHOREWOOD $19.22 $45.68 $118.98 $183.88 4/1/2015 6006886 ALDEN ESTATES OF SKOKIE 7 SKOKIE $22.33 $55.98 $84.28 $162.59 7/1/2014 6005193 ALDEN LAKELAND REHAB AND HCC 6 6 CHICAGO $14.19 $48.50 $138.83 $201.52 4/1/2015 6009849 ALDEN LINCOLN PARK REHAB 6 6 CHICAGO $11.23 $52.87 $96.69 $160.79 4/1/2015 6005714 ALDEN LONG GROVE REHAB 8 8 LONG GROVE $14.63 $50.21 $94.38 $159.22 4/1/2015 6014765 ALDEN NORTH SHORE REHAB AND HC 7 7 SKOKIE $21.70 $55.98 $127.57 $205.25 4/1/2015 6014500 ALDEN NORTHMOOR REHAB AND HHC 6 6 CHICAGO $22.43 $51.87 $106.66 $180.96 4/1/2015 6014773 ALDEN OF WATERFORD 8 8 AURORA $19.48 $55.98 $103.15 $178.61 4/1/2015 6014922 ALDEN ORLAND PARK REHAB AND HC 7 7 ORLAND PARK $18.80 $55.98 $102.62 $177.40 4/1/2015 6007165 ALDEN PARK STRATHMOOR 1 1 ROCKFORD $11.07 $49.65 $98.27 $158.99 4/1/2015 6001366 ALDEN POPLAR CR REHAB AND HCC 7 7 HOFFMAN ESTATES $18.21 $52.08 $105.85 $176.14 4/1/2015 6012645 ALDEN PRINCETON REHAB AND HCC 6 6 CHICAGO $17.33 $51.00 $89.69 $158.02 4/1/2015 6008304 ALDEN TERRACE OF MCHENRY REHAB 8 8 MCHENRY $10.10 $43.65 $100.85 $154.60 4/1/2015 6013353 ALDEN TOWN MANOR REHAB AND HCC 7 7 CICERO $20.74 $49.73 $97.01 $167.48 4/1/2015 6000459 ALDEN VALLEY RIDGE REHAB HCC 7 7 BLOOMINGDALE $12.68 $51.37 $90.24 $154.29 4/1/2015 6009856 ALDEN WENTWORTH REHAB AND HCC 6 6 CHICAGO $17.55 $44.13 $92.11 $153.79 4/1/2015 6003529 ALEDO REHAB HEALTH CARE CTR 10 10 ALEDO $9.14 $38.14 $63.81 $111.09 4/1/2015 6004014 ALHAMBRA CARE CENTER 11 11 ALHAMBRA $10.44 $28.46 $68.00 $106.90 4/1/2015 7/1/2014 6000087 ALL AMERICAN NURSING HOME 6 6 CHICAGO $11.59 $45.18 $83.22 $139.99 4/1/2015 6000129 ALPINE FIRESIDE HEALTH CENTER 1 1 ROCKFORD $15.30 $47.68 $79.63 $142.61 4/1/2015 6000152 ALTON MEM HOSP HATCH SNF UNIT 11 ALTON $5.44 $46.71 $78.51 $130.66 7/1/2014 6002778 ALTON REHAB AND NURSING CENTER 11 11 ALTON $11.52 $43.69 $77.67 $132.88 4/1/2015 7/1/2014 6000186 AMBASSADOR NURSING REHAB CTR 6 6 CHICAGO $13.74 $50.93 $107.25 $171.92 4/1/2015 6001267 AMBERWOOD CARE CENTRE 1 1 ROCKFORD $11.17 $40.82 $93.59 $145.58 4/1/2015 6001788 ANNA REHAB AND NURSING CENTER 5 5 ANNA $10.12 $40.67 $67.63 $118.42 4/1/2015 6005730 APERION CARE AMBOY 1 1 AMBOY $7.42 $40.92 $83.43 $131.77 4/1/2015 6001150 APERION CARE BRIDGEPORT 5 5 BRIDGEPORT $9.39 $43.93 $86.16 $139.48 4/1/2015 6007207 APERION CARE BURBANK 7 7 BURBANK $18.32 $55.98 $113.32 $187.62 4/1/2015 6008064 APERION CARE CHICAGO HEIGHTS 7 7 CHICAGO $14.05 $43.24 $87.69 $144.98 4/1/2015 6005508 APERION CARE DECATUR 4 4 DECATUR $12.92 $39.00 $83.57 $135.49 4/1/2015 6002547 APERION CARE DOLTON 7 7 DOLTON $18.79 $49.25 $102.64 $170.68 4/1/2015

Transcript of ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY …illinois department of healthcare and family...

Page 1: ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY …illinois department of healthcare and family services bureau of rate development and analysis medicaid rate list for nursing facilities

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6000012 A MERKLE C KNIPPRATH N H 4 4 CLIFTON $9.07 $46.85 $68.81 $124.73 4/1/20156000020 ABBINGTON REHAB NURSING CENTER 7 7 ROSELLE $13.19 $49.47 $85.03 $147.69 4/1/20156000038 ABBOTT HOUSE 8 HIGHLAND PARK $11.47 $49.04 $55.09 $115.60 7/1/2014 Eligible for Provisional Licensure as SMHRF6000046 ADDOLORATA VILLA 7 7 WHEELING $13.92 $55.98 $98.29 $168.19 4/1/20156007959 ALBANY CARE INC 7 EVANSTON $15.70 $33.26 $55.95 $104.91 7/1/2014 Eligible for Provisional Licensure as SMHRF6000103 ALDEN ALMA NELSON MANOR 1 1 ROCKFORD $14.99 $49.65 $87.03 $151.67 4/1/20156014757 ALDEN DES PLAINES REHAB HHC 7 7 DES PLAINES $22.20 $55.98 $108.73 $186.91 4/1/20156003735 ALDEN ESTATES OF BARRINGTON 7 7 BARRINGTON $23.27 $55.98 $145.85 $225.10 4/1/20156013429 ALDEN ESTATES OF EVANSTON 7 7 EVANSTON $19.32 $55.98 $114.25 $189.55 4/1/20156007033 ALDEN ESTATES OF NAPERVILLE 7 7 NAPERVILLE $16.88 $53.32 $114.76 $184.96 4/1/20156016695 ALDEN ESTATES OF SHOREWOOD 9 9 SHOREWOOD $19.22 $45.68 $118.98 $183.88 4/1/20156006886 ALDEN ESTATES OF SKOKIE 7 SKOKIE $22.33 $55.98 $84.28 $162.59 7/1/20146005193 ALDEN LAKELAND REHAB AND HCC 6 6 CHICAGO $14.19 $48.50 $138.83 $201.52 4/1/20156009849 ALDEN LINCOLN PARK REHAB 6 6 CHICAGO $11.23 $52.87 $96.69 $160.79 4/1/20156005714 ALDEN LONG GROVE REHAB 8 8 LONG GROVE $14.63 $50.21 $94.38 $159.22 4/1/20156014765 ALDEN NORTH SHORE REHAB AND HC 7 7 SKOKIE $21.70 $55.98 $127.57 $205.25 4/1/20156014500 ALDEN NORTHMOOR REHAB AND HHC 6 6 CHICAGO $22.43 $51.87 $106.66 $180.96 4/1/20156014773 ALDEN OF WATERFORD 8 8 AURORA $19.48 $55.98 $103.15 $178.61 4/1/20156014922 ALDEN ORLAND PARK REHAB AND HC 7 7 ORLAND PARK $18.80 $55.98 $102.62 $177.40 4/1/20156007165 ALDEN PARK STRATHMOOR 1 1 ROCKFORD $11.07 $49.65 $98.27 $158.99 4/1/20156001366 ALDEN POPLAR CR REHAB AND HCC 7 7 HOFFMAN ESTATES $18.21 $52.08 $105.85 $176.14 4/1/20156012645 ALDEN PRINCETON REHAB AND HCC 6 6 CHICAGO $17.33 $51.00 $89.69 $158.02 4/1/20156008304 ALDEN TERRACE OF MCHENRY REHAB 8 8 MCHENRY $10.10 $43.65 $100.85 $154.60 4/1/20156013353 ALDEN TOWN MANOR REHAB AND HCC 7 7 CICERO $20.74 $49.73 $97.01 $167.48 4/1/20156000459 ALDEN VALLEY RIDGE REHAB HCC 7 7 BLOOMINGDALE $12.68 $51.37 $90.24 $154.29 4/1/20156009856 ALDEN WENTWORTH REHAB AND HCC 6 6 CHICAGO $17.55 $44.13 $92.11 $153.79 4/1/20156003529 ALEDO REHAB HEALTH CARE CTR 10 10 ALEDO $9.14 $38.14 $63.81 $111.09 4/1/20156004014 ALHAMBRA CARE CENTER 11 11 ALHAMBRA $10.44 $28.46 $68.00 $106.90 4/1/2015 7/1/20146000087 ALL AMERICAN NURSING HOME 6 6 CHICAGO $11.59 $45.18 $83.22 $139.99 4/1/20156000129 ALPINE FIRESIDE HEALTH CENTER 1 1 ROCKFORD $15.30 $47.68 $79.63 $142.61 4/1/20156000152 ALTON MEM HOSP HATCH SNF UNIT 11 ALTON $5.44 $46.71 $78.51 $130.66 7/1/20146002778 ALTON REHAB AND NURSING CENTER 11 11 ALTON $11.52 $43.69 $77.67 $132.88 4/1/2015 7/1/20146000186 AMBASSADOR NURSING REHAB CTR 6 6 CHICAGO $13.74 $50.93 $107.25 $171.92 4/1/20156001267 AMBERWOOD CARE CENTRE 1 1 ROCKFORD $11.17 $40.82 $93.59 $145.58 4/1/20156001788 ANNA REHAB AND NURSING CENTER 5 5 ANNA $10.12 $40.67 $67.63 $118.42 4/1/20156005730 APERION CARE AMBOY 1 1 AMBOY $7.42 $40.92 $83.43 $131.77 4/1/20156001150 APERION CARE BRIDGEPORT 5 5 BRIDGEPORT $9.39 $43.93 $86.16 $139.48 4/1/20156007207 APERION CARE BURBANK 7 7 BURBANK $18.32 $55.98 $113.32 $187.62 4/1/20156008064 APERION CARE CHICAGO HEIGHTS 7 7 CHICAGO $14.05 $43.24 $87.69 $144.98 4/1/20156005508 APERION CARE DECATUR 4 4 DECATUR $12.92 $39.00 $83.57 $135.49 4/1/20156002547 APERION CARE DOLTON 7 7 DOLTON $18.79 $49.25 $102.64 $170.68 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6006845 APERION CARE EVANSTON 7 7 EVANSTON $20.53 $48.47 $111.62 $180.62 4/1/20156015333 APERION CARE FOREST PARK 7 7 FOREST PARK $20.78 $48.88 $108.65 $178.31 4/1/20156007280 APERION CARE HIGHWOOD 8 8 HIGHWOOD $19.52 $44.78 $110.49 $174.79 4/1/20156014617 APERION CARE INTERNATIONAL 6 6 CHICAGO $22.20 $48.75 $116.59 $187.54 4/1/20156008650 APERION CARE JACKSONVILLE 3 3 JACKSONVILLE $8.98 $39.56 $79.48 $128.02 4/1/20156000095 APERION CARE LITCHFIELD 3 3 LITCHFIELD $9.67 $40.08 $74.41 $124.16 4/1/2015 7/1/20146001077 APERION CARE MIDLOTHIAN 7 7 MIDLOTHIAN $14.70 $45.18 $83.29 $143.17 4/1/20156002059 APERION CARE OAK LAWN 7 7 OAK LAWN $16.48 $50.10 $129.23 $195.81 4/1/20156007520 APERION CARE PLUM GROVE 7 7 PALATINE $20.49 $46.83 $113.74 $181.06 4/1/20156002661 APERION CARE SPRINGFIELD 3 3 SPRINGFIELD $8.12 $42.00 $67.89 $118.01 4/1/20156004204 APERION CARE ST ELMO 5 5 SAINT ELMO $11.27 $42.14 $103.18 $156.59 4/1/20156008312 APERION CARE WILMINGTON 9 9 WILMINGTON $9.75 $44.03 $94.96 $148.74 4/1/20156000384 APOSTOLIC CHRISTIAN HOME 2 2 ROANOKE $14.69 $50.44 $85.04 $150.17 4/1/20156002885 APOSTOLIC CHRISTIAN HOME 2 2 EUREKA $15.55 $49.92 $73.01 $138.48 4/1/20156000400 APOSTOLIC CHRISTIAN RESTMOR 2 2 MORTON $16.85 $50.44 $77.51 $144.80 4/1/20156000426 APOSTOLIC CHRISTIAN SKYLINES 2 2 PEORIA $13.82 $49.59 $77.01 $140.42 4/1/20156000467 APPLEWOOD REHABILITATION CTR 7 7 MATTESON $16.08 $49.08 $104.42 $169.58 4/1/20156006852 ARBA CARE CENTER OF COLFAX 4 4 COLFAX $11.16 $50.44 $85.13 $146.73 4/1/20156005847 ARBA CARE CENTER OF ELGIN 8 8 ELGIN $11.47 $54.20 $82.74 $148.41 4/1/20156006308 