1. ©2011 LarsonAllen LLP 111 Massachusetts Administrator & Director of Nurses Wage & Benefit Update For The Massachusetts Chapter of the American College of Health Care Administrators Notre Dame Healthcare Center Worcester, Massachusetts June 23 rd,, 2011

2. ©2011 LarsonAllen LLP 2 Footnotes Facilities are unique in their reporting needs and it is not uncommon to code general ledger items differently, which effects comparison reporting. Many facilities report FTE’s greater than 1.0 for Administrator & Wage Benefit. Some organizations may compensate Administrator’s completely or partially through the HCF-3 Management Company cost report. Median equals the mid-point of cost reported.

3. ©2011 LarsonAllen LLP 3 2009 – 2008 Mass Administrator Salary & Benefits

4. ©2011 LarsonAllen LLP 4 2009 – 2008 Mass Administrator Wage & Benefits – Not-for-Profit

5. ©2011 LarsonAllen LLP 5 2009 – 2008 Mass Administrator Wage & Benefits – For-Profit

6. ©2011 LarsonAllen LLP 6 Massachusetts Counties

7. ©2011 LarsonAllen LLP 7 2009 Administrator Compensation Average by County

8. ©2011 LarsonAllen LLP 8 Administrator Average Wages & Benefits 2009 vs 2008

9. ©2011 LarsonAllen LLP 9 2009 - 2008 Average Administrator Salary by County (Salary, Health Ins, Pensions, Other Benefits)

10. ©2011 LarsonAllen LLP 10 2009-2008 Average Director of Nurses Salary & Benefits

11. ©2011 LarsonAllen LLP 11 2009-2008 Director of Nurses Wage & Benefit for Non-Profit

12. ©2011 LarsonAllen LLP 12 2009-2008 Director of Nurses Wage & Benefit For Profit

13. ©2011 LarsonAllen LLP 13 2009 Director of Nurses Salary & Benefits by County

14. ©2011 LarsonAllen LLP 14 2009-2003 Selected Cost Centers PPD Comparison

15. ©2011 LarsonAllen LLP 15 2010-2003 Selected Cost Centers PPD Comparison (* 2010 based on 191 Mass Facilities)

16. ©2011 LarsonAllen LLP 16 LarsonAllen LLP – Background CPAs, Consultants & Advisors History and experience LarsonAllen is one of the top 20 accounting firms in the nation, according to Accounting Today. We provide assurance, accounting, tax consulting, and advisory services to organizations and individuals managing business ventures and finance. Founded in 1953, LarsonAllen is dedicated to creating a noticeably different experience for our clients. We provide our clients with industry specialists and high quality business resources. With approximately 1,800 people and more than 40 locations, we have significant depth and talent, experience, and national perspective. LarsonAllen is an independent member of Nexia International, a top 10 worldwide organization providing global connections. Our mission – Create a noticeable different client experience. We serve our clients with quality and integrity and meet their needs through a primary advisor relationship. We stress open communication, efficiency, and a relationship grounded in fairness and trust as your accountants, consultants, and advisors.

17. ©2011 LarsonAllen LLP 17 LarsonAllen LLP Offices

18. ©2011 LarsonAllen LLP 18 Profile ---- Richard Hamilton, CNHA, R.Ph., MBA Principal Rick has extensive experience in entitlement, clinical coverage, documentation, billing, audit triggers, and managed care contracting. His specialties include operational strategies maximizing reimbursement and implementing compliance programs. Experience in serving clients Rick has over 25 years of health care experience including long term care operations, administration, planning and organizing new senior care programs in housing, assisted living, adult day health care, medical model clinics and long term care pharmacy services. Technical expertise Rick’s focus in on regulatory compliance and maximizing operational reimbursement for long term care organizations. His SNF consulting expertise frequently focuses on benchmark comparisons, operational reviews, survey preparation and assistance, third party reimbursement issues, litigation support, clinical reimbursement appeals, pharmacy pricing analyses and rehabilitation services. Educational / professional involvement Rick holds a Master in Business Administration from Suffolk University, Boston, MA, a Bachelor of Science Degree in Pharmacy from the Massachusetts College of Pharmacy, Boston, MA, and an Associate Degree in Nursing Home Administration from Northern Essex Community College in Haverhill, MA. He is a Certified Nursing Home Administrator, Fellow of the American College of Health Care Administrators (ACHCA), past Massachusetts Chapter President and a Registered Pharmacist. His professional affiliations include Board Member of the Massachusetts Long Term Care Finance Association (LTCFA) and memberships in the American Society of Consultant Pharmacists (ASCP) and Massachusetts Chapter of the American Medical Directors Association (MAMDA). A frequent speaker, Rick actively participates and supports state and regional associations and presents from a unique perspective integrating his clinical, operational and fiscal backgrounds.

19. ©2011 LarsonAllen LLP 19 Follow our blog for current discussions on health care. www.larsonallen.com/blog www.larsonallen.com/blog www.twitter.com/larsonallen www.twitter.com/larsonallenhc www.facebook.com/larsonallen www.linkedin.com/companies/ larsonallen Contact Us Richard Hamilton, CNHA, R.Ph., MBA Principal Healthcare 617-984-8142 Cell: 617-371-6034 rhamilton@larsonallen.com 300 Crown Colony Drive, Suite 310 Quincy, MA 02169 Main: 617-984-8100, Fax: 617-984-8150 www.larsonallen.com