Document:

EX-10.1

 Exhibit 10.1 

SETTLEMENT AGREEMENT 

This Settlement Agreement (Agreement) is entered into among the United States of America, acting through the United States Department of
Justice and on behalf of the Office of Inspector General (OIG-HHS) of the Department of Health and Human Services (HHS) (collectively the “United States”), RehabCare Group, Inc., and RehabCare Group East, Inc. (collectively
“RehabCare”), Kindred Healthcare, Inc. (“Kindred,” with Kindred and RehabCare hereafter collectively referred to as “Defendants”), and Janet Halpin and Shawn Fahey (collectively the “Relators”) (hereafter
collectively referred to as “the Parties”), through their authorized representatives. 
 RECITALS 

A. RehabCare provides rehabilitative services, including physical, occupational, and speech therapy, to patients at numerous skilled nursing
facilities (SNFs) nationwide. Kindred, a Delaware corporation with its headquarters in Louisville, Kentucky, is a healthcare services company that operates various businesses through its subsidiaries. On June 1, 2011, Kindred Healthcare
Development, Inc., a subsidiary of Kindred, merged with and into RehabCare Group, Inc., with RehabCare Group, Inc. continuing as the surviving corporation. In 2010 and 2011, the SNFs at which RehabCare provided rehabilitative services included those
listed on Attachment A. These SNFs billed Medicare for services provided to their patients, and their bills were based, in part, on the information and rehabilitation therapy provided by their contractor, RehabCare. 

  
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 B. On December 7, 2011, Janet Halpin and Shawn Fahey filed a qui tam action in the
United States District Court for the District of Massachusetts captioned United States ex rel. Halpin and Fahey v. Kindred Healthcare, Inc., Case No. 1:11cv12139-RGS, pursuant to the qui tam provisions of the False Claims Act, 31
U.S.C. § 3730(b) (the “Civil Action”). Among other things, the qui tam complaint alleged that RehabCare caused its SNF customers to bill for unreasonable and unnecessary rehabilitation therapy. On February 3, 2015, the
United States intervened in the Civil Action as to Relators’ allegations that RehabCare caused the submission of false claims under Medicare Part A. Relators subsequently filed an amended complaint on March 9, 2015. 

C. The United States contends that Defendants caused to be submitted claims for payment to the Medicare Program (Medicare), Title XVIII of the
Social Security Act, 42 U.S.C. §§ 1395-1395kkk-1. 
 D. The United States contends that it has certain civil claims against
Defendants arising from RehabCare’s conduct of allegedly causing the submission of false claims to Medicare Part A as alleged in the United States’ Complaint in Intervention insofar as it applies to patients who were provided therapy at
the SNFs listed on Attachment A during the period from January 1, 2009 to September 30, 2013, had a length of stay of at least 33 days, and whose care was billed to Medicare at the highest resource utilization group (RUG) rate, ultra high,
at least once during that Medicare Part A stay. The United States further contends that it has certain civil claims against Defendants arising from RehabCare’s conduct in allegedly providing a kickback, as described in the United
States’ Complaint in Intervention, which allegedly caused the 

  
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submission of false claims to Medicare by: Friendship Village SNF in Dublin, Ohio; The Forum at Ranch San Antonio SNF in Cupertino, California; Aldersly Gardens SNF in San Rafael, California;
Wesley Pines SNF in Lumberton, North Carolina; Henry Ford Village SNF in Dearborn, Michigan; and the Residences of Thomas Circle SNF in Washington, DC. The conduct described in this Paragraph D is referred to herein as the “Covered
Conduct.” 
 E. Defendants deny the allegations in Paragraph D and in the Civil Action. 

F. This Agreement is neither an admission of liability by Defendants nor a concession by the United States that its claims are not well
founded. 
 G. Relators claim entitlement under 31 U.S.C. § 3730(d) to a share of the proceeds of this Settlement Agreement and to
Relators’ reasonable expenses, attorneys’ fees and costs. 
 To avoid the delay, uncertainty, inconvenience, and expense of
protracted litigation, and in consideration of the mutual promises and obligations of this Settlement Agreement, the Parties agree and covenant as follows: 

TERMS AND CONDITIONS 
 1.
Defendants shall pay to the United States $125 million plus interest at a rate of 1.875 percent from August 31, 2015 through the date of full payment (Settlement Amount), no later than 10 days after the Effective Date of this Agreement by
electronic funds transfer pursuant to written instructions to be provided by the Office of the United States Attorney for the District of Massachusetts. 

  
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 2. Conditioned upon the United States receiving the Settlement Amount from Defendants and as soon
as feasible after receipt, the United States shall pay $23,888,000 to Relators by electronic transfer. 
 3. Relators and their counsel
Jeffrey Newman Esq. have claims for their attorney’s fees and costs incurred in the prosecution of this action (the “Fees Claim”), evidence of which has been presented to the Defendant. In addition, Relator Janet Halpin has
asserted a 3730(h) retaliation claim (the “3730(h) Claim”) against the Defendant.
 The Fees Claim and Relator Halpin’s
3730(h) Claim are not released herein. Should the parties be unable to resolve the Fees Claim and/or the 3730(h) Claim, then the United States District Court shall have continuing jurisdiction to issue an order with regard to the
Fees Claim, and the 3730(h) Claim shall be allowed to litigate to completion. 
 4. Subject to the exceptions in Paragraph 7 (concerning
excluded claims) below, and conditioned upon Defendants’ full payment of the Settlement Amount, the United States fully and finally releases Defendants, together with their current and former parent corporations; current and former direct and
indirect subsidiaries; current and former brother or sister corporations; current and former divisions; current and former owners; current and former directors, officers, and employees; and the predecessors, successors, transferees, and assigns of
any of them, from any civil or administrative monetary claim the United States has for the Covered Conduct under the False Claims Act, 31 U.S.C. §§ 3729-33; the Civil Monetary Penalties Law, 42 U.S.C. § 1320a-7a; the Program
Fraud Civil Remedies Act, 31 U.S.C. §§ 3801-12; any statutory provision creating a cause of action for civil damages or civil penalties for which the Civil Division 

  
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of the Department of Justice has actual and present authority to assert and compromise pursuant to 28 C.F.R. Part O, Subpart I, § 0.45(d); or the common law theories of payment by
mistake, unjust enrichment, and fraud. 
 5. Subject to the exceptions in Paragraph 7 below, and conditioned upon Defendants’ full
payment of the Settlement Amount, Relators, for themselves and for their heirs, successors, attorneys, agents, and assigns, fully and finally release Defendants, together with their current and former parent corporations; current and former direct
and indirect subsidiaries; current and former brother or sister corporations; current and former divisions; current and former owners; current and former directors, officers, and employees; and the predecessors, successors, transferees, and assigns
of any of the them from any civil monetary claim Relators have on behalf of the United States for the Covered Conduct under the False Claims Act, 31 U.S.C. §§ 3729-33. Nothing herein shall be deemed as a release by the Relators or their
counsel of the Defendants concerning their existing claims for fees and costs relating to the prosecution of these claims, or a Release of the Defendants by Relator Halpin for her pending claim against the Defendants pursuant to 31 U.S.C. §
3730(h). 
 6. In consideration of the obligations of Defendants in this Agreement, and in the Corporate Integrity Agreement (CIA) entered
into between OIG-HHS and Defendants, and conditioned upon Defendants’ full payment of the Settlement Amount, the OIG-HHS agrees to release and refrain from instituting, directing, or maintaining any administrative action seeking exclusion from
Medicare, Medicaid, and other Federal health care programs (as defined in 42 U.S.C. § 1320a-7b(f)) against Defendants under 42 U.S.C. § 1320a-7a (Civil Monetary Penalties Law) or 42 U.S.C. § 1320a-7(b)(7)

  
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(permissive exclusion for fraud, kickbacks, and other prohibited activities) for the Covered Conduct, except as reserved in Paragraph 7 (concerning excluded claims), below, and as reserved
in this Paragraph. The OIG-HHS expressly reserves all rights to comply with any statutory obligations to exclude Defendants from Medicare, Medicaid, and other Federal health care programs under 42 U.S.C. § 1320a-7(a) (mandatory exclusion)
based upon the Covered Conduct. Nothing in this Paragraph precludes the OIG-HHS from taking action against entities or persons, or for conduct and practices, for which claims have been reserved in Paragraph 7, below. 

7. Notwithstanding the releases given in paragraphs 4, 5 and 6 of this Agreement, or any other term of this Agreement, the following claims of
the United States are specifically reserved and are not released: 
  

	 	a.	Any liability arising under Title 26, U.S. Code (Internal Revenue Code); 

  

	 	b.	Any criminal liability; 

  

	 	c.	Except as explicitly stated in this Agreement, any administrative liability, including mandatory exclusion from Federal health care programs; 

 

	 	d.	Any liability to the United States (or its agencies) for any conduct other than the Covered Conduct; 

  

	 	e.	Any liability based upon obligations created by this Agreement; 

  

	 	f.	Any liability for express or implied warranty claims or other claims for defective or deficient products or services, including quality of goods and services; 

  
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	 	g.	Any liability for personal injury or property damage or for other consequential damages arising from the Covered Conduct; and 

  

	 	h.	Except as otherwise provided for in this Agreement, any liability of individuals. 

 8. Relators
and their heirs, successors, attorneys, agents, and assigns shall not object to this Agreement but agree and confirm that this Agreement is fair, adequate, and reasonable under all the circumstances, pursuant to 31 U.S.C. § 3730(c)(2)(B).
Conditioned upon Relators’ receipt of the payment described in Paragraph 2, Relators and their heirs, successors, attorneys, agents, and assigns fully and finally release, waive, and forever discharge the United States, its agencies, officers,
agents, employees, and servants, from any claims arising from the filing of the Civil Action or under 31 U.S.C. § 3730, and from any claims to a share of the proceeds of this Agreement and/or the Civil Action. 

9. Relators, for themselves, and for their heirs, successors, attorneys, agents, and assigns, release Defendants, and their officers, agents,
and employees, from any liability to Relators arising from the filing of the Civil Action, or under 31 U.S.C. § 3730(d) for expenses or attorney’s fees and costs. 

10. Defendants waive and shall not assert any defenses Defendants may have to any criminal prosecution or administrative action relating to
the Covered Conduct that may be based in whole or in part on a contention that, under the Double Jeopardy Clause in the Fifth Amendment of the Constitution, or under the Excessive Fines Clause in the Eighth Amendment of the Constitution, this
Agreement bars a remedy sought in such criminal prosecution or administrative action. Nothing in this paragraph or any other 

  
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provision of this Agreement constitutes an agreement by the United States concerning the characterization of the Settlement Amount for purposes of the Internal Revenue laws, Title 26 of the
United States Code. 
 11. Defendants fully and finally release the United States, its agencies, officers, agents, employees, and servants,
from any claims (including attorney’s fees, costs, and expenses of every kind and however denominated) that Defendants have asserted, could have asserted, or may assert in the future against the United States, its agencies, officers, agents,
employees, and servants, related to the Covered Conduct and the United States’ investigation and prosecution thereof. 
 12. Defendants
fully and finally release Relators from any claims (including attorney’s fees, costs, and expenses of every kind and however denominated) that Defendants have asserted, could have asserted, or may assert in the future against the Relator,
related to the Relators’ claims in the Civil Action and the Relators’ investigation and prosecution thereof. 
 13. The Settlement
Amount shall not be decreased as a result of the denial of claims for payment now being withheld from payment by any Medicare contractor (e.g., Medicare Administrative Contractor, fiscal intermediary, carrier) or any state payer, related to
the Covered Conduct; and Defendants agree not to resubmit to any Medicare contractor or any state payer any previously denied claims related to the Covered Conduct, and agree not to appeal any such denials of claims. 

14. Defendants agree to the following: 

a. Unallowable Costs Defined: All costs (as defined in the Federal Acquisition Regulation, 48 C.F.R. § 31.205-47; and in
Titles XVIII and XIX of the 

  
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Social Security Act, 42 U.S.C. §§ 1395-1395kkk and 1396-1396w-5; and the regulations and official program directives promulgated thereunder) incurred by or on behalf of Defendants,
their present or former officers, directors, employees, shareholders, and agents in connection with: 
  

	 	(1)	the matters covered by this Agreement; 

  

	 	(2)	the United States’ audit(s) and civil and criminal investigation(s) of the matters covered by this Agreement; 

  

	 	(3)	Defendants’ investigation, defense, and corrective actions undertaken in response to the United States’ audit(s) and civil and criminal investigation(s) in connection with the matters covered by this Agreement
(including attorney’s fees); 

  

	 	(4)	the negotiation and performance of this Agreement; 

  

	 	(5)	the payment Defendants make to the United States pursuant to this Agreement and any payments that Defendants may make to Relators, including costs and attorney’s fees; and 

 

	 	(6)	the negotiation of, and obligations undertaken pursuant to the CIA to: 

  

	 	(i)	retain an independent review organization to perform annual reviews as described in Section III of the CIA; and 

(ii) prepare and submit reports to the OIG-HHS, 

are unallowable costs for government contracting purposes and under the Medicare Program, Medicaid Program, TRICARE Program, and Federal Employees Health
Benefits Program (FEHBP) (hereinafter referred to as Unallowable Costs). However, 

  
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nothing in paragraph 14.a.(6) that may apply to the obligations undertaken pursuant to the CIA affects the status of costs that are not allowable based on any other authority applicable to
Defendants. 
 b. Future Treatment of Unallowable Costs: Unallowable Costs shall be separately determined and accounted for by
Defendants, and Defendants shall not charge such Unallowable Costs directly or indirectly to any contracts with the United States or any State Medicaid program, or seek payment for such Unallowable Costs through any cost report, cost statement,
information statement, or payment request submitted by Defendants or any of their subsidiaries or affiliates to the Medicare, Medicaid, TRICARE, or FEHBP Programs. 

c. Treatment of Unallowable Costs Previously Submitted for Payment: Defendants further agree that within 90 days of the Effective Date
of this Agreement they shall identify to applicable Medicare and TRICARE fiscal intermediaries, carriers, and/or contractors, and Medicaid and FEHBP fiscal agents, any Unallowable Costs (as defined in this Paragraph) included in payments previously
sought from the United States, or any State Medicaid program, including, but not limited to, payments sought in any cost reports, cost statements, information reports, or payment requests already submitted by Defendants or any of their subsidiaries
or affiliates and shall request, and agree, that such cost reports, cost statements, information reports, or payment requests, even if already settled, be adjusted to account for the effect of the inclusion of the Unallowable Costs. Defendants agree
that the United States, at a minimum, shall be entitled to recoup from Defendants any overpayment plus applicable interest and penalties as a result of the inclusion of such Unallowable Costs on previously-submitted cost reports, information
reports, cost statements, or requests for payment. 

  
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 Any payments due after the adjustments have been made shall be paid to the United States pursuant
to the direction of the Department of Justice and/or the affected agencies. The United States reserves its rights to disagree with any calculations submitted by Defendants or any of its subsidiaries or affiliates on the effect of inclusion of
Unallowable Costs (as defined in this Paragraph) on Defendants or any of their subsidiaries’ or affiliates’ cost reports, cost statements, or information reports. 

d. Nothing in this Agreement shall constitute a waiver of the rights of the United States to audit, examine, or re-examine Defendants’
books and records, or the books and records of its subsidiaries or affiliates to determine that no Unallowable Costs have been claimed in accordance with the provisions of this Paragraph. 

15. This Agreement is intended to be for the benefit of the Parties, their current and former parent corporations, subsidiaries, predecessors,
successors, and assigns only. The Parties do not release any claims against any other person or entity, except to the extent provided for in Paragraph 16 (waiver for beneficiaries paragraph), below. 

16. Defendants agree that they waive and shall not seek or cause others to seek payment for any of the health care billings covered by this
Agreement from any health care beneficiaries or their parents, sponsors, legally responsible individuals, or third party payors based upon the claims defined as Covered Conduct. 