ARBA CARE CENTER OF TOLUCA 2 2 TOLUCA $8.57 $48.85 $76.82 $134.24 4/1/20156001010 ARBA CARE CTR OF BLOOMINGTON 4 4 BLOOMINGTON $9.88 $49.89 $82.97 $142.74 4/1/20156008155 ARBOUR HEALTH CARE CENTER 6 6 CHICAGO $13.16 $44.39 $74.80 $132.35 4/1/20156009823 ARCOLA HEALTH CARE CENTER 4 4 ARCOLA $9.63 $36.01 $61.78 $107.42 4/1/20156014906 ARIA POST ACUTE CARE 7 7 HILLSIDE $21.46 $49.62 $102.22 $173.30 4/1/20156000517 ARTHUR HOME 4 4 ARTHUR $9.51 $47.66 $78.80 $135.97 4/1/20156016729 ASBURY GARDENS NSG AND REHAB 8 NORTH AURORA $19.48 $45.20 $90.20 $154.88 9/5/20146008205 ASPEN REHAB AND HEALTH CARE 10 10 SILVIS $10.87 $50.96 $56.36 $118.19 4/1/20156016273 ASSISI HCC AT CLARE OAKS 7 7 BARTLETT $18.18 $55.98 $92.95 $167.11 4/1/20156006662 ASTORIA PLACE LIVING REHAB CTR 6 6 CHICAGO $17.76 $56.24 $119.75 $193.75 4/1/20156003834 ATRIUM HEALTH CARE CENTER LTD 6 6 CHICAGO $13.36 $45.27 $92.22 $150.85 4/1/20156007181 AUBURN REHAB AND HCC 3 3 AUBURN $8.78 $35.60 $86.11 $130.49 4/1/20156014344 AVANTARA LONG GROVE 8 8 LONG GROVE $17.46 $47.61 $114.01 $179.08 4/1/20156009096 AVANTARA PARK RIDGE 7 7 PARK RIDGE $14.88 $55.98 $107.85 $178.71 4/1/20156003214 AVANTI WELLNESS AND REHAB 7 7 NILES $16.75 $49.29 $111.29 $177.33 4/1/20156011340 AVISTON COUNTRYSIDE MANOR 11 11 AVISTON $13.24 $42.38 $76.94 $132.56 4/1/20156000640 BALLARD RESPIRATORY AND REHAB 7 7 DES PLAINES $17.48 $55.82 $137.08 $210.38 4/1/20156000657 BALMORAL NURSING HOME 6 6 CHICAGO $11.01 $32.49 $66.00 $109.50 4/1/20156000731 BARRY COMMUNITY CARE 3 3 BARRY $9.06 $40.29 $66.24 $115.59 4/1/20156008171 BATAVIA REHAB HEALTH CARE CTR 8 8 BATAVIA $12.57 $55.98 $77.55 $146.10 4/1/20156000764 BAYSIDE TERRACE 8 WAUKEGAN $10.85 $38.53 $54.39 $103.77 7/1/2014 Eligible for Provisional Licensure as SMHRF6000806 BEECHER MANOR NURSG AND RHB CT 9 9 BEECHER $19.71 $53.08 $99.24 $172.03 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6000822 BELHAVEN NURSING REHAB CTR 6 6 CHICAGO $17.31 $55.98 $131.38 $204.67 4/1/20156000848 BELMONT NURSING HOME 6 CHICAGO $12.65 $49.57 $56.10 $118.32 7/1/2014 Eligible for Provisional Licensure as SMHRF6000855 BEMENT HEALTH CARE CENTER 4 4 BEMENT $10.47 $41.46 $76.20 $128.13 4/1/20156005391 BENTON REHAB HEALTH CARE CTR 5 5 BENTON $7.81 $43.31 $74.87 $125.99 4/1/20156010110 BERKELEY NURSING REHAB CENTER 7 7 OAK PARK $17.32 $55.98 $96.53 $169.83 4/1/20156000863 BETHALTO CARE 11 11 BETHALTO $9.57 $44.50 $83.53 $137.60 4/1/20156014872 BETHANY REHAB AND HCC 1 1 DEKALB $17.50 $51.52 $82.59 $151.61 4/1/20156000889 BETHANY TERRACE NURSING CENTRE 7 7 MORTON GROVE $15.83 $49.44 $85.07 $150.34 4/1/20156006688 BETHESDA HOME AND RETIREMENT C 6 6 CHICAGO $13.46 $55.98 $83.95 $153.39 4/1/20156000962 BIG MEADOWS INC 1 1 SAVANNA $13.91 $48.57 $81.08 $143.56 4/1/2015 7/1/20146000988 BIRCHWOOD PLAZA INC 6 6 CHICAGO $12.71 $39.49 $89.76 $141.96 4/1/20156000996 BLOOMINGTON REHAB AND HCC 4 4 BLOOMINGTON $9.66 $50.44 $60.76 $120.86 4/1/20156001069 BOURBONNAIS TERRACE NH 9 BOURBONNAIS $10.27 $34.73 $52.94 $97.94 7/1/2014 Eligible for Provisional Licensure as SMHRF6001101 BREESE NURSING HOME 11 11 BREESE $10.21 $41.54 $66.71 $118.46 4/1/20156001119 BRENTWOOD NORTH HC REHAB CTR 8 8 RIVERWOODS $13.90 $55.98 $115.55 $185.43 4/1/20156005474 BRIA OF BELLEVILLE 11 11 BELLEVILLE $12.67 $41.92 $98.48 $153.07 4/1/20156007983 BRIA OF CAHOKIA 11 11 CAHOKIA $10.50 $38.76 $93.14 $142.40 4/1/20156007991 BRIA OF CHICAGO HEIGHTS 7 7 S CHICAGO HTS $15.63 $40.26 $87.79 $143.68 4/1/20156000954 BRIA OF FOREST EDGE 6 6 CHICAGO $11.79 $36.89 $95.37 $144.05 4/1/20156003503 BRIA OF GENEVA 8 8 GENEVA $11.25 $55.98 $113.81 $181.04 4/1/20156010086 BRIA OF PALOS HILLS 7 7 PALOS HILLS $14.88 $45.78 $103.63 $164.29 4/1/2015 7/1/20146001283 BRIA OF RIVER OAKS 7 7 BURNHAM $13.82 $36.83 $97.75 $148.40 4/1/20156009930 BRIA OF WESTMONT 7 7 WESTMONT $12.58 $44.26 $108.24 $165.08 4/1/20156001143 BRIAR PLACE 7 7 INDIAN HEAD PRK $13.86 $44.40 $76.59 $134.85 4/1/20156001168 BRIDGEVIEW HEALTH CARE CENTER 7 7 BRIDGEVIEW $15.05 $45.78 $110.82 $171.65 4/1/20156000353 BRIDGEWAY SENIOR LIVING 7 7 BENSENVILLE $9.22 $55.98 $98.43 $163.63 4/1/20156001176 BRIGHTVIEW HEALTHCARE REHAB 6 6 CHICAGO $13.86 $52.58 $92.63 $159.07 4/1/20156001689 BRONZEVILLE PARK NSG LIVING CT 6 6 CHICAGO $15.43 $45.18 $95.79 $156.40 4/1/20156002018 BRYN MAWR CARE INC 6 CHICAGO $15.01 $32.48 $55.85 $103.34 7/1/2014 Eligible for Provisional Licensure as SMHRF6001242 BUCKINGHAM PAVILION 6 6 CHICAGO $14.49 $41.32 $88.35 $144.16 4/1/20156001259 BURGESS SQUARE HEALTHCARE CTR 7 7 WESTMONT $11.90 $51.15 $86.19 $149.24 4/1/20156001275 BURGIN MANOR OF OLNEY INC 5 5 OLNEY $11.71 $38.61 $77.73 $128.05 4/1/20156001291 BURNSIDE COMMUNITY HEALTH CTR 4 4 MARSHALL $11.67 $46.84 $70.11 $128.62 4/1/20156001317 CAHOKIA NURSING AND REHAB CTR 11 11 CAHOKIA $14.07 $42.39 $87.99 $144.45 4/1/20156014674 CALHOUN NURSING AND REHAB CTR 3 3 HARDIN $14.40 $39.41 $69.32 $123.13 4/1/20156001333 CALIFORNIA GDNS NUR REHAB CTR 6 6 CHICAGO $14.32 $44.14 $76.38 $134.84 4/1/20156008635 CAMBRIDGE NURSING REHAB CENTER 7 7 SKOKIE $16.85 $50.53 $117.29 $184.67 4/1/20156002489 CAPITOL HLTHCARE AND REHAB CTR 3 3 SPRINGFIELD $9.91 $40.88 $75.17 $125.96 4/1/20156009203 CARBONDALE REHAB AND NRSG CTR 5 5 CARBONDALE $9.04 $42.88 $69.32 $121.24 4/1/20156016166 CARBONDALE REHAB NRSG CTR II 5 5 CARBONDALE $7.38 $41.10 $73.21 $121.69 4/1/20156001424 CARE CENTER OF ABINGDON 2 2 ABINGDON $10.61 $43.92 $69.21 $123.74 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6009336 CARLINVILLE REHAB AND HLTC 3 3 CARLINVILLE $11.97 $43.24 $77.04 $132.25 4/1/20156001465 CARLTON AT THE LAKE 6 6 CHICAGO $19.28 $50.66 $87.38 $157.32 4/1/20156001473 CARLYLE HEALTHCARE CENTER INC 11 11 CARLYLE $14.18 $44.61 $85.81 $144.60 4/1/2015 7/1/20146001507 CARRIER MILLS NURSING REHAB CT 5 5 CARRIER MILLS $12.50 $40.09 $84.25 $136.84 4/1/20156000970 CASEY HEALTH CARE CENTER 4 4 CASEY $10.20 $48.94 $74.45 $133.59 4/1/20156010227 CASEYVILLE NRSG AND REHAB CTR 11 11 CASEYVILLE $13.23 $40.07 $81.87 $135.17 4/1/20156009948 CEDAR POINTE REHAB AND NURSING 7 7 CICERO $14.84 $39.14 $71.63 $125.61 4/1/20156002869 CEDAR RIDGE HEALTH REHAB CTR 11 11 LEBANON $12.66 $46.71 $75.24 $134.61 4/1/20156001523 CENTER HOME HISPANIC ELDERLY 6 6 CHICAGO $15.60 $54.41 $105.31 $175.32 4/1/20156001564 CENTRAL BAPTIST VILLAGE 7 7 NORRIDGE $16.29 $55.98 $87.99 $160.26 4/1/20156001580 CENTRAL NURSING REHAB CENTER 6 6 CHICAGO $9.44 $27.73 $94.57 $131.74 4/1/20156001598 CENTRAL PLAZA 6 CHICAGO $13.51 $44.74 $66.60 $124.85 7/1/2014 Eligible for Provisional Licens 7/1/20146012355 CENTRALIA MANOR 5 5 CENTRALIA $16.97 $41.30 $86.79 $145.06 4/1/20156008601 CHALET LIVING AND REHAB CENTER 6 6 CHICAGO $15.94 $55.98 $110.29 $182.21 4/1/20156001630 CHAMPAIGN COUNTY NURSING HOME 4 4 URBANA $16.85 $54.84 $70.89 $142.58 4/1/20156001457 CHAMPAIGN URBANA NURSING REHAB 4 4 SAVOY $14.96 $50.44 $77.14 $142.54 4/1/20156001358 CHARLESTON REHAB HEALTH CARE 4 4 CHARLESTON $7.16 $42.27 $74.37 $123.80 4/1/20156010367 CHATEAU NURSING AND REHAB 7 7 WILLOWBROOK $16.27 $51.15 $115.30 $182.72 4/1/2015 7/1/20146008841 CHESTER REHAB AND NURSING CTR 5 5 CHESTER $9.62 $43.38 $62.88 $115.88 4/1/20156001697 CHICAGO RIDGE NURSING CENTER 7 7 CHICAGO RIDGE $13.89 $36.49 $83.28 $133.66 4/1/20156001739 CHRISTIAN NURSING HOME 3 3 LINCOLN $12.95 $44.38 $82.04 $139.37 4/1/20156001770 CISNE REHAB AND HEALTH CENTER 5 5 CISNE $7.72 $43.93 $99.68 $151.33 4/1/20156016554 CLAREMONT HANOVER PARK 7 7 HANOVER PARK $30.18 $55.98 $91.90 $178.06 4/1/20156014195 CLAREMONT REHAB AND LIVING CTR 8 8 BUFFALO GROVE $18.10 $50.88 $114.33 $183.31 4/1/20156005144 CLARIDGE HEALTHCARE CENTER 8 8 LAKE BLUFF $10.83 $40.10 $117.84 $168.77 4/1/20156001796 CLARK MANOR CONVALESCENT CTR 6 6 CHICAGO $16.68 $40.10 $82.02 $138.80 4/1/20156001838 CLAYBERG FULTON CO N CTR 2 2 CUBA $6.52 $55.63 $70.10 $132.25 4/1/20156001846 CLAYTON RESIDENTAL HOME 6 CHICAGO $14.12 $42.80 $66.18 $123.10 7/1/2014 Eligible for Provisional Licensure as SMHRF6001887 CLINTON MANOR LIVING CENTER 11 11 NEW BADEN $11.34 $45.93 $73.82 $131.09 4/1/20156004469 COBDEN REHAB AND NRSG CENTER 5 5 COBDEN $9.87 $39.73 $55.01 $104.61 4/1/20156007496 COLLINSVILLE REHAB HEALTH