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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building 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 $70.34 $126.26 10/1/20156000020 ABBINGTON REHAB NURSING CENTER 7 7 ROSELLE $14.60 $49.47 $80.45 $144.52 10/1/2015 7/1/20146000038 ABBOTT HOUSE 8 8 HIGHLAND PARK $11.47 $49.04 $55.09 $115.60 7/1/2014 Eligible for Provisional License as SMHRF6000046 ADDOLORATA VILLA 7 7 WHEELING $13.92 $55.98 $100.44 $170.34 10/1/20156007959 ALBANY CARE INC 7 7 EVANSTON $15.70 $33.26 $55.95 $104.91 7/1/2014 Eligible for Provisional License as SMHRF6000103 ALDEN ALMA NELSON MANOR 1 1 ROCKFORD $14.99 $49.65 $82.94 $147.58 10/1/20156014757 ALDEN DES PLAINES REHAB HHC 7 7 DES PLAINES $22.20 $55.98 $98.24 $176.42 10/1/20156003735 ALDEN ESTATES OF BARRINGTON 7 7 BARRINGTON $23.27 $55.98 $136.64 $215.89 10/1/20156013429 ALDEN ESTATES OF EVANSTON 7 7 EVANSTON $19.32 $55.98 $104.92 $180.22 10/1/20156007033 ALDEN ESTATES OF NAPERVILLE 7 7 NAPERVILLE $16.88 $53.32 $108.65 $178.85 10/1/20156016695 ALDEN ESTATES OF SHOREWOOD 9 9 SHOREWOOD $19.22 $45.68 $90.11 $155.01 10/1/20156006886 ALDEN ESTATES OF SKOKIE 7 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 $139.92 $202.61 10/1/20156009849 ALDEN LINCOLN PARK REHAB 6 6 CHICAGO $11.23 $52.87 $94.03 $158.13 10/1/20156005714 ALDEN LONG GROVE REHAB 8 8 LONG GROVE $14.63 $50.21 $99.25 $164.09 10/1/20156014765 ALDEN NORTH SHORE REHAB AND HC 7 7 SKOKIE $21.70 $55.98 $95.53 $173.21 10/1/20156014500 ALDEN NORTHMOOR REHAB AND HHC 6 6 CHICAGO $22.43 $51.87 $107.99 $182.29 10/1/20156014773 ALDEN OF WATERFORD 8 8 AURORA $19.48 $55.98 $97.32 $172.78 10/1/20156014922 ALDEN ORLAND PARK REHAB AND HC 7 7 ORLAND PARK $18.80 $55.98 $97.86 $172.64 10/1/20156007165 ALDEN PARK STRATHMOOR 1 1 ROCKFORD $11.07 $49.65 $98.89 $159.61 10/1/20156001366 ALDEN POPLAR CR REHAB AND HCC 7 7 HOFFMAN ESTATES $18.21 $52.08 $105.58 $175.87 10/1/20156012645 ALDEN PRINCETON REHAB AND HCC 6 6 CHICAGO $17.33 $51.00 $86.48 $154.81 10/1/20156008304 ALDEN TERRACE OF MCHENRY REHAB 8 8 MCHENRY $10.10 $43.65 $105.49 $159.24 10/1/20156013353 ALDEN TOWN MANOR REHAB AND HCC 7 7 CICERO $20.74 $49.73 $98.87 $169.34 10/1/20156000459 ALDEN VALLEY RIDGE REHAB HCC 7 7 BLOOMINGDALE $12.68 $51.37 $102.23 $166.28 10/1/20156009856 ALDEN WENTWORTH REHAB AND HCC 6 6 CHICAGO $17.55 $44.13 $90.72 $152.40 10/1/20156003529 ALEDO REHAB HEALTH CARE CTR 10 10 ALEDO $9.14 $38.14 $70.26 $117.54 10/1/20156004014 ALHAMBRA CARE CENTER 11 11 ALHAMBRA $10.44 $28.46 $59.22 $98.12 10/1/2015 7/1/20146000087 ALL AMERICAN NURSING HOME 6 6 CHICAGO $11.97 $45.18 $86.14 $143.29 10/1/2015 7/1/20146000129 ALPINE FIRESIDE HEALTH CENTER 1 1 ROCKFORD $15.30 $47.68 $84.61 $147.59 10/1/20156000152 ALTON MEM HOSP HATCH SNF UNIT 11 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 $96.16 $151.37 10/1/2015 7/1/20146000186 AMBASSADOR NURSING REHAB CTR 6 6 CHICAGO $13.74 $50.93 $117.41 $182.08 10/1/20156001267 AMBERWOOD CARE CENTRE 1 1 ROCKFORD $11.17 $40.82 $94.35 $146.34 10/1/20156001788 ANNA REHAB AND NURSING CENTER 5 5 ANNA $10.12 $40.67 $76.22 $127.01 10/1/20156005730 APERION CARE AMBOY 1 1 AMBOY $7.42 $40.92 $90.15 $138.49 10/1/20156001150 APERION CARE BRIDGEPORT 5 5 BRIDGEPORT $9.39 $43.93 $96.75 $150.07 10/1/20156007207 APERION CARE BURBANK 7 7 BURBANK $18.32 $55.98 $119.43 $193.73 10/1/20156008064 APERION CARE CHICAGO HEIGHTS 7 7 CHICAGO $14.05 $43.24 $85.79 $143.08 10/1/20156005508 APERION CARE DECATUR 4 4 DECATUR $12.92 $39.00 $86.91 $138.83 10/1/20156002547 APERION CARE DOLTON 7 7 DOLTON $18.79 $49.25 $105.76 $173.80 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building 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 $111.95 $180.95 10/1/20156015333 APERION CARE FOREST PARK 7 7 FOREST PARK $20.78 $48.88 $116.96 $186.62 10/1/20156007280 APERION CARE HIGHWOOD 8 8 HIGHWOOD $19.52 $44.78 $115.05 $179.35 10/1/20156014617 APERION CARE INTERNATIONAL 6 6 CHICAGO $22.20 $48.75 $107.75 $178.70 10/1/20156008650 APERION CARE JACKSONVILLE 3 3 JACKSONVILLE $8.98 $39.56 $89.12 $137.66 10/1/20156000095 APERION CARE LITCHFIELD 3 3 LITCHFIELD $9.67 $40.08 $65.24 $114.99 10/1/2015 7/1/20146001077 APERION CARE MIDLOTHIAN 7 7 MIDLOTHIAN $14.70 $45.18 $93.26 $153.14 10/1/20156002059 APERION CARE OAK LAWN 7 7 OAK LAWN $16.48 $50.10 $132.59 $199.17 10/1/20156007520 APERION CARE PLUM GROVE 7 7 PALATINE $20.49 $46.83 $113.78 $181.10 10/1/20156002661 APERION CARE SPRINGFIELD 3 3 SPRINGFIELD $8.12 $42.00 $64.08 $114.20 10/1/20156004204 APERION CARE ST ELMO 5 5 SAINT ELMO $11.27 $42.14 $94.62 $148.03 10/1/20156008312 APERION CARE WILMINGTON 9 9 WILMINGTON $9.75 $44.03 $94.99 $148.77 10/1/20156000384 APOSTOLIC CHRISTIAN HOME 2 2 ROANOKE $14.69 $50.44 $79.36 $144.49 10/1/20156002885 APOSTOLIC CHRISTIAN HOME 2 2 EUREKA $15.55 $49.92 $70.72 $136.19 10/1/20156000400 APOSTOLIC CHRISTIAN RESTMOR 2 2 MORTON $16.85 $50.44 $78.25 $145.54 10/1/20156000426 APOSTOLIC CHRISTIAN SKYLINES 2 2 PEORIA $13.82 $49.59 $76.36 $139.77 10/1/20156000467 APPLEWOOD REHABILITATION CTR 7 7 MATTESON $16.08 $49.08 $111.15 $176.31 10/1/20156006852 ARBA CARE CENTER OF COLFAX 4 4 COLFAX $11.16 $50.44 $94.02 $155.62 10/1/20156005847 ARBA CARE CENTER OF ELGIN 8 8 ELGIN $11.47 $54.20 $100.00 $165.67 10/1/20156006308 ARBA CARE CENTER OF TOLUCA 2 2 TOLUCA $8.57 $48.85 $82.71 $140.13 10/1/20156001010 ARBA CARE CTR OF BLOOMINGTON 4 4 BLOOMINGTON $9.88 $49.89 $84.91 $144.68 10/1/20156008155 ARBOUR HEALTH CARE CENTER 6 6 CHICAGO $13.16 $44.39 $73.78 $131.33 10/1/20156009823 ARCOLA HEALTH CARE CENTER 4 4 ARCOLA $9.63 $36.01 $60.08 $105.72 10/1/20156014906 ARIA POST ACUTE CARE 7 7 HILLSIDE $21.46 $49.62 $104.69 $175.77 10/1/20156000517 ARTHUR HOME 4 4 ARTHUR $9.51 $47.66 $86.17 $143.34 10/1/20156016729 ASBURY GARDENS NSG AND REHAB 8 8 NORTH AURORA $19.48 $45.20 $108.06 $172.74 10/1/20156008205 ASPEN REHAB AND HEALTH CARE 10 10 SILVIS $10.87 $50.96 $60.20 $122.03 10/1/20156016273 ASSISI HCC AT CLARE OAKS 7 7 BARTLETT $18.18 $55.98 $92.36 $166.52 10/1/20156006662 ASTORIA PLACE LIVING REHAB CTR 6 6 CHICAGO $17.76 $56.24 $117.10 $191.10 10/1/20156003834 ATRIUM HEALTH CARE CENTER LTD 6 6 CHICAGO $13.36 $45.27 $86.27 $144.90 10/1/20156007181 AUBURN REHAB AND HCC 3 3 AUBURN $8.78 $35.60 $79.06 $123.44 10/1/20156014344 AVANTARA LONG GROVE 8 8 LONG GROVE $17.46 $47.61 $119.99 $185.06 10/1/20156009096 AVANTARA PARK RIDGE 7 7 PARK RIDGE $14.88 $55.98 $115.21 $186.07 10/1/20156003214 AVANTI WELLNESS AND REHAB 7 7 NILES $16.75 $49.29 $109.70 $175.74 10/1/20156011340 AVISTON COUNTRYSIDE MANOR 11 11 AVISTON $13.24 $42.38 $75.93 $131.55 10/1/20156000640 BALLARD RESPIRATORY AND REHAB 7 7 DES PLAINES $17.48 $55.82 $158.89 $232.19 10/1/20156000657 BALMORAL NURSING HOME 6 6 CHICAGO $11.01 $32.49 $66.99 $110.49 10/1/20156000731 BARRY COMMUNITY CARE 3 3 BARRY $9.06 $40.29 $75.61 $124.96 10/1/20156008171 BATAVIA REHAB HEALTH CARE CTR 8 8 BATAVIA $12.57 $55.98 $71.62 $140.17 10/1/20156000764 BAYSIDE TERRACE 8 8 WAUKEGAN $10.85 $38.53 $54.39 $103.77 7/1/2014 Eligible for Provisional License as SMHRF6000806 BEECHER MANOR NURSG AND RHB CT 9 9 BEECHER $19.71 $53.08 $100.89 $173.68 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building 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 $130.68 $203.97 10/1/20156000889 BELLA TERRA MORTON GROVE 7 7 MORTON GROVE $15.83 $49.44 $111.09 $176.36 10/1/20156000848 BELMONT NURSING HOME 6 6 CHICAGO $12.65 $49.57 $56.10 $118.32 7/1/2014 Eligible for Provisional License as SMHRF6000855 BEMENT HEALTH CARE CENTER 4 4 BEMENT $10.47 $41.46 $79.20 $131.13 10/1/20156005391 BENTON REHAB HEALTH CARE CTR 5 5 BENTON $9.26 $43.31 $65.99 $118.56 10/1/2015 7/1/20146010110 BERKELEY NURSING REHAB CENTER 7 7 OAK PARK $18.15 $55.98 $100.31 $174.44 10/1/2015 7/1/20146000863 BETHALTO CARE 11 11 BETHALTO $9.57 $44.50 $82.42 $136.49 10/1/20156014872 BETHANY REHAB AND HCC 1 1 DEKALB $18.85 $51.52 $79.86 $150.23 10/1/2015 7/1/20146006688 BETHESDA HOME AND RETIREMENT C 