Nevada Exclusions/Sanctions

Business Name Margaret Vancil Southern Nevada Personal Care Dianna Speight Betty Sandra Ray Edwin Advincula Jesus Rena Rene Perez Debbie A Way Ernest Speight

Lizbeth Perez Lolita Taqueban Delfina Sambas Irma Chiang Rafael

Jose Rivera Vanxay Rasasak Emilie Damaso

Lizbeth Ortiz Maria Barraza Adelaida Guevarra-Tolentino Aida Rodriguez-Ramirez Angel Valentin Calderon Elijah Akpan Linda Coate Mark Delmendo Beulah Michelle Upshaw

Sally Saeli Charleen Gay Winter

Harriston Bass Nelida Calina Margaret Childs Christine D. Nay

Excellent PCA Keri D. Nelson

Advanced Pain Management & Family Care

The Pond House of Nevada Fabiana Alfaro

Ema Gomez Mitchell Home Sweet Home Group Care

Nevada Exclusions/Sanctions

Legal Entity Golden Acres Retirement Home

Admired of Las Vegas

Persons with controlling inerest of 5% or more

Vladmir Saud, Ilona Shukar

Medicaid Provider

X X

NPI 9005001613 9005037500

Provider Type 30 48

X

9005041296 48

X

9005002025 30

X

9005034002

1093910291

X

9005056443 58

9005041064

9005055163

X

9005041445 30/48/58

Termination Date

4/4/2006 6/20/2006 10/19/2006 12/20/2006 12/20/2006 2/20/2007 2/20/2007 2/20/2007 4/19/2007 7/31/2007 7/31/2007 11/20/2007 2/20/2008 2/20/2008 10/20/2008 11/20/2008 1/20/2009 7/13/2010 7/20/2009 7/20/2009 10/20/2010 10/20/2010 10/20/2010 10/20/2010 1/19/2011 2/20/2011 3/20/2011 3/20/2011 4/20/2011 4/20/2011

6/5/2011 7/20/2011

Sanction Tier

Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal

2 Federal

Sanction Period Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent

7 years Permanent

NV Medicaid Sanction Period End Date

Federal Reinstate

Date

6/5/2018

Holistic Care Inc

Phil Y. Chen Diane Stewart, Robert C.

Hammer

X

1841226636 20

X

9005056716 57

X

1710171426 57

7/25/2011

8/17/2011 8/18/2011 8/18/2011 8/31/2011

3

3 Federal Federal

2

12 months

12 months Permanent Permanent

7 years

7/25/2012 8/17/2012

8/31/2018

Nevada Exclusions/Sanctions

Business Name

Personal Caregivers of Nevada Angels in the Midst Home Care

Best Choice Home Healthcare Inc Amanda Gilreath Steven C. Wein

Shannon Renae Trautman Nenita Glover Dustie Jackson Nathu Rakesh

James E. Beecham Edison DeFiesta

Obteen Nehemiah Nassiri Just a Touch of Love Su Casa Personal Care Sandal A. Kelly

Consultation & Counseling Associates

James R. Eells MD Pearl Richardson Leticia Buchanan

Mario Davis Jr Eugene Chen Cecilia Ristau Della Kennedy JC Group Home II Marilyn Eddleman Eleanor Larock Rodolfo Quinones Maria Morena Alas

Mayhill Manor

Priscilla Villabroza aka Priscilla Baguisi Pangilinan & Precilla Banguisi Angel Eye Hospice Vinay Bararia

Ocean Adult, Child & Family Services Angelia Chupa Nelie Magtaas Denise Dill

Legal Entity Sonteslou Inc Harris & Williams Inc Barbara H. Cota

Nathu Compassionate Care Lab Medicine Consultants Dare to Dream Addus Healthcare NV Inc

Unity Family Services Mario Davis Jr

Unity Family Services Jove V. Chan

Naidas Enterprises Inc

Angel Eye Hospice Inc Vinay Bararia

Ocean Adult, Child & Family Services

Persons with controlling inerest of 5% or more

Selena Perez Rosa Laundry

Medicaid Provider

X X

NPI 9005050057 9005056781 9005053150 9005051105

Provider Type

30/48/58 30

Termination Date

9/1/2011 9/19/2011

Sanction Tier

3 3

Sanction Period

NV Medicaid Sanction Period End Date

Federal Reinstate

Date

12 months 12 months

9/1/2012 9/19/2012

Shonna McKnight

X

9005042013 58

X

1316910326 20

X

1780645648 20

1346579034

X

1609041490 14

X

1811957830 30

X

1699872614 14

9/19/2011 9/20/2011 9/20/2011 9/20/2011 9/20/2011 9/20/2011 9/20/2011 10/20/2011 10/20/2011 10/20/2011 11/7/2011 11/10/2011 11/23/2011