CARE 11 11 COLLINSVILLE $11.15 $38.29 $78.21 $127.65 4/1/20156001945 COLONIAL HLTHCARE AND REHAB CT 2 2 PRINCETON $11.17 $46.28 $81.11 $138.56 4/1/20156001952 COLONIAL MANOR 4 4 DANVILLE $16.24 $50.44 $83.45 $150.13 4/1/20156013106 COLUMBIA REHAB AND NURSING CTR 11 11 COLUMBIA $16.05 $46.24 $87.91 $150.20 4/1/20156001994 COLUMBUS MANOR RES CARE HOME 6 CHICAGO $9.11 $31.41 $44.46 $84.98 7/1/2014 Eligible for Provisional Licensure as SMHRF6002067 COLUMBUS PARK NURS REHAB CTR 6 6 CHICAGO $17.30 $40.15 $78.22 $135.67 4/1/20156002026 COMMUNITY CARE CENTER 6 6 CHICAGO $11.77 $39.06 $78.80 $129.63 4/1/20156006175 COMMUNITY NRSG AND REHAB CTR 7 7 NAPERVILLE $15.71 $50.90 $119.61 $186.22 4/1/20156016711 CONCORDIA VILLAGE CARE CENTER 3 3 SPRINGFIELD $16.85 $40.28 $57.96 $115.09 4/1/20156002075 CONTINENTAL NURSING REHAB CTR 6 6 CHICAGO $13.34 $50.31 $93.11 $156.76 4/1/20156003420 CORNERSTONE REHAB AND HC 2 2 PEORIA HEIGHTS $11.84 $50.44 $73.06 $135.34 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6015200 COULTERVILLE REHAB AND HCC 5 5 COULTERVILLE $18.18 $43.93 $70.37 $132.48 4/1/20156002141 COUNTRY HEALTH INC 4 4 GIFFORD $26.69 $50.44 $77.54 $154.67 4/1/20156002174 COUNTRYSIDE CARE CENTRE 8 8 AURORA $14.40 $46.13 $109.40 $169.93 4/1/20156002190 COUNTRYSIDE NRSG AND REHAB CTR 7 7 DOLTON $16.11 $41.83 $113.65 $171.59 4/1/20156005631 COUNTRYVIEW CARE CTR OF MACOMB 2 2 MACOMB $7.99 $47.66 $61.23 $116.88 4/1/20156003008 COURTYARD HEALTHCARE CENTER 7 7 BERWYN $14.02 $50.15 $102.79 $166.96 4/1/20156001093 COVENANT HEALTH CARE CENTER 7 7 NORTHBROOK $14.88 $55.98 $93.83 $164.69 4/1/20156002208 COVENANT HEALTH CARE CENTER 8 8 BATAVIA $17.23 $55.98 $96.97 $170.18 4/1/20156011373 COVENTRY LIVING CENTER 1 1 STERLING $14.15 $51.52 $89.24 $154.91 4/1/20156002273 CRESTWOOD TERRACE NURSING CTR 7 7 CRESTWOOD $13.11 $35.07 $58.00 $106.18 4/1/20156010136 CROSSROADS CARE CTR WOODSTOCK 8 8 WOODSTOCK $11.80 $48.90 $94.43 $155.13 4/1/20156002299 CRYSTAL PINES REHAB AND HCC 8 8 CRYSTAL LAKE $15.09 $53.62 $93.29 $162.00 4/1/20156002307 CUMBERLAND REHAB HEALTH CARE 4 4 GREENUP $9.41 $44.13 $81.42 $134.96 4/1/20156002364 DANVILLE CARE CENTER LTD 4 4 DANVILLE $10.98 $46.64 $107.92 $165.54 4/1/20156010342 DAYSTAR NURSING AND REHAB CTR 5 5 CAIRO $11.91 $42.46 $88.64 $143.01 4/1/20156007363 DECATUR MANOR HEALTHCARE 4 DECATUR $11.85 $33.69 $55.99 $101.53 7/1/2014 Eligible for Provisional Licensure as SMHRF6003081 DECATUR REHAB HEALTH CARE CTR 4 4 DECATUR $9.63 $50.44 $73.05 $133.12 4/1/20156015630 DEKALB COUNTY REHAB AND NSG 1 1 DEKALB $16.41 $48.93 $80.42 $145.76 4/1/20156005276 DIXON REHAB AND HCC 1 1 DIXON $10.26 $45.42 $79.29 $134.97 4/1/20156002521 DOBSON PLAZA 7 7 EVANSTON $15.87 $48.15 $99.38 $163.40 4/1/20156002539 DOCTORS NURSING AND REHAB CTR 5 5 SALEM $13.36 $38.22 $96.75 $148.33 4/1/20156002570 DOUGLAS NURSING AND REHAB CTR 4 4 MATTOON $15.09 $44.20 $87.96 $147.25 4/1/20156002612 DUPAGE CONV 7 7 WHEATON $12.98 $66.81 $100.49 $180.28 4/1/20156002943 DUQUOIN NURSING AND REHAB 5 5 DUQUOIN $8.35 $37.19 $84.68 $130.22 4/1/20156003222 EAST BANK CENTER LLC 1 1 LOVES PARK $5.37 $48.05 $120.94 $174.36 4/1/20156007025 EASTSIDE HEALTH CARE CENTER 3 3 PITTSFIELD $10.49 $43.90 $66.58 $120.97 4/1/20156009237 EASTVIEW TERRACE 4 4 SULLIVAN $9.43 $44.46 $71.87 $125.76 4/1/20156002679 EDEN VILLAGE 11 11 GLEN CARBON $12.09 $44.73 $74.06 $130.88 4/1/20156002729 EDWARDSVILLE NRSNG REHAB CTR 11 11 EDWARDSVILLE $12.27 $42.28 $86.07 $140.62 4/1/20156009559 EFFINGHAM REHAB HEALTH CARE CT 5 5 EFFINGHAM $8.98 $41.70 $75.04 $125.72 4/1/20156002745 EL PASO HEALTH CARE CENTER 2 2 EL PASO $12.05 $45.14 $51.25 $108.44 4/1/20156002810 ELIZABETH NURSING HOME INC 1 1 ELIZABETH $7.07 $44.08 $73.51 $124.66 4/1/20156010144 ELMBROOK NURSING 7 7 ELMHURST $12.90 $50.63 $111.96 $175.49 4/1/20156002828 ELMHURST EXTENDED CARE CENTER 7 7 ELMHURST $11.94 $54.24 $105.37 $171.55 4/1/20156002836 ELMS NURSING HOME 2 2 MACOMB $10.38 $52.79 $72.14 $135.31 4/1/20156008270 ELMWOOD CARE 7 7 ELMWOOD PARK $18.63 $41.81 $127.25 $187.69 4/1/20156005961 ELMWOOD NURSING AND REHAB CTR 11 11 MARYVILLE $13.40 $41.32 $93.52 $148.24 4/1/20156002844 ELMWOOD TERRACE HEALTHCARE CTR 8 8 AURORA $11.11 $51.77 $93.04 $155.92 4/1/20156002851 ELSTON NURSING AND REHAB CENTR 6 6 CHICAGO $14.24 $50.36 $99.00 $163.60 4/1/20156005425 ENFIELD REHAB HEALTH CARE 5 5 ENFIELD $8.25 $43.93 $66.55 $118.73 4/1/20156004667 ESTATES OF HYDE PARK 6 6 CHICAGO $13.72 $43.56 $75.80 $133.08 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6002877 EUNICE C SMITH HOME 11 11 ALTON $5.44 $46.71 $89.06 $141.21 4/1/20156002901 EVENGLOW LODGE 4 4 PONTIAC $12.09 $48.31 $75.30 $135.70 4/1/20156002133 EVERGREEN NURSING AND REHAB CT 5 5 EFFINGHAM $10.62 $38.12 $81.72 $130.46 4/1/20156002950 FAIR HAVENS CHRISTIAN HOME 4 4 DECATUR $12.09 $50.22 $77.18 $139.49 4/1/20156002976 FAIR OAKS HEALTH CARE CENTER 8 8 CRYSTAL LAKE $15.55 $55.98 $108.98 $180.51 4/1/20156002984 FAIR OAKS REHAB AND HCC 1 1 SOUTH BELOIT $13.77 $50.75 $81.14 $145.66 4/1/20156003024 FAIRHAVEN CHRISTIAN RET HOME 1 1 ROCKFORD $16.41 $51.52 $78.88 $146.81 4/1/20156001051 FAIRMONT CARE CENTRE 6 6 CHICAGO $16.22 $49.59 $109.86 $175.67 4/1/20156003040 FAIRVIEW HAVEN NURSING HOME 4 4 FAIRBURY $13.93 $50.44 $76.62 $140.99 4/1/20156003099 FAIRVIEW NURSING CENTER 5 5 DUQUOIN $9.40 $36.15 $63.02 $108.57 4/1/20156003107 FAITH CARE CENTER 11 11 HIGHLAND $16.84 $46.44 $82.31 $145.59 4/1/20156004824 FARMER CITY REHAB AND HC 4 4 FARMER CITY $10.73 $47.43 $67.57 $125.73 4/1/20156003115 FARMINGTON COUNTRY MANOR 2 2 FARMINGTON $12.37 $49.24 $62.94 $124.55 4/1/2015 7/1/20146003123 FAYETTE COUNTY HOSPITAL NH 5 5 VANDALIA $6.15 $43.93 $56.18 $106.26 4/1/20156001614 FIRESIDE HOUSE OF CENTRALIA 5 5 CENTRALIA $10.38 $40.52 $72.38 $123.28 4/1/20156000939 FLANAGAN REHAB HEALTH CARE 4 4 FLANAGAN $10.95 $50.44 $63.67 $125.06 4/1/20156003172 FLORA GARDENS CARE CENTER 5 5 FLORA $9.80 $41.19 $77.80 $128.79 4/1/20156003156 FLORA REHAB HEALTH CARE CTR 5 5 FLORA $8.57 $43.93 $72.17 $124.67 4/1/20156003180 FLORENCE NURSING HOME 8 8 MARENGO $12.61 $49.25 $109.44 $171.30 4/1/2015 7/1/20146003198 FONDULAC REHAB HEALTH CARE CTR 2 2 EAST PEORIA $12.22 $50.44 $69.23 $131.89 4/1/20156001135 FOREST CITY REHAB AND NRSG CTR 1 1 ROCKFORD $12.58 $35.60 $77.20 $125.38 4/1/20156000483 FOREST VIEW REHAB NURSING CTR 7 7 ITASCA $14.27 $47.27 $117.28 $178.82 4/1/20156000137 FOSTER HEALTH AND REHAB CENTER 6 6 CHICAGO $14.85 $47.14 $119.44 $181.43 4/1/2015 7/1/20146003248 FOUNTAIN VIEW INC 5 5 ELDORADO $11.85 $30.18 $64.40 $106.43 4/1/20156012413 FRANCISCAN VILLAGE 7 7 LEMONT $13.46 $55.98 $92.75 $162.19 4/1/20156003289 FRANKFORT HEALTHCARE REHAB CTR 5 5 WEST FRANKFORT $8.80 $40.24 $75.63 $124.67 4/1/20156003297 FRANKFORT TERRACE NURSING CTR 9 9 FRANKFORT $10.80 $38.53 $67.73 $117.06 4/1/20156003305 FRANKLIN GROVE LIVING REHAB 1 1 FRANKLIN GROVE $11.11 $46.91 $80.14 $138.16 4/1/20156003321 FREEBURG CARE CENTER INC 11 11 FREEBURG $10.77 $36.01 $78.09 $124.87 4/1/20156003339 FREEPORT REHAB AND HEALTH CARE 1 1 FREEPORT $13.40 $45.38 $73.76 $132.54 4/1/20156003388 FRIENDSHIP MANOR 10 10 ROCK ISLAND $13.40 $50.35 $70.94 $134.69 4/1/20156015895 FRIENDSHIP MANOR HEALTH CARE 5 5 NASHVILLE $10.06 $38.41 $78.73 $127.20 4/1/20156005979 FRIENDSHIP SKILLED NSG REHAB 3 3 CARLINVILLE $10.32 $44.49 $85.11 $139.92 4/1/20156003404 FRIENDSHIP VILLAGE 7 7 SCHAUMBURG $15.83 $55.98 $121.18 $192.99 4/1/20156003438 GALENA STAUSS NURSING HOME 1 1 GALENA $7.78 $51.11 $70.38 $129.27 4/1/20156009567 GARDENVIEW MANOR 4 4 DANVILLE $8.21 $37.42 $82.29 $127.92 4/1/20156006837 GENERATIONS HCN AT OAKTON PAV 7 7 DES PLAINES $16.40 $39.50 $92.14 $148.04 4/1/20156006076 GENESIS SENIOR LIVING ALEDO 10 10 ALEDO $12.09 $47.02 $66.39 $125.50 4/1/20156003552 GIBSON COMMUNITY HOSPITAL ANNE 4 4 GIBSON CITY $15.97 $50.44 $72.42 $138.83 4/1/20156003578 GILMAN HEALTHCARE CENTER 4 4 GILMAN $13.97 $44.51 $84.17 $142.65 4/1/20156006191 GLEN BRIDGE NURSING AND REHAB 7 7 NILES $15.26 $45.95 $107.70 $168.91 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6003586 GLEN OAKS NURSING REHAB CENTER 7 7 NORTHBROOK $14.22 $44.61 $77.98 $136.81 4/1/20156008833 GLEN SAINT ANDREW LIVING COMM 7 7 