17. Upon the United States’ receipt of the Settlement Amount described in Paragraph 1, above, the United States and Relators shall
promptly sign and file in the 

  
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Civil Action a Joint Stipulation To Dismiss Defendants from the Civil Action pursuant to Rule 41(a)(1). The Civil Action will be dismissed as to Defendants with prejudice as to Relators, but as
to the United States with prejudice only as to the Covered Conduct. 
 18. Each Party shall bear its own legal and other costs incurred in
connection with this matter, including the preparation and performance of this Agreement. 
 19. Each party and signatory to this Agreement
represents that it freely and voluntarily enters in to this Agreement without any degree of duress or compulsion. 
 20. This Agreement is
governed by the laws of the United States. The exclusive jurisdiction and venue for any dispute relating to this Agreement is the United States District Court for the District of Massachusetts. For purposes of construing this Agreement, this
Agreement shall be deemed to have been drafted by all Parties to this Agreement and shall not, therefore, be construed against any Party for that reason in any subsequent dispute. 

21. This Agreement constitutes the complete agreement between the Parties. This Agreement may not be amended except by written consent of the
Parties. 
 22. The undersigned represent and warrant that they are fully authorized to execute this Agreement on behalf of the persons and
entities indicated below. 
 23. This Agreement may be executed in counterparts, each of which constitutes an original and all of which
constitute one and the same Agreement. 
 24. This Agreement is binding on Defendants’ successors, transferees, heirs, and assigns.

 25. This Agreement is binding on Relators’ successors, transferees, heirs, and assigns. 

  
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 26. All parties consent to the United States’ disclosure of this Agreement, and information
about this Agreement, to the public. 
 27. This Agreement is effective on the date of signature of the last signatory to the Agreement
(Effective Date of this Agreement). Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this Agreement. 
 [signatures
follow] 

  
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 THE UNITED STATES OF AMERICA 

 

							
	DATED: January 12, 2016	 		 	BY:	 	 /s/ Gregg Shapiro

		 		 		 	GREGG SHAPIRO
		 		 		 	Assistant United States Attorney
		 		 		 	District of Massachusetts
				
	DATED: January 11, 2016	 		 	BY:	 	 /s/ Christelle Klovers

		 		 		 	CHRISTELLE KLOVERS
		 		 		 	ROHITH SRINIVAS
		 		 		 	Trial Attorneys
		 		 		 	Commercial Litigation Branch
		 		 		 	Civil Division
		 		 		 	U.S. Department of Justice
				
	DATED: January 11, 2016	 		 	BY:	 	 /s/ Robert K. Deconti

		 		 		 	ROBERT K. DECONTI
		 		 		 	Assistant Inspector General for Legal Affairs
		 		 		 	Office of Counsel to the Inspector General
		 		 		 	Office of Inspector General
		 		 		 	U.S. Department of Health and Human Services
				
		 		 		 	RELATORS
				
	DATED: January 6, 2016	 		 	BY:	 	 /s/ Janet Halpin

		 		 		 	JANET HALPIN
				
	DATED: January 6, 2016	 		 	BY:	 	 /s/ Shawn Fahey

		 		 		 	SHAWN FAHEY
				
	DATED: January 6, 2016	 		 	BY:	 	 /s/ Jeffrey A. Newman

		 		 		 	JEFFREY A. NEWMAN
		 		 		 	Law Offices of Jeffrey A. Newman & Associates
		 		 		 	Counsel for Relators

  
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 DEFENDANTS 
  

							
	DATED: January 8, 2016	 		 	BY:	 	 /s/ Benjamin A. Breier

		 		 		 	BENJAMIN A. BREIER
		 		 		 	Chief Executive Officer
		 		 		 	Kindred Healthcare, Inc.
				
	DATED: January 7, 2016	 		 	BY:	 	 /s/ Jon B. Rousseau

		 		 		 	JON B. ROUSSEAU
		 		 		 	President
		 		 		 	RehabCare Group, Inc.
				
	DATED: January 7, 2016	 		 	BY:	 	 /s/ Jon B. Rousseau

		 		 		 	JON B. ROUSSEAU
		 		 		 	President
		 		 		 	RehabCare Group East, Inc.
				
	DATED: January 8, 2016	 		 	BY:	 	 /s/ Glenn P. Hendrix

		 		 		 	GLENN P. HENDRIX
		 		 		 	Arnall Golden Gregory, LLP
		 		 		 	Counsel for Kindred Healthcare, Inc., RehabCare
		 		 		 	Group, Inc., and RehabCare Group East, Inc.

  
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 ATTACHMENT A 
  

							
	 Count
	  	 SNF Name
	  	 City
	  	 State

	1	  	Abbey Delray North	  	Delray Beach	  	FL
	2	  	Abbey Delray South	  	Delray Beach	  	FL
	3	  	Aberdeen Village	  	Olathe	  	KS
	4	  	Abramson Center for Jewish Life	  	North Wales	  	PA
	5	  	Ackert Park Skilled Care Community	  	University City	  	MO
	6	  	Advanced Health & Rehab Center of Garland	  	Garland	  	TX
	7	  	Alexander Nininger SVNH	  	Pembroke Pines	  	FL
	8	  	All Faith Pavilion	  	Chicago	  	IL
	9	  	Althea Woodland	  	Silver Spring	  	MD
	10	  	Amenity Manor	  	Topsham	  	ME
	11	  	Anderson House	  	Shoreline	  	WA
	12	  	Arkansas Convalescent Center	  	Pine Bluff	  	AR
	13	  	Arkansas Nursing and Rehab Center	  	Texarkana	  	AR
	14	  	Arlington Residence & Rehab	  	Arlington	  	TX
	15	  	Ashford Hall	  	Irving	  	TX
	16	  	Atrium Health Care and Rehabilitation Center	  	Cahokia	  	IL
	17	  	Aurora Rehab & Living Center	  	Aurora	  	IL
	18	  	Ausable Valley Continuing Care Retirement Community	  	Fairview	  	MI
	19	  	Avalon Helath Care Center at Stoneridge	  	Mystic	  	CT
	20	  	Aviston Countryside Manor	  	Aviston	  	IL
	21	  	Bala Nursing Center	  	Philadelphia	  	PA
	22	  	Baya Pointe Nursing Center	  	Lake City	  	FL
	23	  	Baywood Court	  	Castro Valley	  	CA
	24	  	Beacon Hill	  	Lombard	  	IL
	25	  	Beacon Ridge	  	Indiana	  	PA
	26	  	Beauvais Manor on the Park	  	St Louis	  	MO
	27	  	Becker Shoop Center	  	Racine	  	WI
	28	  	Bedford Court	  	Silver Spring	  	MD
	29	  	Belleville Healthcare and Rehabilitation	  	Belleville	  	IL
	30	  	Bellevue Health and Rehabilitation Center	  	Oklahoma City	  	OK
	31	  	Berkeley Square Retirement Community	  	Hamilton	  	OH
	32	  	Bethany Community Home	  	Alexandria	  	MN
	33	  	Bethany Lutheran Home, Inc.	  	Council Bluffs	  	IA
	34	  	Bethany on 42nd	  	Fargo	  	ND
	35	  	Bethesda Dilworth	  	St Louis	  	MO
	36	  	Bethesda Meadow	  	Ellisville	  	MO
	37	  	Bethesda Southgate	  	St. Louis	  	MO
	38	  	Bishop Care Ctr	  	Bishop	  	CA
	39	  	Blair House of Tewksbury	  	Tewksbury	  	MA
	40	  	Blaire House of Milford	  	Milford	  	MA
	41	  	Blough Healthcare Center	  	Bethlehem	  	PA
	42	  	Bon Secours - DePaul Medical Center TCU	  	Norfolk	  	VA
	43	  	Bon Secours - Maryview Nursing Center	  	Suffolk	  	VA
	44	  	Bon Secours St. Petersburg	  	St Petersburg	  	FL
	45	  	Brandon Woods of Dartmouth Inc.	  	South Dartmouth	  	MA
	46	  	Brandon Woods of New Bedford	  	New Bedford	  	MA
	47	  	Brentwood Place IV	  	Dallas	  	TX
	48	  	Brentwood Place One	  	Dallas	  	TX
	49	  	Brentwood Place Three	  	Dallas	  	TX

							
	50	  	Brentwood Place Two	  	Dallas	  	TX
	51	  	Breton Rehabilitation and Living Centre	  	Grand Rapids	  	MI
	52	  	Brightmoor Nursing Center	  	Griffin	  	GA
	53	  	Brighton Gardens of Bellaire	  	Bellaire	  	TX
	54	  	Brighton Gardens Yorba Linda	  	Yorba Linda	  	CA
	55	  	Broad Creek Care Center	  	Hilton Head Island	  	SC
	56	  	Broomall Rehab and Nursing Center	  	Broomall	  	PA
	57	  	Buckingham’s Choice	  	Adamstown	  	MD
	58	  	Buckner Villa Siesta Home	  	Austin	  	TX
	59	  	Calhoun County Medical Care Facility	  	Battle Creek	  	MI
	60	  	Camp Care	  	Inman	  	SC
	61	  	Canterbury Towers Health Center	  	Tampa	  	FL
	62	  	Carillon Senior Living Campus	  	Lubbock	  	TX
	63	  	Carlyle Healthcare Center	  	Carlyle	  	IL
	64	  	Carrington Place	  	Wytheville	  	VA
	65	  	Casa Arena Blanca Health Care	  	Alamogordo	  	NM
	66	  	Casa De Oro Care Center	  	Las Cruces	  	NM
	67	  	Casa Del Sol Senior Care Center	  	Las Cruces	  	NM
	68	  	Casa Maria Nursing Center	  	Roswell	  	NM
	69	  	CC Young Memorial Home	  	Dallas	  	TX
	70	  	Cedar Creek	  	Norman	  	OK
	71	  	Cedar Crest	  	Janesville	  	WI
	72	  	Cedar View Rehab & Healthcare Ctr	  	Austin	  	TX
	73	  	Cedarcrest Manor	  	Washington	  	MO
	74	  	Cedars at the JCA	  	Chesterfield	  	MO
	75	  	Cedarview Care Center	  	Owatonna	  	MN
	76	  	Charleston Rehabilitation & Health Care Center	  	Charleston	  	IL
	77	  	Christian Care Center of Bedford County	  	Shelbyville	  	TN
	78	  	Christian Care Center of Johnson City	  	Johnson City	  	TN
	79	  	Christian Care Center of Kuttawa	  	Kuttawa	  	KY
	80	  	Christian Care Center of Springfield	  	Springfield	  	TN
	81	  	Christian Care Ctr of Rutherford County	  	Smyrna	  	TN
	82	  	Christian Health Center of Corbin	  	Corbin	  	KY
	83	  	Christian Health Center of Hopkinsville	  	Hopkinsville	  	KY
	84	  	Christian Health Center of Louisville	  	Louisville	  	KY
	85	  	Church Creek	  	Arlington Heights	  	IL
	86	  	Citizens Care & Rehab Center of Frederick	  	Frederick	  	MD
	87	  	Clare Oaks in Bartlett	  	Bartlett	  	IL
	88	  	Claridge House	  	North Miami	  	FL
	89	  	Clark Lindsey Village	  	Urbana	  	IL
	90	  	Clark Retirement Community	  	Grand Rapids	  	MI
	91	  	Clement Manor	  	Greenfield	  	WI
	92	  	Clover Manor Inc.	  	Auburn	  	ME
	93	  	Collington Episcopal Life Care Community	  	Mitchellville	  	MD
	94	  	Colonial Acres	  	Golden Valley	  	MN
	95	  	Colonial Healthcare	  	Auburn	  	CA
	96	  	Columbia	  	Wyocena	  	WI
	97	  	Community Care Ctr	  	Chicago	  	IL
	98	  	Community Nursing & Rehab	  	Naperville	  	IL
	99	  	Concordia Life Care Community	  	Oklahoma City	  	OK

							
	100	  	Copper Ridge	  	Sykesville	  	MD
	101	  	Cornerstone Nursing and Rehabilitation Center	  	Dunn	  	NC
	102	  	Courtland Terrace	  	Gastonia	  	NC
	103	  	Courtyards at Fort Worth	  	Fort Worth	  	TX
	104	  	Courville at Manchester	  	Manchester	  	NH
	105	  	Courville of Nashua	  	Nashua	  	NH
	106	  	Covenant Village of Florida	  	Plantation	  	FL
	107	  	Cranford Health and Extended Care Center	  	Cranford	  	NJ
	108	  	Crawford County Care Center	  	Saegertown	  	PA
	109	  	Crestview Manor Nursing & Rehabilitation Center	  	Belton	  	TX
	110	  	Crestwood Care Centre	  	Crestwood	  	IL
	111	  	Crouse Community Center	  	Morrisville	  	NY
	112	  	Cumberland Nursing and Rehabilitation Center	  	Fayetteville	  	NC
	113	  	Cypress Club Inc	  	Hilton Head	  	SC
	114	  	Dallas Retirement Village	  	Dallas	  	OR
	115	  	Daughters of Israel Nursing Home	  	West Orange	  	NJ
	116	  	Deer Meadows Residence	  	Philadelphia	  	PA
	117	  	Deerbrook Skilled Nursing & Rehab Center	  	Humble	  	TX
	118	  	Delta Nursing & Rehab Ctr	  	Visalia	  	CA
	119	  	Denton Rehabilitation and Nursing Center	  	Denton	  	TX
	120	  	Derby Health and Rehabilitation Center	  	Derby	  	KS
	121	  	Doctors Nursing and Rehabilitaion Center	  	Salem	  	IL
	122	  	Donalson Care Centers	  	Fayetteville	  	TN
	123	  	Douglas Rehabilitation and Care Center	  	Mattoon	  	IL
	124	  	E.F. Bertha Kruse Memorial Lutheran Village	  	Brenham	  	TX
	125	  	Eden Hill Communities	  	New Braunfels	  	TX
	126	  	Edgehill	  	Stamford	  	CT
	127	  	El Dorado Care Ctr	  	Placerville	  	CA
	128	  	Ephrata Manor	  	Ephrata	  	PA
	129	  	Episcopal Church Home	  	St. Paul	  	MN
	130	  	Estrella Oaks Rehabilitation and Care Center	  	Georgetown	  	TX
	131	  	Eventide at Sheyenne Crossings	  	West Fargo	  	ND
	132	  	Eventide on Eighth	  	Moorhead	  	MN
	133	  	Evergreen Nursing and Rehab	  	Effingham	  	IL
	134	  	Excelsior Springs Nursing & Rehab	  	Excelsior Springs	  	MO
	135	  	Fairhaven	  	Sykesville	  	MD
	136	  	Fairmount Homes	  	Ephrata	  	PA
	137	  	Falcons Landing	  	Potomac Falls	  	VA
	138	  	Fall Brook Nursing & Rehab	  	Houston	  	TX
	139	  	Falmouth By the Sea	  	Falmouth	  	ME
	140	  	Family Health and Rehabilitation Center	  	Wichita	  	KS
	141	  	Ferncliff Nursing Home	  	Rhinebeck	  	NY
	142	  	Fleet Landing	  	Altantic Beach	  	FL
	143	  	Flora Rehabilitation & Health Care Center	  	Flora	  	IL
	144	  	Florida Presbyterian Homes	  	Lakeland	  	FL
	145	  	Focus Rehab and Nursing at Utica	  	Utica	  	NY
	146	  	Foothill Oaks Care Ctr	  	Auburn	  	CA
	147	  	Fountain at Bronson Place (or the Springs at the Fountains)	  	Kalamazoo	  	MI
	148	  	Fountainview Center for Alzheimer’s Disease	  	Atlanta	  	GA
	149	  	Four Fountains Convalescent Center	  	Belleville	  	IL