6 6 CHICAGO $13.46 $55.98 $88.27 $157.71 10/1/20156000962 BIG MEADOWS INC 1 1 SAVANNA $13.91 $48.57 $72.66 $135.14 10/1/2015 7/1/20146000988 BIRCHWOOD PLAZA INC 6 6 CHICAGO $12.71 $39.49 $91.42 $143.62 10/1/20156000996 BLOOMINGTON REHAB AND HCC 4 4 BLOOMINGTON $9.66 $50.44 $59.17 $119.27 10/1/20156001069 BOURBONNAIS TERRACE NH 9 9 BOURBONNAIS $10.27 $34.73 $52.94 $97.94 7/1/2014 Eligible for Provisional License as SMHRF6001101 BREESE NURSING HOME 11 11 BREESE $10.21 $41.54 $70.93 $122.68 10/1/20156001119 BRENTWOOD NORTH HC REHAB CTR 8 8 RIVERWOODS $13.90 $55.98 $124.06 $193.94 10/1/20156001127 BRENTWOOD SUB ACUTE HEALTHCARE 7 7 BURBANK $19.23 $51.75 $132.84 $203.82 10/1/20156005474 BRIA OF BELLEVILLE 11 11 BELLEVILLE $12.67 $41.92 $102.06 $156.65 10/1/20156007983 BRIA OF CAHOKIA 11 11 CAHOKIA $10.50 $38.76 $87.04 $136.30 10/1/20156007991 BRIA OF CHICAGO HEIGHTS 7 7 S CHICAGO HTS $17.19 $40.26 $105.15 $162.60 10/1/2015 7/1/20146000954 BRIA OF FOREST EDGE 6 6 CHICAGO $11.79 $36.89 $108.63 $157.31 10/1/20156003503 BRIA OF GENEVA 8 8 GENEVA $11.25 $55.98 $115.37 $182.60 10/1/20156010086 BRIA OF PALOS HILLS 7 7 PALOS HILLS $14.88 $45.78 $104.32 $164.98 10/1/2015 7/1/20146001283 BRIA OF RIVER OAKS 7 7 BURNHAM $16.05 $36.83 $96.56 $149.44 10/1/2015 7/1/20146009930 BRIA OF WESTMONT 7 7 WESTMONT $12.58 $44.26 $115.40 $172.24 10/1/20156001143 BRIAR PLACE 7 7 INDIAN HEAD PRK $13.86 $44.40 $70.59 $128.85 10/1/20156001168 BRIDGEVIEW HEALTH CARE CENTER 7 7 BRIDGEVIEW $15.05 $45.78 $110.94 $171.77 10/1/20156000353 BRIDGEWAY SENIOR LIVING 7 7 BENSENVILLE $9.22 $55.98 $97.19 $162.39 10/1/20156001176 BRIGHTVIEW HEALTHCARE REHAB 6 6 CHICAGO $13.86 $52.58 $108.86 $175.30 10/1/20156001689 BRONZEVILLE PARK NSG LIVING CT 6 6 CHICAGO $16.09 $45.18 $89.56 $150.83 10/1/2015 7/1/20146002018 BRYN MAWR CARE INC 6 6 CHICAGO $15.01 $32.48 $55.85 $103.34 7/1/2014 Eligible for Provisional License as SMHRF6001242 BUCKINGHAM PAVILION 6 6 CHICAGO $14.49 $41.32 $85.49 $141.30 10/1/20156001259 BURGESS SQUARE HEALTHCARE CTR 7 7 WESTMONT $11.90 $51.15 $91.38 $154.43 10/1/20156001275 BURGIN MANOR OF OLNEY INC 5 5 OLNEY $11.71 $38.61 $83.47 $133.79 10/1/20156001291 BURNSIDE COMMUNITY HEALTH CTR 4 4 MARSHALL $11.67 $46.84 $72.01 $130.52 10/1/20156001317 CAHOKIA NURSING AND REHAB CTR 11 11 CAHOKIA $14.07 $42.39 $85.77 $142.23 10/1/20156014674 CALHOUN NURSING AND REHAB CTR 3 3 HARDIN $14.40 $39.41 $70.25 $124.06 10/1/20156001333 CALIFORNIA GDNS NUR REHAB CTR 6 6 CHICAGO $14.32 $44.14 $72.84 $131.30 10/1/20156008635 CAMBRIDGE NURSING REHAB CENTER 7 7 SKOKIE $16.85 $50.53 $121.07 $188.45 10/1/20156002489 CAPITOL HLTHCARE AND REHAB CTR 3 3 SPRINGFIELD $9.91 $40.88 $84.29 $135.08 10/1/20156009203 CARBONDALE REHAB AND NRSG CTR 5 5 CARBONDALE $9.04 $42.88 $69.39 $121.31 10/1/20156016166 CARBONDALE REHAB NRSG CTR II 5 5 CARBONDALE $7.38 $41.10 $77.24 $125.72 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6001424 CARE CENTER OF ABINGDON 2 2 ABINGDON $12.34 $43.92 $62.78 $119.04 10/1/2015 7/1/20146009336 CARLINVILLE REHAB AND HLTC 3 3 CARLINVILLE $11.97 $43.24 $78.55 $133.76 10/1/20156001465 CARLTON AT THE LAKE 6 6 CHICAGO $19.28 $50.66 $87.81 $157.75 10/1/20156001473 CARLYLE HEALTHCARE CENTER INC 11 11 CARLYLE $14.18 $44.61 $82.69 $141.48 10/1/2015 7/1/20146001507 CARRIER MILLS NURSING REHAB CT 5 5 CARRIER MILLS $12.50 $40.09 $86.73 $139.32 10/1/20156000970 CASEY HEALTH CARE CENTER 4 4 CASEY $10.20 $48.94 $65.29 $124.43 10/1/20156010227 CASEYVILLE NRSG AND REHAB CTR 11 11 CASEYVILLE $13.23 $40.07 $84.56 $137.86 10/1/20156009948 CEDAR POINTE REHAB AND NURSING 7 7 CICERO $14.84 $39.14 $72.87 $126.85 10/1/20156002869 CEDAR RIDGE HEALTH REHAB CTR 11 11 LEBANON $12.66 $46.71 $91.74 $151.11 10/1/20156001523 CENTER HOME HISPANIC ELDERLY 6 6 CHICAGO $15.60 $54.41 $107.43 $177.44 10/1/20156001564 CENTRAL BAPTIST VILLAGE 7 7 NORRIDGE $16.29 $55.98 $84.93 $157.20 10/1/20156001580 CENTRAL NURSING HOME 6 6 CHICAGO $9.44 $27.73 $96.18 $133.35 10/1/20156001598 CENTRAL PLAZA 6 6 CHICAGO $13.51 $44.74 $66.60 $124.85 7/1/2014 Eligible for Provisional Licen 7/1/20146012355 CENTRALIA MANOR 5 5 CENTRALIA $16.97 $41.30 $89.54 $147.81 10/1/20156008601 CHALET LIVING AND REHAB CENTER 6 6 CHICAGO $15.94 $55.98 $97.83 $169.75 10/1/20156001630 CHAMPAIGN COUNTY NURSING HOME 4 4 URBANA $16.85 $54.84 $68.24 $139.93 10/1/20156001457 CHAMPAIGN URBANA NURSING REHAB 4 4 SAVOY $14.96 $50.44 $74.62 $140.02 10/1/20156001358 CHARLESTON REHAB HEALTH CARE 4 4 CHARLESTON $7.16 $42.27 $79.42 $128.85 10/1/20156010367 CHATEAU NURSING AND REHAB 7 7 WILLOWBROOK $16.27 $51.15 $117.56 $184.98 10/1/2015 7/1/20146008841 CHESTER REHAB AND NURSING CTR 5 5 CHESTER $10.69 $43.38 $64.66 $118.73 10/1/2015 7/1/20146001697 CHICAGO RIDGE NURSING CENTER 7 7 CHICAGO RIDGE $13.89 $36.49 $78.75 $129.13 10/1/20156001739 CHRISTIAN NURSING HOME 3 3 LINCOLN $12.95 $44.38 $76.59 $133.92 10/1/20156001770 CISNE REHAB AND HEALTH CENTER 5 5 CISNE $7.72 $43.93 $114.64 $166.29 10/1/20156016554 CLAREMONT HANOVER PARK 7 7 HANOVER PARK $26.15 $55.98 $120.95 $203.08 10/1/20156014195 CLAREMONT REHAB AND LIVING CTR 8 8 BUFFALO GROVE $18.10 $50.88 $110.97 $179.95 10/1/20156005144 CLARIDGE HEALTHCARE CENTER 8 8 LAKE BLUFF $10.83 $40.10 $112.44 $163.37 10/1/20156001796 CLARK MANOR CONVALESCENT CTR 6 6 CHICAGO $16.68 $40.10 $88.03 $144.81 10/1/20156001838 CLAYBERG FULTON CO N CTR 2 2 CUBA $10.69 $55.63 $79.12 $145.44 10/1/2015 7/1/20146001846 CLAYTON RESIDENTAL HOME 6 6 CHICAGO $14.12 $42.80 $66.18 $123.10 7/1/2014 Eligible for Provisional License as SMHRF6001887 CLINTON MANOR LIVING CENTER 11 11 NEW BADEN $11.34 $45.93 $73.64 $130.91 10/1/20156004469 COBDEN REHAB AND NRSG CENTER 5 5 COBDEN $9.87 $39.73 $60.69 $110.29 10/1/20156007496 COLLINSVILLE REHAB HEALTH CARE 11 11 COLLINSVILLE $11.15 $38.29 $76.48 $125.92 10/1/20156001945 COLONIAL HLTHCARE AND REHAB CT 2 2 PRINCETON $11.17 $46.28 $90.52 $147.97 10/1/20156001952 COLONIAL MANOR 4 4 DANVILLE $16.24 $50.44 $74.98 $141.66 10/1/20156013106 COLUMBIA REHAB AND NURSING CTR 11 11 COLUMBIA $16.05 $46.24 $86.18 $148.47 10/1/20156001994 COLUMBUS MANOR RES CARE HOME 6 6 CHICAGO $9.11 $31.41 $44.46 $84.98 7/1/2014 Eligible for Provisional License as SMHRF6002067 COLUMBUS PARK NURS REHAB CTR 6 6 CHICAGO $17.30 $40.15 $79.61 $137.06 10/1/20156002026 COMMUNITY CARE CENTER 6 6 CHICAGO $11.77 $39.06 $78.73 $129.56 10/1/20156006175 COMMUNITY NRSG AND REHAB CTR 7 7 NAPERVILLE $15.71 $50.90 $116.40 $183.01 10/1/20156016711 CONCORDIA VILLAGE CARE CENTER 3 3 SPRINGFIELD $16.85 $40.28 $107.76 $164.89 10/1/20156002075 CONTINENTAL NURSING REHAB CTR 6 6 CHICAGO $13.34 $50.31 $96.06 $159.71 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6003420 CORNERSTONE REHAB AND HC 2 2 PEORIA HEIGHTS $11.84 $50.44 $69.84 $132.12 10/1/20156015200 COULTERVILLE REHAB AND HCC 5 5 COULTERVILLE $18.18 $43.93 $71.40 $133.51 10/1/20156002141 COUNTRY HEALTH INC 4 4 GIFFORD $26.69 $50.44 $72.73 $149.86 10/1/20156002174 COUNTRYSIDE CARE CENTRE 8 8 AURORA $15.60 $46.13 $107.45 $169.18 10/1/2015 7/1/20146002190 COUNTRYSIDE NRSG AND REHAB CTR 7 7 DOLTON $16.11 $41.83 $100.22 $158.16 10/1/20156005631 COUNTRYVIEW CARE CTR OF MACOMB 2 2 MACOMB $9.68 $47.66 $61.50 $118.84 10/1/2015 7/1/20146003008 COURTYARD HEALTHCARE CENTER 7 7 BERWYN $14.02 $50.15 $100.10 $164.27 10/1/20156001093 COVENANT HEALTH CARE CENTER 7 7 NORTHBROOK $14.88 $55.98 $96.19 $167.05 10/1/20156002208 COVENANT HEALTH CARE CENTER 8 8 BATAVIA $17.23 $55.98 $94.04 $167.25 10/1/20156011373 COVENTRY LIVING CENTER 1 1 STERLING $14.15 $51.52 $87.49 $153.16 10/1/20156002273 CRESTWOOD TERRACE NURSING CTR 7 7 CRESTWOOD $13.11 $35.07 $59.78 $107.96 10/1/20156010136 CROSSROADS CARE CTR WOODSTOCK 8 8 WOODSTOCK $11.80 $48.90 $90.23 $150.93 10/1/20156002299 CRYSTAL PINES REHAB AND HCC 8 8 CRYSTAL LAKE $15.09 $53.62 $99.29 $168.00 10/1/20156002307 CUMBERLAND REHAB HEALTH CARE 4 4 GREENUP $9.41 $44.13 $70.99 $124.53 10/1/20156002364 DANVILLE CARE CENTER LTD 4 4 DANVILLE $10.98 $46.64 $98.12 $155.74 10/1/20156010342 DAYSTAR NURSING AND REHAB CTR 5 5 CAIRO $11.91 $42.46 $79.12 $133.49 10/1/20156007363 DECATUR MANOR HEALTHCARE 4 4 DECATUR $11.85 $33.69 $55.99 $101.53 7/1/2014 Eligible for Provisional License as SMHRF6003081 DECATUR REHAB HEALTH CARE CTR 4 4 DECATUR $10.04 $50.44 $70.97 $131.45 10/1/2015 7/1/20146015630 DEKALB COUNTY REHAB AND NSG 1 1 DEKALB $16.84 $48.93 $81.70 $147.47 10/1/2015 7/1/20146005276 DIXON REHAB AND HCC 1 1 DIXON $10.26 $45.42 $81.77 $137.45 10/1/20156002521 DOBSON PLAZA 7 7 EVANSTON $15.87 $48.15 $105.42 $169.44 10/1/20156002539 DOCTORS NURSING AND REHAB CTR 5 5 SALEM $13.36 $38.22 $108.25 $159.83 10/1/20156002570 DOUGLAS NURSING AND REHAB CTR 4 4 MATTOON $15.09 $44.20 $86.85 $146.14 10/1/20156002612 DUPAGE CONV 7 7 WHEATON $12.98 $66.81 $101.89 $181.68 10/1/20156002943 DUQUOIN NURSING AND REHAB 5 5 DUQUOIN $8.35 $37.19 $91.70 $137.24 10/1/20156003222 EAST BANK CENTER LLC 1 1 LOVES PARK $5.37 $48.05 $112.58 $166.00 10/1/20156007025 EASTSIDE HEALTH CARE CENTER 3 3 PITTSFIELD $10.49 $43.90 $72.62 $127.01 10/1/20156009237 EASTVIEW TERRACE 4 4 SULLIVAN $10.14 $44.46 $71.81 $126.41 10/1/2015 7/1/20146002679 EDEN VILLAGE 11 11 GLEN CARBON $12.09 $44.73 $69.51 $126.33 10/1/20156002729 EDWARDSVILLE NRSNG REHAB CTR 11 11 EDWARDSVILLE $12.27 $42.28 $92.42 $146.97 10/1/20156009559 EFFINGHAM REHAB HEALTH CARE CT 5 5 EFFINGHAM $8.98 $41.70 $66.61 $117.29 10/1/20156002745 EL PASO HEALTH CARE CENTER 2 2 EL PASO $12.05 $45.14 $49.14 $106.33 10/1/20156003248 ELDORADO REHAB AND HEALTHCARE 5 5 ELDORADO $11.85 $30.18 $63.09 $105.12 10/1/20156002810 ELIZABETH NURSING HOME INC 1 1 ELIZABETH $7.07 $44.08 $68.14 $119.29 10/1/20156010144 ELMBROOK NURSING 7 7 ELMHURST $12.90 $50.63 $112.80 $176.33 10/1/20156002828 ELMHURST EXTENDED CARE CENTER 7 7 ELMHURST $11.94 $54.24 $84.86 $151.04 10/1/20156002836 ELMS NURSING HOME 2 2 MACOMB $10.38 $52.79 $76.34 $139.51 10/1/20156008270 ELMWOOD CARE 7 7 ELMWOOD PARK $18.63 $41.81 $127.07 $187.51 10/1/20156005961 ELMWOOD NURSING AND REHAB CTR 11 11 MARYVILLE $13.40 $41.32 $91.16 $145.88 10/1/20156002844 ELMWOOD TERRACE HEALTHCARE CTR 8 8 AURORA $11.11 $51.77 $94.28 $157.16 10/1/20156002851 ELSTON NURSING AND REHAB CENTR 6 6 CHICAGO $14.24 $50.36 $95.63 $160.23 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6005425 ENFIELD REHAB HEALTH CARE 5 5 ENFIELD $8.25 $43.93 $66.76 $118.94 10/1/2015 6004667 ESTATES OF HYDE PARK 6 6 CHICAGO $13.72 $43.56 $70.80 $128.08 10/1/20156002877 EUNICE C SMITH HOME 11 11 ALTON $5.44 $46.71 $91.80 $143.95 10/1/20156002901 EVENGLOW LODGE 4 4 PONTIAC $12.09 $48.31 $85.30 $145.70 10/1/20156002133 EVERGREEN NURSING AND REHAB CT 5 5 EFFINGHAM $10.62 $38.12 $74.58 $123.32 10/1/20156002950 FAIR HAVENS CHRISTIAN HOME 4 4 DECATUR $12.09 $50.22 $74.56 $136.87 10/1/20156002976 FAIR OAKS HEALTH CARE CENTER 8 8 CRYSTAL LAKE $15.55 $55.98 $106.46 $177.99 10/1/20156002984 FAIR OAKS REHAB AND HCC 1 1 SOUTH BELOIT $13.77 $50.75 $82.00 $146.52 10/1/20156003024 FAIRHAVEN CHRISTIAN RET HOME 1 1 ROCKFORD $16.41 $51.52 $73.81 $141.74 10/1/20156001051 FAIRMONT CARE CENTRE 6 6 CHICAGO $16.22 $49.59 $113.33 $179.14 10/1/20156003040 FAIRVIEW HAVEN NURSING HOME 4 4 FAIRBURY $13.93 $50.44 $96.86 $161.23 10/1/20156003099 FAIRVIEW NURSING CENTER 5 5 DUQUOIN $9.40 $36.15 $67.88 $113.43 10/1/20156003107 FAITH CARE CENTER 11 11 HIGHLAND $16.84 $46.44 $77.92 $141.20 10/1/20156004824 FARMER CITY REHAB AND HC 4 4 FARMER CITY $10.73 $47.43 $68.79 $126.95 10/1/20156003115 FARMINGTON COUNTRY MANOR 2 2 FARMINGTON $12.37 $49.24 $73.67 $135.28 10/1/2015 7/1/20146003123 FAYETTE COUNTY HOSPITAL NH 5 5 VANDALIA $6.15 $43.93 $61.98 $112.06 10/1/20156001614 FIRESIDE HOUSE OF CENTRALIA 5 5 CENTRALIA $10.38 $40.52 $69.05 $119.95 10/1/20156000939 FLANAGAN REHAB HEALTH CARE 4 4 FLANAGAN $10.95 $50.44 $72.21 $133.60 10/1/20156003172 FLORA GARDENS CARE CENTER 5 5 FLORA $10.68 $41.19 $77.28 $129.15 10/1/2015 7/1/20146003156 FLORA REHAB HEALTH CARE CTR 5 5 FLORA $11.82 $43.93 $75.78 $131.53 10/1/2015 7/1/20146003180 FLORENCE NURSING HOME 8 8 MARENGO $12.61 $49.25 $86.67 $148.53 10/1/2015 7/1/20146003198 FONDULAC REHAB HEALTH CARE CTR 2 2 EAST PEORIA $12.22 $50.44 $72.76 $135.42 10/1/20156001135 FOREST CITY REHAB AND NRSG CTR 1 1 ROCKFORD $12.58 $35.60 $73.47 $121.65 10/1/20156000483 FOREST VIEW REHAB NURSING CTR 7 7 ITASCA $14.27 $47.27 $118.17 $179.71 10/1/20156000137 FOSTER HEALTH AND REHAB CENTER 6 6 CHICAGO $14.85 $47.14 $125.65 $187.64 10/1/2015 7/1/20146012413 FRANCISCAN VILLAGE 7 7 LEMONT $13.46 $55.98 $88.38 $157.82 10/1/20156003289 FRANKFORT HEALTHCARE REHAB CTR 5 5 WEST FRANKFORT $8.80 $40.24 $70.82 $119.86 10/1/20156003297 FRANKFORT TERRACE NURSING CTR 9 9 FRANKFORT $10.80 $38.53 $70.99 $120.32 10/1/20156003305 FRANKLIN GROVE LIVING REHAB 1 1 FRANKLIN GROVE $11.11 $46.91 $80.03 $138.05 10/1/20156003321 FREEBURG CARE CENTER INC 11 11 FREEBURG $10.77 $36.01 $76.50 $123.28 10/1/20156003388 FRIENDSHIP MANOR 10 10 ROCK ISLAND $13.83 $50.35 $68.52 $132.70 10/1/2015 7/1/20146015895 FRIENDSHIP MANOR HEALTH CARE 5 5 NASHVILLE $10.06 $38.41 $80.38 $128.85 10/1/20156005979 FRIENDSHIP SKILLED NSG REHAB 3 3 CARLINVILLE $10.32 $44.49 $78.38 $133.19 10/1/20156003404 FRIENDSHIP VILLAGE 7 7 SCHAUMBURG $16.97 $55.98 $120.48 $193.43 10/1/2015 7/1/20146003438 GALENA STAUSS NURSING HOME 1 1 GALENA $7.78 $51.11 $67.48 $126.37 10/1/20156009567 GARDENVIEW MANOR 4 4 DANVILLE $8.21 $37.42 $78.91 $124.54 10/1/20156006837 GENERATIONS HCN AT OAKTON PAV 7 7 DES PLAINES $16.40 $39.50 $111.79 $167.69 10/1/20156006076 GENESIS SENIOR LIVING ALEDO 10 10 ALEDO $12.09 $47.02 $66.94 $126.05 10/1/20156003552 GIBSON COMMUNITY HOSPITAL ANNE 4 4 GIBSON CITY $15.97 $50.44 $61.99 $128.40 10/1/20156003578 GILMAN HEALTHCARE CENTER 4 4 GILMAN $13.97 $44.51 $82.79 $141.27 10/1/20156006191 GLEN BRIDGE NURSING AND REHAB 7 7 NILES $15.26 $45.95 $109.74 $170.95 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building 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 $80.37 $139.20 10/1/20156008833 GLEN SAINT ANDREW LIVING COMM 7 7 NILES $8.74 $55.98 $100.19 $164.91 10/1/20156003610 GLEN VIEW TERRACE NURSING CTR 7 7 GLENVIEW $18.90 $53.28 $115.57 $187.75 10/1/20156003594 GLENCREST HLTHCR AND REHAB CTR 6 6 CHICAGO $15.75 $49.38 $135.84 $200.97 10/1/20156006647 GLENLAKE TERRACE NURSING REHAB 8 8 WAUKEGAN $11.79 $42.52 $107.77 $162.08 10/1/20156007918 GLENSHIRE NURSING REHAB CENTRE 7 7 RICHTON PARK $18.34 $51.25 $118.32 $187.91 10/1/20156003628 GLENWOOD HEALTHCARE AND REHAB 7 7 GLENWOOD $16.72 $48.77 $123.18 $188.67 10/1/20156003636 GOLDEN GOOD SHEPHERD HOME 3 3 GOLDEN $10.43 $43.06 $66.12 $119.61 10/1/20156007637 GOOD SAM PROPHETS RIVERVIEW 1 1 PROPHETSTOWN $12.52 $51.52 $78.88 $142.92 10/1/20156003495 GOOD SAM SOC GENESEO VILLAGE 10 10 GENESEO $14.24 $48.44 $67.95 $130.63 10/1/20156001515 GOOD SAM SOCIETY MT CARROLL 1 1 MT CARROLL $14.24 $48.25 $74.52 $137.01 10/1/20156003677 GOOD SAMARITAN FLANAGAN 4 4 FLANAGAN $12.09 $50.44 $69.57 $132.10 10/1/20156003685 GOOD SAMARITAN HOME OF QUINCY 3 3 QUINCY $16.84 $44.49 $68.36 $129.69 10/1/20156005573 GOOD SAMARITAN PONTIAC 4 4 PONTIAC $10.80 $49.55 $69.54 $129.89 10/1/20156003727 GOTTLIEB MEMORIAL HOSPITAL 7 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 $80.17 $138.83 10/1/20156001986 GRANITE NURSING AND REHAB CTR 11 11 GRANITE CITY $17.95 $38.49 $76.96 $133.40 10/1/20156003776 GRASMERE PLACE 6 6 CHICAGO $12.38 $37.00 $53.51 $102.89 7/1/2014 Eligible for Provisional Licen 7/1/20146015499 GREEK AMERICAN REHAB CARE CTR 7 7 WHEELING $17.26 $53.43 $104.35 $175.04 10/1/20156016570 GREENFIELDS OF GENEVA 8 8 GENEVA $18.18 $55.98 $90.20 $164.36 7/1/20146000202 GREENWOOD CARE 7 7 EVANSTON $15.65 $39.53 $55.16 $110.34 7/1/2014 Eligible for Provisional License as SMHRF6003511 GROSSE POINTE MANOR 7 7 NILES $19.37 $51.62 $101.85 $172.84 10/1/20156008593 GROVE AT THE LAKE LIVING REHAB 8 8 ZION $15.38 $49.89 $101.34 $166.61 10/1/20156005516 GROVE LINCOLN PARK LIV AND REH 6 6 CHICAGO $14.70 $44.99 $125.58 $185.27 10/1/20156008916 GROVE OF EVANSTON 7 7 EVANSTON $17.94 $55.98 $135.63 $209.55 10/1/20156000574 GROVE OF FOX VALLEY 8 8 AURORA $15.74 $44.74 $106.30 $166.78 10/1/20156003057 GROVE OF LAGRANGE PARK 7 7 LAGRANGE PARK $18.50 $52.81 $115.83 $187.14 10/1/2015 7/1/20146003412 GROVE OF NORTHBROOK L AND R 7 7 NORTHBROOK $16.72 $50.77 $104.72 $172.21 10/1/20156009625 GROVE OF SKOKIE LIV AND REHAB 7 7 SKOKIE $16.39 $47.36 $115.75 $179.50 10/1/2015 6003933 HALLMARK HOUSE NURSING CENTER 2 2 PEKIN $13.16 $49.37 $79.44 $141.97 10/1/20156003974 HAMILTON MEM REHAB AND HCC 5 5 MCLEANSBORO $13.26 $43.93 $71.37 $128.56 10/1/20156004006 HAMMOND HENRY DISTRICT HOSPITA 10 10 GENESEO $16.84 $53.08 $66.98 $136.90 10/1/20156004048 HARBOR CREST HOME INC 1 1 FULTON $5.80 $47.43 $57.39 $110.62 10/1/20156013684 HARMONY NURSING AND REHAB CTR 6 6 CHICAGO $20.50 $51.74 $113.27 $185.51 10/1/20156004089 HAVANA HEALTH CARE CENTER 3 3 HAVANA $12.00 $41.19 $78.70 $131.89 10/1/20156015317 HAWTHORNE INN OF DANVILLE 4 4 DANVILLE $15.75 $41.96 $84.17 $141.88 10/1/20156009310 HEARTHSTONE MANOR 8 8 WOODSTOCK $14.54 $55.98 $81.46 $151.98 10/1/2015 7/1/20146013437 HEARTLAND CHRISTIAN VILLAGE 4 4 NEOGA $14.24 $46.85 $81.14 $142.23 10/1/20156004121 HEARTLAND MANOR INC 4 4 CASEY $10.83 $49.76 $68.02 $128.61 10/1/20156011597 HEARTLAND OF CANTON 2 2 CANTON $14.56 $49.02 $80.08 $143.66 10/1/20156000301 HEARTLAND OF CHAMPAIGN 4 4 CHAMPAIGN $11.11 $50.44 $87.14 $148.69 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building 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 $85.03 $148.29 10/1/20156003446 HEARTLAND OF GALESBURG 2 2 GALESBURG $17.02 $50.44 $79.33 $146.79 10/1/20156011613 HEARTLAND OF HENRY 2 2 HENRY $14.85 $48.47 $77.05 $140.37 10/1/20156005649 HEARTLAND OF MACOMB 2 2 MACOMB $15.73 $50.44 $79.14 $145.31 10/1/20156006233 HEARTLAND OF MOLINE 10 10 MOLINE $14.50 $48.19 $91.91 $154.60 10/1/20156000244 HEARTLAND OF NORMAL 4 4 NORMAL $14.04 $50.44 $86.90 $151.38 10/1/20156011571 HEARTLAND OF PAXTON 4 4 PAXTON $16.13 $49.50 $78.50 $144.13 10/1/20156000293 HEARTLAND OF PEORIA 2 2 PEORIA $14.35 $49.03 $77.38 $140.76 10/1/20156008056 HEARTLAND OF RIVERVIEW 2 2 EAST PEORIA $16.76 $50.44 $95.67 $162.87 10/1/20156004139 HEATHER HEALTH CARE CENTER 7 7 HARVEY $16.52 $49.69 $77.26 $143.47 10/1/20156000814 HEDDINGTON OAKS 2 2 WEST PEORIA $16.84 $50.22 $68.60 $135.66 10/1/2015 9/25/20136004147 HEIGHTS HLTHCARE AND REHAB CTR 2 2 PEORIA HEIGHTS $9.54 $48.20 $76.34 $134.08 10/1/20156006704 HELIA HEALTHCARE OF BELLEVILLE 11 11 BELLEVILLE $9.81 $46.71 $108.67 $165.19 10/1/20156016091 HELIA HEALTHCARE OF BENTON 5 5 BENTON $3.66 $43.93 $70.96 $118.55 10/1/20156003800 HELIA HEALTHCARE OF CHAMPAIGN 4 4 CHAMPAIGN $9.27 $44.00 $69.01 $122.28 10/1/20156005870 HELIA HEALTHCARE OF ENERGY 5 5 ENERGY $7.78 $36.52 $76.20 $120.50 10/1/20156004493 HELIA HEALTHCARE OF GREENVILLE 5 11 GREENVILLE $5.08 $44.33 $69.10 $118.51 10/1/20156006910 HELIA HEALTHCARE OF OLNEY 5 5 OLNEY $9.36 $26.23 $73.89 $109.48 10/1/20156003255 HELIA SOUTHBELT HEALTHCARE 11 11 BELLEVILLE $11.59 $43.65 $77.69 $132.93 10/1/20156012066 HENDERSON CO RETIREMENT CENTER 2 2 STRONGHURST $12.85 $45.59 $65.78 $124.22 10/1/20156003917 HENRY AND JANE VONDERLIETH CTR 3 3 MT PULASKI $11.67 $44.49 $72.81 $128.97 10/1/20156000756 HERITAGE HEALTH 3 3 JACKSONVILLE $13.79 $44.49 $77.57 $135.85 10/1/20156000780 HERITAGE HEALTH BEARDSTOWN 3 3 BEARDSTOWN $11.88 $44.49 $79.23 $135.60 10/1/20156004261 HERITAGE HEALTH BLOOMINGTON 4 4 BLOOMINGTON $18.46 $50.44 $75.20 $144.10 10/1/20156000723 HERITAGE HEALTH CARLINVILLE 3 3 CARLINVILLE $12.89 $43.01 $67.48 $123.38 10/1/20156007199 HERITAGE HEALTH CHILLICOTHE 2 2 CHILLICOTHE $12.60 $50.41 $74.94 $137.95 10/1/2015 6002083 HERITAGE HEALTH DWIGHT 4 4 DWIGHT $15.32 $50.32 $71.26 $136.90 10/1/20156005920 HERITAGE HEALTH EL PASO 2 2 EL PASO $16.72 $50.44 $79.03 $146.19 10/1/20156006902 HERITAGE HEALTH ELGIN 8 8 ELGIN $14.27 $55.33 $110.81 $180.41 10/1/2015 7/1/20146003560 HERITAGE HEALTH GIBSON CITY 4 4 GIBSON CITY $12.89 $50.40 $64.48 $127.77 10/1/20156000681 HERITAGE HEALTH GILLESPIE 3 3 GILLESPIE $12.41 $43.33 $67.01 $122.75 10/1/20156004592 HERITAGE HEALTH HOOPESTON 4 4 HOOPESTON $17.99 $47.75 $67.55 $133.29 10/1/20156001440 HERITAGE HEALTH LASALLE 2 2 LA SALLE $11.36 $43.96 $81.42 $136.74 10/1/2015 7/1/20146000699 HERITAGE HEALTH LITCHFIELD 3 3 LITCHFIELD $13.64 $44.41 $85.18 $143.23 10/1/20156004253 HERITAGE HEALTH MENDOTA 2 2 MENDOTA $11.94 $50.01 $75.58 $137.53 10/1/20156005367 HERITAGE HEALTH MINONK 2 2 MINONK $14.96 $50.44 $87.18 $152.58 10/1/20156010128 HERITAGE HEALTH MOUNT ZION 4 4 MOUNT ZION $16.56 $49.83 $62.75 $129.14 10/1/20156004287 HERITAGE HEALTH MT STERLING 3 3 MOUNT STERLING $12.22 $44.49 $70.74 $127.45 10/1/20156008510 HERITAGE HEALTH NORMAL 4 4 NORMAL $16.29 $49.94 $80.68 $146.91 10/1/20156000707 HERITAGE HEALTH PANA 3 3 PANA $13.23 $41.85 $77.84 $132.92 10/1/20156004303 HERITAGE HEALTH PERU 2 2 PERU $15.13 $48.38 $91.21 $154.72 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building 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 $71.99 $129.33 10/1/20156004279 HERITAGE HEALTH SPRINGFIELD 3 3 SPRINGFIELD $14.65 $44.49 $80.53 $139.67 10/1/20156000715 HERITAGE HEALTH STAUNTON 3 3 STAUNTON $12.01 $44.49 $83.44 $139.94 10/1/2015 7/1/20146004311 HERITAGE HEALTH STREATOR 2 2 STREATOR $15.89 $49.16 $77.67 $142.72 10/1/20156004337 HERITAGE SQUARE 1 1 DIXON $9.07 $50.53 $91.99 $151.59 10/1/20156003362 HERRIN REHAB AND NRSG CENTER 5 5 HERRIN $8.46 $37.53 $64.97 $110.96 10/1/2015 7/1/20146004352 HICKORY NURSING PAVILION INC 7 7 HICKORY HILLS $15.52 $49.25 $73.97 $138.74 10/1/20156016687 HICKORY POINT CHRISTIAN VILL 4 4 FORSYTH $16.85 $46.11 $120.55 $183.51 10/1/20156001663 HIGHLAND HEALTH CARE CENTER 11 11 HIGHLAND $9.69 $46.52 $81.86 $138.07 10/1/20156000392 HIGHLAND OAKS 8 8 ELGIN $14.39 $55.98 $87.60 $157.97 10/1/20156004402 HILLCREST HOME 10 10 GENESEO $14.69 $46.04 $72.22 $132.95 10/1/20156004410 HILLCREST RETIREMENT VILG LTD 8 8 ROUND LAKE $12.53 $46.74 $91.63 $150.90 10/1/2015 7/1/20146004428 HILLSBORO REHAB AND HLTC 3 3 HILLSBORO $11.14 $42.63 $71.78 $125.55 10/1/20156004451 HILLSIDE REHAB AND CARE CENTER 9 9 YORKVILLE $6.68 $47.72 $85.76 $140.16 10/1/20156004477 HILLTOP SKILLED NURSING REHAB 4 4 CHARLESTON $11.49 $35.29 $84.33 $131.11 10/1/20156004485 HILLVIEW HEALTH CARE CENTER 5 5 VIENNA $8.72 $37.65 $61.98 $108.35 10/1/20156004501 HITZ MEMORIAL HOME 11 11 ALHAMBRA $11.23 $46.71 $80.95 $138.89 10/1/20156004550 HOLY FAMILY VILLA 7 7 PALOS PARK $18.18 $55.98 $69.06 $143.22 10/1/20156006761 HOPE CREEK CARE CENTER 10 10 EAST MOLINE $16.85 $50.35 $67.92 $135.12 10/1/20156004212 ILLINI HERITAGE REHAB AND HC 4 4 CHAMPAIGN $9.69 $41.99 $68.92 $120.60 10/1/20156013023 ILLINI RESTORATIVE CARE 10 10 SILVIS $15.55 $51.52 $68.81 $135.88 10/1/20156004675 ILLINOIS KNIGHTS TEMPLAR HOME 4 4 PAXTON $11.67 $50.44 $73.86 $135.97 10/1/20156012579 IMBODEN CREEK LIVING CENTER 4 4 DECATUR $15.52 $50.44 $63.22 $129.18 10/1/20156004733 IMPERIAL GROVE PAVILION 6 6 CHICAGO $17.73 $53.60 $107.69 $179.02 10/1/20156001028 INTEGRITY HC OF GODFREY 11 11 GODFREY $12.12 $46.71 $112.12 $170.95 10/1/20156007116 INTEGRITY HC OF SMITHTON 11 11 SMITHTON $10.57 $46.71 $60.10 $117.38 10/1/20156009534 INTEGRITY HC OF WOOD RIVER 11 11 WOOD RIVER $14.15 $46.71 $75.48 $136.34 10/1/2015 7/1/20146004790 IROQUOIS RESIDENT HOME 4 4 WATSEKA $11.67 $50.44 $92.60 $154.71 10/1/20156004832 JACKSON SQ NURSING REHAB CTR 6 6 CHICAGO $16.82 $48.78 $101.79 $167.39 10/1/2015 7/1/20146004840 JACKSONVILLE SKILLED NRSG REH 3 3 JACKSONVILLE $11.08 $38.22 $86.69 $135.99 10/1/20156004899 JENNINGS TERRACE 8 8 AURORA $9.69 $45.20 $77.60 $132.49 10/1/20156013312 JERSEYVILLE MANOR 3 3 JERSEYVILLE $16.12 $40.75 $80.99 $137.86 10/1/20156004907 JERSEYVILLE NSG AND REHAB CTR 3 3 JERSEYVILLE $16.22 $43.79 $85.68 $145.69 10/1/20156004964 JOLIET TERRACE NURSING CTR 9 9 JOLIET $10.57 $37.90 $60.40 $108.87 10/1/20156005433 JONESBORO REHAB HEALTH CARE 5 5 JONESBORO $9.58 $43.92 $77.35 $130.85 10/1/20156004972 KANKAKEE TERRACE NURSING CTR 9 9 BOURBONNAIS $12.04 $38.02 $57.85 $107.91 7/1/2014 Eligible for Provisional License as SMHRF6006126 KENSINGTON PLACE NRSG REHAB 6 6 CHICAGO $14.06 $45.30 $99.66 $159.02 10/1/20156005011 KEWANEE CARE HOME 10 10 KEWANEE $12.85 $44.88 $75.17 $132.90 10/1/20156005060 KNOX COUNTY NURSING HOME 2 2 KNOXVILLE $14.24 $51.77 $76.00 $142.01 10/1/20156005128 LAHARPE DAVIER HEALTH CARE 3 3 LA HARPE $9.69 $44.23 $78.28 $132.20 10/1/20156009807 LAKE PARK CENTER 8 8 WAUKEGAN $9.38 $32.88 $56.94 $99.20 7/1/2014 Eligible for Provisional License 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 10-01-2015Building 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 $108.53 $172.33 10/1/2015 7/1/20146005169 LAKEFRONT NURSING REHAB CTR 6 6 CHICAGO $13.50 $47.53 $90.07 $151.10 10/1/20156005185 LAKELAND REHAB AND HCC 5 5 EFFINGHAM $11.81 $42.62 $76.64 $131.07 10/1/20156005227 LAKEVIEW REHAB NURSING CENTER 6 6 CHICAGO $13.51 $54.89 $129.42 $197.82 10/1/20156005235 LAKEWOOD NURSING AND REHAB CTR 9 9 PLAINFIELD $18.85 $49.99 $115.41 $184.25 10/1/20156005250 LASALLE COUNTY NURSING HOME 2 2 OTTAWA $12.09 $54.60 $72.69 $139.38 10/1/20156001044 LEBANON CARE CENTER 11 11 LEBANON $11.01 $37.58 $73.23 $121.82 10/1/20156005284 LEE MANOR NURSING HM 7 7 DES PLAINES $16.88 $44.33 $120.30 $181.51 10/1/20156014492 LEMONT NURSING AND REHAB CTR 7 7 LEMONT $21.17 $50.59 $117.46 $189.22 10/1/20156005292 LENA LIVING CENTER 1 1 LENA $7.64 $47.56 $70.64 $125.84 10/1/2015 6012157 LEROY MANOR 4 4 LEROY $15.43 $45.75 $75.25 $136.43 10/1/20156005300 LEWIS MEMORIAL 3 3 SPRINGFIELD $11.23 $44.49 $83.33 $139.05 10/1/20156011993 LEXINGTON HEALTH CARE CENTER 7 7 BLOOMINGDALE $18.25 $51.26 $102.66 $172.17 10/1/20156005318 LEXINGTON HEALTH CARE CTR INC 7 7 LOMBARD $15.73 $49.10 $109.04 $173.87 10/1/20156012967 LEXINGTON OF CHICAGO RIDGE 7 7 CHICAGO RIDGE $21.14 $48.71 $109.37 $179.22 10/1/20156013098 LEXINGTON OF ELMHURST 7 7 ELMHURST $17.03 $51.93 $111.74 $180.70 10/1/20156013361 LEXINGTON OF LAGRANGE 7 7 LAGRANGE $23.21 $53.46 $117.90 $194.57 10/1/20156014138 LEXINGTON OF LAKE ZURICH 8 8 LAKE ZURICH $17.94 $50.32 $103.35 $171.61 10/1/20156014682 LEXINGTON OF ORLAND PARK 7 7 ORLAND PARK $21.06 $47.43 $105.81 $174.30 10/1/20156012553 LEXINGTON OF SCHAUMBURG 7 7 SCHAUMBURG $21.18 $49.62 $100.35 $171.15 10/1/20156012975 LEXINGTON OF STREAMWOOD 7 7 STREAMWOOD $21.20 $50.66 $108.07 $179.93 10/1/20156014369 LEXINGTON OF WHEELING 7 7 WHEELING $20.99 $50.62 $100.84 $172.45 10/1/20156005359 LIBERTYVILLE MANOR EXT CARE 8 8 LIBERTYVILLE $12.08 $55.55 $58.60 $126.23 10/1/20156005375 LIEBERMAN CENTER FOR HEALTH 7 7 SKOKIE $14.88 $56.24 $98.30 $169.42 10/1/2015 7/1/20146005563 LITTLE SISTERS OF THE POOR 6 6 CHICAGO $10.11 $55.98 $77.97 $144.06 10/1/20156005599 LUTHERAN CARE CTR 5 5 ALTAMONT $12.16 $43.93 $70.87 $126.96 10/1/20156005607 LUTHERAN HOME FOR THE AGED 7 7 ARLINGTON HGTS $18.18 $55.98 $79.37 $153.53 10/1/2015 7/1/20146005615 LUTHERAN HOME INC 2 2 PEORIA $12.52 $50.44 $58.17 $121.13 10/1/20156005623 LYDIA HEALTHCARE 7 7 ROBBINS $15.40 $38.27 $57.09 $110.76 7/1/2014 Eligible for Provisional License as SMHRF6016885 MANOR COURT OF CARBONDALE 5 5 CARBONDALE $16.84 $38.89 $78.78 $134.51 10/1/20156015879 MANOR COURT OF CLINTON 4 4 CLINTON $17.98 $46.11 $79.38 $143.47 10/1/20156016133 MANOR COURT OF FREEPORT 1 1 FREEPORT $17.96 $51.52 $79.36 $148.84 10/1/20156013189 MANOR COURT OF MARYVILLE 11 11 MARYVILLE $13.47 $44.96 $88.87 $147.30 10/1/20156016190 MANOR COURT OF PEORIA 2 2 PEORIA $20.79 $46.11 $84.07 $150.97 10/1/20156015887 MANOR COURT OF PERU 2 2 PERU $17.87 $46.11 $81.63 $145.61 10/1/20156015861 MANOR COURT OF PRINCETON 2 2 PRINCTON $16.81 $46.11 $78.51 $141.43 10/1/2015 6000228 MANORCARE OF ARLINGTON HEIGHTS 7 7 ARLINGTON HTS $18.32 $55.98 $105.02 $179.32 10/1/20156000277 MANORCARE OF ELGIN 8 8 ELGIN $16.04 $55.98 $91.21 $163.23 10/1/20156012686 MANORCARE OF ELK GROVE VILLAGE 7 7 ELK GROVE VLG $21.58 $53.57 $104.62 $179.77 10/1/20156006332 MANORCARE OF HINSDALE 7 7 HINSDALE $11.08 $55.98 $94.42 $161.48 10/1/20156012611 MANORCARE OF HOMEWOOD 7 7 HOMEWOOD $21.11 $53.81 $112.19 $187.11 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building 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 $102.79 $165.57 10/1/20156010482 MANORCARE OF LIBERTYVILLE 8 8 LIBERTYVILLE $16.43 $55.40 $105.69 $177.52 10/1/20156000251 MANORCARE OF NAPERVILLE 7 7 NAPERVILLE $14.95 $55.98 $109.12 $180.05 10/1/20156015168 MANORCARE OF NORTHBROOK 7 7 NORTHBROOK $21.70 $53.30 $102.61 $177.61 10/1/20156000236 MANORCARE OF OAK LAWN EAST 7 7 OAK LAWN $19.76 $54.32 $110.15 $184.23 10/1/20156000343 MANORCARE OF OAK LAWN WEST 7 7 OAK LAWN $17.75 $55.08 $111.22 $184.05 10/1/20156010912 MANORCARE OF PALOS HTS EAST 7 7 PALOS HEIGHTS $21.54 $53.48 $105.08 $180.10 10/1/20156014534 MANORCARE OF PALOS HTS WEST 7 7 PALOS HEIGHTS $23.37 $55.98 $106.76 $186.11 10/1/20156000327 MANORCARE OF ROLLING MEADOWS 7 7 ROLLING MEADOWS $19.67 $52.27 $96.64 $168.58 10/1/20156011589 MANORCARE OF SOUTH HOLLAND 7 7 SOUTH HOLLAND $21.20 $54.26 $109.74 $185.20 10/1/20156000335 MANORCARE OF WESTMONT 7 7 WESTMONT $17.31 $55.98 $98.00 $171.29 10/1/20156006563 MANORCARE OF WILMETTE 7 7 WILMETTE $18.26 $55.98 $94.58 $168.82 10/1/20156005706 MAPLE CREST CARE CENTRE 1 1 BELVIDERE $13.70 $46.96 $106.01 $166.67 10/1/2015 7/1/20146005722 MAPLE LAWN HEALTH CENTER 2 2 EUREKA $12.09 $50.44 $65.51 $128.04 10/1/20156005748 MAR KA NURSING HOME 11 11 MASCOUTAH $10.11 $43.42 $79.79 $133.32 10/1/20156005755 MARGARET MANOR 6 6 CHICAGO $12.48 $49.03 $45.45 $106.96 7/1/2014 Eligible for Provisional License as SMHRF6005763 MARGARET MANOR NORTH 6 6 CHICAGO $11.04 $42.94 $54.24 $108.22 7/1/2014 Eligible for Provisional License as SMHRF6005797 MARIGOLD REHABILITATION HCC 2 2 GALESBURG $11.91 $46.74 $59.19 $117.84 10/1/20156003230 MARION REHAB AND NRSG CENTER 5 5 MARION $15.03 $41.60 $84.78 $141.41 10/1/20156011688 MASON CITY AREA NURSING HOME 3 3 MASON CITY $12.52 $44.49 $68.54 $125.55 10/1/20156004691 MASON POINT 4 4 SULLIVAN $9.37 $50.44 $64.08 $123.89 10/1/20156005888 MATTOON REHAB AND HCC 4 4 MATTOON $10.99 $48.76 $72.97 $132.72 10/1/20156005896 MAYFIELD CARE CENTER INC 6 6 CHICAGO $12.21 $49.50 $104.40 $166.11 10/1/20156005904 MCALLISTER NURSING AND REHAB 7 7 TINLEY PARK $18.03 $54.05 $100.36 $172.44 10/1/20156005938 MCKINLEY COURT 4 4 DECATUR $14.32 $47.72 $95.59 $157.63 10/1/2015 7/1/20146005946 MCLEAN COUNTY NURSING HOME 4 4 NORMAL $9.51 $54.49 $63.29 $127.29 10/1/20156005417 MCLEANSBORO REHAB HEALTH CARE 5 5 MCLEANSBORO $9.24 $43.93 $78.58 $131.75 10/1/20156005953 MEADOW MANOR SKILLED NRSG REH 3 3 TAYLORVILLE $10.26 $39.30 $84.46 $134.02 10/1/20156013120 MEADOWBROOK MANOR 9 9 BOLINGBROOK $17.07 $46.15 $116.01 $179.23 10/1/20156014518 MEADOWBROOK MANOR NAPERVILLE 7 7 NAPERVILLE $18.61 $48.91 $106.21 $173.73 10/1/20156016281 MEADOWBROOK MANOR OF LAGRANGE 7 7 LA GRANGE $16.22 $44.69 $115.10 $176.01 10/1/20156005987 MEADOWOOD 5 5 GRAYVILLE $9.03 $28.31 $62.13 $99.47 10/1/20156006001 MEADOWS MENNONITE 4 4 CHENOA $13.40 $49.26 $80.64 $143.30 10/1/20156006019 MEDINA NURSING CENTER INC 1 1 DURAND $14.27 $48.91 $84.52 $147.70 10/1/20156006035 MEMORIAL CARE CENTER 11 11 BELLEVILLE $6.15 $46.71 $109.22 $162.08 10/1/20156006050 MENDOTA LUTHERAN HOME 2 2 MENDOTA $12.09 $49.20 $77.23 $138.52 10/1/20156016737 MERCY CIRCLE 6 6 CHICAGO $18.18 $45.20 $111.98 $175.36 10/1/20156015697 MERCY HARVARD HOSPITAL CR CTR 8 8 HARVARD $10.15 $55.98 $74.54 $140.67 10/1/20156015812 MERIDIAN VILLAGE CARE CENTER 11 11 GLEN CARBON $16.85 $46.71 $78.53 $142.09 10/1/20156006118 METROPOLIS REHAB AND HCC 5 5 METROPOLIS $16.62 $43.74 $68.38 $128.74 10/1/20156006134 MID AMERICA CARE CENTER 6 6 CHICAGO $15.40 $47.51 $86.89 $149.80 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building 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 $106.34 $160.61 10/1/20156001341 MIDWEST REHAB AND RESPIRATORY 11 11 BELLEVILLE $11.34 $44.45 $83.10 $138.89 10/1/2015 7/1/20146014294 MILLER HEALTHCARE CENTER 9 9 KANKAKEE $18.18 $49.74 $106.84 $174.76 10/1/20156006258 MOMENCE MEADOWS NURSING AND RE 9 9 MOMENCE $13.27 $50.62 $113.22 $177.11 10/1/20156006266 MONMOUTH NURSING HOME 2 2 MONMOUTH $12.52 $46.60 $66.85 $125.97 10/1/20156006290 MONROE PAVILION HEALTH CENTER 6 6 CHICAGO $12.63 $41.79 $52.34 $106.76 7/1/2014 Eligible for Provisional License as SMHRF6006316 MONTEBELLO HEALTH CARE CENTER 3 3 HAMILTON $9.52 $38.57 $76.05 $124.14 10/1/2015 7/1/20146004444 MONTGOMERY NURSING AND REHAB 3 3 HILLSBORO $11.19 $42.47 $70.05 $123.71 10/1/20156013171 MONTGOMERY PLACE 6 6 CHICAGO $14.39 $55.98 $41.29 $111.66 10/1/20156005698 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 $77.18 $134.14 7/1/20156006407 MORTON TERRACE H AND R CENTRE 2 2 MORTON $11.73 $40.00 $82.82 $134.55 10/1/20156006399 MORTON VILLA HLTH AND REH CTR 2 2 MORTON $11.23 $38.85 $87.24 $137.32 10/1/20156012322 MOWEAQUA NRSG AND RETIREMENT 4 4 MOWEAQUA $12.66 $38.65 $76.38 $127.69 10/1/20156012512 MT VERNON COUNTRYSIDE MANOR 5 5 MT VERNON $14.89 $41.16 $78.01 $134.06 10/1/20156001531 MT VERNON HEALTH CARE CENTER 5 5 MOUNT VERNON $8.92 $36.80 $71.78 $117.50 10/1/20156010904 NATHAN HEALTH CARE CENTER 11 11 EAST ST LOUIS $14.20 $41.10 $64.68 $119.98 10/1/20156006498 NATURE TRAIL HEALTH CARE CTR 5 5 MOUNT VERNON $10.03 $43.93 $93.52 $147.48 10/1/2015 7/1/20146006506 NAZARETHVILLE RETIREMENT HOME 7 7 DES PLAINES $11.10 $55.98 $76.37 $143.45 10/1/20156006514 NEIGHBORS REHABILITATION CNTR 1 1 BYRON $11.58 $48.47 $84.32 $144.37 10/1/2015 6006522 NEW ATHENS HOME FOR THE AGED 11 11 NEW ATHENS $9.94 $44.26 $87.28 $141.48 10/1/20156002091 NEWMAN REHAB HEALTH CARE CTR 4 4 NEWMAN $8.59 $49.18 $87.90 $145.67 10/1/2015 6006548 NEWTON REST HAVEN 5 5 NEWTON $6.40 $41.39 $64.82 $112.61 10/1/20156003644 NILES NURSING AND REHAB CTR 7 7 NILES $16.56 $47.23 $107.21 $171.00 10/1/20156006555 NOKOMIS REHAB HEALTH CARE CTR 3 3 NOKOMIS $11.41 $37.88 $73.25 $122.54 10/1/20156006571 NORRIDGE GARDENS 7 7 NORRIDGE $16.53 $47.35 $108.05 $171.93 10/1/20156006589 NORTH ADAMS HOME INC 3 3 MENDON $12.95 $40.30 $67.98 $121.23 10/1/20156006605 NORTH AURORA CARE CENTER 8 8 NORTH AURORA $10.64 $49.29 $59.97 $119.90 10/1/2015 6000210 NORTH LOGAN HEALTHCARE CENTER 4 4 DANVILLE $9.40 $40.03 $92.04 $141.47 10/1/20156006670 NORTHWOODS CARE CENTRE 1 1 BELVIDERE $14.74 $46.05 $104.89 $165.68 10/1/2015 7/1/20146006696 NORWOOD CROSSING 6 6 CHICAGO $13.92 $55.98 $94.83 $164.73 10/1/2015 7/1/20146006274 OAK HILL 11 11 WATERLOO $16.85 $47.78 $75.29 $139.92 10/1/20156006779 OAK LAWN RESPIRATORY AND REHAB 7 7 OAK LAWN $11.58 $47.75 $166.29 $225.62 10/1/20156006720 OAKBROOK HEALTHCARE CENTER LTD 7 7 OAK BROOK $14.07 $51.25 $109.79 $175.11 10/1/20156006829 OAKRIDGE HEALTHCARE CENTER 7 1 HILLSIDE $11.01 $53.21 $106.00 $170.22 10/1/20156003487 OAKVIEW HTS CONT CARE REHAB 5 5 MOUNT CARMEL $15.97 $43.47 $64.04 $123.48 10/1/20156006860 ODD FELLOWS REBEKAH HOME 4 4 MATTOON $12.52 $48.70 $65.03 $126.25 10/1/20156006878 ODIN HEALTH CARE CENTER 5 5 ODIN $11.42 $42.84 $85.45 $139.71 10/1/2015 7/1/20146009989 OREGON LIVING AND REHAB CENTER 1 1 OREGON $12.13 $47.39 $84.31 $143.83 10/1/20156006985 OTTAWA PAVILION LTD 2 2 OTTAWA $18.14 $46.58 $76.87 $141.59 10/1/20156006993 OUR LADY OF ANGELS RETIREMENT 9 9 JOLIET $14.88 $50.50 $78.93 $144.31 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building 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 $58.16 $108.02 10/1/20156006795 PARAMOUNT OAK PARK R AND N CTR 7 7 OAK PARK $14.57 $44.45 $92.95 $151.97 10/1/20156004766 PARC AT JOLIET 9 9 JOLIET $12.87 $45.02 $95.29 $153.18 10/1/20156007090 PARIS HEALTH CARE CENTER 4 4 PARIS $11.07 $46.60 $79.73 $137.40 10/1/20156007140 PARK HOUSE NURSING REHAB CTR 6 6 CHICAGO $11.51 $47.06 $78.42 $136.99 10/1/20156003073 PARK PLACE OF BELVIDERE 1 1 BELVIDERE $9.50 $45.80 $88.72 $144.02 10/1/20156003875 PARK POINTE HEALTHCARE REHAB 9 9 MORRIS $19.22 $53.08 $92.73 $165.03 10/1/20156007157 PARK RIDGE CARE CENTER 7 7 PARK RIDGE $16.48 $55.44 $103.71 $175.63 10/1/2015 7/1/20146002315 PARK VIEW REHAB CENTER 6 6 CHICAGO $14.72 $41.72 $82.82 $139.26 10/1/2015 7/1/20146007934 PARK VILLA NURSING REHAB CTR 7 7 PALOS HEIGHTS $20.01 $53.58 $93.66 $167.25 10/1/20156001374 PARKER NURSING AND REHAB CTR 2 2 STREATOR $11.16 $43.62 $103.67 $158.45 10/1/20156005003 PARKSHORE ESTATES NRSG REHAB 6 6 CHICAGO $13.59 $48.85 $101.01 $163.45 10/1/20156014385 PARKWAY MANOR 5 5 MARION $19.68 $42.39 $83.08 $145.15 10/1/2015 7/1/20146009799 PAVILION OF WAUKEGAN 8 8 WAUKEGAN $12.63 $55.98 $107.31 $175.92 10/1/20156003206 PAXTON HEALTHCARE AND REHAB 4 4 PAXTON $15.55 $50.44 $72.99 $138.98 10/1/20156003339 PEARL PAVILION 1 1 FREEPORT $13.40 $45.38 $68.18 $126.96 10/1/20156011712 PEKIN MANOR 2 2 PEKIN $18.02 $44.32 $84.44 $146.78 10/1/20156007355 PERSHING GARDENS HC CENTER 7 7 STICKNEY $15.24 $50.42 $86.30 $151.96 10/1/20156007371 PETERSON PARK HEALTH CARE CTR 6 6 CHICAGO $18.58 $48.71 $104.80 $172.09 10/1/20156016539 PHOENIX REHAB NURSING CARE 5 5 CARMI $8.21 $43.35 $71.74 $123.30 10/1/20156007389 PIATT COUNTY NURSING HOME 4 4 MONTICELLO $11.23 $52.43 $71.14 $134.80 10/1/20156005441 PINCKNEYVILLE NURSING REHAB 5 5 PINCKNEYVILLE $10.70 $37.09 $71.68 $119.47 10/1/2015 7/1/20146007413 PINE ACRES REHAB LIVING CENTER 1 1 DEKALB $17.96 $51.52 $91.89 $161.37 10/1/2015 7/1/20146004741 PINE CREST HEALTH CARE 7 7 HAZEL CREST $17.78 $46.12 $76.11 $140.01 10/1/20156007447 PINECREST MANOR 1 1 MT MORRIS $13.82 $50.58 $67.71 $132.11 10/1/20156003792 PIPER CITY REHAB LIVING CTR 4 4 PIPER CITY $9.67 $50.44 $66.62 $126.73 10/1/20156012470 PITTSFIELD MANOR 3 3 PITTSFIELD $14.89 $40.30 $72.22 $127.41 10/1/20156007470 PLEASANT HILL HEALTHCARE 3 3 GIRARD $12.63 $38.68 $66.67 $117.98 10/1/20156007488 PLEASANT MEADOWS SENIOR LIVING 4 4 CHRISMAN $12.52 $48.02 $81.43 $141.97 10/1/20156007512 PLEASANT VIEW LUTHER HOME 2 2 OTTAWA $16.41 $50.44 $77.97 $144.82 10/1/2015 7/1/20146007504 PLEASANT VIEW REHAB AND HCC 1 1 MORRISON $9.30 $45.95 $67.82 $123.07 10/1/20156007546 POLO REHABILITATION AND HCC 1 1 POLO $9.94 $49.51 $77.26 $136.71 10/1/20156004642 PONTIAC HEALTHCARE AND REHAB 4 4 PONTIAC $13.67 $48.27 $74.01 $135.95 10/1/20156007561 PRAIRIE CITY REHAB AND HC 2 2 PRAIRIE CITY $9.17 $43.60 $53.96 $106.73 10/1/20156008502 PRAIRIE CROSSING LVG AND REHAB 1 1 SHABBONA $10.85 $47.64 $91.87 $150.36 10/1/20156011746 PRAIRIE MANOR NURSING REHAB 7 7 CHICAGO HEIGHTS $23.91 $49.26 $120.04 $193.21 10/1/2015 7/1/20146007082 PRAIRIE ROSE HEALTH CARE CTR 3 3 PANA $9.13 $41.42 $81.36 $131.91 10/1/20156001812 PRAIRIE VIEW CARE OF LEWISTOWN 2 2 LEWISTOWN $8.06 $42.03 $86.16 $136.25 10/1/20156006027 PRAIRIE VLG HEALTHCARE CTR INC 3 3 JACKSONVILLE $9.67 $38.31 $82.84 $130.82 10/1/20156007595 PRAIRIEVIEW LUTHERAN HOME 4 4 DANFORTH $12.95 $50.44 $76.43 $139.82 10/1/20156005771 PRESENCE COR MARIAE CENTER 1 1 ROCKFORD $12.52 $51.52 $70.49 $134.53 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6005854 PRESENCE MARYHAVEN NSG REHAB 7 7 GLENVIEW $14.39 $55.98 $99.80 $170.17 10/1/20156005912 PRESENCE MCAULEY MANOR 8 8 AURORA $12.98 $55.98 $67.71 $136.67 10/1/20156007009 PRESENCE OUR LADY OF VICTORY 9 9 BOURBONNAIS $14.39 $53.08 $89.59 $157.06 10/1/20156007439 PRESENCE PINE VIEW CARE CENTER 8 8 SAINT CHARLES $10.96 $55.98 $77.36 $144.30 10/1/20156014575 PRESENCE RESURRECTION LIFE CTR 6 6 CHICAGO $17.23 $54.57 $79.93 $151.73 10/1/20156007892 PRESENCE RESURRECTION NRC 7 7 PARK RIDGE $10.64 $54.29 $95.43 $160.36 10/1/20156008874 PRESENCE SAINT BENEDICT NRC 7 7 NILES $13.92 $55.98 $112.68 $182.58 10/1/20156008817 PRESENCE ST ANNE CENTER 1 1 ROCKFORD $12.09 $51.52 $88.58 $152.19 10/1/20156008973 PRESENCE ST JOSEPH CENTER 1 1 FREEPORT $14.24 $51.52 $80.23 $145.99 10/1/20156012678 PRESENCE VILLA FRANCISCAN 9 9 JOLIET $14.39 $53.08 $91.67 $159.14 10/1/20156009591 PRESENCE