3 Federal Federal Federal Federal Federal

2 Federal Federal Federal

2 3 3

12 months Permanent Permanent Permanent Permanent Permanent

7 years Permanent Permanent Permanent

7 years 12 months 12 months

9/19/2012

9/20/2018

11/7/2018 11/10/2012 11/23/2012

Sandal A. Kelly

Mario Davis Jr Jove V. Chan

Prudence Landicho, Luz Hlavaty

X

1073768982 14

1679546139

X

1285777946

14

X

1447546262

14

X

1881982098 14

X

1992089585 82

X

1811987845 20

X

1689963274 14

X

9005055981

57

X

9055035751 58

X

9005054471

57

11/23/2011

12/9/2011 12/27/2011 12/27/2011 1/27/2012 3/15/2012 3/20/2012 3/26/2012

4/1/2012 4/4/2012 4/19/2012 4/19/2012 4/22/2012

5/29/2012

3

3 3 3 1 Federal Federal 3 1 3 Federal Federal Federal

2

12 months

12 months 12 months 12 months Permanent Permanent Permanent 12 months Permanent 12 months Permanent Permanent Permanent

7 years

11/23/2012 12/9/2012 12/27/2012 12/27/2012

3/26/2013 4/4/2013

5/2/2019

Camilo Q. Primero Marvie Lee Hill

1346481728

6/20/2012 Federal Permanent

X

1649398835 64/65

6/20/2012 Federal Permanent

X

1679679096 20

7/27/2012

3

12 months 7/27/2013

X

1902137664 14

7/31/2012 8/20/2012 8/20/2012 8/20/2012

3 Federal Federal Federal

12 months Permanent Permanent Permanent

7/31/2013

Page 2 of 7

Business Name Yolanda Hoskins

Victor Manuel Socarras-Carmenates Graceful Touch

Gwynne Cunningham Deangelo Henderson Jummal Joy Ibrahim Jessica Enamorado Natasha R. Lambert

Daniel Guy Alvin Sil Oh Ratasha D. Bates Lilia A. Serrano

Corazon Murillo Tammy K. Murphy

Jianzhu Liang Eugene Porreca MD Marcen Home Care Svcs

Amy Jean Grover aka Amy Jean Hutchinson Patricia Caldwell

Ocean Adult, Child & Family Services Felicia K. Wesley Osbel Rodriguez Gloria Repollo

Albert Szu Yun Yeh MD Sara Vilchis-Mendez

Zion Safe Haven LLC Roderick Hill Joyce M. Hill James Hanna Marcia Giller

Janice V. Burch Achievement Day Program

Lawrence Care Homes II Rosalba Sanchez

Flotsol Inc

Joy Mobility & Medical Supplies

Nevada Exclusions/Sanctions

Legal Entity Graceful Touch Golden Heart Medical Supply

Las Vegas Pain Institute & Medical Eugene Porreca MD

Marcen Home Care Svcs

Zion Safe Haven LLC Zion Safe Haven LLC Zion Safe Haven LLC Achievement Day Program Lawrence Care Homes II

Flotsol Inc Joy Mobility & Medical Supplies

NV Medicaid

Sanction

Federal

Persons with controlling Medicaid

Provider Termination Sanction Sanction

Period End Reinstate

inerest of 5% or more Provider

NPI

Type

Date

Tier

Period

Date

Date

8/20/2012 Federal Permanent

Charles W. Mitchell

X

1891093621 30

8/20/2012 9/12/2012 9/20/2012 9/20/2012 9/20/2012 10/18/2012 10/18/2012 10/18/2012 10/18/2012 10/18/2012 10/18/2012

Federal 3

Federal Federal Federal Federal Federal Federal Federal Federal Federal

Permanent 12 months Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent

9/12/2013

Eugene Porreca MD Marieta G. Emelo

X

1285802553 36

X

9005041585 58

X

1871562652 20

X

9005055734 30

10/20/2012 11/20/2012 11/20/2012 11/28/2012 12/20/2012

Federal 2

Federal

3

Permanent 7 years

Permanent

12 months

8/4/2018

9/20/2013 12/20/2013

12/20/2012 12/20/2012

Federal Federal

Permanent Permanent

Joseph Lewellyn

1962432417 20

12/20/2012 12/20/2012 1/20/2013 1/20/2013 2/20/2013 2/20/2013

Federal Federal Federal Federal Federal Federal

Permanent Permanent Permanent Permanent Permanent Permanent

Roderick & Joyce M. Hill Joyce M. Hill Joyce M. Hill

Adreana Robinson Lillie Brooks

Oluwole & Latasha Adegboruwa & Debra L.