							
	150	  	Franciscan Villa	  	Milwaukee	  	WI
	151	  	Friendship Village	  	Kalamazoo	  	MI
	152	  	Friendship Village Chesterfield	  	Chesterfield	  	MO
	153	  	Friendship Village of Columbus Ohio, Inc.	  	Columbus	  	OH
	154	  	Friendship Village of South County	  	St. Louis	  	MO
	155	  	Garden Manor Extended Care Center	  	Middletown	  	OH
	156	  	Garden Spot Village	  	New Holland	  	PA
	157	  	Garden View Care Center at Dougherty Ferry	  	Valley Park	  	MO
	158	  	Garden Villa of Bedford	  	Bedford	  	IN
	159	  	Garden Villa of Bloomington	  	Bloomington	  	IN
	160	  	Glenbrook Health Center	  	Carlsbad	  	CA
	161	  	Glenburn Home	  	Linton	  	IN
	162	  	Good Samaritan Hot Springs Village	  	Hot Springs	  	AR
	163	  	Good Samaritan Society - Bonell Community	  	Villag Greeley	  	CO
	164	  	Gorham House	  	Gorham	  	ME
	165	  	Grace Care Center	  	Wichita Falls	  	TX
	166	  	Grace Care Center of Lufkin	  	Lufkin	  	TX
	167	  	Grace Pointe Continuing Care Senior Campus	  	Greeley	  	CO
	168	  	Grand Village	  	Grand Rapids	  	MN
	169	  	Greene Acres Nursing Home	  	Paragould	  	AR
	170	  	Greenery Specialty Care Center	  	Canonsburg	  	PA
	171	  	Greenwood Village South	  	Greenwood	  	IN
	172	  	Hanford Nursing & Rehabilitation Center	  	Hanford	  	CA
	173	  	Harbour Health Center	  	Port Charlotte	  	FL
	174	  	Harbour’s Edge	  	Delray Beach	  	FL
	175	  	Harnett Woods Nursing and Rehabilitation Center	  	Dunn	  	NC
	176	  	Hawthorne House	  	Freeport	  	ME
	177	  	Helia Healthcare of Benton	  	Benton	  	IL
	178	  	Heritage Manor of Canton	  	Canton	  	TX
	179	  	Heritage Oaks	  	Arlington	  	TX
	180	  	Heritage Place	  	Mesquite	  	TX
	181	  	Hidden Lake Center	  	Raytown	  	MO
	182	  	Highland Acres Nursing and Rehabilitation Center	  	Lumberton	  	NC
	183	  	Highland Pines	  	Longview	  	TX
	184	  	Hillside Heights Rehabilitation Suites	  	Canyon	  	TX
	185	  	Hillside Rehab & Care Center	  	Yorkville	  	IL
	186	  	Hobbs Health Care Center	  	Hobbs	  	NM
	187	  	Holiday Nursing Center	  	Center	  	TX
	188	  	Holiday Resorts - Salina	  	Salina	  	KS
	189	  	Holland Home - Raybrook Manor	  	Grand Rapids	  	MI
	190	  	Holzer Consolidated Health System	  	Bidwell	  	OH
	191	  	Hometown Nursing and Rehab	  	Hometown	  	PA
	192	  	Horizons Living and Rehab Center	  	Brunswick	  	ME
	193	  	Hunter Hills Nursing and Rehabilitation Center	  	Rocky Mountain	  	NC
	194	  	Hy-Pana House Care Ctr	  	Fresno	  	CA
	195	  	IHS Treyton Oaks	  	Louisville	  	KY
	196	  	Imboden Creek	  	Decatur	  	IL
	197	  	Inn at Sarasota Bay Club	  	Sarasota	  	FL
	198	  	Jackson County Medical Care Facility	  	Jackson	  	MI
	199	  	Jewish Home and Care Center	  	Milwaukee	  	WI

							
	200	  	Jordan’s Nursing Home	  	Bridgman	  	MI
	201	  	Kansas City Presbyterian Manor	  	Kansas City	  	KS
	202	  	Kewanee Care Home	  	Kenwanee	  	IL
	203	  	Kings Nursing & Rehab Ctr	  	Hanford	  	CA
	204	  	Kingswood Senior Living Community	  	Kansas City	  	MO
	205	  	Kirby Pines Manor	  	Memphis	  	TN
	206	  	Kirkwood by the River	  	Birmingham	  	AL
	207	  	Knox County Nursing Home	  	Knoxville	  	IL
	208	  	Ladera Nursing & Rehab Center	  	Albuquerque	  	NM
	209	  	Lake Harris Health Center	  	Leesburg	  	FL
	210	  	Lake Winona Manor	  	Winona	  	MN
	211	  	Lakebridge Health Care Center	  	Johnson City	  	TN
	212	  	Lakeland Health Care Center	  	Elkhorn	  	WI
	213	  	Lakeshore Lutheran Home	  	Duluth	  	MN
	214	  	Lakeshore Manor	  	Racine	  	WI
	215	  	Lakeside Nursing Center	  	Jacksonville	  	FL
	216	  	Lakeview Nursing and Rehabilitation Centre	  	Chicago	  	IL
	217	  	Landis Homes Retire Comm Indep Living Facility	  	Lititz	  	PA
	218	  	Las Cruces Nursing Center	  	Las Cruces	  	NM
	219	  	Las Palomas Nursing & Rehab Center	  	Albuquerque	  	NM
	220	  	Laurel Baye Healthcare of Greenville	  	Greenville	  	SC
	221	  	Laurel View Village	  	Davidsville	  	PA
	222	  	Legend Healthcare & Rehabilitation of Euless	  	Euless	  	TX
	223	  	Legend Healthcare and Rehabilitation - Greenville	  	Greenville	  	TX
	224	  	Lexington Manor Healthcare	  	Lexington	  	MO
	225	  	Liberty Inn	  	Delray Beach	  	FL
	226	  	Liberty Nursing Center of Englewood	  	Englewood	  	OH
	227	  	Liberty Nursing Center of Hempstead Manor	  	Portsmouth	  	OH
	228	  	Liberty Retirement Comm. of Washington	  	Dayton	  	OH
	229	  	Lincoln Meadows Care Center	  	Lincoln	  	CA
	230	  	Lincoln Village	  	Racine	  	WI
	231	  	Linwood Gardens Care Ctr	  	Visalia	  	CA
	232	  	Live Oak Manor	  	Live Oak	  	CA
	233	  	Logan Elm	  	Circleville	  	OH
	234	  	Longhorn Village	  	Austin	  	TX
	235	  	Longmeadow Healthcare Center	  	Justin	  	TX
	236	  	Loretto Health and Rehabilitation Center	  	Syracuse	  	NY
	237	  	Lourdes Nursing Home	  	Waterford	  	MI
	238	  	Lutheran Haven	  	Oveido	  	FL
	239	  	Lutheran Home Frankenmuth	  	Frankenmuth	  	MI
	240	  	Lutheran Home Livonia	  	Livonia	  	MI
	241	  	Lutheran Home Monroe	  	Monroe	  	MI
	242	  	Macon Health Care Center	  	Macon	  	MO
	243	  	Magnolia Manor of Columbia	  	Columbia	  	SC
	244	  	Magnolia Manor of Greenwood	  	Greenwood	  	SC
	245	  	Magnolia Manor of Inman	  	Inman	  	SC
	246	  	Magnolia Manor of Rock Hill	  	Rock Hill	  	SC
	247	  	Magnolia Manor of Spartanburg	  	Spartanburg	  	SC
	248	  	Magnolia Place of Greenville	  	Greenville	  	SC
	249	  	Magnolia Place of Spartanburg	  	Spartanburg	  	SC

							
	250	  	Magnum Health & Rehab of Adrian	  	Adrian	  	MI
	251	  	Magnum Health & Rehab of Albion	  	Albion	  	MI
	252	  	Magnum Health & Rehab of Hastings	  	Hastings	  	MI
	253	  	Magnum Health & Rehab of Monroe	  	Monroe	  	MI
	254	  	Manor Park	  	Midland	  	TX
	255	  	Manzano Del Sol	  	Albuquerque	  	NM
	256	  	Marianna Health & Rehabilitation Center	  	Marianna	  	FL
	257	  	Marigold Rehab & Health Care Center	  	Galesburg	  	IL
	258	  	Mark Twain Caring Center	  	Poplar Bluff	  	MO
	259	  	Marquette	  	Indianapolis	  	IN
	260	  	Mary Queen and Mother Center	  	St. Louis	  	MO
	261	  	Masonic Center for Health & Rehab	  	Dousman	  	WI
	262	  	McKinley Health Care Ctr	  	Sacramento	  	CA
	263	  	McKinley Manor	  	Gallup	  	NM
	264	  	Meadow Ridge	  	Redding	  	CT
	265	  	Meadow View Manor	  	Grass Valley	  	CA
	266	  	Meadows	  	Nashville	  	TN
	267	  	Menno Haven Inc.	  	Chambersburg	  	PA
	268	  	Mercy Medical Daphne	  	Daphne	  	AL
	269	  	Mercy Retirement & Care Ctr	  	Oakland	  	CA
	270	  	Merry Haven Care Center	  	Snohomish	  	WA
	271	  	Messiah Lifeways at Messiah Village	  	Mechanicsburg	  	PA
	272	  	Meth Wick Health Center	  	Cedar Rapids	  	IA
	273	  	Mid-America Care Center	  	Chicago	  	IL
	274	  	Milton Health Care LLC	  	Milton	  	MA
	275	  	Mimosa Manor	  	Keller	  	TX
	276	  	Mission Arch Care Center	  	Roswell	  	NM
	277	  	Mission Nursing and Rehabilitation Center	  	Mission	  	TX
	278	  	Monroe Manor	  	Paris	  	MO
	279	  	Montebello Healthcare Ctr	  	Hamilton	  	IL
	280	  	Montereau in Warren Woods	  	Tulsa	  	OK
	281	  	Monterey Pines Care Ctr	  	Monterey	  	CA
	282	  	Montgomery Nursing Home	  	Montgomery	  	NY
	283	  	Montgomery Place	  	Chicago	  	IL
	284	  	Moravian Village of Bethlehem	  	Bethlehem	  	PA
	285	  	Mount Carmel Nursing and Rehab	  	Mount Carmel	  	PA
	286	  	Mountain View Specialty Care Center, Inc.	  	Greensburg	  	PA
	287	  	Mt Vernon Countryside Manor	  	Mt. Vernon	  	IL
	288	  	Mulberry Manor	  	Stephenville	  	TX
	289	  	Napa Nursing Ctr	  	Napa	  	CA
	290	  	New Hope Manor	  	Cedar Park	  	TX
	291	  	NMS Healthcare of Hagerstown	  	Hagerstown	  	MD
	292	  	North Point	  	Paola	  	KS
	293	  	Northridge Care Center	  	Reseda	  	CA
	294	  	Northview	  	St. Louis	  	MO
	295	  	Oakland Heights Nursing & Rehab	  	Oakland	  	CA
	296	  	Oakview Heights Continuous Care & Rehab	  	Mt Carmel	  	IL
	297	  	Oklahoma Methodist Manor	  	Tulsa	  	OK
	298	  	Osprey Point	  	Bushnell	  	FL
	299	  	Ozark Mountain Regional H/C	  	Crane	  	MO

							
	300	  	Pacific Haven Healthcare Center	  	Garden Grove	  	CA
	301	  	Palm Terrace of Mattoon	  	Mattoon	  	IL
	302	  	Park Manor of Conroe	  	Conroe	  	TX
	303	  	Park Manor of Cyfair	  	Houston	  	TX
	304	  	Park Manor of Cypress Station	  	Houston	  	TX
	305	  	Park Manor of Humble	  	Humble	  	TX
	306	  	Park Manor of Quail Valley	  	Missouri City	  	TX
	307	  	Park Manor of Southbelt	  	Houston	  	TX
	308	  	Park Manor of The Woodlands	  	The Woodlands	  	TX
	309	  	Park Manor of Tomball	  	Tomball	  	TX
	310	  	Park Manor of Westchase	  	Houston	  	TX
	311	  	Park Manor Rehab & Health Care Ctr	  	Middletown	  	NY
	312	  	Park Place Manor Inc	  	Belton	  	TX
	313	  	Park Ridge Nursing Center	  	Jacksonville	  	FL
	314	  	Park View Health Center	  	Oshkosh	  	WI
	315	  	Park Vista Health Center	  	Fullerton	  	CA
	316	  	Parkhouse	  	Royersord	  	PA
	317	  	Parkway Place	  	Houston	  	TX
	318	  	Pataskala Oaks Care Center	  	Pataskala	  	OH
	319	  	Pathstone Living	  	Mankato	  	MN
	320	  	Pecan Valley Rehab and Healthcare Ctr	  	San Antonio	  	TX
	321	  	Pine Ridge	  	Stevensville	  	MI
	322	  	Placerville Pines Care Ctr	  	Placerville	  	CA
	323	  	Pleasant Springs Healthcare Center	  	Mt. Pleasant	  	TX
	324	  	Pleasant Valley Nursing Center	  	Derry	  	NH
	325	  	Pleasant View	  	Corunna	  	MI
	326	  	Premier Estates of Muscatine (previously Carrington Place of Muscatine)	  	Muscatine	  	IA
	327	  	Preston Residence at Jenners Pond	  	West Grove	  	PA
	328	  	Prestonwood Rehabilitation & Nursing Center	  	Plano	  	TX
	329	  	Providence Place	  	Kansas City	  	KS
	330	  	Quality Care of Waco	  	Waco	  	TX
	331	  	Querencia at Barton Creek	  	Austin	  	TX
	332	  	Red Cliffs Regional	  	St. George	  	UT
	333	  	Redbanks Nursing Home	  	Henderson	  	KY
	334	  	Regency Nursing Care Residence	  	Springfield	  	IL
	335	  	Regents Park at Aventura	  	Aventura	  	FL
	336	  	Regents Park of Boca Raton	  	Boca Raton	  	FL
	337	  	Retama Manor South	  	Victoria	  	TX
	338	  	Retirement Nursing Center	  	Austin	  	TX
	339	  	Riddle Village	  	Media	  	PA
	340	  	Ridgetop Haven Health Care Center	  	Ridgetop	  	TN
	341	  	Rio Rancho Nursing & Rehab Center	  	Rio Rancho	  	NM
	342	  	Riverside Health and Rehab (previously Driftwood Rehab and Nursing Center)	  	Charleston	  	SC
	343	  	Riverview Health & Rehabilitation Center	  	Savannah	  	GA
	344	  	Roan Highlands Nursing Center	  	Roan Mountain	  	TN
	345	  	Roanoke Landing Nursing and Rehabilitation Center	  	Plymouth	  	NC
	346	  	Roanoke River Nursing and Rehabilitation Center	  	Williamston	  	NC
	347	  	Rochelle Rehabilitation Health Care Center	  	Rochelle	  	IL
	348	  	Rome Hosp - Res. Health Care Facility	  	Rome	  	NY

							
	349	  	Roseville Care Ctr	  	Roseville	  	CA
	350	  	Ross Manor	  	Bangor	  	ME
	351	  	Royal Manor Health Center	  	Waco	  	TX
	352	  	Saint Ann’s Home for the Aged	  	Grand Rapids	  	MI
	353	  	Samaritan Keep Hom	  	Watertown	  	NY
	354	  	San Juan Manor	  	Farmington	  	NM
	355	  	Sandalwood Manor, Inc	  	Wheat Ridge	  	CO
	356	  	Seacrest Village Ret Comm	  	Encinitas	  	CA
	357	  	Seal Rock LLC	  	Saco	  	ME
	358	  	Seaside Retirement & Nursing Center	  	Portland	  	ME
	359	  	Seven Acres Jewish Senior Care Services	  	Houston	  	TX
	360	  	Shady Lane	  	Manitowoc	  	WI
	361	  	Sharmar Village Care Center	  	Pueblo	  	CO
	362	  	Shell Point Village Nursing Pavilion	  	Ft. Myers	  	FL
	363	  	Shenandoah Manor Nursing Center	  	Shenandoah	  	PA
	364	  	Sheridan Health Care Center (or The Grove at the Lake)	  	Zion	  	IL
	365	  	Sienna Extended Care & Rehab	  	Midwest City	  	OK
	366	  	Sierra Hills Care Center, Inc.	  	Roseville	  	CA
	367	  	Silverado Senior Living/Turtle Creek	  	Dallas	  	TX
	368	  	Simpson House	  	Philadelphia	  	PA
	369	  	Sister Servants of the Immaculate Heart of Mary	  	Monroe	  	MI
	370	  	Skyline Ridge Nursing and Rehabilitation Center	  	Canon City	  	CO
	371	  	South Elgin Rehabilitation and Health Care Center	  	South Elgin	  	IL
	372	  	Southview Manor	  	Chicago	  	IL
	373	  	Southwest Nursing and Rehab -	  	Ft. Worth	  	TX
	374	  	Spokane Veterans’ Home	  	Spokane	  	WA
	375	  	St Lukes Miners Memorial Geriatric Center	  	Coaldale	  	PA
	376	  	St. Andre Health Care	  	Biddeford	  	ME
	377	  	St. Anne Home, Inc.	  	Greensburg	  	PA
	378	  	St. Catherine Laboure’ Manor	  	Jacksonville	  	FL
	379	  	St. Clair Nursing Center	  	St. Clair	  	MO
	380	  	St. Francis Nursing Center	  	Newport News	  	VA
	381	  	St. Martins in the Pines	  	Irondale	  	AL
	382	  	Stillwater Healthcare	  	Bangor	  	ME
	383	  	Stone Oak Care Center	  	San Antonio	  	TX
	384	  	Stoneridge Towne Center	  	Myerstown	  	PA
	385	  	Sunrise View	  	Everett	  	WA
	386	  	Sunset Hills Health and Rehab Center	  	St. Louis	  	MO
	387	  	Sunset Villa Care Center	  	Roswell	  	NM
	388	  	Sylvan Health Center	  	Clearwater	  	FL
	389	  	TableRock HealthCare	  	Kimberling City	  	MO
	390	  	Terence Cardinal Cooke Health Care Center	  	New York	  	NY
	391	  	Terrace NH Operator	  	Waukegan	  	IL
	392	  	Terrace of Daytona Beach LLC	  	Daytona Beach	  	FL
	393	  	Texoma Healthcare Center	  	Sherman	  	TX
	394	  	The Arbors	  	Amarillo	  	TX
	395	  	The Blakeford at Green Hills	  	Nashville	  	TN
	396	  	The Bluffs (Formerly Boone)	  	Columbia	  	MO
	397	  	The Carriage House of Bay City	  	Bay City	  	MI
	398	  	The Chesapeake	  	Newport News	  	VA

