August 14, 2015 Our Reference:CCN 454081 Shelah A. Adams, CEO Timberlawn Mental Health System 4600 Samuell BlvdDallas, TX75315 Dear Ms. Adams: The Centers for Medicare & Medicaid Services (CMS) notified you on J uly 23, 2015, that Timberlawn Health System would be terminated from the Medicare program on August 7, 2015, because of deficiencies that represented an immediate jeopardy to patient health and safety. On August 5, 2015, we sent you a notice that the termination date was extended to August 13, 2015, to accommodate the Federal court hearing on August 11, 2015. This is to notify you that the Medicare provider agreement of Timberlawn Mental Health System terminated at 12:01 a.m., on August 14, 2015. Please refer to our J uly 23, 2015, letter for your appeal rights. No payment for patients admitted on or after that time and date will be made by the Medicare program. For patients admitted prior to August 14, 2015, payment may continue to be made for up to 30 days of covered inpatient hospital services furnished on and after August 14, 2015. A list with the names and health insurance claim numbers of the Medicare patients remaining in your hospital on August 14, 2015, must be forwarded immediately to the Centers for Medicare & Medicaid Services, Division of Survey and Certification, Attention: Ginger Odle, 1301 Young Street, Room 827, Dallas, TX 75202. You may contact Dodjie Guioa at 214-767-6179 or by e-mail dodjie.guioa@cms.hhs.gov, if you have questions regarding this matter. Sincerely, Ginger Odle, Manager Enforcement Branch Enclosure:CMS-2567 cc:Accrediting Organization, DSHS