Jones

Enriqueta Trinidad

X

1376844480 14

X

1003114984 14

X

1801185731 14

X

1902044084 14

X

9005056948 57

X

1205012812 33

1912167149

X

9005048309

33

3/6/2013 3/6/2013 3/10/2013 3/20/2013 3/20/2013 3/20/2013 3/26/2013 4/17/2013 4/18/2013

3 3 3 Federal Federal Federal 3 2 Federal

12 months 12 months 12 months Permanent Permanent Permanent 12 months

7 years Permanent

3/6/2014 3/6/2014 3/10/2014

3/26/2014 4/17/2020

5/8/2013 5/8/2013

3

12 months

5/8/2014

3

12 months

5/8/2014

Page 3 of 7

Business Name

Joy Mobility & Medical Supplies Aurora Volero-Alvarez Baljinder Singh Pannu

Rainbow Child & Family Services Della Kennedy

Unity Family Services Guardian Angels Tyrone Starks

Constance D. Edwards Richard Hiler Edden Lynn Carol Nanas

HealTherapy of NV Lorretta Nason

Charleston Residential Garren Morris Craig Thomas Erik Badgett

Searchlight Healthcare Charities Cassandra D. Little Luzviminda R. Jose

Kenisha Wright-Abeene Niurvis Rodriguez Ini Odong

Alegria C. Phankonsy aka Alegria Souvannavong Katherine Rivera

Ernesto Guerra-Perez United Medical Supplies

Ronald E. Lakeman Dipak K. Desai MD

Marlo Vinson Keith Mathahs Yolanda Rodriguez Isidora DeGuzman Enriqueta Trinidad William Alston

Leni Alston Sherice J. Williams Bennette R. Manalang

Nevada Exclusions/Sanctions

Legal Entity Joy Mobility & Medical Supplies

Rainbow Child & Family Services Unity Family Services

Unity Family Services Guardian Angels

HealTherapy of NV The Charleston Residential

Unity Family Services Erik Badgett

Troy P. Bertoli MD

Kenisha Wright-Abeene High Desert State Prison

DME Company

United Medical Supplies

LV Home Sweet Home

Persons with controlling inerest of 5% or more

Enriqueta Trinidad

Medicaid Provider

X

NPI 1912167149 9005048309

Provider Type

33

Mary Jo Jones aka Mary Jo

Gil

X

1174818223 14

X

1689963274 14

1962667527

Marvie Lee Hill, Eddie

1376817619

Wormwood

X

1225302573

14

Lauren McFadden

X

1174881924 30

Suzanne Pindell, Terra Shepherd

Erik Badgett Troy P. Bertoli MD

X

1124219712 14

X

9005033871 57

X

9005033871 57

X

1285920959 14

X

1033418702 82

X

1306140629 14

X

1598106049 20

X

9005058076 58

Termination Date

5/14/2013 5/20/2013 6/20/2013

6/20/2013 7/4/2013

7/18/2013 8/16/2013 8/20/2013 9/19/2013 9/19/2013 9/19/2013 9/19/2013

9/23/2013 11/1/2013 11/1/2013 11/5/2013 11/8/2013 11/20/2013 11/20/2013 12/19/2013 1/20/2014 2/10/2014 2/20/2014 2/20/2014

Sanction Tier

3 Federal Federal

Federal 3

Federal 3

Federal Federal Federal Federal Federal

2 Federal Federal

2 Federal

3 3 Federal Federal 1 Federal Federal

Sanction Period

12 months Permanent Permanent

Permanent 12 months

Permanent 12 months Permanent Permanent Permanent Permanent Permanent

7 years Permanent Permanent

7 years Permanent 12 months 12 months Permanent Permanent Permanent Permanent Permanent