NILES $8.74 $55.98 $89.17 $153.89 4/1/20156003610 GLEN VIEW TERRACE NURSING CTR 7 7 GLENVIEW $18.90 $53.28 $111.10 $183.28 4/1/20156003594 GLENCREST HLTHCR AND REHAB CTR 6 6 CHICAGO $15.75 $49.38 $134.43 $199.56 4/1/20156006647 GLENLAKE TERRACE NURSING REHAB 8 8 WAUKEGAN $11.79 $42.52 $104.31 $158.62 4/1/20156007918 GLENSHIRE NURSING REHAB CENTRE 7 7 RICHTON PARK $18.34 $51.25 $120.40 $189.99 4/1/20156003628 GLENWOOD HEALTHCARE AND REHAB 7 7 GLENWOOD $16.72 $48.77 $123.96 $189.45 4/1/20156003636 GOLDEN GOOD SHEPHERD HOME 3 3 GOLDEN $10.43 $43.06 $65.70 $119.19 4/1/20156007637 GOOD SAM PROPHETS RIVERVIEW 1 1 PROPHETSTOWN $12.52 $51.52 $79.04 $143.08 4/1/20156003495 GOOD SAM SOC GENESEO VILLAGE 10 10 GENESEO $14.24 $48.44 $68.28 $130.96 4/1/20156001515 GOOD SAM SOCIETY MT CARROLL 1 1 MT CARROLL $14.24 $48.25 $69.71 $132.20 4/1/20156003677 GOOD SAMARITAN FLANAGAN 4 4 FLANAGAN $12.09 $50.44 $80.11 $142.64 4/1/20156003685 GOOD SAMARITAN HOME OF QUINCY 3 3 QUINCY $16.84 $44.49 $70.87 $132.20 4/1/20156005573 GOOD SAMARITAN PONTIAC 4 4 PONTIAC $10.80 $49.55 $62.12 $122.47 4/1/20156003727 GOTTLIEB MEMORIAL HOSPITAL 7 MELROSE PARK $7.85 $55.98 $55.81 $119.64 7/1/20146060524 GRAHAM HOSP EXT CARE FACILITY 2 2 CANTON $8.22 $50.44 $75.64 $134.30 4/1/20156001986 GRANITE NURSING AND REHAB CTR 11 11 GRANITE CITY $17.95 $38.49 $83.98 $140.42 4/1/20156003776 GRASMERE PLACE 6 CHICAGO $12.38 $37.00 $53.51 $102.89 7/1/2014 Eligible for Provisional Licens 7/1/20146015499 GREEK AMERICAN REHAB CARE CTR 7 7 WHEELING $17.26 $53.43 $83.66 $154.35 4/1/20156016570 GREENFIELDS OF GENEVA 8 GENEVA $18.18 $55.98 $90.20 $164.36 7/1/20146000202 GREENWOOD CARE 7 EVANSTON $15.65 $39.53 $55.16 $110.34 7/1/2014 Eligible for Provisional Licensure as SMHRF6003511 GROSSE POINTE MANOR 7 7 NILES $19.37 $51.62 $107.83 $178.82 4/1/20156008593 GROVE AT THE LAKE LIVING REHAB 8 8 ZION $15.38 $49.89 $105.68 $170.95 4/1/20156005516 GROVE LINCOLN PARK LIV AND REH 6 6 CHICAGO $14.70 $44.99 $124.18 $183.87 4/1/20156008916 GROVE OF EVANSTON 7 7 EVANSTON $17.94 $55.98 $136.66 $210.58 4/1/20156000574 GROVE OF FOX VALLEY 8 8 AURORA $15.74 $44.74 $110.58 $171.06 4/1/20156003057 GROVE OF LAGRANGE PARK 7 7 LAGRANGE PARK $17.08 $52.81 $119.08 $188.97 4/1/20156003412 GROVE OF NORTHBROOK L AND R 7 7 NORTHBROOK $16.72 $50.77 $100.63 $168.12 4/1/20156009625 GROVE OF SKOKIE LIV AND REHAB 7 7 SKOKIE $16.39 $47.36 $115.11 $178.86 4/1/20156003933 HALLMARK HOUSE NURSING CENTER 2 2 PEKIN $13.16 $49.37 $82.26 $144.79 4/1/20156003974 HAMILTON MEM REHAB AND HCC 5 5 MCLEANSBORO $13.26 $43.93 $66.66 $123.85 4/1/20156004006 HAMMOND HENRY DISTRICT HOSPITA 10 10 GENESEO $16.84 $53.08 $58.86 $128.78 4/1/20156004048 HARBOR CREST HOME INC 1 1 FULTON $5.80 $47.43 $61.08 $114.31 4/1/20156013684 HARMONY NURSING AND REHAB CTR 6 6 CHICAGO $20.50 $51.74 $111.69 $183.93 4/1/20156004089 HAVANA HEALTH CARE CENTER 3 3 HAVANA $12.00 $41.19 $69.69 $122.88 4/1/20156015317 HAWTHORNE INN OF DANVILLE 4 4 DANVILLE $15.75 $41.96 $97.34 $155.05 4/1/20156009310 HEARTHSTONE MANOR 8 8 WOODSTOCK $11.10 $55.98 $80.74 $147.82 4/1/20156013437 HEARTLAND CHRISTIAN VILLAGE 4 4 NEOGA $14.24 $46.85 $81.35 $142.44 4/1/20156004121 HEARTLAND MANOR INC 4 4 CASEY $10.83 $49.76 $74.63 $135.22 4/1/20156011597 HEARTLAND OF CANTON 2 2 CANTON $14.56 $49.02 $80.47 $144.05 4/1/20156000301 HEARTLAND OF CHAMPAIGN 4 4 CHAMPAIGN $11.11 $50.44 $94.49 $156.04 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6000285 HEARTLAND OF DECATUR 4 4 DECATUR $15.59 $47.67 $90.41 $153.67 4/1/20156003446 HEARTLAND OF GALESBURG 2 2 GALESBURG $17.02 $50.44 $75.03 $142.49 4/1/20156011613 HEARTLAND OF HENRY 2 2 HENRY $14.85 $48.47 $75.00 $138.32 4/1/20156005649 HEARTLAND OF MACOMB 2 2 MACOMB $15.73 $50.44 $76.77 $142.94 4/1/20156006233 HEARTLAND OF MOLINE 10 10 MOLINE $14.50 $48.19 $77.86 $140.55 4/1/20156000244 HEARTLAND OF NORMAL 4 4 NORMAL $14.04 $50.44 $91.44 $155.92 4/1/20156011571 HEARTLAND OF PAXTON 4 4 PAXTON $16.13 $49.50 $82.02 $147.65 4/1/20156000293 HEARTLAND OF PEORIA 2 2 PEORIA $14.35 $49.03 $79.66 $143.04 4/1/20156008056 HEARTLAND OF RIVERVIEW 2 2 EAST PEORIA $16.76 $50.44 $76.93 $144.13 4/1/20156004139 HEATHER HEALTH CARE CENTER 7 7 HARVEY $16.52 $49.69 $77.16 $143.37 4/1/20156000814 HEDDINGTON OAKS 2 2 WEST PEORIA $6.52 $50.22 $69.48 $126.22 4/1/20156004147 HEIGHTS HLTHCARE AND REHAB CTR 2 2 PEORIA HEIGHTS $9.54 $48.20 $68.83 $126.57 4/1/20156006704 HELIA HEALTHCARE OF BELLEVILLE 11 11 BELLEVILLE $9.81 $46.71 $97.43 $153.95 4/1/20156016091 HELIA HEALTHCARE OF BENTON 5 5 BENTON $3.66 $43.93 $77.44 $125.03 4/1/20156003800 HELIA HEALTHCARE OF CHAMPAIGN 4 4 CHAMPAIGN $9.27 $44.00 $64.22 $117.49 4/1/20156005870 HELIA HEALTHCARE OF ENERGY 5 5 ENERGY $7.78 $36.52 $74.52 $118.82 4/1/20156004493 HELIA HEALTHCARE OF GREENVILLE 5 11 GREENVILLE $5.08 $44.33 $65.38 $114.79 4/1/20156006910 HELIA HEALTHCARE OF OLNEY 5 5 OLNEY $9.36 $26.23 $74.05 $109.64 4/1/20156003255 HELIA SOUTHBELT HEALTHCARE 11 11 BELLEVILLE $11.59 $43.65 $75.37 $130.61 4/1/20156012066 HENDERSON CO RETIREMENT CENTER 2 2 STRONGHURST $12.85 $45.59 $61.33 $119.77 4/1/20156003917 HENRY AND JANE VONDERLIETH CTR 3 3 MT PULASKI $11.67 $44.49 $77.64 $133.80 4/1/20156000756 HERITAGE HEALTH 3 3 JACKSONVILLE $13.79 $44.49 $72.46 $130.74 4/1/20156000780 HERITAGE HEALTH BEARDSTOWN 3 3 BEARDSTOWN $11.88 $44.49 $73.67 $130.04 4/1/20156004261 HERITAGE HEALTH BLOOMINGTON 4 4 BLOOMINGTON $18.46 $50.44 $74.65 $143.55 4/1/20156000723 HERITAGE HEALTH CARLINVILLE 3 3 CARLINVILLE $12.89 $43.01 $71.77 $127.67 4/1/20156007199 HERITAGE HEALTH CHILLICOTHE 2 2 CHILLICOTHE $12.60 $50.41 $68.72 $131.73 4/1/20156002083 HERITAGE HEALTH DWIGHT 4 4 DWIGHT $15.32 $50.32 $70.53 $136.17 4/1/20156005920 HERITAGE HEALTH EL PASO 2 2 EL PASO $16.72 $50.44 $76.15 $143.31 4/1/20156006902 HERITAGE HEALTH ELGIN 8 8 ELGIN $13.40 $55.33 $97.60 $166.33 4/1/20156003560 HERITAGE HEALTH GIBSON CITY 4 4 GIBSON CITY $12.89 $50.40 $63.14 $126.43 4/1/20156000681 HERITAGE HEALTH GILLESPIE 3 3 GILLESPIE $12.41 $43.33 $73.46 $129.20 4/1/20156004592 HERITAGE HEALTH HOOPESTON 4 4 HOOPESTON $17.99 $47.75 $67.50 $133.24 4/1/20156001440 HERITAGE HEALTH LASALLE 2 2 LA SALLE $9.64 $43.96 $75.57 $129.17 4/1/20156000699 HERITAGE HEALTH LITCHFIELD 3 3 LITCHFIELD $13.64 $44.41 $82.58 $140.63 4/1/20156004253 HERITAGE HEALTH MENDOTA 2 2 MENDOTA $11.94 $50.01 $76.72 $138.67 4/1/20156005367 HERITAGE HEALTH MINONK 2 2 MINONK $14.96 $50.44 $80.88 $146.28 4/1/20156010128 HERITAGE HEALTH MOUNT ZION 4 4 MOUNT ZION $16.56 $49.83 $66.66 $133.05 4/1/20156004287 HERITAGE HEALTH MT STERLING 3 3 MOUNT STERLING $12.22 $44.49 $74.94 $131.65 4/1/20156008510 HERITAGE HEALTH NORMAL 4 4 NORMAL $16.29 $49.94 $78.14 $144.37 4/1/20156000707 HERITAGE HEALTH PANA 3 3 PANA $13.23 $41.85 $80.49 $135.57 4/1/20156004303 HERITAGE HEALTH PERU 2 2 PERU $15.13 $48.38 $82.28 $145.79 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6002125 HERITAGE HEALTH ROBINSON 5 5 ROBINSON $13.41 $43.93 $75.93 $133.27 4/1/20156004279 HERITAGE HEALTH SPRINGFIELD 3 3 SPRINGFIELD $14.65 $44.49 $77.80 $136.94 4/1/20156000715 HERITAGE HEALTH STAUNTON 3 3 STAUNTON $10.92 $44.49 $83.49 $138.90 4/1/20156004311 HERITAGE HEALTH STREATOR 2 2 STREATOR $15.89 $49.16 $80.10 $145.15 4/1/20156004337 HERITAGE SQUARE 1 1 DIXON $9.07 $50.53 $85.18 $144.78 4/1/20156003362 HERRIN REHAB AND NRSG CENTER 5 5 HERRIN $8.46 $37.53 $75.40 $121.39 4/1/2015 7/1/20146004352 HICKORY NURSING PAVILION INC 7 7 HICKORY HILLS $15.52 $49.25 $72.77 $137.54 4/1/20156016687 HICKORY POINT CHRISTIAN VILL 4 4 FORSYTH $16.85 $46.11 $107.19 $170.15 1/1/20156001663 HIGHLAND HEALTH CARE CENTER 11 11 HIGHLAND $9.69 $46.52 $95.62 $151.83 4/1/20156000392 HIGHLAND OAKS 8 8 ELGIN $14.39 $55.98 $90.46 $160.83 4/1/20156004402 HILLCREST HOME 10 10 GENESEO $14.69 $46.04 $73.71 $134.44 4/1/20156004410 HILLCREST RETIREMENT VILG LTD 8 8 ROUND LAKE $12.53 $46.74 $98.42 $157.69 4/1/2015 7/1/20146004428 HILLSBORO REHAB AND HLTC 3 3 HILLSBORO $11.14 $42.63 $70.22 $123.99 4/1/20156004451 HILLSIDE REHAB AND CARE CENTER 9 9 YORKVILLE $6.68 $47.72 $85.86 $140.26 4/1/20156004477 HILLTOP SKILLED NURSING REHAB 4 4 CHARLESTON $11.49 $35.29 $76.26 $123.04 4/1/20156004485 HILLVIEW