AMENDED STATEMENT OF FINANCIAL AFFAIRS FOR CLAYTON HEALTH FACILITIES, L.P. ( )

Transcription

1 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 1 of 28 IN THE UNITED STATES BANKRUPTCY COURT FOR THE NORTHERN DISTRICT OF TEXAS FORT WORTH DIVISION In re: PREFERRED CARE INC., et. al. Debtors. Chapter 11 Case No.: (Jointly Administered) AMENDED STATEMENT OF FINANCIAL AFFAIRS FOR CLAYTON HEALTH FACILITIES, L.P. ( )

2 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 2 of 28 Stephen A. McCartin (TX ) Mark C. Moore (TX ) GARDERE WYNNE SEWELL LLP 2021 McKinney Avenue, Suite 1600 Dallas, TX Telephone: (214) Facsimile: (214) smccartin@gardere.com mmoore@gardere.com COUNSEL TO DEBTORS AND DEBTORS-IN-POSSESSION IN THE UNITED STATES BANKRUPTCY COURT FOR THE NORTHERN DISTRICT OF TEXAS FORT WORTH DIVISION In re: Preferred Care Inc. Bowling Green Health Facilities, L.P. Brandenburg Health Facilities, L.P. Cadiz Health Facilities, L.P. Campbellsville Health Facilities, L.P. Elizabethtown Health Facilities, L.P. Elsmere Health Facilities, L.P. Fordsville Health Facilities, L.P. Franklin Health Facilities, L.P. Hardinsburg Health Facilities, L.P. Henderson Health Facilities, L.P. Irvine Health Facilities, L.P. Morganfield Health Facilities, L.P. Owensboro Health Facilities, L.P. Paducah Health Facilities, L.P. Pembroke Health Facilities, L.P. Richmond Health Facilities - Kenwood, L.P. Richmond Health Facilities - Madison, L.P. Salyersville Health Facilities, L.P. Somerset Health Facilities, L.P. Springfield Health Facilities, L.P. Stanton Health Facilities, L.P. Artesia Health Facilities, L.P. Bloomfield Health Facilities, L.P. Clayton Health Facilities, L.P. Desert Springs Health Facilities, L.P. Espanola Health Facilities, L.P. Gallup Health Facilities, L.P. Lordsburg Health Facilities, L.P. Chapter 11 Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Case No.: Gardere v.1

3 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 3 of 28 Pinnacle Health Facilities XXXIII, L.P. Raton Health Facilities, L.P. SF Health Facilities, L.P. SF Health Facilities-Casa Real, L.P. Silver City Health Facilities, L.P. Debtors. Case No.: Case No.: Case No.: Case No.: Case No.: GLOBAL NOTES AND STATEMENT OF LIMITATIONS, METHODOLOGY, AND DISCLAIMER REGARDING AMENDMENTS TO THE DEBTORS SCHEDULES AND STATEMENTS Preferred Care Inc. and each of its debtor affiliates, as debtors-in-possession (collectively, the Debtors ) 1 filed their Schedules of Assets and Liabilities (the Schedules 2 ) and Statement of Financial Affairs (the Statements and, collectively with the Schedules, the Schedules and Statements ) on or about January 5, 2018 or January 7, 2018, both in each Debtor s respective case and in Case No (the Main Case ). Attached to and incorporated into the Schedules and Statements were Global Notes intended to provide additional information regarding the limitations of and methodology used in the preparation of the Schedules and Statements (the Global Notes ). The Global Notes comprise an integral part of the Schedules and Statements and should be referred to and considered in connection with any review of such Schedules and Statements. Additionally, though the Global Notes have not been attached to the amended Schedules and Statements in their entirety, the Debtors incorporate such Global Notes by reference as if fully set forth herein. The Global Notes should be referred to and considered in connection with any review of the Debtors amended Schedules and Statements filed concurrently herewith. 3 1 A list of the Debtors in these chapter 11 cases, along with the last four digits of each Debtor s federal tax identification number, is attached hereto. 2 The term Schedules includes: Schedules A/B, D, E/F, G, and H, along with the applicable summaries and all attachments appurtenant thereto. 3 At this time, the Debtors are only amending Schedules E/F and H. The Debtors are amending and restating the entirety of their Statements. Gardere v.1 2