							
	399	  	The Cloisters of Mission Hills (or Shea Family Health Mission Hills)	  	San Diego	  	CA
	400	  	The Fountains at the Carlotta	  	Palm Desert	  	CA
	401	  	The Fountains of Canterbury	  	Oklahoma City	  	OK
	402	  	The Highlands of Dallas (or Forest Lane Healthcare Center)	  	Dallas	  	TX
	403	  	The Jefferson	  	Arlington	  	VA
	404	  	The Legacy at Preston Hollow	  	Dallas	  	TX
	405	  	The Legacy at Willow Bend	  	Plano	  	TX
	406	  	The Meadows at Edgewood	  	North Andover	  	MA
	407	  	The Neighborhoods at Quail Creek - Americare	  	Springfield	  	MO
	408	  	The Neighbors	  	Byron	  	IL
	409	  	The Park in Plano	  	Plano	  	TX
	410	  	The Renaissance of Kessler Park	  	Dallas	  	TX
	411	  	The Riverside	  	New York	  	NY
	412	  	The Riverview	  	St. Louis	  	MO
	413	  	The Sarah Chudnow Campus	  	Mequon	  	WI
	414	  	The Springs at Crystal Lake	  	Crystal Lake	  	IL
	415	  	The Springs at Pacific Regent (or the Fountains at Pacific Regent)	  	Bellevue	  	WA
	416	  	The Village at Gleannloch Farms	  	Spring	  	TX
	417	  	The Village at Northrise - Desert Willow	  	Las Cruces	  	NM
	418	  	The Village at Richardson	  	Richardson	  	TX
	419	  	The Village of Germantown - Skilled	  	Germantown	  	TN
	420	  	The Villages of North Branch	  	North Branch	  	MN
	421	  	The Washington House (or the Fountains at the Washington House)	  	Alexandria	  	VA
	422	  	The Waterford Health Care Center	  	Juno Beach	  	FL
	423	  	Timberlake Care Ctr	  	Kansas City	  	MO
	424	  	Trail Lake Nursing and Rehab	  	Fort Worth	  	TX
	425	  	Trezevant Manor (or Allen Morgan Health & Rehabilitation Center)	  	Memphis	  	TN
	426	  	Tri County Nursing Home	  	Trenton	  	FL
	427	  	Tri-County Extended Care Center	  	Fairfield	  	OH
	428	  	Tudor Oaks Retirement Community	  	Muskego	  	WI
	429	  	Tulare Nursing & Rehab Ctr	  	Tulare	  	CA
	430	  	United Methodist Village North	  	Lawrenceville	  	IL
	431	  	United Zion Retirement Community	  	Lititz	  	PA
	432	  	Valley View Skilled Nursing Ctr	  	Ukiah	  	CA
	433	  	Vantage House	  	Columbia	  	MD
	434	  	Vi at Aventura	  	Aventura	  	FL
	435	  	Vi at Bentley Village	  	Naples	  	FL
	436	  	Vi at Highlands Ranch	  	Highlands Ranch	  	CO
	437	  	Vi at Lakeside Village	  	Lantana	  	FL
	438	  	Vi at the Glen	  	Glenview	  	IL
	439	  	Villa Valencia	  	Laguna Hills	  	CA
	440	  	Vindobona Nursing Home	  	Braddock Heights	  	MD
	441	  	Vista Grande Villa	  	Jackson	  	MI
	442	  	Wadley Care Center	  	Purcell	  	OK
	443	  	Walnut Hills	  	Austin	  	TX
	444	  	Warr Acres	  	Oklahoma City	  	OK
	445	  	Washington Veterans’ Home	  	Retsil	  	WA
	446	  	Wasserman Hebrew Home	  	Rockville	  	MD

							
	447	  	Water’s Edge Extended Care	  	Delray Beach	  	FL
	448	  	Wesley Commons	  	Greenwood	  	SC
	449	  	West Ridge Associates	  	Cedar Rapids	  	IA
	450	  	Westbury	  	Jackson	  	GA
	451	  	Westbury Health & Rehabilitation	  	McDonough	  	GA
	452	  	Westgate Gardens Care Ctr	  	Visalia	  	CA
	453	  	Westminster Manor	  	Austin	  	TX
	454	  	Westminster Village Terre Haute	  	Terre Haute	  	IN
	455	  	Westmont Nursing & Rehab Center	  	Westmont	  	IL
	456	  	Westmoreland	  	Chillicothe	  	OH
	457	  	Westover Hills	  	San Antonio	  	TX
	458	  	Westover Retirement Community	  	Hamilton	  	OH
	459	  	Whispering Pines (now Aperion Care Valparaiso)	  	Valparaiso	  	IN
	460	  	White Oak Rehabilitation & Health Care Center	  	Mount Vernon	  	IL
	461	  	Wichita Presbyterian Manor	  	Wichita	  	KS
	462	  	William Hill Manor	  	Easton	  	MD
	463	  	Willow Gardens Care Center	  	Marion	  	IA
	464	  	Willow Park	  	Lawton	  	OK
	465	  	Willowcreek Rehabilitation and Nursing Center	  	Belleville	  	IL
	466	  	Willows Health Center	  	Rockford	  	IL
	467	  	Windsong Village Convalescent Center	  	Pearland	  	TX
	468	  	Windsor - Monterey Care Center	  	Monterey	  	CA
	469	  	Windsor Chico Care Center	  	Chico	  	CA
	470	  	Windsor Chico Creek Care & Rehabilitation Center	  	Chico	  	CA
	471	  	Windsor Gardens Rehabilitation Center of Salinas	  	Salinas	  	CA
	472	  	Windsor Hills	  	Oklahoma City	  	OK
	473	  	Windsor Redding Care Center	  	Redding	  	CA
	474	  	Windsor-Hampton Care Center	  	Stockton	  	CA
	475	  	Wingate at Andover	  	Andover	  	MA
	476	  	Wingate at Beacon	  	Beacon	  	NY
	477	  	Wingate at Brighton (or Wingate at Boston)	  	Boston	  	MA
	478	  	Wingate at Dutchess	  	Fishkill	  	NY
	479	  	Wingate at East Longmeadow	  	East Longmeadow	  	MA
	480	  	Wingate at Haverhill	  	Haverhill	  	MA
	481	  	Wingate at Lowell	  	Lowell	  	MA
	482	  	Wingate at Needham	  	Needham	  	MA
	483	  	Wingate at Reading	  	Reading	  	MA
	484	  	Wingate at Silver Lake	  	Kingston	  	MA
	485	  	Wingate at South Hadley	  	South Hadley	  	MA
	486	  	Wingate at Springfield	  	Springfield	  	MA
	487	  	Wingate at Sudbury	  	Sudbury	  	MA
	488	  	Wingate at Ulster	  	Highland	  	NY
	489	  	Wingate at West Springfield	  	West Springfield	  	MA
	490	  	Wingate at Wilbraham	  	Wilbraham	  	MA
	491	  	Winterhaven Health Care Center	  	Houston	  	TX
	492	  	Wisconsin Lutheran Care Center	  	Milwaukee	  	WI
	493	  	Wolf Creek Care Center	  	Grass Valley	  	CA
	494	  	Woodland Terrace of Citrus County	  	Hernanado	  	FL
	495	  	Wood-Lawn	  	Batesville	  	AR
	496	  	Woodside Lutheran Home	  	Green Bay	  	WI
	497	  	Wyndemere	  	Wheaton	  	IL
	498	  	Zerbe Sisters Nursing Center	  	Narvon	  	PAEX-10.2

 Exhibit 10.2 

CORPORATE INTEGRITY AGREEMENT 

BETWEEN THE 
 OFFICE OF
INSPECTOR GENERAL 
 OF THE 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

AND 
 REHABCARE GROUP,
INC. 
 AND 

KINDRED HEALTHCARE, INC. 
  

	I.	PREAMBLE  

 RehabCare Group Inc., (RehabCare) and Kindred Healthcare, Inc., (Kindred) hereby enter
into this Corporate Integrity Agreement (CIA) with the Office of Inspector General (OIG) of the United States Department of Health and Human Services (HHS) to promote compliance with the statutes, regulations, and written directives of Medicare,
Medicaid, and all other Federal health care programs (as defined in 42 U.S.C. § 1320a-7b(f)) (Federal health care program requirements). 
 RehabCare
provides contract rehabilitation therapy services to patients in skilled nursing facilities (SNFs), hospitals, and outpatient clinics, and is a wholly-owned subsidiary of Kindred, a healthcare services company that provides a continuum of post-acute
care services in a variety of care settings. Except as otherwise provided herein, this CIA shall apply only to RehabCare and the provision of contract rehabilitation therapy services. Although Kindred undertakes certain obligations under this CIA,
all obligations relate to the operation of RehabCare and shall specifically exclude Kindred subsidiaries or operating divisions that are not involved in providing contract rehabilitation therapy services. Contemporaneously with this CIA, Kindred and
RehabCare are entering into a Settlement Agreement with the United States. 
 Prior to the Effective Date of this CIA (as defined below), Kindred
established a voluntary corporate compliance program (the Compliance Program) which includes a Chief Compliance Officer, Code of Conduct, written policies and procedures, a disclosure program, screening measures, regular compliance training for
employees, and various compliance auditing programs. Kindred shall continue its Compliance Program throughout the term of this CIA and shall do so in accordance with the terms set forth below. Kindred may modify its Compliance Program as
appropriate, but, at a minimum, Kindred shall ensure that during the term of this CIA, it shall comply with the obligations set forth herein. 
  

RehabCare and Kindred - Corporate Integrity Agreement 

  
 1 

	II.	TERM AND SCOPE OF THE CIA 

 A. The period of the compliance obligations assumed by
Kindred under this CIA shall be five years from the effective date of this CIA. The “Effective Date” shall be the date on which the final signatory of this CIA executes this CIA. Each one-year period, beginning with the one-year period
following the Effective Date, shall be referred to as a “Reporting Period.” 
 B. Sections VII, X, and XI shall expire no later
than 120 days after OIG’s receipt of: (1) Kindred’s final annual report; or (2) any additional materials submitted by Kindred pursuant to OIG’s request, whichever is later. 

C. The scope of this CIA shall be governed by the following definitions: 

1. “Covered Persons” includes: 
  

	 	a.	all owners who are natural persons (other than shareholders who: (1) have an ownership interest of less than 5% in Kindred’s stock, and (2) acquired the ownership interest through public trading);

  

	 	b.	all officers, directors, and employees of RehabCare; 

  

	 	c.	officers, directors, and employees of Kindred who provide operational oversight of services provided by RehabCare; 

  

	 	b.	all contractors, subcontractors, agents, and other persons who are involved in the provision, oversight, or support of contract rehabilitation therapy services provided by RehabCare; 

Notwithstanding the above, this term does not include part-time or per diem employees, contractors, subcontractors, agents, and other persons
who are not reasonably expected to work more than 160 hours during a Reporting Period, except that any such individuals shall become “Covered Persons” at the point when they work more than 160 hours during a Reporting Period. 

2. “Relevant Covered Persons” includes all Covered Persons who directly provide contract rehabilitation therapy services, or provide
oversight of or support for contract therapy services, provided by RehabCare in third party owned and operated SNFs. 
  

RehabCare and Kindred - Corporate Integrity Agreement 

  
 2 

	III.	CORPORATE INTEGRITY OBLIGATIONS 

 Kindred shall establish and maintain a
Compliance Program that includes the following elements: 
  

	 	A.	Compliance Officer and Committee 

 1. Compliance Officer. Within 90 days after the
Effective Date, Kindred shall appoint an employee to serve as its Compliance Officer and shall maintain a Compliance Officer for the term of the CIA. The Compliance Officer shall be a member of senior management of Kindred, shall report directly to
the Chief Executive Officer of Kindred, and shall not be or be subordinate to the General Counsel or Chief Financial Officer or have any responsibilities that involve acting in any capacity as legal counsel or supervising legal counsel functions for
Kindred. The Compliance Officer shall be responsible for, without limitation: 
  

	 	a.	developing and implementing policies, procedures, and practices designed to ensure compliance with the requirements set forth in this CIA and with Federal health care program requirements; 

 

	 	b.	making periodic (at least quarterly) reports regarding compliance matters directly to the Board of Directors of Kindred, and shall be authorized to report on such matters to the Board of Directors at any time. Written
documentation of the Compliance Officer’s reports to the Board of Directors shall be made available to OIG upon request; 

  

	 	c.	monitoring the day-to-day compliance activities engaged in by Kindred and RehabCare as well as for any reporting obligations created under this CIA. 

Any noncompliance job responsibilities of the Compliance Officer shall be limited and must not interfere with the Compliance Officer’s
ability to perform the duties outlined in this CIA. 
  
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Corporate Integrity Agreement 

  
 3 

 Kindred shall report to OIG, in writing, any changes in the identity or position description of
the Compliance Officer, or any actions or changes that would affect the Compliance Officer’s ability to perform the duties necessary to meet the obligations in this CIA, within five days after such a change. 

2. Compliance Committee. Within 90 days after the Effective Date, Kindred shall appoint a Compliance Committee. The Compliance
Committee shall, at a minimum, include the Compliance Officer and other members of senior management necessary to meet the requirements of this CIA (e.g., senior executives of relevant Kindred and RehabCare departments, such as billing,
clinical, human resources, audit, and operations). The Compliance Officer shall chair the Compliance Committee and the Committee shall support the Compliance Officer in fulfilling his/her responsibilities (e.g., shall assist in the analysis
of RehabCare’s risk areas and shall oversee monitoring of internal and external audits and investigations). The Compliance Committee shall meet at least quarterly. The minutes of the Compliance Committee meetings shall be made available to OIG
upon request. 
 Kindred shall report to OIG, in writing, any changes in the composition of the Compliance Committee, or any actions or
changes that would affect the Compliance Committee’s ability to perform the duties necessary to meet the obligations in this CIA, within 15 days after such a change. 

3. Board of Directors Compliance Obligations. The Board of Directors (or a committee of the Board) of Kindred (Board) shall be
responsible for the review and oversight of matters related to compliance with Federal health care program requirements and the obligations of this CIA. The Board must include independent (i.e., non-executive) members. 

The Board shall, at a minimum, be responsible for the following: 
  

	 	a.	meeting at least quarterly to review and oversee Kindred’s compliance program for RehabCare, including but not limited to the performance of the Compliance Officer and Compliance Committee; 

 

	 	b.	submitting to the OIG a description of the documents and other materials it reviewed, as well as any additional steps taken, such as the engagement of an independent advisor or other third party resources, in its
oversight of the compliance program and in support of making the resolution below during each Reporting Period; and 

  

	 	c.	for each Reporting Period of the CIA, adopting a resolution, signed by each member of the Board summarizing its review and oversight of RehabCare’s compliance with Federal health care program requirements and the
obligations of this CIA. 

