Date of original submission: 2/11/2016

TAB A

Tab A 1 of 52

TAB B

Royal HealthGroup Skilled Nursing Facilities Mamary, Inc. Management Company

Owner Entity DBA Owner Entity J&B Partnership, LLP

DBA

Royal Health Group, LLC Royal Taber Nursing & Rehabilitation Center

Royal Nursing Center, LLC

Royal Health Group, LLC

Royal Falmouth Nursing & Rehabilitation Center

Royal Cape Cod Nursing & Rehabilitation Center

1999

2000

Royal Megansett Nursing & Rehabilitation Center– North Falmouth (1997)

Royal Norwell Nursing & Rehabilitation Center, LLC

184 Main, LLC

95 Commercial, LLC

Royal Fairhaven Nursing & Rehabilitation Center (2007)

Royal Braintree Nursing & Rehabilitation Center (2008)

Royal Norwell Nursing & Rehabilitation Center (2013)

2007

2008

2013

Mashpee Acquisition, LLC Royal of Cotuit Nursing & Rehabilitation Center (2014)

Acquisition Date

1997

2014

A total of 828 Licensed Beds serving the communities of the South Shore, South Coast and Cape Cod since 1997

TAB C

TAB D

TAB E

TAB F

TAB G

TAB H

TAB I

Amortization Schedule

l

June 2016

r�uly 2016

Aug. 2016

$2 9,790 .9 5

$22,299 .28

- $29,79 0 �__

$22,353 .17

$29,790.95

I Sept. 2016

$22,407.19

$29, 790 . 95

$ 22,461 .3

20 1 6

$29, 790 . 95

$2 2,570.04

1��2017

$29,790.95

�� 2016

i-

rFe

$29 ,790.95 $29,790 .95

��--

Mar 2017

1 April 2017

$22,624.58

---

June 2017

$29, 79 95 -�

$22,734 06

$29,790 95

$22,789.00

July 2017

$29,790.95

Aug. 2017

$22,844.08

$29 ,790.95

$29,7 90. 9 5

$7,383.76

$22,313.2 0

$3,032, 940.36

$44,139.04

$2, 96 5,393.36

2;:; =·--;;;,;;;�= �-

$7, 329 .61 ___ $29,6 42. s1 __

$3, 010, 79. o =-._ : ____ _ $2,9 7, 963.3 9 $36,918.13 � ____ _

$7,275.32

$7,220.91

-----

$7,166.37

$7,056.88

$51,3 05. 41

$58,417 � --$65,473.98

--

$7,001.94

-------$6,946.87

$23,065.71

-----------·

$29 , 790.95

$23,121.45

$6,780.85 $6,725. 24

$6,669.50

$2,897,355.46

$86, 314.46

$2,828,823.09

$2,851,722.37

$93,150.78

$2,805,868.47

$106,656 .87

$2,759,792.66

$99, 9 31.63

------

$2 9 0 , 2 ���-

$2,874,566.45

------------- ---------------$23,010.1 0

$2,942,768.78

$72,475.93 $ 79,422.79

$6,89 - $22,899.28 �------·- __ $22,954.62 $6,8 36.32

$29,790.95

Sept. 20 1 7

$ 3,077,700.72

$22,67 $7,111.69 � �---

$29,790.95

J May 2017

$7,49 1.67

---;;�----·---$1

�---

$22,515.62

$7, 491.67

$2,782,858.3 7

$1 ,326.37 $ ,736,671.21 ------------------------------- ------------Oct. 201 7

$29,790.95

$23,1 77.33

13

$6,6 13.62

2

$11 9 ,9 39.99

$2, 1 ,493.8 -----·-------- ----·--------------------·--------

Nov. 2017

F

$29,790.95

1·0ec.2017 --·---;2--;790. 9;2 018

_

$29,790.95

-

�29,790 .95 J eb. 201a : __ ___ ___ Mar. 2018

$29,790.95

$23,233.34

$23,28 9.48 _

$23. 345.77

$23,402.19 $23,458.74

$6,557.61

$6,501.46

$8.445.1 8 _ $6,388.76

7 3

9

$126,497.60

$2,6 9 0,26 0.55

$139,444.24

$2.643.625.30

--�132, 99 9�6-----·--;;;�71.0�-

___

$145,833.00

$2,620,223.11

___

.