VILLA SCALABRINI NC 7 7 NORTHLAKE $12.05 $55.95 $109.76 $177.76 10/1/20156007876 PROVIDENCE DOWNERS GROVE 7 7 DOWNERS GROVE $14.88 $55.98 $88.66 $159.52 10/1/20156007843 PROVIDENCE PALOS HEIGHTS 7 7 PALOS HEIGHTS $14.39 $55.98 $95.78 $166.15 10/1/20156016356 RADFORD GREEN 8 8 LINCOLNSHIRE $18.90 $55.98 $95.57 $170.45 10/1/20156008734 RAINBOW BEACH CARE CENTER 6 6 CHICAGO $17.66 $55.19 $57.64 $130.49 7/1/2014 Eligible for Provisional License as SMHRF6007702 RANDOLPH COUNTY CARE CENTER 5 5 SPARTA $6.52 $44.40 $79.07 $129.99 10/1/2015 6007751 RED BUD REGIONAL CARE 5 5 RED BUD $11.46 $43.93 $67.99 $123.38 10/1/20156008239 REGENCY CARE 3 3 SPRINGFIELD $15.16 $44.49 $66.37 $126.02 10/1/20156011381 REGENCY CARE OF MORRIS 9 9 MORRIS $15.77 $53.01 $94.71 $163.49 10/1/20156007793 REGENCY REHABILITATION CENTER 7 7 NILES $21.04 $48.46 $111.06 $180.56 10/1/20156014831 RENAISSANCE AT 87TH STREET 6 6 CHICAGO $22.15 $51.34 $102.04 $175.53 10/1/20156014641 RENAISSANCE AT MIDWAY 6 6 CHICAGO $20.12 $49.75 $106.66 $176.53 10/1/20156014823 RENAISSANCE AT SOUTH SHORE 6 6 CHICAGO $20.74 $52.59 $104.42 $177.75 10/1/20156006712 RENAISSANCE CARE CENTER 2 2 CANTON $10.70 $37.41 $74.45 $122.56 10/1/20156003958 RENAISSANCE PARK SOUTH 6 6 CHICAGO $14.80 $48.00 $91.92 $154.72 10/1/20156007850 REST HAVEN MANOR INC 5 5 ALBION $3.97 $37.18 $56.59 $97.74 10/1/20156007884 RESTHAVE HOME OF WHITESIDE CO 1 1 MORRISON $6.15 $47.87 $71.10 $125.12 10/1/20156007942 RIDGEVIEW CARE CENTER 5 5 OBLONG $8.78 $35.23 $68.36 $112.37 10/1/2015 6003453 RIDGEVIEW REHAB NURSING CENTER 6 6 CHICAGO $15.67 $48.06 $88.10 $151.83 10/1/20156007975 RIDGWAY REHAB AND NRSG CENTER 5 5 RIDGWAY $9.27 $34.50 $86.36 $130.13 10/1/2015 7/1/20146008007 RIVER BLUFF NURSING HOME 1 1 ROCKFORD $14.24 $53.75 $71.94 $139.93 10/1/2015 7/1/20146000434 RIVER CROSSING REHAB 2 2 GALESBURG $11.89 $40.51 $99.04 $151.44 10/1/20156001085 RIVER NORTH BRADLEY H AND R 9 9 BRADLEY $13.08 $42.10 $98.08 $153.26 10/1/20156004758 RIVER VIEW REHAB CENTER 8 8 ELGIN $12.62 $42.33 $83.06 $138.01 10/1/20156008015 RIVERSHORES HLTH AND REHAB CTR 2 2 MARSEILLES $11.07 $46.72 $84.88 $142.67 10/1/20156002646 RIVERWOOD REHAB 10 10 EAST MOLINE $12.88 $44.26 $70.39 $127.53 10/1/2015 7/1/20146008072 ROBINGS MANOR REHAB HLTH CR 3 3 BRIGHTON $12.11 $36.39 $74.11 $122.61 10/1/20156008098 ROCHELLE GARDENS CARE CENTER 1 1 ROCHELLE $8.80 $44.99 $57.90 $111.69 10/1/20156008106 ROCHELLE REHAB HEALTH CARE 1 1 ROCHELLE $10.07 $51.52 $72.75 $134.34 10/1/20156008114 ROCK FALLS REHAB HLTH CARE CTR 1 1 ROCK FALLS $9.89 $51.42 $74.38 $135.69 10/1/20156008130 ROCK ISLAND NURSING REHAB CTR 10 10 ROCK ISLAND $12.50 $40.61 $92.07 $145.18 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6002695 ROCK RIVER GARDENS 1 1 STERLING $8.55 $39.13 $43.56 $91.24 10/1/20156008049 ROCK RIVER HEALTH CARE 1 1 ROCKFORD $10.89 $43.47 $90.62 $144.98 10/1/20156008163 ROLLING HILLS MANOR 8 8 ZION $14.88 $55.98 $90.60 $161.46 10/1/20156005136 ROSEVILLE REHAB HEALTH CARE 2 2 ROSEVILLE $9.62 $46.49 $62.45 $118.56 10/1/20156012074 ROSEWOOD CARE CENTER ALTON 11 11 ALTON $14.95 $42.51 $72.61 $130.07 10/1/20156014237 ROSEWOOD CARE CENTER ELGIN 8 8 ELGIN $16.42 $51.18 $84.92 $152.52 10/1/20156010466 ROSEWOOD CARE CENTER GALESBURG 2 2 GALESBURG $14.23 $41.85 $78.53 $134.61 10/1/20156014633 ROSEWOOD CARE CENTER INVERNESS 7 7 INVERNESS $22.20 $52.72 $92.36 $167.28 10/1/20156012835 ROSEWOOD CARE CENTER JOLIET 9 9 JOLIET $15.52 $50.13 $87.22 $152.87 10/1/20156012587 ROSEWOOD CARE CENTER MOLINE 10 10 MOLINE $14.73 $48.06 $79.35 $142.14 10/1/20156012165 ROSEWOOD CARE CENTER PEORIA 2 2 PEORIA $13.50 $49.68 $77.49 $140.67 10/1/20156014658 ROSEWOOD CARE CENTER ROCKFORD 1 1 ROCKFORD $17.46 $49.15 $82.96 $149.57 10/1/20156010391 ROSEWOOD CARE CENTER SWANSEA 11 11 SWANSEA $13.37 $46.71 $83.89 $143.97 10/1/20156012017 ROSEWOOD CARE CTR EAST PEORIA 2 2 EAST PEORIA $13.84 $48.51 $73.73 $136.08 10/1/20156014401 ROSEWOOD CARE CTR EDWARDSVILLE 11 11 EDWARDSVILLE $16.83 $46.71 $81.08 $144.62 10/1/20156019723 ROSEWOOD CARE CTR NORTHBROOK 7 7 NORTHBROOK $21.11 $53.85 $107.51 $182.47 10/1/20156014666 ROSEWOOD CARE CTR ST CHARLES 8 8 ST CHARLES $19.01 $55.06 $83.93 $158.00 10/1/20156003065 ROSICLARE REHAB HEALTH CR 5 5 ROSICLARE $8.47 $43.93 $69.70 $122.10 10/1/20156005029 ROYAL OAKS CARE CENTER 10 10 KEWANEE $10.12 $37.71 $58.77 $106.60 10/1/20156008320 SACRED HEART HOME 6 6 CHICAGO $12.07 $48.91 $55.59 $116.57 7/1/2014 Eligible for Provisional License as SMHRF6008338 SALEM VILLAGE NURSING AND REHA 9 9 JOLIET $13.08 $49.38 $118.84 $181.30 10/1/20156008346 SALINE CARE CENTER 5 5 HARRISBURG $9.86 $34.43 $77.40 $121.69 10/1/20156008213 SANDWICH REHAB HEALTH CARE 1 1 SANDWICH $11.06 $51.52 $86.36 $148.94 10/1/2015 6001929 SAUK VALLEY SENIOR LIVING 1 1 ROCK FALLS $10.42 $47.83 $79.88 $138.13 10/1/20156008395 SCOTT COUNTY NURSING CENTER 3 3 WINCHESTER $8.22 $45.42 $66.06 $119.70 10/1/20156008460 SELFHELP HOME OF CHICAGO 6 6 CHICAGO $15.83 $55.98 $91.49 $163.30 10/1/20156010250 SEMINARY MANOR 2 2 GALESBURG $13.22 $46.44 $74.58 $134.24 10/1/20156007272 SHARON HEALTH CARE WILLOWS 2 2 PEORIA $9.22 $41.48 $90.56 $141.26 10/1/20156007926 SHARON HEALTH CARE WOODS INC 2 2 PEORIA $9.97 $41.01 $51.08 $102.06 7/1/2014 Eligible for Provisional License as SMHRF6007306 SHARON HEALTHCARE ELMS INC 2 2 PEORIA $10.53 $44.72 $106.54 $161.79 10/1/20156007298 SHARON HEALTHCARE PINES INC 2 2 PEORIA $9.40 $42.36 $68.36 $120.12 10/1/20156008528 SHAWNEE CHRISTIAN NURSING CTR 5 5 HERRIN $11.23 $40.09 $77.01 $128.33 10/1/20156004055 SHAWNEE ROSE CARE CENTER 5 5 HARRISBURG $9.06 $32.62 $69.08 $110.76 10/1/20156008544 SHELBYVILLE MANOR 4 4 SHELBYVILLE $16.06 $41.91 $80.41 $138.38 10/1/20156008536 SHELBYVILLE REHAB HEALTH CARE 4 4 SHELBYVILLE $8.58 $49.62 $81.20 $139.40 10/1/20156008569 SHELDON HEALTH CARE CENTER 4 4 SHELDON $9.89 $50.44 $66.74 $127.07 10/1/20156002687 SHERIDAN SHORES REHAB CENTER 6 6 CHICAGO $18.03 $42.94 $88.04 $149.01 10/1/2015 7/1/20146012827 SHERMAN WEST COURT 8 8 ELGIN $14.88 $55.98 $91.12 $161.98 10/1/20156008643 SKOKIE MEADOWS NURSING CTR II 7 7 SKOKIE $16.07 $37.38 $57.09 $110.54 7/1/2014 Eligible for Provisional License as SMHRF6016059 SMITH CROSSING 9 9 ORLAND PARK $18.18 $45.68 $89.37 $153.23 10/1/20156009732 SMITH VILLAGE 6 6 CHICAGO $11.56 $55.98 $77.44 $144.98 10/1/2015

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6011464 SNYDER VILLAGE 2 2 METAMORA $15.11 $48.71 $69.66 $133.48 10/1/20156008684 SNYDERS VAUGHN HAVEN INC 3 3 RUSHVILLE $9.48 $43.30 $67.57 $120.35 10/1/20156008718 SOUTH ELGIN REHAB HEALTH CARE 8 8 SOUTH ELGIN $10.22 $52.66 $87.70 $150.58 10/1/2015 6016497 SOUTH SUBURBAN REHAB CENTER 7 7 HOMEWOOD $16.52 $49.95 $99.23 $165.70 10/1/20156008759 SOUTHGATE H C 5 5 METROPOLIS $14.28 $41.44 $67.23 $122.95 10/1/20156014781 SOUTHPOINT NURSING REHAB CTR 6 6 CHICAGO $21.00 $48.97 $125.11 $195.08 10/1/20156001895 SOUTHVIEW MANOR NURSING CENTER 6 6 CHICAGO $14.26 $38.92 $72.07 $125.25 10/1/20156016786 SPRING CREEK NRSG REHAB CTR 9 9 JOLIET $10.71 $46.84 $93.78 $151.33 10/1/20156008783 SPRING VALLEY NURSING CENTER 2 2 SPRING VALLEY $7.72 $48.96 $67.10 $123.78 10/1/20156011803 SPRINGS AT CRYSTAL LAKE 8 8 CRYSTAL LAKE $15.71 $45.20 $142.45 $203.36 7/1/20156014567 ST ANTHONYS HOSPITAL SNU 11 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 $73.40 $142.29 10/1/20156008890 ST CLARAS MANOR 3 3 LINCOLN $9.51 $44.24 $71.65 $125.40 10/1/20156010664 ST JAMES WELLNESS REHAB VILLAS 9 9 CRETE $15.16 $53.08 $96.66 $164.90 10/1/20156008940 ST JOHNS HOSPITAL LTC UNIT 3 3 SPRINGFIELD $7.26 $44.49 $73.62 $125.37 10/1/20156011407 ST JOSEPH MED CTR NURSING UNIT 4 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 $113.22 $180.76 10/1/20156009005 ST JOSEPHS HOME FOR THE ELDERL 7 7 PALATINE $9.22 $55.98 $74.06 $139.26 10/1/20156008999 ST JOSEPHS N H 2 2 LACON $4.19 $50.44 $73.29 $127.92 10/1/20156009013 ST MARTHA MANOR 6 6 CHICAGO $13.38 $50.55 $62.74 $126.67 10/1/20156011910 ST PATRICKS RES 7 7 