HEALTH CARE CENTER 5 5 VIENNA $8.72 $37.65 $56.57 $102.94 4/1/20156004501 HITZ MEMORIAL HOME 11 11 ALHAMBRA $11.23 $46.71 $80.24 $138.18 4/1/20156004550 HOLY FAMILY VILLA 7 7 PALOS PARK $18.18 $55.98 $73.56 $147.72 4/1/20156006761 HOPE CREEK CARE CENTER 10 10 EAST MOLINE $16.85 $50.35 $73.79 $140.99 4/1/20156004212 ILLINI HERITAGE REHAB AND HC 4 4 CHAMPAIGN $9.69 $41.99 $66.09 $117.77 4/1/20156013023 ILLINI RESTORATIVE CARE 10 10 SILVIS $15.55 $51.52 $76.45 $143.52 4/1/20156004675 ILLINOIS KNIGHTS TEMPLAR HOME 4 4 PAXTON $11.67 $50.44 $73.09 $135.20 4/1/20156012579 IMBODEN CREEK LIVING CENTER 4 4 DECATUR $15.52 $50.44 $79.72 $145.68 4/1/20156004733 IMPERIAL GROVE PAVILION 6 6 CHICAGO $17.73 $53.60 $116.01 $187.34 4/1/20156001028 INTEGRITY HC OF GODFREY 11 11 GODFREY $12.12 $46.71 $108.65 $167.48 4/1/20156007116 INTEGRITY HC OF SMITHTON 11 11 SMITHTON $10.57 $46.71 $53.56 $110.84 4/1/20156009534 INTEGRITY HC OF WOOD RIVER 11 11 WOOD RIVER $14.15 $46.71 $79.66 $140.52 4/1/2015 7/1/20146004790 IROQUOIS RESIDENT HOME 4 4 WATSEKA $11.67 $50.44 $71.34 $133.45 4/1/20156004832 JACKSON SQ NURSING REHAB CTR 6 6 CHICAGO $15.88 $48.78 $101.33 $165.99 4/1/20156004840 JACKSONVILLE SKILLED NRSG REH 3 3 JACKSONVILLE $11.08 $38.22 $88.90 $138.20 4/1/20156004899 JENNINGS TERRACE 8 8 AURORA $9.69 $45.20 $79.15 $134.04 4/1/20156013312 JERSEYVILLE MANOR 3 3 JERSEYVILLE $16.12 $40.75 $85.02 $141.89 4/1/20156004907 JERSEYVILLE NSG AND REHAB CTR 3 3 JERSEYVILLE $16.22 $43.79 $73.31 $133.32 4/1/20156004964 JOLIET TERRACE NURSING CTR 9 9 JOLIET $10.57 $37.90 $55.35 $103.82 4/1/20156005433 JONESBORO REHAB HEALTH CARE 5 5 JONESBORO $9.58 $43.92 $82.26 $135.76 4/1/20156004972 KANKAKEE TERRACE NURSING CTR 9 BOURBONNAIS $12.04 $38.02 $57.85 $107.91 7/1/2014 Eligible for Provisional Licensure as SMHRF6006126 KENSINGTON PLACE NRSG REHAB 6 6 CHICAGO $14.06 $45.30 $100.18 $159.54 4/1/20156005011 KEWANEE CARE HOME 10 10 KEWANEE $12.85 $44.88 $71.86 $129.59 4/1/20156005060 KNOX COUNTY NURSING HOME 2 2 KNOXVILLE $14.24 $51.77 $76.70 $142.71 4/1/20156005128 LAHARPE DAVIER HEALTH CARE 3 3 LA HARPE $9.69 $44.23 $73.76 $127.68 4/1/20156009807 LAKE PARK CENTER 8 WAUKEGAN $9.38 $32.88 $56.94 $99.20 7/1/2014 Eligible for Provisional Licensure as SMHRF

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6005177 LAKE SHORE HEALTHCARE REHAB 6 6 CHICAGO $14.60 $49.20 $101.97 $165.77 4/1/2015 7/1/20146005169 LAKEFRONT NURSING REHAB CTR 6 6 CHICAGO $13.50 $47.53 $86.08 $147.11 4/1/20156005185 LAKELAND REHAB AND HCC 5 5 EFFINGHAM $11.81 $42.62 $80.41 $134.84 4/1/20156005227 LAKEVIEW REHAB NURSING CENTER 6 6 CHICAGO $13.51 $54.89 $114.52 $182.92 4/1/20156005235 LAKEWOOD NURSING AND REHAB CTR 9 9 PLAINFIELD $18.85 $49.99 $114.87 $183.71 4/1/20156005250 LASALLE COUNTY NURSING HOME 2 2 OTTAWA $12.09 $54.60 $85.60 $152.29 4/1/20156001044 LEBANON CARE CENTER 11 11 LEBANON $11.01 $37.58 $71.63 $120.22 4/1/20156005284 LEE MANOR NURSING HM 7 7 DES PLAINES $16.88 $44.33 $114.96 $176.17 4/1/20156014492 LEMONT NURSING AND REHAB CTR 7 7 LEMONT $21.17 $50.59 $116.34 $188.10 4/1/20156005292 LENA LIVING CENTER 1 1 LENA $7.64 $47.56 $67.62 $122.82 4/1/20156012157 LEROY MANOR 4 4 LEROY $15.43 $45.75 $76.07 $137.25 4/1/20156005300 LEWIS MEMORIAL 3 3 SPRINGFIELD $11.23 $44.49 $77.42 $133.14 4/1/20156011993 LEXINGTON HEALTH CARE CENTER 7 7 BLOOMINGDALE $18.25 $51.26 $103.97 $173.48 4/1/20156005318 LEXINGTON HEALTH CARE CTR INC 7 7 LOMBARD $15.73 $49.10 $108.56 $173.39 4/1/20156012967 LEXINGTON OF CHICAGO RIDGE 7 7 CHICAGO RIDGE $21.14 $48.71 $102.37 $172.22 4/1/20156013098 LEXINGTON OF ELMHURST 7 7 ELMHURST $17.03 $51.93 $113.78 $182.74 4/1/20156013361 LEXINGTON OF LAGRANGE 7 7 LAGRANGE $23.21 $53.46 $104.19 $180.86 4/1/20156014138 LEXINGTON OF LAKE ZURICH 8 8 LAKE ZURICH $17.94 $50.32 $93.51 $161.77 4/1/20156014682 LEXINGTON OF ORLAND PARK 7 7 ORLAND PARK $21.06 $47.43 $100.33 $168.82 4/1/20156012553 LEXINGTON OF SCHAUMBURG 7 7 SCHAUMBURG $21.18 $49.62 $92.99 $163.79 4/1/20156012975 LEXINGTON OF STREAMWOOD 7 7 STREAMWOOD $21.20 $50.66 $108.71 $180.57 4/1/20156014369 LEXINGTON OF WHEELING 7 7 WHEELING $20.99 $50.62 $98.49 $170.10 4/1/20156005359 LIBERTYVILLE MANOR EXT CARE 8 8 LIBERTYVILLE $12.08 $55.55 $40.57 $108.20 4/1/20156005375 LIEBERMAN CENTER FOR HEALTH 7 7 SKOKIE $14.88 $56.24 $91.32 $162.44 4/1/2015 7/1/20146005563 LITTLE SISTERS OF THE POOR 6 6 CHICAGO $10.11 $55.98 $78.68 $144.77 4/1/20156005599 LUTHERAN CARE CTR 5 5 ALTAMONT $12.16 $43.93 $73.21 $129.30 4/1/20156005607 LUTHERAN HOME FOR THE AGED 7 7 ARLINGTON HGTS $13.46 $55.98 $78.82 $148.26 4/1/20156005615 LUTHERAN HOME INC 2 2 PEORIA $12.52 $50.44 $63.89 $126.85 4/1/20156005623 LYDIA HEALTHCARE 7 ROBBINS $15.40 $38.27 $57.09 $110.76 7/1/2014 Eligible for Provisional Licensure as SMHRF6016885 MANOR COURT OF CARBONDALE 5 5 CARBONDALE $16.84 $38.89 $78.36 $134.09 4/1/20156015879 MANOR COURT OF CLINTON 4 4 CLINTON $17.98 $46.11 $82.17 $146.26 4/1/20156016133 MANOR COURT OF FREEPORT 1 1 FREEPORT $17.96 $51.52 $80.33 $149.81 4/1/20156013189 MANOR COURT OF MARYVILLE 11 11 MARYVILLE $13.47 $44.96 $92.16 $150.59 4/1/20156016190 MANOR COURT OF PEORIA 2 2 PEORIA $20.79 $46.11 $79.01 $145.91 4/1/20156015887 MANOR COURT OF PERU 2 2 PERU $17.87 $46.11 $91.33 $155.31 4/1/20156015861 MANOR COURT OF PRINCETON 2 2 PRINCTON $16.81 $46.11 $68.99 $131.91 4/1/20156000228 MANORCARE OF ARLINGTON HEIGHTS 7 7 ARLINGTON HTS $18.32 $55.98 $96.98 $171.28 4/1/20156000277 MANORCARE OF ELGIN 8 8 ELGIN $16.04 $55.98 $90.49 $162.51 4/1/20156012686 MANORCARE OF ELK GROVE VILLAGE 7 7 ELK GROVE VLG $21.58 $53.57 $106.91 $182.06 4/1/20156006332 MANORCARE OF HINSDALE 7 7 HINSDALE $11.08 $55.98 $103.74 $170.80 4/1/20156012611 MANORCARE OF HOMEWOOD 7 7 HOMEWOOD $21.11 $53.81 $109.11 $184.03 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6000269 MANORCARE OF KANKAKEE 9 9 KANKAKEE $14.72 $48.06 $103.90 $166.68 4/1/20156010482 MANORCARE OF LIBERTYVILLE 8 8 LIBERTYVILLE $16.43 $55.40 $97.05 $168.88 4/1/20156000251 MANORCARE OF NAPERVILLE 7 7 NAPERVILLE $14.95 $55.98 $113.30 $184.23 4/1/20156015168 MANORCARE OF NORTHBROOK 7 7 NORTHBROOK $21.70 $53.30 $101.95 $176.95 4/1/20156000236 MANORCARE OF OAK LAWN EAST 7 7 OAK LAWN $19.76 $54.32 $107.25 $181.33 4/1/20156000343 MANORCARE OF OAK LAWN WEST 7 7 OAK LAWN $17.75 $55.08 $109.02 $181.85 4/1/20156010912 MANORCARE OF PALOS HTS EAST 7 7 PALOS HEIGHTS $21.54 $53.48 $111.85 $186.87 4/1/20156014534 MANORCARE OF PALOS HTS WEST 7 7 PALOS HEIGHTS $23.37 $55.98 $107.61 $186.96 4/1/20156000327 MANORCARE OF ROLLING MEADOWS 7 7 ROLLING MEADOWS $19.67 $52.27 $103.91 $175.85 4/1/20156011589 MANORCARE OF SOUTH HOLLAND 7 7 SOUTH HOLLAND $21.20 $54.26 $109.34 $184.80 4/1/20156000335 MANORCARE OF WESTMONT 7 7 WESTMONT $17.31 $55.98 $95.23 $168.52 4/1/20156006563 MANORCARE OF WILMETTE 7 7 WILMETTE $18.26 $55.98 $87.16 $161.40 4/1/20156005706 MAPLE CREST CARE CENTRE 1 1 BELVIDERE $11.91 $46.96 $101.32 $160.19 4/1/20156005722 MAPLE LAWN HEALTH CENTER 2 2 EUREKA $12.09 $50.44 $62.03 $124.56 4/1/20156005748 MAR KA NURSING HOME 11 11 MASCOUTAH $10.11 $43.42 $76.15 $129.68 4/1/20156005755 MARGARET MANOR 6 CHICAGO $12.48 $49.03 $45.45 $106.96 7/1/2014 Eligible for Provisional Licensure as SMHRF6005763 MARGARET MANOR NORTH 6 CHICAGO $11.04 $42.94 $54.24 $108.22 7/1/2014 Eligible for Provisional Licensure as SMHRF6005797 MARIGOLD REHABILITATION HCC 2 2 GALESBURG $11.91 $46.74 $62.79 $121.44 4/1/20156003230 MARION REHAB AND NRSG CENTER 5 5 MARION $15.03 $41.60 $76.85 $133.48 4/1/20156011688 MASON CITY AREA NURSING HOME 3 3 MASON CITY $12.52 $44.49 $70.08 $127.09 4/1/20156004691 MASON POINT 4 4 SULLIVAN $9.37 $50.44 $68.82 $128.63 4/1/20156005888 MATTOON REHAB AND HCC 4 4 MATTOON $10.99 $48.76 $76.48 $136.23 4/1/20156005896 MAYFIELD CARE CENTER INC 6 6 CHICAGO $12.21 $49.50 $97.12 $158.83 4/1/20156005904 MCALLISTER NURSING AND REHAB 7 7 TINLEY PARK $18.03 $54.05 $94.45 $166.53 4/1/20156005938 MCKINLEY COURT 4 4 DECATUR $13.63 $47.72 $94.08 $155.43 4/1/20156005946 MCLEAN COUNTY NURSING HOME 4 4 NORMAL $9.51 $54.49 $58.60 $122.60 4/1/20156005417 MCLEANSBORO REHAB HEALTH CARE 5 5 MCLEANSBORO $9.24 $43.93 $78.38 $131.55 4/1/20156005953 MEADOW MANOR SKILLED