$6,33 .21 $152,165.21 $ , 6,764.3 -----,----·-------- --------------------·----- ---··------------April 1 $29, .95 $ 3,515. 3 $6, 75. 1 $158,440.72 $2,573,248. ----------------20 8

May 2 01 8

790

$29,790.95

2

4

$23,5 72.26

2

2

2 59

7

5

94

$6,218.68

$ 64,6 9.41 $ ,549, 76.68 ------------------···--------------·--------·---------· ··--------- -June 2018

$29,790. 95

$23,629.23

1

$6,161.72

5

2

6

$170, 21. $2,526,04 .45 ---·------------------------·--- ------------ -----------July 0 8 $2 , 0.95 $ 3,686.33 $6,104.61 $176, 25. 4 $2,502,361.11 -·---------------------·---- ------------------------·---------···- ··2 1

Aug. 2018

9 79

2

$29,790.95

$23,743 .57

$29,79 0.95

$23,858.47

$29,790. 95

$23,973.93

--------------------------Sept. 2018 Oct.

20 18

Nov. 2018

$2 9 ,790.95

$2 9,790.95

$23,800.95

$23,916.13

$6,047.37

8

13

9

7

7

$182,97 3.12

$5,989.99

$188,9 6 3 .11

$5,874.82

$200,770 .40

$5,932.47

$2,47 8,617.54

$2,454,816.5 9

$194,895.58

$2,430,958. 1 1

$2,40 ,0 1.98 ------·-----------·------------------------------------------· ··--· Dec. 20 18

$5,817.02

--------------- ---·------------ Jan. 2019

$29,790.95

$24,031.87

$5, 759.08

-

$206,587. 41

-----

--

$212,346.50

7

4

$2,383,068.05

_____ _ _____ ________ ,,

$2,359, 036.18 ,,

June 2019

$29,790.95

Aug. 2019

$29,790.95

July 2019

$24,265.02 $24,323.66

$29,790.95

Sept. 2019

$5,525.93

=

$29,790.95

$2,262,326.54

$245,67 6.44

$2,213,620.45

$256,316.54

$2,164,678.65

$5,4 67.29

$240,267.93

$5,349.58

$251 ,026.02

$24,382.4 4

$5,408.51

$24,500.43

$5,290.52

$24,441.36

$234,800.64

$2,238,002.89

$2,189,179.08

��I:____::::� = : : : :i:==-=:t��-=--:::: : If==��:-::�::: :�:�====

==

�,,:� �;;�;--- :::::;::: -· ::�::::�-=-::::�;���==--:::��E 2020

$2 9 .790.95

$24,797. 9 1

$4. 9 93.03

$281,878.1 1

,,,.,,,.,s

.,,.,,•. ,,

.... 12.82

""·'"·"

$4,752.45

$301,249.52

$4,631.29

$310, 572.75

$2.041 .285.49

�,I�,',: :, : ---:::--:: ::::: -____;:;�---�;;��-==_;;�:;: June 2020

-------- ----------- - --$29,790.95

$25,038.50

July 2020

$29,790.95

$25,099.01

Sept. 2020

$29,7 9 0.95

$25,220.46

Aug. 2020 1·���;020

$29,790.95

$25,159.68

� - --------

$305,941.46

$4,570.48

$1,941,493.11

$1,916,3 94.10 $1 ,891,234.44

$315,143.23

$1,868,013.97

-·· -· ·;9,790.;�- --·-- $25,2�-:�---·--·;4,50;�;;·-�----;;;�;;;;- --- ·-----;����;;�5; --

1 Nov.2020···--� $29,790.95 ___ $25,3�;5�

I I

$4,691.94

"·'''·"'·"