NAPERVILLE $14.88 $53.80 $90.94 $159.62 10/1/20156009120 ST PAULS HOME 11 11 BELLEVILLE $9.51 $46.02 $69.51 $125.04 10/1/20156009112 ST PAULS HOUSE AND HEALTH CARE 6 6 CHICAGO $15.34 $55.98 $89.80 $161.12 10/1/2015 7/1/20146005466 ST VINCENTS HOME INC 3 3 QUINCY $12.06 $40.51 $69.36 $121.93 10/1/20156010441 STEARNS NURSING AND REHAB CTR 11 11 GRANITE CITY $13.68 $41.65 $74.96 $130.29 10/1/20156009161 STEPHENSON NURSING CENTER 1 1 FREEPORT $9.88 $49.89 $66.74 $126.51 10/1/20156009179 STERLING PAVILION LTD 1 1 STERLING $11.67 $41.99 $84.82 $138.48 10/1/20156008494 STONEBRIDGE SENIOR LIVING 5 5 BENTON $9.13 $37.02 $81.76 $127.91 10/1/2015 7/1/20146009211 SULLIVAN REHAB HEALTH CARE CTR 4 4 SULLIVAN $9.76 $41.01 $73.30 $124.07 10/1/20156009245 SUNNY ACRES NURSING HOME 3 3 PETERSBURG $12.52 $43.81 $62.29 $118.62 10/1/20156009252 SUNNY HILL NSG HOME OF WILL CO 9 9 JOLIET $18.18 $62.40 $100.22 $180.80 10/1/20156009294 SUNRISE SKILLED NURSING REHAB 3 3 VIRDEN $10.10 $38.30 $75.59 $123.99 10/1/20156009302 SUNSET HOME 3 3 QUINCY $13.40 $44.49 $80.85 $138.74 10/1/20156009328 SUNSET REHAB HEALTH CARE 2 2 CANTON $13.20 $36.90 $61.41 $111.51 10/1/20156009831 SWANSEA REHAB HEALTH CARE CENT 11 11 SWANSEA $6.57 $39.29 $80.24 $126.10 10/1/2015 6007678 SYCAMORE HEALTHCARE CENTER 3 3 QUINCY $9.02 $32.65 $74.20 $115.87 10/1/2015 7/1/20146007967 SYMPHONY EVANSTON HEALTHCARE 7 7 EVANSTON $18.87 $45.20 $146.39 $210.46 10/1/20156002265 SYMPHONY OF CRESTWOOD 7 7 CRESTWOOD $17.53 $49.50 $106.46 $173.49 10/1/2015 7/1/20146006282 SYMPHONY OF DECATUR 4 4 DECATUR $13.70 $44.44 $99.66 $157.80 10/1/2015 7/1/20146002463 SYMPHONY OF JOLIET 9 9 JOLIET $16.31 $47.40 $110.71 $174.42 10/1/2015 7/1/20146005490 SYMPHONY OF LINCOLN 3 3 LINCOLN $15.05 $42.60 $120.88 $178.53 10/1/2015 7/1/2014

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6014252 TABOR HILLS HEALTHCARE FAC 7 7 NAPERVILLE $17.23 $55.98 $93.74 $166.95 10/1/2015 7/1/20146009369 TAYLORVILLE CARE CENTER 3 3 TAYLORVILLE $10.83 $39.24 $70.69 $120.76 10/1/20156009377 TERRACE NURSING HOME 8 8 WAUKEGAN $12.15 $44.89 $103.82 $160.86 10/1/20156003768 TERRACE ON THE PARK 11 11 MASCOUTAH $10.11 $45.62 $65.28 $121.01 10/1/20156009385 THORNTON HEIGHTS TERRACE LTD 7 7 CHICAGO HEIGHTS $14.68 $40.07 $62.27 $117.02 7/1/2014 Eligible for Provisional License as SMHRF6009393 THREE SPRINGS LODGE NRSG HOME 5 5 CHESTER $9.72 $40.10 $67.51 $117.33 10/1/20156009401 TILLERS NSG AND REHAB CTR 9 9 OSWEGO $16.29 $53.08 $95.65 $165.02 10/1/20156007330 TIMBERCREEK REHAB AND HEALTH C 2 2 PEKIN $11.32 $45.39 $69.01 $125.72 10/1/20156003750 TIMBERPOINT HEALTHCARE CENTER 3 3 CAMP POINT $9.76 $44.15 $92.06 $145.97 10/1/20156009427 TOULON REHAB HEALTH CARE CTR 2 2 TOULON $12.29 $45.01 $65.28 $122.58 10/1/20156003263 TOWER HILL HEALTHCARE CENTER 8 8 SOUTH ELGIN $13.01 $45.97 $99.52 $158.50 10/1/20156009443 TRI STATE NURSING REHAB CENTER 7 7 LANSING $17.37 $50.93 $104.81 $173.11 10/1/20156002588 TUSCOLA HEALTH CARE CENTER 4 4 TUSCOLA $8.90 $38.53 $67.16 $114.59 10/1/20156004188 TWIN LAKES REHAB HEALTH CARE 4 4 PARIS $9.09 $41.32 $87.14 $137.55 10/1/20156009484 TWIN WILLOWS NURSING CENTER 5 5 SALEM $7.02 $35.35 $72.78 $115.15 10/1/20156009492 UNION COUNTY HOSPITAL LTC 5 5 ANNA $4.73 $43.93 $87.48 $136.14 10/1/20156009500 UNITED METHODIST VILLAGE 5 5 LAWRENCEVILLE $8.65 $41.56 $66.96 $117.17 10/1/20156013072 UNITED METHODIST VILLAGE N CAM 5 5 LAWRENCEVILLE $14.27 $40.24 $68.64 $123.15 10/1/20156002711 UNIVERSITY NURSING AND RHB CTR 11 11 EDWARDSVILLE $10.82 $41.10 $92.21 $144.13 10/1/20156009542 VALLEY HI NURSING HOME 8 8 WOODSTOCK $18.18 $62.41 $89.54 $170.13 10/1/20156009260 VANDALIA REHAB HEALTH CARE 5 5 VANDALIA $8.33 $43.47 $74.06 $125.86 10/1/20156007322 VILLA AT EVERGREEN PARK 7 7 EVERGREEN PARK $16.99 $55.98 $88.01 $160.98 10/1/20156007041 VILLA AT PA PETERSON 1 1 ROCKFORD $15.73 $51.52 $79.61 $146.86 10/1/20156007868 VILLA AT SOUTH HOLLAND 7 7 SOUTH HOLLAND $26.32 $55.98 $108.97 $191.27 10/1/20156014856 VILLA AT WINDSOR PARK 6 7 CHICAGO $21.08 $47.06 $108.28 $176.42 10/1/20156012991 VILLA HEALTH CARE INC EAST 3 3 SHERMAN $14.69 $44.49 $77.25 $136.43 10/1/20156011332 VILLAGE AT VICTORY LAKES 8 8 LINDENHURST $12.51 $55.98 $101.02 $169.51 10/1/20156009674 WABASH CHRISTIAN RETIREMENT CR 5 5 CARMI $12.52 $43.79 $77.72 $134.03 10/1/20156009682 WALKER NURSING HOME 3 3 VIRGINIA $12.07 $43.65 $51.57 $107.29 10/1/20156009690 WALNUT MANOR 2 2 WALNUT $11.90 $49.56 $77.16 $138.62 10/1/20156014377 WARREN BARR LINCOLNSHIRE 8 8 LINCOLNSHIRE $17.97 $55.98 $91.47 $165.42 10/1/20156004725 WARREN BARR LIV AND REHAB CTR 6 6 CHICAGO $18.36 $55.98 $106.49 $180.83 10/1/20156014963 WARREN BARR NORTH SHORE 8 8 HIGHLAND PARK $19.27 $54.23 $112.00 $185.50 10/1/20156008825 WARREN BARR SOUTH LOOP 6 6 CHICAGO $15.29 $54.02 $149.31 $218.62 10/1/20156008262 WARREN PARK HEALTH LIVING CTR 6 6 CHICAGO $13.56 $50.85 $62.82 $127.23 10/1/2015 7/1/20146009740 WASHINGTON CHRISTIAN VILLAGE 2 2 WASHINGTON $11.20 $45.83 $83.14 $140.17 10/1/20156002430 WATERFORD NURSING AND REHAB 6 6 CHICAGO $16.40 $38.10 $77.14 $131.64 10/1/20156009757 WATERFRONT TERRACE INC 6 6 CHICAGO $16.34 $48.69 $90.01 $155.04 10/1/20156009765 WATSEKA REHAB HEALTH CARE CTR 4 4 WATSEKA $10.37 $46.59 $64.68 $121.64 10/1/20156009435 WAUCONDA HEALTHCARE AND REHAB 8 8 WAUCONDA $15.67 $50.55 $96.99 $163.21 10/1/20156006365 WAVERLY PLACE OF STOCKTON 1 1 STOCKTON $12.04 $43.60 $82.75 $138.39 10/1/2015 7/1/2014

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ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICESBUREAU OF RATE DEVELOPMENT AND ANALYSISMEDICAID RATE LIST FOR NURSING FACILITIES as of 10-01-2015Building Facility Rate Capital Support Nursing Total Effective Capital Rate

ID Name HSA Area City Rate Rate Rate Rate Date Notes Change Eff Date6009815 WAY FAIR NURSING AND REHAB CTR 5 5 FAIRFIELD $10.73 $39.67 $73.74 $124.14 10/1/20156006100 WESLEY PLACE 6 6 CHICAGO $16.29 $55.98 $99.43 $171.70 10/1/20156009864 WESLEY VILLAGE 2 2 MACOMB $14.79 $45.95 $61.74 $122.48 10/1/20156009872 WEST CHICAGO TERRACE NH 7 7 WEST CHICAGO $11.40 $39.35 $60.30 $111.05 10/1/20156013478 WEST SUBURBAN HOSP MED CTR SNF 7 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 $117.43 $175.58 10/1/20156012173 WESTCHESTER HEALTH AND REHAB C 7 7 WESTCHESTER $19.90 $55.98 $94.62 $170.50 10/1/20156007603 WESTMINSTER PLACE 7 7 EVANSTON $9.22 $55.98 $109.97 $175.17 7/1/20156000194 WESTSIDE REHAB CARE CENTER 5 5 WEST FRANKFORT $7.90 $35.39 $65.36 $108.65 10/1/20156009955 WESTWOOD MANOR 6 6 CHICAGO $14.15 $37.86 $59.75 $111.76 10/1/2015 7/1/20146009963 WHEATON CARE CENTER 7 7 WHEATON $12.74 $47.85 $86.45 $147.04 10/1/20156006597 WHITE HALL NURSING AND REHAB C 3 3 WHITE HALL $12.17 $30.87 $79.96 $123.00 10/1/20156004881 WHITE OAK REHABILITATION HCC 5 5 MOUNT VERNON $11.10 $43.93 $71.92 $126.95 10/1/2015 7/1/20146008379 WILLOW CREST NURS PAVILION LTD 1 1 SANDWICH $12.03 $43.09 $89.62 $144.74 10/1/20156003842 WILLOW ROSE REHAB HEALTH CARE 3 3 JERSEYVILLE $9.01 $40.48 $66.94 $116.43 10/1/20156010037 WILLOWS HEALTH CENTER 1 1 ROCKFORD $12.04 $51.52 $75.70 $139.26 10/1/20156010045 WILSON CARE INC 6 6 CHICAGO $13.63 $37.19 $56.87 $107.69 7/1/2014 Eligible for Provisional License as SMHRF6010052 WINCHESTER HOUSE 8 8 LIBERTYVILLE $7.27 $66.61 $98.51 $172.39 10/1/20156010078 WINDMILL NURSING PAVILION LTD 7 7 SOUTH HOLLAND $15.21 $44.27 $94.25 $153.73 10/1/20156005334 WINFIELD WOODS HEALTHCARE CTR 7 7 WINFIELD $14.12 $44.76 $69.11 $127.99 10/1/20156010094 WINNING WHEELS INC 1 1 PROPHETSTOWN $15.97 $51.52 $86.23 $153.72 10/1/20156010102 WINSTON MANOR CONVALESCENT N H 6 6 CHICAGO $10.01 $36.42 $61.75 $108.18 10/1/20156001713 WOOD GLEN NURSING AND REHAB CE 7 7 WEST CHICAGO $16.31 $45.46 $58.00 $119.77 10/1/20156007074 WOODBRIDGE NURSING PAVILION 6 6 CHICAGO $15.17 $40.95 $92.18 $148.30 10/1/20156008361 WYNSCAPE HEALTH AND REHAB 7 7 WHEATON $14.82 $55.98 $69.61 $140.41 10/1/2015

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