  
 RehabCare and Kindred - Corporate
Integrity Agreement 

  
 4 

 At minimum, the resolution shall include the following language: 

“The Board of Directors has made a reasonable inquiry into the operations of Kindred’s Compliance Program for RehabCare including the
performance of the Compliance Officer and the Compliance Committee. Based on its inquiry and review, the Board has concluded that, to the best of its knowledge, Kindred has implemented an effective Compliance Program for RehabCare to meet Federal
health care program requirements and the obligations of the CIA.” 
 If the Board is unable to provide such a conclusion in the
resolution, the Board shall include in the resolution a written explanation of the reasons why it is unable to provide the conclusion and the steps it is taking to implement an effective Compliance Program for RehabCare. 

Kindred shall report to OIG, in writing, any changes in the composition of the Board, or any actions or changes that would affect the
Board’s ability to perform the duties necessary to meet the obligations in this CIA, within 15 days after such a change. 
 4.
Management Certifications. In addition to the responsibilities set forth in this CIA for all Covered Persons, certain Kindred and RehabCare employees (Certifying Employees) are specifically expected to monitor and oversee activities within
their areas of authority and shall annually certify that the applicable RehabCare division is in compliance with applicable Federal health care program requirements and with the obligations of this CIA. These Certifying Employees shall include, at a
minimum, the following employees (or their functional equivalents): RehabCare - President, Senior Vice President of Finance, Senior Vice President of Quality, Division Vice President of Clinical Operations, Division Vice President of Clinical
Services, Division Senior Vice President of Skilled Rehabilitation Services (SRS), 
  

RehabCare and Kindred - Corporate Integrity Agreement 

  
 5 

 
Senior Vice Presidents of SRS, Regional Vice Presidents of SRS, and Vice President of Sales & Business Development of SRS, Regional Vice Presidents of SRS; and, Kindred - any
Kindred executives who have direct oversight responsibilities for RehabCare including but not limited to the Chief Executive Officer, and Chief Financial Officer. 

For each Reporting Period, each Certifying Employee shall sign a certification that states: 

“I have been trained on and understand the compliance requirements and responsibilities as they relate to [insert name of department], an
area under my supervision. My job responsibilities include ensuring compliance with regard to the [insert name of department] with all applicable Federal health care program requirements, obligations of the Corporate Integrity Agreement, and
Kindred’s policies, and I have taken steps to promote such compliance. To the best of my knowledge, the [insert name of department] of RehabCare is in compliance with all applicable Federal health care program requirements and the obligations
of the Corporate Integrity Agreement. I understand that this certification is being provided to and relied upon by the United States.” 

If any Certifying Employee is unable to provide such a certification, the Certifying Employee shall provide a written explanation of the
reasons why he or she is unable to provide the certification outlined above. 
  

	 	B.	Written Standards 

 1. Code of Conduct. Within 90 days after the Effective Date,
Kindred shall develop, implement, and distribute a written Code of Conduct to all Covered Persons. Kindred shall make the performance of job responsibilities in a manner consistent with the Code of Conduct an element in evaluating the performance of
all employees covered by this CIA. The Code of Conduct shall, at a minimum, set forth: 
  

	 	a.	Kindred’s commitment to full compliance with all Federal health care program requirements, including its commitment to prepare and submit accurate rehabilitation therapy data to its customers, for the purpose of
enabling those customers to submit claims that are consistent with all Federal health care program requirements; 

  

RehabCare and Kindred - Corporate Integrity Agreement 

  
 6 

	 	b.	Kindred’s requirement that all of its Covered Persons shall be expected to comply with all Federal health care program requirements and with Kindred’s own Policies and Procedures; 

 

	 	c.	the requirement that all of Kindred’s Covered Persons shall be expected to report to the Compliance Officer, or other appropriate individual designated by Kindred, suspected violations of any Federal health care
program requirements or of Kindred’s Policies and Procedures; and 

  

	 	d.	the right of all individuals to use the Disclosure Program described in Section III.F, and Kindred’s commitment to nonretaliation and to maintain, as appropriate, confidentiality and anonymity with respect to such
disclosures. 

 Kindred shall review the Code of Conduct at least annually to determine if revisions are appropriate and shall
make any necessary revisions based on such review. The Code of Conduct shall be distributed at least annually to all Covered Persons. 
 2.
Policies and Procedures. Within 90 days after the Effective Date, Kindred shall develop and implement written Policies and Procedures regarding the operation of its compliance program, including the compliance program requirements outlined in
this CIA and Kindred’s compliance with Federal health care program requirements. Throughout the term of this CIA, Kindred shall enforce and comply with its Policies and Procedures and shall make such compliance an element of evaluating the
performance of all employees covered by this CIA. The Policies and Procedures shall address, at a minimum: 
  

	 	a.	the compliance program requirements outlined in this CIA; and 

  

	 	b.	delivery, management and oversight of rehabilitation therapy services by RehabCare to patients in SNFs, including, but not limited to, the requirements that skilled rehabilitation therapy: (1) 

 
 RehabCare and Kindred - Corporate Integrity Agreement 

  
 7 

	 	
be pursuant to a comprehensive assessment and individualized therapy treatment plan; (2) be consistent with the nature and severity of the patient’s individual illness or injury;
(3) comply with accepted standards of medical practice; (4) be reasonable in terms of duration and quantity; (5) be reasonable and necessary given the patient’s condition, and therapy treatment plan to improve, maintain, slow
deterioration of the patient’s condition; and (6) only include services that are so inherently complex that they can be safely and effectively performed only by, or under the supervision of a qualified therapist. 

Within 120 days after the Effective Date, the Policies and Procedures shall be distributed to all Covered Persons. Appropriate and
knowledgeable staff shall be available to explain the Policies and Procedures. 
 At least annually (and more frequently, if appropriate),
Kindred shall assess and update, as necessary, the Policies and Procedures. Within 30 days after the effective date of any revisions or addition of new Policies and Procedures, a description of the revisions shall be communicated to all affected
Covered Persons and any revised or new Policies and Procedures shall be made available to all Covered Persons. 
  

	 	C.	Training and Education 

 1. Training Plan. Within 90 days after the Effective
Date, Kindred shall develop a written plan (Training Plan) that outlines the steps Kindred will take to ensure that: (a) all Covered Persons receive adequate training regarding Kindred’s CIA requirements and Compliance Program, including
the Code of Conduct and (b) all Relevant Covered Persons receive adequate training regarding: (i) the Federal health care program requirements regarding the accuracy of the data required under the Minimum Data Set (MDS) as specified by the
Resident Assessment Instrument User’s Manual, and ensuring appropriate and accurate use of the current Resource Utilization Groups (RUG) classification system; (ii) policies, procedures, and other requirements applicable to the
documentation of therapy services; (iii) the coordinated interdisciplinary approach to providing care and the related communications between rehabilitation therapy disciplines and between skilled nursing and skilled rehabilitation therapy;
(iv) the personal obligation of each individual involved in the provision of therapy services to ensure that a service provided is medically necessary and reasonable given the patient’s condition and treatment plan and meets professionally
recognized standards of care; (v) examples of proper and improper rehabilitation 
  

RehabCare and Kindred - Corporate Integrity Agreement 

  
 8 

 
therapy services, including evaluations and treatment plans; (vi) the personal obligation of each individual involved in the generation and provision of therapy-related information to
RehabCare’s external customers to ensure that such information is accurate and that such skilled therapy services are covered when an individualized assessment of the patient’s clinical condition demonstrates that the specialized judgment,
knowledge, and skills of a qualified therapist are necessary for the performance of the rehabilitation services; (vii) applicable reimbursement statutes, regulations, and program requirements and directives; and (viii) reporting
obligations and legal sanctions for violations of the Federal health care program requirements. 
 The Training Plan shall include
information regarding the training topics, the categories of Covered Persons and Relevant Covered Persons required to attend each training session, the length of the training, the schedule for training, and the format of the training. Within 30 days
of the OIG’s receipt of Kindred’s Training Plan, OIG will notify Kindred of any comments or objections to the Training Plan. Absent notification by the OIG that the Training Plan is unacceptable, Kindred may implement its Training Plan.
Kindred shall furnish training to its Covered Persons and Relevant Covered Persons pursuant to the Training Plan during each Reporting Period. 

If Kindred provided training within 90 days prior to the Effective Date that fully satisfies the all the requirements set forth in Section
III.C.1 above, except for the requirement of prior approval by OIG, then OIG will credit that training for purposes of satisfying the applicable part of either Kindred’s training and education obligations for the first Reporting Period of the
CIA. 
 2. Board Member Training. Within 120 days after the Effective Date, Kindred shall provide at least two hours of training to
each member of the Board of Directors. This training shall address the CIA requirements for Kindred and Kindred’s Compliance Program for RehabCare (including the Code of Conduct), the corporate governance responsibilities of board members, and
the responsibilities of board members with respect to review and oversight of the Compliance Program. Specifically, the training shall address the unique responsibilities of health care Board members, including the risks, oversight areas, and
strategic approaches to conducting oversight of a health care entity. This training may be conducted by an outside compliance expert hired by the Board and should include a discussion of the OIG’s guidance on Board member responsibilities. 

 
 RehabCare and Kindred - Corporate Integrity Agreement 

  
 9 

 New members of the Board of Directors shall receive the Board Member Training described above
within 30 days after becoming a member or within 120 days after the Effective Date, whichever is later. 
 3. Certification. Each
individual who is required to attend training shall certify, in writing or in electronic form, that he or she has received the required training. The certification shall specify the type of training received and the date received. The Compliance
Officer (or designee) shall retain the certifications, along with all course materials. 
 4. Qualifications of Trainer. Persons
providing the training shall be knowledgeable about the subject area. 
 5. Update of Training Plan. Kindred shall review the
Training Plan annually, and, where appropriate, update the Training Plan to reflect changes in Federal health care program requirements, any issues discovered during internal audits or the audits required under this CIA, and any other relevant
information. Any material updates to the Training Plan must be reviewed and approved by the OIG prior to the implementation of the revised Training Plan. Within 30 days of OIG’s receipt of any updates or revisions to Kindred’s Training
Plan, OIG will notify Kindred of any comments or objections to the revised Training Plan. Absent notification from the OIG that the revised Training Plan is unacceptable, Kindred may implement the revised Training Plan. 

6. Computer-based Training. Kindred may provide the training required under this CIA through appropriate computer-based training
approaches. If Kindred chooses to provide computer-based training, they shall make available appropriately qualified and knowledgeable staff or trainers to answer questions or provide additional information to the individuals receiving such
training. 
  

	 	D.	Review Procedures 

 1. General Description 

 

	 	a.	Engagement of Independent Review Organization. Within 90 days after the Effective Date, Kindred shall engage an entity (or entities), such as an accounting, auditing, or consulting firm (hereinafter
“Independent Review Organization” or “IRO”), to perform the reviews listed in 

  

RehabCare and Kindred - Corporate Integrity Agreement 

  
 10 

	 	
this Section III.D. The applicable requirements relating to the IRO are outlined in Appendix A to this CIA, which is incorporated by reference. 

 

	 	b.	Retention of Records. The IRO and Kindred shall retain and make available to OIG, upon request, all work papers, supporting documentation, correspondence, and draft reports (those exchanged between the IRO and
Kindred) related to the reviews. 

 2. Rehabilitation Therapy Services Medical Necessity and Appropriateness Review.
For each Reporting Period, the IRO shall review RehabCare’s provision of rehabilitation therapy services under contracts between RehabCare and third party owned and operated SNFs to determine RehabCare’s adherence to federal program
requirements and conformance to generally accepted medical practices (Rehab Medical Review), and shall prepare a Rehab Medical Review Report, as outlined in Appendix B to this CIA, which is incorporated by reference. 

3. Validation Review. In the event OIG has reason to believe that: (a) any Rehab Medical Review fails to conform to the
requirements of this CIA; or (b) the IRO’s findings or Rehab Medical Review results are inaccurate, OIG may, at its sole discretion, conduct its own review to determine whether the Rehab Medical Review complied with the requirements of the
CIA and/or the findings or Rehab Medical Review results are inaccurate (Validation Review). Kindred shall pay for the reasonable cost of any such review performed by OIG or any of its designated agents. Any Validation Review of a Rehab Medical
Review submitted as part of Kindred’s final Annual Report shall be initiated no later than one year after Kindred’s final submission (as described in Section II) is received by OIG. 

Prior to initiating a Validation Review, OIG shall notify Kindred in writing of its intent to do so and provide an explanation of the reasons
OIG has determined a Validation Review is necessary. Kindred shall have 30 days following the date of the OIG’s written notice to submit a written response to OIG that includes any additional information to clarify the results of the Rehab
Medical Review or to correct the inaccuracy of the Rehab Medical Review; and/or propose alternatives to the proposed Validation Review. The final determination as to whether or not to proceed with a Validation Review shall be made at the sole
discretion of OIG. 
  
 RehabCare and Kindred - Corporate Integrity Agreement

  
 11 

 4. Independence and Objectivity Certification. The IRO shall include in its report(s) to
Kindred a certification that the IRO has (a) evaluated its professional independence and objectivity with respect to the reviews required under this Section III.D and (b) concluded that it is, in fact, independent and objective, in
accordance with the requirements specified in Appendix A to this CIA. 
  

	 	E.	Risk Assessment and Internal Review Process 

 Within 90 days after the Effective
Date, Kindred shall develop and implement a centralized annual risk assessment and internal review process to identify and address risks associated with the provision of rehabilitation therapy information, items or services furnished to Medicare and
Medicaid program beneficiaries for which claims may be submitted. The risk assessment and internal review process should require compliance, legal, and department leaders, at least annually, to: (1) identify and prioritize risks,
(2) develop internal audit work plans related to the identified risk areas, (3) implement the internal audit work plans, (4) develop corrective action plans in response to the results of any internal audits performed, and
(5) track the implementation of the corrective action plans in order to assess the effectiveness of such plans. Kindred shall maintain the risk assessment and internal review process for the term of the CIA. 

 

	 	F.	Disclosure Program 

 Within 90 days after the Effective Date, Kindred shall
establish a Disclosure Program that includes a mechanism (e.g., a toll-free compliance telephone line) to enable individuals to disclose, to the Compliance Officer or some other person who is not in the disclosing individual’s chain of
command, any identified issues or questions associated with Kindred’s policies, conduct, practices, or procedures with respect to a Federal health care program believed by the individual to be a potential violation of criminal, civil, or
administrative law. Kindred shall appropriately publicize the existence of the disclosure mechanism (e.g., via periodic e-mails to employees or by posting the information in prominent common areas). 

The Disclosure Program shall emphasize a nonretribution, nonretaliation policy, and shall include a reporting mechanism for anonymous
communications for which appropriate confidentiality shall be maintained. Upon receipt of a disclosure, the Compliance Officer (or designee) shall gather all relevant information from the disclosing individual. The Compliance Officer (or designee)
shall make a preliminary, good faith inquiry into the allegations set forth in every disclosure to ensure that he or 
  

RehabCare and Kindred - Corporate Integrity Agreement 

  
 12 

 
she has obtained all of the information necessary to determine whether a further review should be conducted. For any disclosure that is sufficiently specific so that it reasonably:
(1) permits a determination of the appropriateness of the alleged improper practice; and (2) provides an opportunity for taking corrective action, Kindred shall conduct an internal review of the allegations set forth in the disclosure and
ensure that proper follow-up is conducted. 
 The Compliance Officer (or designee) shall maintain a disclosure log for all disclosures
directly or indirectly related to the provision of contract rehabilitation therapy services and shall record each disclosure in the disclosure log within 48 hours of receipt of the disclosure. The disclosure log shall include a summary of each
disclosure received (whether anonymous or not), the status of the respective internal reviews, and any corrective action taken in response to the internal reviews. 
  

	 	G.	Ineligible Persons 

 1. Definitions. For purposes of this CIA: 

 

	 	a.	an “Ineligible Person” shall include an individual or entity who: 

  

	 	i.	is currently excluded, debarred, or suspended from participation in the Federal health care programs or in Federal procurement or nonprocurement programs; or 

 

	 	ii.	has been convicted of a criminal offense that falls within the scope of 42 U.S.C. § 1320a-7(a), but has not yet been excluded, debarred, or suspended. 

