STATE OF CALIFORNIA ADJUSTMENTS TO REPORTED COSTS Page 1 Schedule 8A-2 Provider Name: LTC90058F 1538221288 206194113 Provider Number: Provider NPI: OSHPD Facility Number: Fiscal Period: JANUARY 1, 2008 THROUGH DECEMBER 31, 2008 VILLA SCALABRINI TOTAL ADJ (Page 1) 10 11 12 13 14 15 16 AUDIT ADJ AUDIT ADJ AUDIT ADJ AUDIT ADJ AUDIT ADJ AUDIT ADJ AUDIT ADJ AUDIT ADJ AUDIT ADJ Hospice Inpatient Care 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (3,780) (872) 0 0 0 0 14,654 5,710 0 0 (14,172) 0 0 0 0 0 (14,654) (5,710) 6,687 (495) 5,710 14,654 (872) (3,780) 0 Other Routine Services Residential Care Beauty and Barber Other Nonreimbursable Social Services .