-- - -

Dec 2020

$29,79 0 95

J��= ---���0 1

�eb 2021

95

$29,790 9 5

$25,403 75

__ ��s

��-;:�;:;-_-=---;�;o��o __ � �- �-;��8�;;�;·-� $4,38719

,46 1 :_ : ___

$25,526 69

$4,32580

$4,26426

___

$328 488 39 $332,814 9 �

$337,07 8 45

-- - -$�,;;_; ---- ;-3�1;8�.0;

$1,789,986 30

2 ____ -��·�� �-$1, 738,9 94 46

I:: : :,'�=-- : : : ::: .· = : : : : -:--;i: : :_ -- :���.�-� -� {: :::J-1-M-:�. 2021

$29,790.�-s-_ �--

June 2021

$25,588;8

$1,713,406.06

$25,774.34

$4,016.61

$353,517 :1 0

$1,636,269.32

$25,899.07

$3,891.88

$361,363.30

$1,584,533.62

- - � � � � =· ��; :�;-==- �=- ;,;f��-==�: :: : �==�:: J:::-:�-�..::: : :;:�= - - �·; ���?��-= $29,790.95

July 2021

$29,790.95

$25,836.63

Sept. 2021

$29,79 0.95

$25,961.66

Aug.2021

$29,790.95

- .. s 2s.19o .9 s - _- __ -$26,024.40 ,.. · - $29,7 90.95 Nov. 2021 $26, 087.29

l._oct. 2021

I I

I

Dec: 2�21

$29,790.95

April 2022

$29,79 0.95

Jan. �022

May 2022

l" June2022

I

Ju1y 2022 __ _ _

\ Aug. 2022

�� ept 1 S . 20

-

$3,954 .32

$357, 471.42

$3,829.29

$365,192.59

�����i���j��--=�a;;;���� _ _ $3,703.66

$372,662.80

$1,610,432.69

$1,558,571.97

$1,506,460.28

$26,150.33

$3,640.61

$3;6,303.41.

-----;.�80,3��--

$26,404.04

$3,386.91

$390,232.36

$1,375,075.11

$29,790.9���=��;26,2��=��� 3,577. $ :;�--�.��--$379, 8;�:;2_ -�����·--��-.����:. o:6.41=� -

--

$29,790 .9 5

$29,790.95

$29,790 .95 --

$29,790.95

$26,467.85

$3,323.10

-,-=!

·:_-_-,-.�.. -s -, �� --�...

5 ��;-���·-·.

· ' "5 195 ._ � - ·--�� - _ _ ·�= - - - �: · $26,660.21 - $3,130.74 - -

· · - - $29,7;��--- - - -··;;;;;�_;;- ·-· --;,066:1

$393,555.46

$1,348,607.28

....�����:��--

$1,295,479. 51

�:�:�i:i�- ���- - -�- =���i����-�� $403,140.35

-- - ·;���,20;: 66

$1,268,819.31

$1,242,094.68

Date

Payment

Principal

Oct. 022

$2 9,790.95

$ 6,789.22

2

Nov. 2022

$3,001.73

2

$2 9,790.95

$26,853.96

i=�:;;;� - = ��--;;9�90.9; � � -�--�-��1�.�6 -

$409,208.39

$2,936.9 9

$412,145.38

�-�-�--�;�;��=���������--

J Jan. 2023 -- -

-

1-�;;�;;··---··

· -----·;29,790_;;------ --;·;;�:;�;--·-· ·- ; ;�;�:; . · ··--

I

$29,790.95

-

$26,983.91

$2,807.04

$417,824.51

b 0 � - ··; �---·- · · · - $27,0;;;;-·- · --·--;;-;�����-·------��������� Fe . 2 2 -- · ·- · $29, 90.9

1I�·;;;; -

2

��=-�·-

2

- - -;;9,790 .95 -��:��� ·;;;:�.� -� -=�-;;�79.4� ,�-� ;;; - __ �ly 2 023______ $ 9,790.95 - $27,377.ss__ $2,4 13.40 -· _ 2