 

	 	b.	“Exclusion Lists” include: 

  

	 	i.	the HHS/OIG List of Excluded Individuals/Entities (LEIE) (available through the Internet at http://www.oig.hhs.gov); and 

  

	 	ii.	the General Services Administration’s System for Award Management (SAM) (available through the Internet at http://www.sam.gov). 

 
 RehabCare and Kindred - Corporate Integrity Agreement 

  
 13 

 2. Screening Requirements. Kindred shall ensure that all prospective and current Covered
Persons are not Ineligible Persons, by implementing the following screening requirements. 
  

	 	a.	Kindred shall screen all prospective Covered Persons against the Exclusion Lists prior to engaging their services and, as part of the hiring or contracting process, shall require such Covered Persons to disclose whether
they are Ineligible Persons. 

  

	 	b.	Kindred shall screen all current Covered Persons against the Exclusion Lists within 90 days after the Effective Date and thereafter shall screen against the LEIE on a monthly basis and screen against SAM on an annual
basis. 

  

	 	c.	Kindred shall implement a policy requiring all Covered Persons to disclose immediately any debarment, exclusion, or suspension. 

Nothing in this Section III.G affects Kindred’s responsibility to refrain from (and liability for) billing Federal health care programs
for items or services furnished, ordered, or prescribed by an excluded person. Kindred understands that items or services furnished, ordered, or prescribed by excluded persons are not payable by Federal health care programs and that Kindred may be
liable for overpayments and/or criminal, civil, and administrative sanctions for employing or contracting with an excluded person regardless of whether Kindred meets the requirements of Section III.G. 

3. Removal Requirement. If Kindred has actual notice that a Covered Person has become an Ineligible Person, Kindred shall remove such
Covered Person from responsibility for, or involvement with, Kindred’s provision of services or other business operations related to the Federal health care programs and shall remove such Covered Person from any position for which the Covered
Person’s compensation or the items or services furnished, ordered, or prescribed by the Covered Person are paid in whole or part, directly or indirectly, by Federal health care programs or otherwise with Federal funds at least until such time
as the Covered Person is reinstated into participation in the Federal health care programs. 
  

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 14 

 4. Pending Charges and Proposed Exclusions. If Kindred has actual notice that a Covered
Person is charged with a criminal offense that falls within the scope of 42 U.S.C. §§ 1320a-7(a), 1320a-7(b)(1)-(3), or is proposed for exclusion during the Covered Person’s employment or contract term, Kindred shall take all
appropriate actions to ensure that the responsibilities of that Covered Person have not and shall not adversely affect the quality of care rendered to any beneficiary, patient, or resident, or the accuracy of any information provided for the
preparation of claims submitted to any Federal health care program. 
  

	 	H.	Notification of Government Investigation or Legal Proceeding 

 Within 30 days
after discovery, Kindred shall notify OIG, in writing, of any ongoing investigation or legal proceeding known to Kindred conducted or brought by a governmental entity or its agents involving an allegation that any operational division or operating
unit within Kindred Healthcare, Inc. has committed a crime or has engaged in fraudulent activities. This notification shall include a description of the allegation, the identity of the investigating or prosecuting agency, and the status of such
investigation or legal proceeding. Kindred shall also provide written notice to OIG within 30 days after the resolution of the matter, and shall provide OIG with a description of the findings and/or results of the investigation or proceeding, if
any. 
  

	 	I.	Reportable Events 

 1. Definition of Reportable Event. For purposes of this CIA, a
“Reportable Event” means anything that involves: 
  

	 	a.	a matter that a reasonable person would consider a probable violation of criminal, civil, or administrative laws applicable to any Federal health care program for which penalties or exclusion may be authorized;

  

	 	b.	the employment of or contracting with a Covered Person who is an Ineligible Person as defined by Section III.G.1.a; or 

  

	 	c.	the filing of a bankruptcy petition by any operating division of Kindred. 

 A Reportable Event may be the
result of an isolated event or a series of occurrences. 
  
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Corporate Integrity Agreement 

  
 15 

 2. Reporting of Reportable Events. If Kindred determines (after a reasonable opportunity
to conduct an appropriate review or investigation of the allegations) through any means that there is a Reportable Event, Kindred shall notify OIG, in writing, within 30 days after making the determination that the Reportable Event exists. 

3. Reportable Events under Section III.I.1.a. For Reportable Events under Section III.I.1.a, the report to OIG shall include: 

 

	 	a.	a complete description of all details relevant to the Reportable Event, including, at a minimum, the types of claims, transactions or other conduct giving rise to the Reportable Event; the period during which the
conduct occurred; and the names of entities and individuals believed to be implicated, including an explanation of their roles in the Reportable Event; 

  

	 	b.	a statement of the Federal criminal, civil or administrative laws that are probably violated by the Reportable Event; 

  

	 	c.	the Federal health care programs affected by the Reportable Event; 

  

	 	d.	a description of Kindred’s actions taken to correct the Reportable Event and prevent it from recurring. 

4. Reportable Events under Section III.I.1.b. For Reportable Events under Section III.I.1.b, the report to OIG shall include: 

 

	 	a.	the identity of the Ineligible Person and the job duties performed by that individual; 

  

	 	b.	the dates of the Ineligible Persons employment or contractual relationship; 

  

	 	c.	a description of the Exclusion Lists screening that Kindred completed before and/or during the Ineligible Person’s employment or contract and any flaw or breakdown in the Ineligible Persons screening process that
led to the hiring or contracting with the Ineligible Person; 

  

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	 	d.	a description of how the Reportable Event was discovered; and 

  

	 	e.	a description of any corrective action implemented to prevent future employment or contracting with an Ineligible Person. 

5. Reportable Events under Section III.I.1.c. For Reportable Events under Section III.I.1.c, the report to the OIG shall include
documentation of the bankruptcy filing and a description of any Federal health care program authorities implicated. 
 6. Reportable
Events Involving the Stark Law. If applicable, notwithstanding the reporting requirements outlined above, any Reportable Event that involves solely a probable violation of section 1877 of the Social Security Act, 42 U.S.C. §1395nn (the
Stark Law) should be submitted by Kindred to the Centers for Medicare & Medicaid Services (CMS) through the self-referral disclosure protocol (SRDP), with a copy to the OIG. If Kindred identifies a probable violation of the Stark Law and
repays the applicable overpayment directly to the CMS contractor, then Kindred is not required by this Section III.I to submit the Reportable Event to CMS through the SRDP. 
  

	IV.	SUCCESSOR LIABILITY; CHANGES TO BUSINESS UNITS OR LOCATIONS 

  

	 	A.	Sale of Business, Business Unit or Location 

 In the event that, after the Effective
Date, Kindred proposes to sell any or all of its contract rehabilitation therapy business, business units or locations (whether through a sale of assets, sale of stock, or other type of transaction) that are subject to this CIA, Kindred shall notify
OIG of the proposed sale at least 30 days prior to the sale of its contract rehabilitation therapy business, business unit or location. For purposes of this CIA, a business unit or location shall not include sites of services in which Kindred has no
ownership interest. This notification shall include a description of the contract rehabilitation therapy business, business unit or location to be sold, a brief description of the terms of the sale, and the name and contact information of the 

 
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prospective purchaser. This CIA shall be binding on the purchaser of the contract rehabilitation therapy business, business unit or location, unless otherwise determined and agreed to in writing
by the OIG. 
  

	 	B.	Change or Closure of Business, Business Unit or Location 

 In the event that, after the
Effective Date, Kindred changes locations or closes a contract rehabilitation therapy business, business unit or location Kindred shall notify OIG of this fact as soon as possible, but no later than 30 days after the date of change or closure of the
business, business unit or location. 
  

	 	C.	Purchase or Establishment of New Business, Business Unit or Location 

 In the
event that, after the Effective Date, Kindred purchases or establishes a new contract rehabilitation therapy business, business unit or location Kindred shall notify OIG at least 30 days prior to such purchase or the operation of the new contract
rehabilitation therapy business, business unit or location. This notification shall include the address of the new contract rehabilitation therapy business, business unit or location, phone number, fax number, and, if applicable, the Medicare and
state Medicaid program provider number and/or supplier number(s). Each new contract rehabilitation therapy business, business unit or location and all Covered Persons at each new business, business unit or location shall be subject to the applicable
requirements of this CIA, unless otherwise determined and agreed to in writing by the OIG. 
  

	V.	IMPLEMENTATION AND ANNUAL REPORTS 

  

	 	A.	Implementation Report 

 Within 150 days after the Effective Date, Kindred shall submit a
written report to OIG summarizing the status of its implementation of the requirements of this CIA (Implementation Report). The Implementation Report shall, at a minimum, include: 

1. the name, address, phone number, and position description of the Compliance Officer required by Section III.A, and a summary of other
noncompliance job responsibilities the Compliance Officer may have; 
 2. the names and positions of the members of the Compliance Committee
required by Section III.A; 
  
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 3. the names of the Board members who are responsible for satisfying the Board of Directors
compliance obligations described in Section III.A.3; 
 4. the names and positions of the Certifying Employees required by Section III.A.4;

 5. a copy of Kindred’s Code of Conduct required by Section III.B.1; 

6. a summary of all Policies and Procedures required by Section III.B (copies of the Policies and Procedures shall be made available to OIG
upon request); 
 7. the Training Plan required by Section III.C.1 and a description of the Board of Directors training required by Section
III.C.2 (including a summary of the topics covered, the length of the training; and when the training was provided); 
 8. the following
information regarding the IRO(s): (a) identity, address, and phone number; (b) a copy of the engagement letter; (c) information to demonstrate that the IRO has the qualifications outlined in Appendix A to this CIA; (d) a summary
and description of any and all current and prior engagements and agreements between Kindred and the IRO; and (e) a certification from the IRO regarding its professional independence and objectivity with respect to Kindred; 

9. a description of the risk assessment and internal review process required by Section III.E; 

10. a description of the Disclosure Program required by Section III.F; 

11. a certification that Kindred has implemented the screening requirements described in Section III.G regarding Ineligible Persons, or a
description of why Kindred cannot provide such a certification; 
 12. a description of Kindred’s corporate structure, including
identification of any parent and sister companies, subsidiaries, and their respective lines of business; 
 13. a list of all of
Kindred’s contract therapy business units or locations as defined by Section IV (including mailing addresses), the corresponding name under which each location is doing business; the corresponding phone numbers and fax numbers, and if
applicable, each location’s Medicare and state Medicaid program provider number(s) and/or National Provider Identifier number(s); and 

14. the certifications required by Section V.C. 
  

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	 	B.	Annual Reports 

 Kindred shall submit to OIG annually a report with respect to the status
of, and findings regarding, Kindred’s compliance activities for each of the five Reporting Periods (Annual Report). Each Annual Report shall include, at a minimum: 

1. any change in the identity, position description, or other noncompliance job responsibilities of the Compliance Officer; any change in the
membership of the Compliance Committee described in Section III.A, any change in the Board members who are responsible for satisfying the Board of Directors compliance obligations described in Section III.A.3, and any change in the group of
Certifying Employees described in Section III.A.4; 
 2. the dates of each report made by the Compliance Officer to the Board (written
documentation of such reports shall be made available to OIG upon request); 
 3. the Board resolution required by Section III.A.3 and a
description of the documents and other materials reviewed by the Board, as well as any additional steps taken, in its oversight of the compliance program and in support of making the resolution; 

4. a summary of any significant changes or amendments to Kindred’s Code of Conduct or the Policies and Procedures required by Section
III.B and the reasons for such changes (e.g., change in contractor policy); 
 5. a copy of Kindred’s Training Plan developed
under Section III.C and the following information regarding each type of training required by the Training Plan: a description of the training, including a summary of the topics covered; the length of sessions, a schedule of training sessions, a
general description of the categories of individuals required to complete the training, and the process by which Kindred ensures that all designated employees receive appropriate training. A copy of all training materials and the documentation to
support this information shall be made available to OIG upon request. 
  
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 6. a complete copy of all reports prepared pursuant to Section III.D, along with a copy of the
IRO’s engagement letter, and Kindred’s response to the reports, along with corrective action plan(s) related to any issues raised by the reports; 

7. a summary and description of any and all current and prior engagements and agreements between Kindred and the IRO (if different from what
was submitted as part of the Implementation Report) and a certification from the IRO regarding its professional independence and objectivity with respect to Kindred; 

8. a description of the risk assessment and internal review process required by Section III.E, a summary of any material changes to the
process, and a description of the reasons for such changes; 
 9. a summary of all internal audits performed pursuant to Section III.E
during the Reporting Period and any corrective action plans developed in response to those internal audits. Copies of the internal audit reports and corrective action plans shall be made available to OIG upon request; 

10. a summary of the disclosures in the disclosure log required by Section III.F that relate to Federal health care programs (the complete
disclosure log shall be made available to OIG upon request); 
 11. a certification that Kindred has completed the screening required by
Section III.G regarding Ineligible Persons; 
 12. a summary describing any ongoing investigation or legal proceeding required to have been
reported pursuant to Section III.H. The summary shall include a description of the allegation, the identity of the investigating or prosecuting agency, and the status of such investigation or legal proceeding; 

13. a summary of Reportable Events (as defined in Section III.I) identified during the Reporting Period and the status of any corrective
action relating to all such Reportable Events; 
 14. if applicable, a summary describing any audits conducted during the applicable
Reporting Period by a Medicare or state Medicaid program contractor or any government entity or contractor, involving a review of Federal health care program claims for rehabilitation therapy by RehabCare, and Kindred’s response/corrective
action plan (including information regarding any Federal health care program refunds) relating to the audit findings; 
  

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 15. a description of all changes to the most recently provided list of Kindred’s contract
therapy business units or locations (including addresses) as required by Section V.A.13; and 
 16. the certifications required by Section
V.C. 
 The first Annual Report shall be received by OIG no later than 60 days after the end of the first Reporting Period. Subsequent
Annual Reports shall be received by OIG no later than the anniversary date of the due date of the first Annual Report. 
  

	 	C.	Certifications  

 1. Certifying Employees. In each Annual Report, Kindred shall
include the certifications of Certifying Employees as required by Section III.A.4; 
 2. Compliance Officer and Chief Executive Officer.
The Implementation Report and each Annual Report shall include a certification by the Compliance Officer and Chief Executive Officer that: 
  

	 	a.	to the best of his or her knowledge, except as otherwise described in the report, Kindred and RehabCare are in compliance with all of the requirements of this CIA; and 

 

	 	b.	he or she has reviewed the report and has made reasonable inquiry regarding its content and believes that the information in the report is accurate and truthful. 

3. Chief Financial Officer. The first Annual Report shall include a certification by Kindred’s Chief Financial Officer that, to
the best of his or her knowledge, Kindred has complied with its obligations under the Settlement Agreement: (a) if applicable, not to resubmit to any Federal health care program payors any previously denied claims related to the Covered Conduct
addressed in the Settlement Agreement, and not to appeal any such denials of claims; (b) not to charge to or otherwise seek payment from federal or state payors for unallowable costs (as defined in the Settlement Agreement); and (c) to
identify and adjust any past charges or claims for unallowable costs. 
  
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	 	D.	Designation of Information 

 Kindred shall clearly identify any portions of its
submissions that it believes are trade secrets, or information that is commercial or financial and privileged or confidential, and therefore potentially exempt from disclosure under the Freedom of Information Act (FOIA), 5 U.S.C. § 552. Kindred
shall refrain from identifying any information as exempt from disclosure if that information does not meet the criteria for exemption from disclosure under FOIA. 
  

	VI.	NOTIFICATIONS AND SUBMISSION OF REPORTS 

 Unless otherwise stated in writing after
the Effective Date, all notifications and reports required under this CIA shall be submitted to the following entities: 
 OIG: 

Administrative and Civil Remedies Branch 

Office of Counsel to the Inspector General 

Office of Inspector General 

U.S. Department of Health and Human Services 

Cohen Building, Room 5527 
 330
Independence Avenue, S.W. 
 Washington, DC 20201 

Telephone: 202.619.2078 

Facsimile: 202.205.0604 

Kindred and RehabCare: 

Kelly Priegnitz 
 Senior Vice
President and Chief Compliance Officer 
 680 South Fourth Street 

Louisville, KY 40202 

Telephone: (502) 596-7320 

Unless otherwise specified, all notifications and reports required by this CIA may be made by certified mail, overnight mail, hand delivery,
or other means, provided that there is proof that such notification was received. For purposes of this requirement, internal facsimile confirmation sheets do not constitute proof of receipt. Upon request by OIG, Kindred may be required to provide
OIG with an electronic copy of each notification or report required by this CIA in searchable portable document format (pdf), in addition to a paper copy. 
  