NRSG REH 3 3 TAYLORVILLE $10.26 $39.30 $86.38 $135.94 4/1/20156013120 MEADOWBROOK MANOR 9 9 BOLINGBROOK $17.07 $46.15 $119.72 $182.94 4/1/20156014518 MEADOWBROOK MANOR NAPERVILLE 7 7 NAPERVILLE $18.61 $48.91 $105.65 $173.17 4/1/20156016281 MEADOWBROOK MANOR OF LAGRANGE 7 7 LA GRANGE $16.22 $44.69 $110.60 $171.51 4/1/20156005987 MEADOWOOD 5 5 GRAYVILLE $9.03 $28.31 $62.61 $99.95 4/1/20156006001 MEADOWS MENNONITE 4 4 CHENOA $13.40 $49.26 $75.47 $138.13 4/1/20156006019 MEDINA NURSING CENTER INC 1 1 DURAND $14.27 $48.91 $78.73 $141.91 4/1/20156006035 MEMORIAL CARE CENTER 11 11 BELLEVILLE $6.15 $46.71 $126.88 $179.74 4/1/20156006050 MENDOTA LUTHERAN HOME 2 2 MENDOTA $12.09 $49.20 $75.62 $136.91 4/1/20156016737 MERCY CIRCLE 6 CHICAGO $18.18 $45.20 $88.90 $152.28 1/10/20156015697 MERCY HARVARD HOSPITAL CR CTR 8 8 HARVARD $10.15 $55.98 $86.08 $152.21 4/1/20156015812 MERIDIAN VILLAGE CARE CENTER 11 11 GLEN CARBON $16.85 $46.71 $78.85 $142.41 4/1/20156006118 METROPOLIS REHAB AND HCC 5 5 METROPOLIS $16.62 $43.74 $65.26 $125.62 4/1/20156006134 MID AMERICA CARE CENTER 6 6 CHICAGO $15.40 $47.51 $83.22 $146.13 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6003826 MIDWAY NEUROLOGICAL REHAB CTR 7 7 BRIDGEVIEW $14.24 $40.03 $101.90 $156.17 4/1/20156001341 MIDWEST REHAB AND RESPIRATORY 11 11 BELLEVILLE $11.34 $44.45 $78.50 $134.29 4/1/2015 7/1/20146014294 MILLER HEALTHCARE CENTER 9 9 KANKAKEE $18.18 $49.74 $92.48 $160.40 4/1/20156006258 MOMENCE MEADOWS NURSING AND RE 9 9 MOMENCE $13.27 $50.62 $113.22 $177.11 4/1/20156006266 MONMOUTH NURSING HOME 2 2 MONMOUTH $12.52 $46.60 $63.95 $123.07 4/1/20156006290 MONROE PAVILION HEALTH CENTER 6 CHICAGO $12.63 $41.79 $52.34 $106.76 7/1/2014 Eligible for Provisional Licensure as SMHRF6006316 MONTEBELLO HEALTH CARE CENTER 3 3 HAMILTON $9.52 $38.57 $69.18 $117.27 4/1/2015 7/1/20146004444 MONTGOMERY NURSING AND REHAB 3 3 HILLSBORO $11.19 $42.47 $75.41 $129.07 4/1/20156013171 MONTGOMERY PLACE 6 6 CHICAGO $14.39 $55.98 $41.29 $111.66 4/1/20156005698 MOORINGS HEALTH CENTER 7 7 ARLINGTON HGTS $14.39 $54.40 $94.38 $163.17 10/1/20146006381 MORRISON HSP FOUR SEASONS 1 1 MORRISON $5.44 $51.52 $68.07 $125.03 4/1/20156006407 MORTON TERRACE H AND R CENTRE 2 2 MORTON $11.73 $40.00 $84.06 $135.79 4/1/20156006399 MORTON VILLA HLTH AND REH CTR 2 2 MORTON $11.23 $38.85 $71.69 $121.77 4/1/20156012322 MOWEAQUA NRSG AND RETIREMENT 4 4 MOWEAQUA $12.66 $38.65 $68.05 $119.36 4/1/20156012512 MT VERNON COUNTRYSIDE MANOR 5 5 MT VERNON $14.89 $41.16 $74.32 $130.37 4/1/20156001531 MT VERNON HEALTH CARE CENTER 5 5 MOUNT VERNON $8.92 $36.80 $65.36 $111.08 4/1/20156010904 NATHAN HEALTH CARE CENTER 11 11 EAST ST LOUIS $14.20 $41.10 $66.42 $121.72 4/1/20156006498 NATURE TRAIL HEALTH CARE CTR 5 5 MOUNT VERNON $10.03 $43.93 $88.50 $142.46 4/1/2015 7/1/20146006506 NAZARETHVILLE RETIREMENT HOME 7 7 DES PLAINES $11.10 $55.98 $78.81 $145.89 4/1/20156006514 NEIGHBORS REHABILITATION CNTR 1 1 BYRON $11.58 $48.47 $90.71 $150.76 4/1/20156006522 NEW ATHENS HOME FOR THE AGED 11 11 NEW ATHENS $9.94 $44.26 $70.68 $124.88 4/1/20156002091 NEWMAN REHAB HEALTH CARE CTR 4 4 NEWMAN $8.59 $49.18 $75.81 $133.58 4/1/20156006548 NEWTON REST HAVEN 5 5 NEWTON $6.40 $41.39 $60.88 $108.67 4/1/20156003644 NILES NURSING AND REHAB CTR 7 7 NILES $16.56 $47.23 $93.87 $157.66 4/1/20156006555 NOKOMIS REHAB HEALTH CARE CTR 3 3 NOKOMIS $11.41 $37.88 $71.37 $120.66 4/1/20156006571 NORRIDGE GARDENS 7 7 NORRIDGE $16.53 $47.35 $107.48 $171.36 4/1/20156006589 NORTH ADAMS HOME INC 3 3 MENDON $12.95 $40.30 $69.60 $122.85 4/1/20156006605 NORTH AURORA CARE CENTER 8 8 NORTH AURORA $10.64 $49.29 $62.94 $122.87 4/1/20156000210 NORTH LOGAN HEALTHCARE CENTER 4 4 DANVILLE $9.40 $40.03 $77.27 $126.70 4/1/20156006670 NORTHWOODS CARE CENTRE 1 1 BELVIDERE $13.63 $46.05 $95.97 $155.65 4/1/20156006696 NORWOOD CROSSING 6 6 CHICAGO $12.98 $55.98 $91.15 $160.11 4/1/20156006274 OAK HILL 11 11 WATERLOO $16.85 $47.78 $72.69 $137.32 4/1/20156006779 OAK LAWN RESPIRATORY AND REHAB 7 7 OAK LAWN $11.58 $47.75 $158.87 $218.20 4/1/20156006720 OAKBROOK HEALTHCARE CENTER LTD 7 7 OAK BROOK $14.07 $51.25 $100.86 $166.18 4/1/20156006829 OAKRIDGE HEALTHCARE CENTER 7 1 HILLSIDE $11.01 $53.21 $83.65 $147.87 4/1/20156003487 OAKVIEW HTS CONT CARE REHAB 5 5 MOUNT CARMEL $15.97 $43.47 $67.94 $127.38 4/1/20156006860 ODD FELLOWS REBEKAH HOME 4 4 MATTOON $12.52 $48.70 $68.17 $129.39 4/1/20156006878 ODIN HEALTH CARE CENTER 5 5 ODIN $11.42 $42.84 $76.22 $130.48 4/1/2015 7/1/20146009989 OREGON LIVING AND REHAB CENTER 1 1 OREGON $12.13 $47.39 $77.42 $136.94 4/1/20156006985 OTTAWA PAVILION LTD 2 2 OTTAWA $18.14 $46.58 $85.90 $150.62 4/1/20156006993 OUR LADY OF ANGELS RETIREMENT 9 9 JOLIET $14.88 $50.50 $80.41 $145.79 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6002109 PALM TERRACE OF MATTOON 4 4 MATTOON $11.09 $38.77 $58.54 $108.40 4/1/20156006795 PARAMOUNT OAK PARK R AND N CTR 7 7 OAK PARK $14.57 $44.45 $80.05 $139.07 4/1/20156004766 PARC AT JOLIET 9 9 JOLIET $12.87 $45.02 $97.54 $155.43 4/1/20156007090 PARIS HEALTH CARE CENTER 4 4 PARIS $11.07 $46.60 $81.10 $138.77 4/1/20156007140 PARK HOUSE NURSING REHAB CTR 6 6 CHICAGO $11.51 $47.06 $76.80 $135.37 4/1/20156003073 PARK PLACE OF BELVIDERE 1 1 BELVIDERE $9.50 $45.80 $79.45 $134.75 4/1/20156003875 PARK POINTE HEALTHCARE REHAB 9 9 MORRIS $19.22 $53.08 $91.07 $163.37 4/1/20156007157 PARK RIDGE CARE CENTER 7 7 PARK RIDGE $15.33 $55.44 $90.92 $161.69 4/1/20156002315 PARK VIEW REHAB CENTER 6 6 CHICAGO $12.68 $41.72 $83.51 $137.91 4/1/20156007934 PARK VILLA NURSING REHAB CTR 7 7 PALOS HEIGHTS $20.01 $53.58 $95.15 $168.74 4/1/20156001374 PARKER NURSING AND REHAB CTR 2 2 STREATOR $11.16 $43.62 $106.94 $161.72 4/1/20156005003 PARKSHORE ESTATES NRSG REHAB 6 6 CHICAGO $13.59 $48.85 $89.14 $151.58 4/1/20156014385 PARKWAY MANOR 5 5 MARION $15.67 $42.39 $79.02 $137.08 4/1/20156009799 PAVILION OF WAUKEGAN 8 8 WAUKEGAN $12.63 $55.98 $105.87 $174.48 4/1/20156003206 PAXTON HEALTHCARE AND REHAB 4 4 PAXTON $15.55 $50.44 $87.62 $153.61 4/1/20156011712 PEKIN MANOR 2 2 PEKIN $18.02 $44.32 $78.88 $141.22 4/1/20156007355 PERSHING GARDENS HC CENTER 7 7 STICKNEY $15.24 $50.42 $74.04 $139.70 4/1/20156007371 PETERSON PARK HEALTH CARE CTR 6 6 CHICAGO $18.58 $48.71 $101.54 $168.83 4/1/20156016539 PHOENIX REHAB NURSING CARE 5 5 CARMI $8.21 $43.35 $74.40 $125.96 4/1/20156007389 PIATT COUNTY NURSING HOME 4 4 MONTICELLO $11.23 $52.43 $71.63 $135.29 4/1/20156005441 PINCKNEYVILLE NURSING REHAB 5 5 PINCKNEYVILLE $10.70 $37.09 $75.58 $123.37 4/1/2015 7/1/20146007413 PINE ACRES REHAB LIVING CENTER 1 1 DEKALB $17.09 $51.52 $90.99 $159.60 4/1/20156004741 PINE CREST HEALTH CARE 7 7 HAZEL CREST $17.78 $46.12 $77.77 $141.67 4/1/20156007447 PINECREST MANOR 1 1 MT MORRIS $13.82 $50.58 $64.14 $128.54 4/1/20156003792 PIPER CITY REHAB LIVING CTR 4 4 PIPER CITY $9.67 $50.44 $72.90 $133.01 4/1/20156012470 PITTSFIELD MANOR 3 3 PITTSFIELD $14.89 $40.30 $80.05 $135.24 4/1/20156007470 PLEASANT HILL HEALTHCARE 3 3 GIRARD $12.63 $38.68 $68.07 $119.38 4/1/20156007488 PLEASANT MEADOWS SENIOR LIVING 4 4 CHRISMAN $12.52 $48.02 $81.11 $141.65 4/1/20156007512 PLEASANT VIEW LUTHER HOME 2 2 OTTAWA $8.22 $50.44 $68.83 $127.49 4/1/20156007504 PLEASANT VIEW REHAB AND HCC 1 1 MORRISON $9.30 $45.95 $74.39 $129.64 4/1/20156007546 POLO REHABILITATION AND HCC 1 1 POLO $9.94 $49.51 $75.62 $135.07 4/1/20156004642 PONTIAC HEALTHCARE AND REHAB 4 4 PONTIAC $13.67 $48.27 $94.74 $156.68 4/1/20156007561 PRAIRIE CITY REHAB AND HC 2 2 PRAIRIE CITY $9.17 $43.60 $55.16 $107.93 4/1/20156008502 PRAIRIE CROSSING LVG AND REHAB 1 1 SHABBONA $10.85 $47.64 $87.43 $145.92 4/1/20156011746 PRAIRIE MANOR NURSING REHAB 7 7 CHICAGO HEIGHTS $23.91 $49.26 $123.45 $196.62 4/1/2015 7/1/20146007082 PRAIRIE ROSE HEALTH CARE CTR 3 3 PANA $9.13 $41.42 $82.00 $132.55 4/1/20156001812 PRAIRIE VIEW CARE OF LEWISTOWN 2 2 LEWISTOWN $8.06 $42.03 $99.05 $149.14 4/1/20156006027 PRAIRIE VLG HEALTHCARE CTR INC 3 3 JACKSONVILLE $9.67 $38.31 $79.30 $127.28 4/1/20156007595 PRAIRIEVIEW LUTHERAN HOME 4 4 DANFORTH $12.95 $50.44 $76.53 $139.92 4/1/20156005771 PRESENCE COR MARIAE CENTER 1 1 ROCKFORD $12.52 $51.52 $83.69 $147.73 4/1/20156005854 PRESENCE MARYHAVEN NSG REHAB 7 7 GLENVIEW $14.39 $55.98 $94.31 $164.68 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6005912 PRESENCE MCAULEY MANOR 8 8 AURORA $12.98 $55.98 $82.10 $151.06 4/1/20156007009 PRESENCE OUR LADY OF VICTORY 9 9 BOURBONNAIS $14.39 $53.08 $94.45 $161.92 4/1/20156007439 PRESENCE PINE VIEW CARE CENTER 8 8 SAINT CHARLES $10.96 $55.98 $74.29 $141.23 4/1/20156014575 PRESENCE RESURRECTION LIFE CTR 6 6 CHICAGO $17.23 $54.57 $77.90 $149.70 4/1/20156007892 PRESENCE RESURRECTION NRC 7 7 PARK RIDGE $10.64 $54.29 $93.05 $157.98 4/1/20156008874 PRESENCE SAINT BENEDICT NRC 7 7 NILES $13.92 $55.98 $97.01 $166.91 4/1/20156008817 PRESENCE ST ANNE CENTER 1 1 ROCKFORD $12.09 $51.52 $80.37 $143.98 4/1/20156008973 PRESENCE ST JOSEPH CENTER 1 1 FREEPORT $14.24 $51.52 $81.18 $146.94 4/1/20156012678 PRESENCE VILLA FRANCISCAN 9 9 JOLIET $14.39 $53.08 $75.72 $143.19 4/1/20156009591 PRESENCE VILLA SCALABRINI NC 7 7 NORTHLAKE $12.05 $55.95 $107.75 $175.75 4/1/20156007876 PROVIDENCE DOWNERS GROVE 7 7 DOWNERS GROVE $14.88 $55.98 $71.67 $142.53 4/1/20156007843 PROVIDENCE PALOS HEIGHTS 7 7 PALOS HEIGHTS $14.39 $55.98 $90.31 $160.68 4/1/20156016356 RADFORD GREEN 8 8 LINCOLNSHIRE $18.90 $55.98 $132.54 $207.42 4/1/20156008734 RAINBOW BEACH CARE CENTER 6 CHICAGO $17.66 $55.19 $57.64 $130.49 7/1/2014 Eligible for Provisional Licensure as SMHRF6007702 RANDOLPH COUNTY CARE CENTER 5 5 SPARTA $6.52 $44.40 $62.42 $113.34 4/1/20156007751 RED BUD REGIONAL CARE 5 5 RED BUD $11.46 $43.93 $73.77 $129.16 4/1/20156008239 REGENCY NURSING CARE RESIDENCE 3 3 SPRINGFIELD $15.16 $44.49 $73.57 $133.22 4/1/20156007793 REGENCY REHABILITATION CENTER 7 7 NILES $21.04 $48.46 $105.73 $175.23 4/1/20156014831 RENAISSANCE AT 87TH STREET 6 6 CHICAGO $22.15 $51.34 $109.26 $182.75 4/1/20156014641 RENAISSANCE AT MIDWAY 6 6 CHICAGO $20.12 $49.75 $109.33 $179.20 4/1/20156014823 RENAISSANCE AT SOUTH SHORE 6 6 CHICAGO $20.74 $52.59 $105.53 $178.86 4/1/20156006712 RENAISSANCE CARE CENTER 2 2 CANTON $10.70 $37.41 $80.77 $128.88 4/1/20156003958 RENAISSANCE PARK SOUTH 6 6 CHICAGO $14.80 $48.00 $95.18 $157.98 4/1/20156007850 REST HAVEN MANOR INC 5 5 ALBION $3.97 $37.18 $54.07 $95.22 4/1/20156007884 RESTHAVE HOME OF WHITESIDE CO 1 1 MORRISON $6.15 $47.87 $67.03 $121.05 4/1/20156007942 RIDGEVIEW CARE CENTER 5 5 OBLONG $8.78 $35.23 $63.77 $107.78 4/1/20156003453 RIDGEVIEW REHAB NURSING CENTER 6 6 CHICAGO $15.67 $48.06 $82.97 $146.70 4/1/20156007975 RIDGWAY REHAB AND NRSG CENTER 5 5 RIDGWAY $9.27 $34.50 $89.38 $133.15 4/1/2015 7/1/20146008007 RIVER BLUFF NURSING HOME 1 1 ROCKFORD $10.80 $53.75 $69.50 $134.05 4/1/20156000434 RIVER CROSSING REHAB 2 2 GALESBURG $11.89 $40.51 $101.46 $153.86 4/1/20156001085 RIVER NORTH BRADLEY H AND R 9 9 BRADLEY $13.08 $42.10 $95.26 $150.44 4/1/20156004758 RIVER VIEW REHAB CENTER 8 8 ELGIN $12.62 $42.33 $80.51 $135.46 4/1/20156008015 RIVERSHORES HLTH AND REHAB CTR 2 2 MARSEILLES $11.07 $46.72 $72.57 $130.36 4/1/20156002646 RIVERWOOD REHAB 10 10 EAST MOLINE $12.88 $44.26 $86.28 $143.42 4/1/2015 7/1/20146008072 ROBINGS MANOR REHAB HLTH CR 3 3 BRIGHTON $12.11 $36.39 $74.53 $123.03 4/1/20156008098 ROCHELLE GARDENS CARE CENTER 1 1 ROCHELLE $8.80 $44.99 $61.56 $115.35 4/1/20156008106 ROCHELLE REHAB HEALTH CARE 1 1 ROCHELLE $10.07 $51.52 $73.20 $134.79 4/1/20156008114 ROCK FALLS REHAB HLTH CARE CTR 1 1 ROCK FALLS $9.89 $51.42 $68.52 $129.83 4/1/20156008130 ROCK ISLAND NURSING REHAB CTR 10 10 ROCK ISLAND $12.50 $40.61 $84.04 $137.15 4/1/20156002695 ROCK RIVER GARDENS 1 1 STERLING $8.55 $39.13 $43.88 $91.56 4/1/20156008049 ROCK RIVER HEALTH CARE 1 1 ROCKFORD $10.89 $43.47 $77.45 $131.81 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6008163 ROLLING HILLS MANOR 8 8 ZION $14.88 $55.98 $93.90 $164.76 4/1/20156005136 ROSEVILLE REHAB HEALTH CARE 2 2 ROSEVILLE $9.62 $46.49 $65.68 $121.79 4/1/20156012074 ROSEWOOD CARE CENTER ALTON 11 11 ALTON $14.95 $42.51 $82.46 $139.92 4/1/20156014237 ROSEWOOD CARE CENTER ELGIN 8 8 ELGIN $16.42 $51.18 $81.41 $149.01 4/1/20156010466 ROSEWOOD CARE CENTER GALESBURG 2 2 GALESBURG $14.23 $41.85 $77.79 $133.87 4/1/20156014633 ROSEWOOD CARE CENTER INVERNESS 7 7 INVERNESS $22.20 $52.72 $87.22 $162.14 4/1/20156012835 ROSEWOOD CARE CENTER JOLIET 9 9 JOLIET $15.52 $50.13 $90.22 $155.87 4/1/20156012587 ROSEWOOD CARE CENTER MOLINE 10 10 MOLINE $14.73 $48.06 $75.47 $138.26 4/1/20156012165 ROSEWOOD CARE CENTER PEORIA 2 2 PEORIA $13.50 $49.68 $75.00 $138.18 4/1/20156014658 ROSEWOOD CARE CENTER ROCKFORD 1 1 ROCKFORD $17.46 $49.15 $80.22 $146.83 4/1/20156010391 ROSEWOOD CARE CENTER SWANSEA 11 11 SWANSEA $13.37 $46.71 $91.27 $151.35 4/1/20156012017 ROSEWOOD CARE CTR EAST PEORIA 2 2 EAST PEORIA $13.84 $48.51 $77.20 $139.55 4/1/20156014401 ROSEWOOD CARE CTR EDWARDSVILLE 11 11 EDWARDSVILLE $16.83 $46.71 $73.55 $137.09 4/1/20156019723 ROSEWOOD CARE CTR NORTHBROOK 7 7 NORTHBROOK $21.11 $53.85 $108.94 $183.90 4/1/20156014666 ROSEWOOD CARE CTR ST CHARLES 8 8 ST CHARLES $19.01 $55.06 $78.37 $152.44 4/1/20156003065 ROSICLARE REHAB HEALTH CR 5 5 ROSICLARE $8.47 $43.93 $69.38 $121.78 4/1/20156005029 ROYAL OAKS CARE CENTER 10 10 KEWANEE $10.12 $37.71 $60.46 $108.29 4/1/20156008320 SACRED HEART HOME 6 CHICAGO $12.07 $48.91 $55.59 $116.57 7/1/2014 Eligible for Provisional Licensure as SMHRF6008338 SALEM VILLAGE NURSING AND REHA 9 9 JOLIET $13.08 $49.38 $118.98 $181.44 4/1/20156008346 SALINE CARE CENTER 5 5 HARRISBURG $9.86 $34.43 $77.31 $121.60 4/1/20156008213 SANDWICH REHAB HEALTH CARE CTR 1 1 SANDWICH $11.06 $51.52 $74.08 $136.66 4/1/20156001929 SAUK VALLEY SENIOR LIVING 1 1 ROCK FALLS $10.42 $47.83 $72.16 $130.41 4/1/20156008395 SCOTT COUNTY NURSING CENTER 3 3 WINCHESTER $8.22 $45.42 $67.07 $120.71 4/1/20156008460 SELFHELP HOME OF CHICAGO 6 6 CHICAGO $15.83 $55.98 $78.61 $150.42 4/1/20156010250 SEMINARY MANOR 2 2 GALESBURG $13.22 $46.44 $71.50 $131.16 4/1/20156007272 SHARON HEALTH CARE WILLOWS 2 2 PEORIA $9.22 $41.48 $82.79 $133.49 4/1/20156007926 SHARON HEALTH CARE WOODS INC 2 PEORIA $9.97 $41.01 $51.08 $102.06 7/1/2014 Eligible for Provisional Licensure as SMHRF6007306 SHARON HEALTHCARE ELMS INC 2 2 PEORIA $10.53 $44.72 $98.87 $154.12 4/1/20156007298 SHARON HEALTHCARE PINES INC 2 2 PEORIA $9.40 $42.36 $66.13 $117.89 4/1/20156008528 SHAWNEE CHRISTIAN NURSING CTR 5 5 HERRIN $11.23 $40.09 $71.23 $122.55 4/1/20156004055 SHAWNEE ROSE CARE CENTER 5 5 HARRISBURG $9.06 $32.62 $69.10 $110.78 4/1/20156008544 SHELBYVILLE MANOR 4 4 SHELBYVILLE $16.06 $41.91 $87.72 $145.69 4/1/20156008536 SHELBYVILLE REHAB HEALTH CARE 4 4 SHELBYVILLE $8.58 $49.62 $97.76 $155.96 4/1/20156008569 SHELDON HEALTH CARE CENTER 4 4 SHELDON $9.89 $50.44 $64.79 $125.12 4/1/20156002687 SHERIDAN SHORES REHAB CENTER 6 6 CHICAGO $18.03 $42.94 $89.76 $150.73 4/1/2015 7/1/20146012827 SHERMAN WEST COURT 8 8 ELGIN $14.88 $55.98 $68.22 $139.08 4/1/20156008643 SKOKIE MEADOWS NURSING CTR II 7 SKOKIE $16.07 $37.38 $57.09 $110.54 7/1/2014 Eligible for Provisional Licensure as SMHRF6016059 SMITH CROSSING 9 9 ORLAND PARK $18.18 $45.68 $85.80 $149.66 4/1/20156009732 SMITH VILLAGE 6 6 CHICAGO $11.56 $55.98 $86.77 $154.31 4/1/20156011464 SNYDER VILLAGE 2 2 METAMORA $15.11 $48.71 $70.71 $134.53 4/1/20156008684 SNYDERS VAUGHN HAVEN INC 3 3 RUSHVILLE $9.48 $43.30 $65.20 $117.98 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6008718 SOUTH ELGIN REHAB HEALTH CARE 8 8 SOUTH ELGIN $10.22 $52.66 $92.60 $155.48 4/1/20156016497 SOUTH SUBURBAN REHAB CENTER 7 7 HOMEWOOD $16.52 $49.95 $102.67 $169.14 4/1/20156008759 SOUTHGATE H C 5 5 METROPOLIS $14.28 $41.44 $70.39 $126.11 4/1/20156014781 SOUTHPOINT NURSING REHAB CTR 6 6 CHICAGO $21.00 $48.97 $113.88 $183.85 4/1/20156001895 SOUTHVIEW MANOR NURSING CENTER 6 6 CHICAGO $14.26 $38.92 $76.84 $130.02 4/1/20156016786 SPRING CREEK NRSG REHAB CTR 6 9 JOLIET $10.71 $46.84 $40.66 $98.21 4/1/20156008783 SPRING VALLEY NURSING CENTER 2 2 SPRING VALLEY $7.72 $48.96 $61.89 $118.57 4/1/20156011803 SPRINGS AT CRYSTAL LAKE 8 CRYSTAL LAKE $15.71 $45.20 $90.20 $151.11 7/1/20146014567 ST ANTHONYS HOSPITAL SNU 11 ALTON $6.15 $46.71 $25.90 $78.76 7/1/20146008866 ST ANTHONYS NURSING AND REHAB 10 10 ROCK ISLAND $17.37 $51.52 $75.34 $144.23 4/1/20156008890 ST CLARAS MANOR 3 3 LINCOLN $9.51 $44.24 $74.70 $128.45 4/1/20156010664 ST