I

Aug. 202 3

$29,790.95

r:;r�-�-;�;;�;-·-----·---;;;;;_ -- �;-------�;;�;�- --- ---; , 9 . 9 7 0 951

$27,443.71

$ ,347. 4 2

2

-

$1,188,451.50

�-�����2�� � =: - $1,134,548.73

- - --- ;1��;�;;:�

$423, 4;_;--- - - ---;�;�:;;�;-- - -

- ;;,�- ;�� ----- --·-· $42;,;�;;;··· . May 2023. -- -- ----;;:;��;; -- -- ---; 7,2 ;�,;�-- ·;;,54 �.;------;�;;,;98. 9; ·�-;9�;90.9� ---- - ·;;7�; 80.02

$1,215,305.46

; - -- --· -0-5-;,;;;�-----

-· -·---$��;5,9;:;-·

$430,878·.���-- ��:�;;;4-7��;·-�-

$43 3, 91 .n _ __ ___ $9 ,210 .3 _ _ 2 71 1 ____

$435,639.01

$943,826.60

- · ; :; 9� ; ;;:- ��� - , ,; ------�;6 -- ; ; 5 ---- -·· ; 80. ------ -3 919 2 .57 -·

$2;.790 .9;--·-� -$;;,�_;;···-·----�;;�::;--·----;440 13�-�;----- - $88;;40.0�----.

$27.64;�; --- - - ----���;�;�;- -----;�;, ;;;_�� . Dec. 2023··-·· -- $29,79� 9�--- ---- ·;;;�;;�- -- --·-;,;�-�; - ·---- $444 ,�;�; . $2,0 14.02 - -$29,;��;--- - -;�- ��;;;·-�: $27,7 76.93 . / Jan ._2024. ;�2� - - - --�;;;; ��- -- - ;�.-�; - - . 9 - -;�;.;;_��---- - $2 7 - - $1.946 8 _

1-

I-;;�:

-- --- $86�.;;;--

---;;;;,386:;;- -

; -- ---�$805,610 -

- --;;�.;;;� - - -- --

!:::;� .·.·• •t�;:��.-·.·.tt: : �: ••·�=:���� �=-=t;;fi;L� __-}::;gt_•-1 May 2024

$29,790.95

June 2024

$1,608.81

�;9.790.;; --- ··--- �;;:;�;-;�

$1,472.43

$693,829.38

$455,437.07

$665,715.19

· Aug.- 0;4- - -----·- ;;9,7 9;; - - - -- - ---;�;,;;�.;�·-··. ·----$� ,;;_ ;o 2

$458,586.59

$60 9,282.81

$29,790.95

j Oct.202�---

r�

N

ov

. 2024 - -

Dec. 2024�--

Jan. 2025

..

$29,790.95

$28,386.9 5

- �-�j�����--- -·-.

� ��� ��- _

$29,790.95

$28,662.35

---;; ;�;- ---- ---; ;;�;��, $29,790.95

Feb. 2025

Mar. 2025

April 2025

June 2025

r-�-;;;�---·---·r l-oct.-;025 - -

�o�.' 202� -

ID��.- ;0�5- -

$28,593.25

$29,010.37

.

$29,790.95

-

$29,080.48

S29,790.9;-·· - -·-·;;�150.75 -- ­

- - $29,790_;; --- ··-;2�,; ;�_;; ·-;;�-,;��;-- - · - --·-;;;:;1�82

··- --;29,79�;�---·

$29,362.61

· · 7 9 7 9 -. -- ;�;- ;;;� - ; . ;� � -·-;;-9�7�-���-- - - -----�;�.- ;o- ��70

$524,121.80

2

$438,341.87

$989.89

$468,440.55

$380,809.19

$920.29

$29,790.95

$552,57 7.35

$466,391.33

$28,870.66

$28,940.43

$580,964.30

$1,128.59

$29,790.95

2

$28,801.06

$460,059.02

$637,533.06

- $46 95 9 -������-� ���= � ���:�� . --- :��--$:4: -_,=--�-� � -= � - -- - $1,197.69 $465,262.74 $467,004.2 $1,059.33

