Hampshire

Genesis HealthCare – Hampshire Center

Romney, WV
December 31, 2014

BALANCE SHEET
ASSETS
Current Assets
Cash in Bank    28,896
Accounts Receivable    616,155
Inventories    23,717
Prepaids & Other Current Assets    (40,472)
Related Party Accounts    4,792,609
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Total Current Assets        5,420,905

Property and Equipment Net        71,102

Identifiable Intangible Assets – Favorable Lease        0

Other Assets        199
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Total Assets        5,492,206
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LIABILITIES AND EQUITY
Current Liabilities
Accounts Payable    170,198
Accrued Expenses & Payroll Withholdings    199,485
Current maturities of long-term obligations    0
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Total Current Liabilities        369,683

Long Term Liabilities
Escheatable Funds    (1,793)
L/T Debt Capital Lease Obligation    0
Deferred G/L Straight-Lining Leases    0
LT Debt Financing Obligation    0
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Total Long Term Liabilities         (1,793)
Equity            5,124,315
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Total Liabilities and Equity        5,492,206
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INCOME STATEMENT
Revenue
Nursing Home Revenue    7,174,819
Other Operating    17
—————–
Total Operating Revenue        7,174,836

Expenses
Nursing services    1,943,765
General and Administrative     1,504,060
Other Operating    1,749,846
Lease    420,000
Interest    (232,999)
Depreciation and Amortization    16,086
Non-Recurring    0
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Total Expenses        5,400,758
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Net Income        1,774,078
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Net Income        1,774,078
Adjustment to reconcile net income

Cash Flows from Operating Activities
Depreciation & Amortization    16,086
Decrease in trade receivables    35,588
Decrease in inventory    865
Decrease in prepaid & other current assets    3,136
Increase in accounts payable & accrued expenses    29,494
Increase in related party accounts    ######

Net cash used by operating activities        (125,474)
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Cash Flows from Investing Activities
Increase in Property, Plant & Equip    (22,653)
Decrease in deferred financing costs    0

Net cash used in investing activities        (22,653)
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Cash Flows from Financing Activities
Increase in L/T Debt Capital Lease Obligation    0
Contributed capital    0
Increase in LT Debt – Financing Obligation    0
Increase in Deferred G/L Straight-Lining Leases    0
Net cash provided by financing activities        0
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Decrease in cash balance        (148,127)

Cash, beginning of the year        20,827

Cash, end of the year        (127,300)                ————–
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OWNERSHIP: Genesis WV Holdings LLC

The statements are provided pursuant to the Health Care Facility Disclosure Laws. I certify that the above audited statements are true and correct to the best of my knowledge. This financial data is available for public inspection at the office of the West Virginia Health Care Cost Review Authority, 100 Dee Drive, Charleston, WV during regular hours, 9:00 a.m. to 5:00 p.m. on any business day.

4-8-1c
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