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	VII.	OIG INSPECTION, AUDIT, AND REVIEW RIGHTS 

 In addition to any other rights
OIG may have by statute, regulation, or contract, OIG or its duly authorized representative(s) may examine and/or request copies of Kindred’s books, records, and other documents and supporting materials that relate to contract rehabilitation
therapy services and/or conduct on-site reviews of any of Kindred’s contract rehabilitation therapy business unit locations, for the purpose of verifying and evaluating: (a) Kindred’s and RehabCare’s compliance with the terms of
this CIA and (b) Kindred’s and RehabCare’s compliance with the requirements of the Federal health care programs. The documentation described above shall be made available by Kindred to OIG or its duly authorized representative(s) at
all reasonable times for inspection, audit, and/or reproduction. Furthermore, for purposes of this provision, OIG or its duly authorized representative(s) may interview any of Kindred’s or RehabCare’s Covered Persons who consent to be
interviewed at the individual’s place of business during normal business hours or at such other place and time as may be mutually agreed upon between the individual and OIG. Kindred shall assist OIG or its duly authorized representative(s) in
contacting and arranging interviews with such individuals upon OIG’s request. Kindred’s and RehabCare’s Covered Persons may elect to be interviewed with or without a representative of Kindred or RehabCare present. 

 

	VIII.	DOCUMENT AND RECORD RETENTION 

 Kindred and RehabCare shall maintain for
inspection all documents and records relating to reimbursement from the Federal health care programs and to compliance with this CIA for six years (or longer if otherwise required by law) from the Effective Date. 

 

	IX.	DISCLOSURES 

 Consistent with HHS’s FOIA procedures, set forth in 45
C.F.R. Part 5, OIG shall make a reasonable effort to notify Kindred prior to any release by OIG of information submitted by Kindred pursuant to its obligations under this CIA and identified upon submission by Kindred as trade secrets, or information
that is commercial or financial and privileged or confidential, under the FOIA rules. With respect to such releases, Kindred shall have the rights set forth at 45 C.F.R. § 5.65(d). 

 
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	X.	BREACH AND DEFAULT PROVISIONS 

 Kindred and RehabCare are expected to fully and
timely comply with all of their CIA obligations. 
  

	 	A.	Stipulated Penalties for Failure to Comply with Certain Obligations 

 As a contractual
remedy, Kindred, RehabCare and OIG hereby agree that failure to comply with certain obligations as set forth in this CIA may lead to the imposition of the following monetary penalties (hereinafter referred to as “Stipulated Penalties”) in
accordance with the following provisions. 
 1. A Stipulated Penalty of $2,500 (which shall begin to accrue on the day after the date the
obligation became due) for each day Kindred and/or RehabCare, as applicable, fails to establish and implement any of the following obligations as described in Sections III and IV: 

 

	 	a.	a Compliance Officer; 

  

	 	b.	a Compliance Committee; 

  

	 	c.	the Board of Directors compliance obligations; 

  

	 	d.	the management certification obligations; 

  

	 	e.	a written Code of Conduct; 

  

	 	f.	written Policies and Procedures; 

  

	 	g.	the development and/or implementation of a Training Plan for the training of Covered Persons, Relevant Covered Persons, and Board Members; 

 

	 	h.	a risk assessment and internal review process as required by Section III.E; 

  

	 	i.	a Disclosure Program; 

  

	 	j.	Ineligible Persons screening and removal requirements; 

  

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	 	k.	notification of Government investigations or legal proceedings; 

  

	 	l.	reporting of Reportable Events; and 

  

	 	m.	disclosure of changes to Kindred’s contract therapy business units or locations. 

 2. A
Stipulated Penalty of $2,500 (which shall begin to accrue on the day after the date the obligation became due) for each day Kindred and/or RehabCare, as applicable, fails to engage and use an IRO, as required by Section III.D, Appendix A, or
Appendix B. 
 3. A Stipulated Penalty of $2,500 (which shall begin to accrue on the day after the date the obligation became due) for
each day Kindred and/or RehabCare, as applicable, fails to submit the Implementation Report or any Annual Reports to OIG in accordance with the requirements of Section V by the deadlines for submission. 

4. A Stipulated Penalty of $2,500 (which shall begin to accrue on the day after the date the obligation became due) for each day Kindred
and/or RehabCare, as applicable, fails to submit any report in accordance with the requirements of Section III.D and Appendix B. 
 5. A
Stipulated Penalty of $1,500 for each day Kindred and/or RehabCare, as applicable, fails to grant access as required in Section VII. (This Stipulated Penalty shall begin to accrue on the date Kindred fails to grant access.) 

6. A Stipulated Penalty of $50,000 for each false certification submitted by or on behalf of Kindred and/or RehabCare, as applicable, as part
of its Implementation Report, any Annual Report, additional documentation to a report (as requested by the OIG), or otherwise required by this CIA. 

7. A Stipulated Penalty of $1,000 for each day Kindred and/or RehabCare, as applicable, fails to comply fully and adequately with any
obligation of this CIA. OIG shall provide notice to Kindred stating the specific grounds for its determination that Kindred and/or RehabCare, as applicable, has failed to comply fully and adequately with the CIA obligation(s) at issue and steps
Kindred shall take to 
  
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comply with the CIA. (This Stipulated Penalty shall begin to accrue 10 days after the date Kindred receives this notice from OIG of the failure to comply.) A Stipulated Penalty as described in
this Subsection shall not be demanded for any violation for which OIG has sought a Stipulated Penalty under Subsections 1- 6 of this Section. 
  

	 	B.	Timely Written Requests for Extensions 

 Kindred may, in advance of the due date,
submit a timely written request for an extension of time to perform any act or file any notification or report required by this CIA. Notwithstanding any other provision in this Section, if OIG grants the timely written request with respect to an
act, notification, or report, Stipulated Penalties for failure to perform the act or file the notification or report shall not begin to accrue until one day after Kindred fails to meet the revised deadline set by OIG. Notwithstanding any other
provision in this Section, if OIG denies such a timely written request, Stipulated Penalties for failure to perform the act or file the notification or report shall not begin to accrue until three days after Kindred receives OIG’s written
denial of such request or the original due date, whichever is later. A “timely written request” is defined as a request in writing received by OIG at least five days prior to the date by which any act is due to be performed or any
notification or report is due to be filed. 
  

	 	C.	Payment of Stipulated Penalties 

 1. Demand Letter. Upon a finding that
Kindred and/or RehabCare, as applicable, has failed to comply with any of the obligations described in Section X.A and after determining that Stipulated Penalties are appropriate, OIG shall notify Kindred of: (a) Kindred’s or
RehabCare’s failure to comply; and (b) OIG’s exercise of its contractual right to demand payment of the Stipulated Penalties. (This notification shall be referred to as the “Demand Letter.”) 

2. Response to Demand Letter. Within 10 days after the receipt of the Demand Letter, Kindred and/or RehabCare, as applicable, shall
either: (a) cure the breach to OIG’s satisfaction and pay the applicable Stipulated Penalties or (b) request a hearing before an HHS administrative law judge (ALJ) to dispute OIG’s determination of noncompliance, pursuant to the
agreed upon provisions set forth below in Section X.E. In the event Kindred and/or RehabCare, as applicable, elects to request an ALJ hearing, the Stipulated Penalties shall continue to accrue until Kindred and/or RehabCare, as applicable, cures, to
OIG’s satisfaction, the alleged breach in dispute. Failure to respond to the Demand Letter in one of these two manners within the allowed time period shall be considered a material breach of this CIA and shall be grounds for exclusion of
RehabCare under Section X.D. 
  
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 3. Form of Payment. Payment of the Stipulated Penalties shall be made by electronic funds
transfer to an account specified by OIG in the Demand Letter. 
 4. Independence from Material Breach Determination. Except as
set forth in Section X.D.1.c, these provisions for payment of Stipulated Penalties shall not affect or otherwise set a standard for OIG’s decision that Kindred and/or RehabCare has materially breached this CIA, which decision shall be made at
OIG’s discretion and shall be governed by the provisions in Section X.D, below. 
  

	 	D.	Exclusion for Material Breach of this CIA 

 1. Definition of Material Breach. A
material breach of this CIA means: 
  

	 	a.	repeated violations or a flagrant violation of any of the obligations under this CIA, including, but not limited to, the obligations addressed in Section X.A; 

 

	 	b.	a failure to report a Reportable Event, take corrective action, or make the appropriate refunds, as required in Section III.I; 

  

	 	c.	a failure to respond to a Demand Letter concerning the payment of Stipulated Penalties in accordance with Section X.C; or 

  

	 	d.	a failure to engage and use an IRO in accordance with Section III.D, Appendix A, Appendix B. 

2. Notice of Material Breach and Intent to Exclude. The parties agree that a material breach of this CIA by Kindred or RehabCare
constitutes an independent basis for RehabCare’s exclusion from participation in the Federal health care programs. The length of the exclusion shall be in the OIG’s discretion, but not more than five years per material breach. Upon a
determination by OIG that Kindred or RehabCare has materially breached this CIA and that exclusion is the appropriate 
  

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remedy, OIG shall notify Kindred of: (a) the material breach; and (b) OIG’s intent to exercise its contractual right to impose exclusion. (This notification shall be referred to as
the “Notice of Material Breach and Intent to Exclude.”) 
 3. Opportunity to Cure. Kindred shall have 30 days from the date
of receipt of the Notice of Material Breach and Intent to Exclude to demonstrate that: 
  

	 	a.	the alleged material breach has been cured; or 

  

	 	b.	the alleged material breach cannot be cured within the 30 day period, but that: (i) Kindred and/or RehabCare, as applicable, has begun to take action to cure the material breach; (ii) Kindred and/or RehabCare,
as applicable, is pursuing such action with due diligence; and (iii) Kindred and/or RehabCare, as applicable, has provided to OIG a reasonable timetable for curing the material breach. 

4. Exclusion Letter. If, at the conclusion of the 30 day period, Kindred fails to satisfy the requirements of Section X.D.3, OIG may
exclude RehabCare from participation in the Federal health care programs. OIG shall notify Kindred in writing of its determination to exclude RehabCare. (This letter shall be referred to as the “Exclusion Letter.”) Subject to the Dispute
Resolution provisions in Section X.E, below, the exclusion shall go into effect 30 days after the date of Kindred’s receipt of the Exclusion Letter. The exclusion shall have national effect. Reinstatement to program participation is not
automatic. At the end of the period of exclusion, RehabCare may apply for reinstatement by submitting a written request for reinstatement in accordance with the provisions at 42 C.F.R. §§ 1001.3001-.3004. 

 

	 	E.	Dispute Resolution 

 1. Review Rights. Upon OIG’s delivery to Kindred of its
Demand Letter or Exclusion Letter, and as an agreed-upon contractual remedy for the resolution of disputes arising under this CIA, Kindred and RehabCare shall be afforded certain review rights comparable to the ones that are provided in 42 U.S.C.
§ 1320a-7(f) and 42 C.F.R. Part 1005 as if they applied to the Stipulated Penalties or exclusion sought pursuant to this CIA. Specifically, OIG’s determination to demand payment of Stipulated Penalties or to seek exclusion shall be subject
to review by an HHS ALJ and, in the event of an appeal, the HHS Departmental Appeals Board (DAB), in a manner consistent with the provisions in 42 C.F.R. § 1005.2-1005.21. 

 
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 Notwithstanding the language in 42 C.F.R. § 1005.2(c), the request for a hearing involving Stipulated
Penalties shall be made within 10 days after receipt of the Demand Letter and the request for a hearing involving exclusion shall be made within 25 days after receipt of the Exclusion Letter. The procedures relating to the filing of a request for a
hearing can be found at http://www.hhs.gov/dab/divisions/civil/procedures/divisionprocedures.html. 
 2. Stipulated Penalties
Review. Notwithstanding any provision of Title 42 of the United States Code or Title 42 of the Code of Federal Regulations, the only issues in a proceeding for Stipulated Penalties under this CIA shall be: (a) whether Kindred and/or
RehabCare, as applicable, were in full and timely compliance with the obligations of this CIA for which OIG demands payment; and (b) the period of noncompliance. Kindred and RehabCare shall have the burden of proving its full and timely
compliance and the steps taken to cure the noncompliance, if any. OIG shall not have the right to appeal to the DAB an adverse ALJ decision related to Stipulated Penalties. If the ALJ agrees with OIG with regard to a finding of a breach of this CIA
and orders Kindred and/or RehabCare, as applicable, to pay Stipulated Penalties, such Stipulated Penalties shall become due and payable 20 days after the ALJ issues such a decision unless Kindred or RehabCare requests review of the ALJ decision by
the DAB. If the ALJ decision is properly appealed to the DAB and the DAB upholds the determination of OIG, the Stipulated Penalties shall become due and payable 20 days after the DAB issues its decision. 

3. Exclusion Review. Notwithstanding any provision of Title 42 of the United States Code or Title 42 of the Code of Federal
Regulations, the only issues in a proceeding for exclusion based on a material breach of this CIA shall be whether Kindred or RehabCare were in material breach of this CIA and, if so, whether: 

 

	 	a.	Kindred or RehabCare cured such breach within 30 days of its receipt of the Notice of Material Breach; or 

  

	 	b.	the alleged material breach could not have been cured within the 30 day period, but that, during the 30 day period following Kindred’s receipt of the Notice of Material Breach: (i) Kindred or RehabCare had
begun to take action to cure the material breach; (ii) Kindred or RehabCare pursued such action with due diligence; and (iii) Kindred or RehabCare provided to OIG a reasonable timetable for curing the material breach. 

 
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 For purposes of the exclusion herein, exclusion shall take effect only after an ALJ decision
favorable to OIG, or, if the ALJ rules for Kindred and/or RehabCare, as applicable, only after a DAB decision in favor of OIG. Kindred’s and/or RehabCare’s, election of its contractual right to appeal to the DAB shall not abrogate
OIG’s authority to exclude RehabCare upon the issuance of an ALJ’s decision in favor of OIG. If the ALJ sustains the determination of OIG and determines that exclusion is authorized, such exclusion shall take effect 20 days after the ALJ
issues such a decision, notwithstanding that Kindred or RehabCare may request review of the ALJ decision by the DAB. If the DAB finds in favor of OIG after an ALJ decision adverse to OIG, the exclusion shall take effect 20 days after the DAB
decision. Kindred and RehabCare shall waive its right to any notice of such an exclusion if a decision upholding the exclusion is rendered by the ALJ or DAB. If the DAB finds in favor of Kindred and RehabCare, RehabCare shall be reinstated effective
on the date of the original exclusion. 
 4. Finality of Decision. The review by an ALJ or DAB provided for above shall not be
considered to be an appeal right arising under any statutes or regulations. Consequently, the parties to this CIA agree that the DAB’s decision (or the ALJ’s decision if not appealed) shall be considered final for all purposes under this
CIA. 
  

	XI.	EFFECTIVE AND BINDING AGREEMENT 

 RehabCare, Kindred and OIG agree as follows:

 A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. 

B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this
CIA. 
 C. OIG may agree to a suspension of Kindred’s and/or RehabCare’s, obligations under this CIA based on a certification by
Kindred and/or RehabCare, as applicable, that it is no longer providing health care items or services that will be billed by any entity to any Federal health care program and it does not have any ownership or control interest, as defined in 42
U.S.C. §1320a-3, in any entity that bills any Federal health care program. If Kindred and/or RehabCare, as applicable, is relieved of its CIA obligations, Kindred and/or RehabCare, as applicable, shall be required to notify OIG in writing at
least 30 days in advance if Kindred and/or RehabCare, as applicable, 
  
 RehabCare
and Kindred - Corporate Integrity Agreement 

  
 31 

 
plans to resume providing health care items or services that are billed by any entity to any Federal health care program or to obtain an ownership or control interest in any entity that bills any
Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. 
 D. All requirements and
remedies set forth in this CIA are in addition to and do not affect (1) Kindred’s and RehabCare’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose
appropriate remedies for failure to follow applicable Federal health care program requirements. 
 E. The undersigned RehabCare and Kindred
signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. 