JAMES WELLNESS REHAB VILLAS 9 9 CRETE $15.16 $53.08 $100.57 $168.81 4/1/20156008940 ST JOHNS HOSPITAL LTC UNIT 3 3 SPRINGFIELD $7.26 $44.49 $56.20 $107.95 4/1/20156011407 ST JOSEPH MED CTR NURSING UNIT 4 BLOOMINGTON $3.66 $50.44 $29.21 $83.31 7/1/20146008957 ST JOSEPH VILLAGE OF CHICAGO 6 6 CHICAGO $11.56 $55.98 $109.15 $176.69 4/1/20156009005 ST JOSEPHS HOME FOR THE ELDERL 7 7 PALATINE $9.22 $55.98 $69.42 $134.62 4/1/20156008999 ST JOSEPHS N H 2 2 LACON $4.19 $50.44 $61.92 $116.55 4/1/20156009013 ST MARTHA MANOR 6 6 CHICAGO $13.38 $50.55 $64.93 $128.86 4/1/20156011910 ST PATRICKS RES 7 7 NAPERVILLE $14.88 $53.80 $91.42 $160.10 4/1/20156009120 ST PAULS HOME 11 11 BELLEVILLE $9.51 $46.02 $69.56 $125.09 4/1/20156009112 ST PAULS HOUSE AND HEALTH CARE 6 6 CHICAGO $13.46 $55.98 $84.43 $153.87 4/1/20156005466 ST VINCENTS HOME INC 3 3 QUINCY $12.06 $40.51 $57.54 $110.11 4/1/20156010441 STEARNS NURSING AND REHAB CTR 11 11 GRANITE CITY $13.68 $41.65 $73.18 $128.51 4/1/20156009161 STEPHENSON NURSING CENTER 1 1 FREEPORT $9.88 $49.89 $64.43 $124.20 4/1/20156009179 STERLING PAVILION LTD 1 1 STERLING $11.67 $41.99 $89.07 $142.73 4/1/20156006365 STOCKTON HEALTHCARE AND REHAB 1 1 STOCKTON $10.27 $43.60 $79.02 $132.89 4/1/20156008494 STONEBRIDGE SENIOR LIVING 5 5 BENTON $9.13 $37.02 $87.05 $133.20 4/1/2015 7/1/20146009211 SULLIVAN REHAB HEALTH CARE CTR 4 4 SULLIVAN $9.76 $41.01 $71.15 $121.92 4/1/20156009245 SUNNY ACRES NURSING HOME 3 3 PETERSBURG $12.52 $43.81 $67.63 $123.96 4/1/20156009252 SUNNY HILL NSG HOME OF WILL CO 9 9 JOLIET $18.18 $62.40 $100.51 $181.09 4/1/20156009294 SUNRISE SKILLED NURSING REHAB 3 3 VIRDEN $10.10 $38.30 $74.01 $122.41 4/1/20156009302 SUNSET HOME 3 3 QUINCY $13.40 $44.49 $81.53 $139.42 4/1/20156009328 SUNSET REHAB HEALTH CARE 2 2 CANTON $13.20 $36.90 $62.08 $112.18 4/1/20156009831 SWANSEA REHAB HEALTH CARE CENT 11 11 SWANSEA $6.57 $39.29 $79.94 $125.80 4/1/20156007678 SYCAMORE HEALTHCARE CENTER 3 3 QUINCY $9.02 $32.65 $72.13 $113.80 4/1/2015 7/1/20146007967 SYMPHONY EVANSTON HEALTHCARE 7 EVANSTON $18.87 $45.20 $96.66 $160.73 1/1/20156002265 SYMPHONY OF CRESTWOOD 7 7 CRESTWOOD $15.25 $49.50 $107.72 $172.47 4/1/20156006282 SYMPHONY OF DECATUR 4 4 DECATUR $11.52 $44.44 $101.94 $157.90 4/1/20156002463 SYMPHONY OF JOLIET 9 9 JOLIET $14.90 $47.40 $110.13 $172.43 4/1/20156005490 SYMPHONY OF LINCOLN 3 3 LINCOLN $13.43 $42.60 $108.52 $164.55 4/1/20156014252 TABOR HILLS HEALTHCARE FAC 7 7 NAPERVILLE $16.29 $55.98 $87.62 $159.89 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6009369 TAYLORVILLE CARE CENTER 3 3 TAYLORVILLE $10.83 $39.24 $76.65 $126.72 4/1/20156009377 TERRACE NURSING HOME 8 8 WAUKEGAN $12.15 $44.89 $101.92 $158.96 4/1/20156003768 TERRACE ON THE PARK 11 11 MASCOUTAH $10.11 $45.62 $78.72 $134.45 4/1/20156009385 THORNTON HEIGHTS TERRACE LTD 7 CHICAGO HEIGHTS $14.68 $40.07 $62.27 $117.02 7/1/2014 Eligible for Provisional Licensure as SMHRF6009393 THREE SPRINGS LODGE NRSG HOME 5 5 CHESTER $9.72 $40.10 $62.28 $112.10 4/1/20156009401 TILLERS NSG AND REHAB CTR 9 9 OSWEGO $16.29 $53.08 $103.74 $173.11 4/1/20156007330 TIMBERCREEK REHAB AND HEALTH C 2 2 PEKIN $11.32 $45.39 $69.18 $125.89 4/1/20156003750 TIMBERPOINT HEALTHCARE CENTER 3 3 CAMP POINT $9.76 $44.15 $80.44 $134.35 4/1/20156009427 TOULON REHAB HEALTH CARE CTR 2 2 TOULON $12.29 $45.01 $60.94 $118.24 4/1/20156003263 TOWER HILL HEALTHCARE CENTER 8 8 SOUTH ELGIN $13.01 $45.97 $97.45 $156.43 4/1/20156009443 TRI STATE NURSING REHAB CENTER 7 7 LANSING $17.37 $50.93 $109.39 $177.69 4/1/20156002588 TUSCOLA HEALTH CARE CENTER 4 4 TUSCOLA $8.90 $38.53 $63.51 $110.94 4/1/20156004188 TWIN LAKES REHAB HEALTH CARE 4 4 PARIS $9.09 $41.32 $81.30 $131.71 4/1/20156009484 TWIN WILLOWS NURSING CENTER 5 5 SALEM $7.02 $35.35 $70.78 $113.15 4/1/20156009492 UNION COUNTY HOSPITAL LTC 5 5 ANNA $4.73 $43.93 $84.35 $133.01 4/1/20156009500 UNITED METHODIST VILLAGE 5 5 LAWRENCEVILLE $8.65 $41.56 $69.00 $119.21 4/1/20156013072 UNITED METHODIST VILLAGE N CAM 5 5 LAWRENCEVILLE $14.27 $40.24 $72.38 $126.89 4/1/20156002711 UNIVERSITY NURSING AND RHB CTR 11 11 EDWARDSVILLE $10.82 $41.10 $96.77 $148.69 4/1/20156009542 VALLEY HI NURSING HOME 8 8 WOODSTOCK $18.18 $62.41 $82.77 $163.36 4/1/20156009260 VANDALIA REHAB HEALTH CARE 5 5 VANDALIA $8.33 $43.47 $72.27 $124.07 4/1/20156007322 VILLA AT EVERGREEN PARK 7 7 EVERGREEN PARK $16.99 $55.98 $93.83 $166.80 4/1/20156007041 VILLA AT PA PETERSON 1 1 ROCKFORD $15.73 $51.52 $67.22 $134.47 4/1/20156007868 VILLA AT SOUTH HOLLAND 7 7 SOUTH HOLLAND $26.32 $55.98 $114.67 $196.97 4/1/20156014856 VILLA AT WINDSOR PARK 6 7 CHICAGO $21.08 $47.06 $104.23 $172.37 4/1/20156012991 VILLA HEALTH CARE INC EAST 3 3 SHERMAN $14.69 $44.49 $76.29 $135.47 4/1/20156011332 VILLAGE AT VICTORY LAKES 8 8 LINDENHURST $12.51 $55.98 $98.35 $166.84 4/1/20156009674 WABASH CHRISTIAN RETIREMENT CR 5 5 CARMI $12.52 $43.79 $71.40 $127.71 4/1/20156009682 WALKER NURSING HOME 3 3 VIRGINIA $12.07 $43.65 $48.15 $103.87 4/1/20156011381 WALNUT GROVE VILLAGE 9 9 MORRIS $15.77 $53.01 $100.04 $168.82 4/1/20156009690 WALNUT MANOR 2 2 WALNUT $11.90 $49.56 $67.59 $129.05 4/1/20156004725 WARREN BARR LIV AND REHAB CTR 6 6 CHICAGO $18.36 $55.98 $112.32 $186.66 4/1/20156014963 WARREN BARR NORTH SHORE 8 8 HIGHLAND PARK $19.27 $54.23 $112.09 $185.59 4/1/20156008825 WARREN BARR SOUTH LOOP 6 6 CHICAGO $15.29 $54.02 $143.39 $212.70 4/1/20156008262 WARREN PARK HEALTH LIVING CTR 6 6 CHICAGO $11.63 $50.85 $64.22 $126.70 4/1/20156009740 WASHINGTON CHRISTIAN VILLAGE 2 2 WASHINGTON $11.20 $45.83 $78.07 $135.10 4/1/20156002430 WATERFORD NURSING AND REHAB 6 6 CHICAGO $16.40 $38.10 $79.95 $134.45 4/1/20156009757 WATERFRONT TERRACE INC 6 6 CHICAGO $16.34 $48.69 $88.08 $153.11 4/1/20156009765 WATSEKA REHAB HEALTH CARE CTR 4 4 WATSEKA $10.37 $46.59 $63.87 $120.83 4/1/20156009435 WAUCONDA HEALTHCARE AND REHAB 8 8 WAUCONDA $15.67 $50.55 $102.74 $168.96 4/1/20156009815 WAY FAIR NURSING AND REHAB CTR 5 5 FAIRFIELD $10.73 $39.67 $74.75 $125.15 4/1/20156014377 WEALSHIRE 8 8 LINCOLNSHIRE $17.97 $55.98 $83.23 $157.18 4/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 04-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6006100 WESLEY PLACE 6 6 CHICAGO $16.29 $55.98 $101.09 $173.36 4/1/20156009864 WESLEY VILLAGE 2 2 MACOMB $14.79 $45.95 $64.44 $125.18 4/1/20156009872 WEST CHICAGO TERRACE NH 7 7 WEST CHICAGO $11.40 $39.35 $65.21 $115.96 4/1/20156013478 WEST SUBURBAN HOSP MED CTR SNF 7 OAK PARK $13.46 $45.20 $49.78 $108.44 7/1/20146001002 WEST SUBURBAN NURSING REHAB 7 7 BLOOMINGDALE $12.51 $45.64 $104.68 $162.83 4/1/20156012173 WESTCHESTER HEALTH AND REHAB C 7 7 WESTCHESTER $19.90 $55.98 $95.78 $171.66 4/1/20156007603 WESTMINSTER PLACE 7 7 EVANSTON $9.22 $55.98 $102.29 $167.49 4/1/20156000194 WESTSIDE REHAB CARE CENTER 5 5 WEST FRANKFORT $7.90 $35.39 $61.36 $104.65 4/1/20156009955 WESTWOOD MANOR 6 6 CHICAGO $12.93 $37.86 $60.98 $111.77 4/1/20156009963 WHEATON CARE CENTER 7 7 WHEATON $12.74 $47.85 $90.15 $150.74 4/1/20156006597 WHITE HALL NURSING AND REHAB C 3 3 WHITE HALL $12.17 $30.87 $80.29 $123.33 4/1/20156004881 WHITE OAK REHABILITATION HCC 5 5 MOUNT VERNON $9.44 $43.93 $77.22 $130.59 4/1/20156008379 WILLOW CREST NURS PAVILION LTD 1 1 SANDWICH $12.03 $43.09 $93.91 $149.03 4/1/20156003842 WILLOW ROSE REHAB HEALTH CARE 3 3 JERSEYVILLE $9.01 $40.48 $70.60 $120.09 4/1/20156010037 WILLOWS HEALTH CENTER 1 1 ROCKFORD $12.04 $51.52 $72.13 $135.69 4/1/20156010045 WILSON CARE INC 6 CHICAGO $13.63 $37.19 $56.87 $107.69 7/1/2014 Eligible for Provisional Licensure as SMHRF6010052 WINCHESTER HOUSE 8 8 LIBERTYVILLE $7.27 $66.61 $99.40 $173.28 4/1/20156010078 WINDMILL NURSING PAVILION LTD 7 7 SOUTH HOLLAND $15.21 $44.27 $86.13 $145.61 4/1/20156005334 WINFIELD WOODS HEALTHCARE CTR 7 7 WINFIELD $14.12 $44.76 $77.49 $136.37 4/1/20156010094 WINNING WHEELS INC 1 1 PROPHETSTOWN $15.97 $51.52 $97.62 $165.11 4/1/20156010102 WINSTON MANOR CONVALESCENT N H 6 6 CHICAGO $10.01 $36.42 $57.92 $104.35 4/1/20156001713 WOOD GLEN NURSING AND REHAB CE 7 7 WEST CHICAGO $16.31 $45.46 $57.24 $119.01 4/1/20156007074 WOODBRIDGE NURSING PAVILION 6 6 CHICAGO $15.17 $40.95 $102.18 $158.30 4/1/20156008361 WYNSCAPE 7 7 WHEATON $14.82 $55.98 $78.05 $148.85 4/1/2015