-- -----------···--�--------·-

r���-:;��-6-- - -;e�. ;�;6

4

$28,731.6

$29,790.95

July 2025 ------- -··· Aug. 2025

2

$457,045.88

$1,404.00 $461,463.02 - - - ;�-.��; -� ·· - ---- -;�;:;8��� --- -. -- ·

$29,790.95

$29,790.95

May 2025

I

$28,182 .14

$28,114.19

$453,760.32

$1,676. 75

I ;�pt. 2024 -

I

$1,744.53

$29,790.95

1-J:1;��;

I

$28,046.41

$850.5

2

$780.58 · ··-----------· $710.47 $640.19

$467,450.66

46 9,360.84 $ $470,211.35 $470,991.93

$409,610.25

$351,938.54

$322,998.11

$29 3,987 .74

- ·-·------- -- ---------·--· $471,702.40

$47 ,34 .60 2

2

$264,907.26 $235,756.51

$472 ,912.34

$ 06,535.30

$428.34

$473,839. 8 1

$147,880.87

$286.25

$474,483.43

$569.74 $499.13

$357.38

$473,411.47

$474,197.19

2

$177,243.48 $1 18,447.31

$88,942.61

TAB J

invoice to the Facility/Facility for such overdue fees. Such invoices shall be due and payable within twenty (20) calendar days of receipt by the Facility/Facility. If the Facility disagrees with any of the Fees, Costs or Expenses due as described in any invoice, the Facility shall promptly bring such disagreement to the attention of the Manager. The Parties shall use their best efforts to resolve any such dispute as expeditiously as possible. The undisputed portion of the invoice will be due and payable in accord with the terms of this Agreement. 6.1.1. Expenses. In addition, the Facility/Facility shall reimburse the Manager for all reasonable and documented expenses (e.g. travel) actually incurred or paid by the Manager in connection with the performance of the Manager’s duties hereunder (“Expenses”), other than the cost of compensating Manager’s personnel or providing benefits to them. Payment for such Expenses shall be made within twenty (20) calendar days of Facility’s receipt of Manager’s invoice. 6.2.

7.

Late Fee: Any Management Fees , Expenses and reimbursable costs not paid within sixty (60) days of the date for such payment shall bear interest at the rate of one percent (1.0%) per month.

Records. 7.1.

Access. During the term of this Agreement, the Facility shall provide the Manager with full access to the Facility, its physical plant and its records. The Manager shall comply with all applicable state and federal laws relative to the confidentiality of medical records, personnel records, or proprietary material; however, nothing herein shall prohibit the Manager from making any disclosure or transmission of information that is necessary in the performance of the Manager’s duties hereunder as permitted or required by law. In addition, Facility’s representative shall have access to the Facility’s records during the Term.

7.2.

Access to Books and Records. Upon the written request of the Secretary of Health and Human Services or the Comptroller General or any of their duly authorized representatives, the Manager and the Facility will make available those contracts, books, documents, and records necessary to verify the nature and extent of the costs of providing services under this Agreement. Such inspection shall be available up to four (4) years after the rendering of such services. If the Manager carries out any of the duties of this Agreement through a subcontract with another party at a value of Ten Thousand Dollars ($10,000) or more over a 12-month period with a related individual or organization, the Manager agrees to include this requirement in any such subcontract. This section is included pursuant to and is governed by the requirements of Public Law 96-499, 952 (1861)(v)(1) of the Social Security Act and the regulations promulgated thereunder. No attorney-client, accountant-client or other legal

Page 16

2016.03.14 Forest Farm Health Care Center CEC Resubmission.pdf ...

Feb 11, 2016 - 2016.03.14 Forest Farm Health Care Center CEC Resubmission.pdf. 2016.03.14 Forest Farm Health Care Center CEC Resubmission.pdf.

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