NV Medicaid Sanction Period End Date

Federal Reinstate

Date

5/14/2014

7/4/2014 8/16/2014

9/23/2020

1/5/2020

11/20/2014 11/20/2014

6/20/2013

X

1639227895 33

X

1053412015 20

X

1104126812 14

2/20/2014 2/20/2014 2/20/2014 2/20/2014 3/20/2014 3/20/2014 3/20/2014 3/20/2014 3/20/2014 3/20/2014 3/20/2014 4/20/2014 4/20/2014 4/20/2014 5/20/2014

Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal Federal

Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent

Page 4 of 7

Business Name Patricia Busch Syed Ahmed MD Kent Swaine

Mary Jo Jones (Gil) Nova Housing for Hope

LC Providers Youth Empowerment

Solange Phillips William R. Butkovich Jr

Dena Rae Farley Mohsina Haroon Ursula A. St Clair Beverly D. Madrid Nancy Morton Stephanie Sierad

Jian P. Yao Roxanne Matney Irene Marquez

Dana Brown Transparent Mental Health

Joseph Scott Jessica Fink Christine Moore Maritza E. Valazquez Lela Merrell Linda Lamury Shana Wickersham Oluwole Adegboruwa Victor Sutton Tanya Troup Ian Pincombe Tonya Rushing Cornell Horn Lula Denise Brown Susan Cusimano Darwin Rosales Estigoy Tammy Lyne Arns Bonnie Lynn Boelhouwer Jeremy Long Michiko Nicole Martin Jan Thompson David Moon Elisa Seering

Legal Entity

Mary Jo Jones (Gil) LC Providers

Youth Empowerment Hope Counseling

Diagnostic Care Transparent Mental Health Transparent Mental Health

Shana Wickersham Flotsol Inc

Assertive Living LLC Serenity Mental Health Mobile Mental Health

Serenity Mental Health From the Heart-Mary Tory Inc Accelerated Rehab and Pain

BPT LLC

Nevada Exclusions/Sanctions

Persons with controlling inerest of 5% or more

Medicaid Provider

X X X

NPI 1811155690 1508807538 1386697415

Provider Type 24 20 20

Leasa Carter Jovan Jackson

X

1639398258 82

X

1417273699 14

X

1801049358 82

X

1225371115 14

X

1861777203 14

1508200676 24

Dana Brown Joseph Scott Joseph Scott

X

9005058720 58

X

9005058712 58

X

1386927390 14

X

1689920910 14

X

1174821367 14

Oluwole Adegboruwa Victor Sutton

X

1487953915 14

X

1205012812 33

X

1558657288 14

X

1912204538 14

X

1437459948 14

X

1578871448 14

X

1548562366 14

X

1114966124 20

X

1215917042 20

X

1275834152 14

Termination Date

5/20/2014 7/31/2014 8/18/2014

9/10/2014 9/30/2014 9/30/2014 9/30/2014 9/30/2014 12/18/2014 12/18/2014 1/20/2015 1/20/2015 2/19/2015 2/19/2015 2/19/2015 2/19/2015 2/26/2015 2/26/2015 2/26/2015 3/18/2015 3/18/2015 4/20/2015 4/20/2015 4/20/2015 5/20/2015 6/18/2015 6/18/2015 6/18/2015 6/18/2015 6/18/2015 7/21/2015 8/20/2015 9/20/2015 9/20/2015 9/20/2015 9/20/2015 9/20/2015 9/20/2015 9/22/2015 9/22/2015 9/24/2015 11/6/2015 11/19/2015

Sanction Tier

Federal 1 3

1 2 2 3 3 Federal Federal Federal Federal Federal Federal Federal Federal 3 3 2 2 2 Federal Federal Federal Federal Federal Federal Federal Federal 2 3 Federal Federal Federal Federal Federal Federal Federal Federal 2 3 3 Federal

Sanction Period Permanent Permanent 12 months Permanent

(OIG action date 7/20/15)

7 years 7 years 12 months 12 months Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent 12 months 12 months 7 years 7 years 7 years Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent 7 years 12 mos Permanent Permanent Permanent Permanent Permanent Permanent Permanent Permanent 7 years 12 mos 12 mos Permanent

NV Medicaid Sanction Period End Date 8/18/2015

9/30/2021 9/30/2021 9/30/2015 9/30/2015

2/26/2016 2/26/2016 2/26/2022 3/18/2022 3/18/2022

6/18/2022 7/21/2016

9/22/2022 9/24/2016 11/6/2016

Federal Reinstate

Date

Page 5 of 7

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