Adult Care Facilities

9/9/2014 ACF (DSRIP)
Analysis of Adult Care Facilities Data - SELF ATTESTATION
Delivery System Reform Incentive Payment Plan
Total 27 100.00%
Qualified 25 92.59%
ACF Condition 1 - Volume  
Volumes >= 35% Final Result  
License # FACILITY NAME Utilization Rate Result
280-E-002 David & Helen Getman Memorial Home 100.00% TRUE TRUE By Appeal
360-F-008 Hamilton Manor 100.00% TRUE TRUE By Appeal
520-F-041 Highland Home for Adults 100.00% TRUE TRUE By Appeal
400-E-117 Jones Manor on the Sound 100.00% TRUE TRUE By Appeal
710-F-064 Narrowsburg Manor LLC 100.00% TRUE TRUE By Appeal
700-F-287 New Brookhaven Town House for Adults 100.00% TRUE TRUE By Appeal
230-F-82 Hedgewood Home for Adults LLC 98.34% TRUE TRUE By Appeal
620-F-036 Green Hills Estate 97.22% TRUE TRUE By Appeal
331-F-266 New South Shore Manor 96.97% TRUE TRUE By Appeal
050-E-010 Central New York Adult Homes, Inc. dba Evergreen Heights 94.83% TRUE TRUE By Appeal
331-F-278 Brooklyn Adult Care Center 94.53% TRUE TRUE By Appeal
620-F-071 Springvalley Rest Home 93.55% TRUE TRUE By Appeal
420-S-391 Lott Assisted Living Operating Corp./ dba Lott Assisted Living Residence 90.91% TRUE TRUE By Appeal
370-F-025 Shire At Culverton 90.60% TRUE TRUE By Appeal
510-f-028 Adirondack Manor Home For Adults 90.23% TRUE TRUE By Appeal
230-F-272 Crystal House Manor, Inc. 88.04% TRUE TRUE By Appeal
AF0519A Johnson Adult Homes - Forestville 85.83% TRUE TRUE By Appeal
050-F-022 Northbrook Heights Home For Adults 81.72% TRUE TRUE By Appeal
610-F-066 Mariners Residence, Inc. 77.86% TRUE TRUE By Appeal
331-E-125 St. Nicholas Home 75.00% TRUE TRUE By Appeal
331-f-022 Signature Senior Living (Formerly Scharome Manor) 66.67% TRUE TRUE By Appeal
070-F038 JJM Health LLC 53.34% TRUE TRUE By Appeal
540-E-050 Elant at Goshen Adult Home 49.53% TRUE TRUE By Appeal
030-E-039 Ideal Senior Living Center 47.33% TRUE TRUE By Appeal
240-S-004 The Bristol Home, Inc. 44.44% TRUE TRUE By Appeal
620-f-076 L'Dor 0.00% FALSE FALSE  
700-893F The Lake Shore Adult Home 0.00% FALSE FALSE  

Highlighted Facility Names Indicate Medicaid Utilization of 35% or greater