F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA.
Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. 
 G. This CIA is by and between the
parties hereto. The CIA is not intended to establish any legal rights for or confer any legal rights upon any non-governmental entities or persons not a party to the CIA. The parties agree, however, that this CIA is a public document and it may be
admissible in a judicial or administrative proceeding. 
  
 RehabCare and Kindred -
Corporate Integrity Agreement 

  
 32 

 ON BEHALF OF KINDRED HEALTHCARE DBA REHABCAREGROUP INC. 

AND KINDRED HEALTHCARE INC. 
  

					
	 /s/ JON B. ROUSSEAU
	 		 	 January 7, 2016

	JON B. ROUSSEAU	 		 	DATE
	President	 		 	
	RehabCare Group, Inc.	 		 	
			
	 /s/ BEN BREIER
	 		 	 January 8, 2016

	BEN BREIER	 		 	DATE
	President and Chief Executive Officer, Kindred Healthcare, Inc.	 		 	
			
	 /s/ GLENN P. HENDRIX
	 		 	 January 8, 2016

	GLENN P. HENDRIX	 		 	DATE
	Arnall Golden Gregory LLP	 		 	

  
 RehabCare and Kindred - Corporate Integrity Agreement

  
 33 

 ON BEHALF OF THE OFFICE OF INSPECTOR GENERAL 

OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES 
  

					
	 /s/ ROBERT K. DECONTI
	 		 	 January 11, 2016

	ROBERT K. DECONTI	 		 	DATE
	Assistant Inspector General for Legal Affairs Office of Inspector General	 		 	
	U. S. Department of Health and Human Services	 		 	
			
	 /s/ TONYA KEUSSEYAN
	 		 	 January 11, 2016

	TONYA KEUSSEYAN	 		 	DATE
	Senior Counsel	 		 	
	Office of Inspector General	 		 	
	U. S. Department of Health and Human Services	 		 	

  
 RehabCare and Kindred - Corporate Integrity Agreement

  
 34 

 APPENDIX A 

INDEPENDENT REVIEW ORGANIZATION 
 This
Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA. 
  

	A.	IRO Engagement 

 1. Kindred shall engage an IRO that possesses the qualifications set
forth in Paragraph B, below, to perform the responsibilities in Paragraph C, below. The IRO shall conduct the review in a professionally independent and objective fashion, as set forth in Paragraph D. Within 30 days after OIG receives the
information identified in Section V.A.8 of the CIA or any additional information submitted by Kindred in response to a request by OIG, whichever is later, OIG will notify Kindred if the IRO is unacceptable. Absent notification from OIG that the IRO
is unacceptable, Kindred may continue to engage the IRO. 
 2. If Kindred engages a new IRO during the term of the CIA, that IRO must also
meet the requirements of this Appendix. If a new IRO is engaged, Kindred shall submit the information identified in Section V.A.8 of the CIA to OIG within 30 days of engagement of the IRO. Within 30 days after OIG receives this information or any
additional information submitted by Kindred at the request of OIG, whichever is later, OIG will notify Kindred if the IRO is unacceptable. Absent notification from OIG that the IRO is unacceptable, Kindred may continue to engage the IRO. 

 

	B.	IRO Qualifications 

 The IRO shall: 

1. assign individuals to conduct the Rehabilitation Therapy Services Medical Necessity and Appropriateness Review (Rehab Medical Review) who
have expertise in the Medicare requirements relating to rehabilitation therapy in skilled nursing facilities and in the general requirements of the Federal health care program(s) from which RehabCare’s customers seeks reimbursement 

2. assign individuals to design and select the Rehab Medical Review sample who are knowledgeable about the appropriate statistical sampling
techniques; 
 3. assign individuals to conduct the Rehab Medical Review who have expertise in the established practice guidelines and
generally accepted standards of medical practice for rehabilitation therapy including those set forth by the American Physical Therapy Association, the American Occupational Therapy Association, and the American Speech-Language-Hearing Association;
and 
 4. have sufficient staff and resources to conduct the review required by the CIA on a timely basis. 

  

					
	Kindred dba RehabCare CIA– Appendix A	 	1	 	

	C.	IRO Responsibilities 

 The IRO shall: 

1. perform each Rehab Medical Review in accordance with the specific requirements of the CIA; 

2. follow all applicable Medicare rules and reimbursement guidelines in making assessments in the Rehab Medical Review; 

3. request clarification from the appropriate authority (e.g., Medicare contractor), if in doubt of the application of a particular
Medicare policy or regulation; 
 4. respond to all OIG inquires in a prompt, objective, and factual manner; and 

5. prepare timely, clear, well-written reports that include all the information required by Appendix B to the CIA. 

 

	D.	IRO Independence and Objectivity 

 The IRO must perform the Rehab Medical Review in a
professionally independent and objective fashion, as defined in the most recent Government Auditing Standards issued by the U.S. Government Accountability Office. 
  

	E.	IRO Removal/Termination 

 1. Kindred and IRO. If Kindred terminates its IRO or if
the IRO withdraws from the engagement during the term of the CIA, Kindred must submit a notice explaining (a) its reasons for termination of the IRO or (b) the IRO’s reasons for its withdrawal to OIG, no later than 30 days after
termination or withdrawal. Kindred must engage a new IRO in accordance with Paragraph A of this Appendix and within 60 days of termination or withdrawal of the IRO. 

2. OIG Removal of IRO. In the event OIG has reason to believe the IRO does not possess the qualifications described in Paragraph B, is
not independent and objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in 

  

					
	Kindred dba RehabCare CIA– Appendix A	 	2	 	

 
Paragraph C, OIG shall notify Kindred in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. Kindred shall have 30 days from the date of
OIG’s written notice to provide information regarding the IRO’s qualifications, independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information
provided by Kindred regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify Kindred in writing that Kindred shall be required to engage a new IRO in accordance with Paragraph A of this Appendix.
Kindred must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require Kindred to engage a new IRO shall be made at the sole discretion of OIG. 

  

					
	Kindred dba RehabCare CIA– Appendix A	 	3	 	

 APPENDIX B 

REHABILITATION THERAPY SERVICES 

MEDICAL NECESSITY AND APPROPRIATENESS REVIEW 

A. Rehabilitation Therapy Medical Necessity and Appropriateness Review. Kindred shall retain an IRO to perform reviews of RehabCare’s provision of
rehabilitation therapy services under contracts between RehabCare and third party owned and operated SNFs (Rehab Medical Review). The purpose of the Rehab Medical Review is to determine RehabCare’s: 1) adherence to Federal healthcare program
requirements applicable to rehabilitation therapy services furnished to SNF patients under Medicare Part A and 2) conformance with practice guidelines and generally accepted medical practices applicable to rehabilitation therapy services. The IRO
shall perform the Rehab Medical Review annually to cover each of the five Reporting Periods. The IRO shall perform all components of each Rehab Medical Review. 

1. Definitions. For the purposes of the Rehab Medical Review, the following definitions shall be used: 

 

	 	a.	Rehab Therapy Patient: A Medicare patient who is covered under Medicare Part A and who received rehabilitation therapy services from RehabCare during the patient’s stay in a third party owned or
operated SNF. 

  

	 	b.	Rehab Therapy Patient Population: The Rehab Therapy Patient Population shall be defined as all Rehab Therapy Patients at a randomly selected Service Location during the 12-month period covered by the Rehab
Medical Review. 

  

	 	c.	Service Location: A third party owned or operated SNF at which RehabCare provides contract rehabilitation therapy services. 

  

	 	d.	Service Location Population: The Service Location Population shall be defined to include all Service Locations at which RehabCare provided contract rehabilitation therapy services during the prior 12-month
period. 

 2. Sample. For the first Reporting Period, the IRO shall first randomly select 25 Service Locations from the
Service Location Population. The IRO then shall select a random sample of 25 Rehab Therapy Patients from the Rehab Therapy Patient Population for each randomly-selected Service Location. For subsequent Reporting 

  

					
	Kindred dba RehabCare CIA– Appendix B	 	1	 	

 
Periods, the OIG may limit the Rehab Therapy Patient Population or the Service Location Population or both to a subset of Rehab Therapy Patients or Service Locations based on Resource Utilization
Group (RUG), length of stay, revenue, patient volume, geographical location or other factors determined by the OIG in its discretion. In the event that OIG exercises its discretion to limit the Rehab Therapy Patient Population or the Service
Location Population, OIG shall notify RehabCare at least 60 days prior to the end of the Reporting Period of any information needed from RehabCare in order for the OIG to identify the Rehab Therapy Patient Population (e.g., RUG level, length of
stay, etc.) or the Service Location Population (e.g., revenue, patient volume information, etc.). The OIG shall notify RehabCare and its IRO of the subset of Rehab Therapy Patients or Service Locations to be reviewed at least 30 days prior to the
end of the Reporting Period. 
 For each Rehab Therapy Patient selected, the IRO shall review all rehabilitation therapy services provided to the Rehab
Therapy Patient by RehabCare during the 12-month period covered by the Rehab Medical Review (Rehabilitation Therapy Services). The Rehabilitation Therapy Services shall be reviewed based on all of the portions of the medical record necessary to make
the findings required under this Appendix for the selected Rehab Therapy Patient, which may include, but not be limited to, physicians’ orders, nursing records, plans of care, therapy treatment plans, daily therapy treatment notes, interim
therapy progress notes, CPT logs, discharge summaries, therapy tests and measurement results. The Rehabilitation Therapy Services shall be reviewed by the IRO to determine if the services provided were medically necessary and appropriate under the
applicable regulations, manuals and guidance, including but not limited to: 1) Federal healthcare program rules and regulations governing the provision of skilled rehabilitation therapy in SNFs; 2) the established practice guidelines and generally
accepted standards of medical practice including those set forth by the American Physical Therapy Association, the American Occupational Therapy Association, and the American Speech-Language-Hearing Association. 

The IRO’s review shall include a determination of whether RehabCare adhered to Medicare requirements related to the following: 

 

	 	a.	eligibility for skilled rehabilitation therapy services; 

  

	 	b.	physician order(s) for any therapy services; 

  

	 	c.	comprehensive, standardized initial therapy assessments based on thorough examination and functional tests and measurements upon admission; 

 

	 	d.	written evaluations describing the needs of the beneficiary including diagnosis, prognosis, physical impairments and specific functional limitations; 

  

					
	Kindred dba RehabCare CIA– Appendix B	 	2	 	

	 	e.	written therapy treatment plans that list interventions that would be provided to address impairments as well as well-defined goals, measurable objectives and timetables; 

 

	 	f.	provision of skilled therapy services that can safely and effectively performed only by, or under the supervision of, a qualified therapist and the service, or the condition of the beneficiary is of a nature that
requires the judgment, knowledge, and skills of physical, speech, or occupational therapists, among other types of medical professionals; 

  

	 	g.	provision of only therapy services that are reasonable and necessary given the beneficiary’s condition and SNF plan of care to improve, maintain, or slow deterioration of the beneficiary’s condition, or
restore his or her prior levels of function; 

  

	 	h.	tracking of rehabilitation therapy minutes; 

  

	 	i.	provision of services according to the frequency and duration prescribed in the therapy treatment plan; and 

  

	 	j.	discharge planning and drafting of post discharge therapy treatment plan. 

 The IRO’s review also shall
include a determination of whether RehabCare adhered to established practice guidelines and generally accepted standards of rehabilitation therapy services relating to the following: 

 

	 	a.	best practices in patient management including examination, evaluation, diagnosis, prognosis and intervention; 

  

	 	b.	use of effective tests and measures to quantify a patient’s impairments and functional limitations; 

  

	 	c.	use of appropriate interventions targeted to a patient’s specific impairments and functional limitations; 

  

	 	d.	setting goals consistent with a patient’s diagnosis and prognosis; 

  

	 	e.	preferred evidence-based practice patterns; 

  

	 	f.	consideration of issues specific to gerontology; and 

  

	 	g.	ethics and professionalism standards for therapists. 

  

					
	Kindred dba RehabCare CIA– Appendix B	 	3	 	

 3. Other Requirements. 

 

	 	a.	Supplemental Materials. The IRO shall request all documentation and materials required for its review of the Rehabilitation Therapy Services selected as part of the Sample, and RehabCare shall furnish such
documentation and materials to the IRO prior to the IRO initiating its review of the Sample. If the IRO accepts any supplemental documentation or materials from RehabCare after the IRO has completed its initial review of the Sample (Supplemental
Materials), the IRO shall identify in the Rehab Medical Review Report the Supplemental Materials, the date the Supplemental Materials were accepted, and the relative weight the IRO gave to the Supplemental Materials in its review. In addition, the
IRO shall include a narrative in the Rehab Medical Review Report describing the process by which the Supplemental Materials were accepted and the IRO’s reasons for accepting the Supplemental Materials. 

 

	 	b.	Use of First Samples Drawn. For the purposes of the Sample discussed in this Appendix, the Service Locations or Rehab Therapy Patients selected in each first sample shall be used (i.e., it is not
permissible to generate more than one list of random samples and then select one for use with the Sample). 

 4. Reporting
of IRO Findings at Service Locations. RehabCare shall notify each Service Location of any Rehab Therapy Patients or Rehabilitation Therapy Services at that Service Location for which the IRO has made a determination that the Rehabilitation
Therapy Services were was not medically necessary and appropriate. 
 B. Rehab Medical Review Report. The IRO shall prepare a Rehab Medical Review
Report as described in this Appendix B for each Rehab Medical Review performed. The following information shall be included in the Rehab Medical Review Report for each Sample. 

1. Rehab Medical Review Methodology. 
  

	 	a.	Rehab Medical Review Population. A description of the Service Location Population and the Rehab Therapy Patient Population subject to the Rehab Medical Review. 

  

					
	Kindred dba RehabCare CIA– Appendix B	 	4	 	

	 	b.	Rehab Medical Review Objective. A clear statement of the objective intended to be achieved by the Rehab Medical Review. 

 

	 	c.	Source of Data. A description of the specific documentation and other information sources relied upon by the IRO when performing the Rehab Medical Review (e.g., patient medical records,
RehabCare policies and procedures; Medicare carrier or intermediary manual or bulletins (including issue and date); practice guidelines issued by the American Physical Therapy Association, the American Occupational Therapy Association, and the
American Speech-Language-Hearing Association; other policies, regulations, or directives; and interviews with relevant RehabCare representatives). 

  

	 	d.	Review Protocol. A narrative description of how the Rehab Medical Review was conducted and what was evaluated. 

  

	 	e.	Supplemental Materials. A description of any Supplemental Materials as required by Section A.3.a above. 

2. Statistical Sampling Documentation. 
  

	 	a.	A description or identification of the statistical sampling software package used to select the Sample. 

  

	 	b.	A copy of the printout of the random numbers generated by the “Random Numbers” function of the statistical sampling software used by the IRO. 

3. Rehab Medical Review Findings. 
  

	 	a.	A narrative explanation of the IRO’s findings and supporting rationale (including adequacy of documentation, patterns noted, etc.) regarding whether each Rehabilitation Therapy Service reviewed by the IRO was
medically necessary and appropriate. 

  

	 	b.	Total number and percentage of Rehabilitation Therapy Services reviewed that the IRO determined were not supported by the medical record and not medically necessary and appropriate. 

  

					
	Kindred dba RehabCare CIA– Appendix B	 	5	 	

	 	c.	A listing Rehab Therapy Patients and Rehabilitation Therapy Services at each Service Location for which the IRO has made a determination that the Rehabilitation Therapy Services were not supported by the medical record
and not medically necessary and appropriate. 

  

	 	d.	The IRO’s report shall include any recommendations for improvements to RehabCare’s services and processes for determining the appropriate rehabilitation services to be provided and for documenting such
services, based on the findings of the Rehab Medical Review. 

 4. Credentials. The names and credentials of the
individuals who: (1) designed the statistical sampling procedures and the review methodology utilized for the Rehab Medical Review and (2) performed the Rehab Medical Review. 

  

					
	Kindred dba RehabCare CIA– Appendix B	 	6

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