4 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 4 of 28 Additional notes regarding methodology and limitations of the amended Schedules and Statements are set forth below: a. Amended Schedule Fs. Where necessary, the Debtors have added additional information to their amended Schedule Fs that is intended to supplement the information already provided in the Schedules and Statements. No existing entries on the Debtors Schedule Fs were changed in these amended Schedule Fs. The Debtors amendments merely added additional parties. b. Amended Schedule Hs. Where necessary, the Debtors have added additional information to their amended Schedule Hs that is intended to supplement the information already provided in the Schedules and Statements. No existing entries on the Debtors Schedule Hs were changed in these amended Schedule Hs. The Debtors amendments merely added additional co-debtors with respect to the notes payable added to the amended Schedule Fs. #END OF GLOBAL NOTES Gardere v.1 3

5 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 5 of 28 Debtors Debtor Last Four Digits of Federal Tax I.D. No. Preferred Care Inc Kentucky LP Debtors Bowling Green Health Facilities, L.P Brandenburg Health Facilities, L.P Cadiz Health Facilities, L.P Campbellsville Health Facilities, L.P Elizabethtown Health Facilities, L.P Elsmere Health Facilities, L.P Fordsville Health Facilities, L.P Franklin Health Facilities, L.P Hardinsburg Health Facilities, L.P Henderson Health Facilities, L.P Irvine Health Facilities, L.P Morganfield Health Facilities, L.P Owensboro Health Facilities, L.P Paducah Health Facilities, L.P Pembroke Health Facilities, L.P Richmond Health Facilities - Kenwood, L.P Richmond Health Facilities - Madison, L.P Salyersville Health Facilities, L.P Somerset Health Facilities, L.P Springfield Health Facilities, L.P Gardere v.1 4

6 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 6 of 28 Stanton Health Facilities, L.P New Mexico LP Debtors Artesia Health Facilities, L.P Bloomfield Health Facilities, L.P Clayton Health Facilities, L.P Desert Springs Health Facilities, L.P Espanola Health Facilities, L.P Gallup Health Facilities, L.P Lordsburg Health Facilities, L.P Pinnacle Health Facilities XXXIII, L.P Raton Health Facilities, L.P SF Health Facilities, L.P SF Health Facilities-Casa Real, L.P Silver City Health Facilities, L.P Gardere v.1 5

7 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 7 of 28 Fill in this information to identify the case: Debtor name CLAYTON HEALTH FACILITIES, L.P. United States Bankruptcy Court for the: NORTHERN DISTRICT OF TEXAS Case number (If known): MXM Check if this is an amended filing Official Form 207 Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy 4/16 The debtor must answer every question. If more space is needed, attach a separate sheet to this form. On the top of any additional pages, write the debtor s name and case number (if known). Part 1: Income 1. Gross revenue from business None Identify the beginning and ending dates of the debtor s fiscal year, which may be a calendar year From the beginning of the 1/1/2017 fiscal year to filing date: From to Filing date MM / DD / YYYY For prior year: 1/1/2016 From to 12/31/2016 MM / DD / YYYY MM / DD / YYYY For the year before that: 1/1/2015 From to 12/31/2015 MM / DD / YYYY MM / DD / YYYY Sources of revenue Check all that apply Operating a business Other Operating a business Other Operating a business Other Gross revenue (before deductions and exclusions) 2,399, $ 2,924, $ 2,642, $ 2. Non-business revenue Include revenue regardless of whether that revenue is taxable. Non-business income may include interest, dividends, money collected from lawsuits, and royalties. List each source and the gross revenue for each separately. Do not include revenue listed in line 1. None From the beginning of the fiscal year to filing date: From to Filing date MM / DD / YYYY Description of sources of revenue Gross revenue from each source (before deductions and exclusions) $ For prior year: From to MM / DD / YYYY MM / DD / YYYY $ For the year before that: From to MM / DD / YYYY MM / DD / YYYY $ Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

8 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 8 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P. Case number (if known) MXM Part 2: List Certain Transfers Made Before Filing for Bankruptcy 3. Certain payments or transfers to creditors within 90 days before filing this case List payments or transfers including expense reimbursements to any creditor, other than regular employee compensation, within 90 days before filing this case unless the aggregate value of all property transferred to that creditor is less than $6,425. (This amount may be adjusted on 4/01/19 and every 3 years after that with respect to cases filed on or after the date of adjustment.) None 3.1. Creditor s name and address Dates Total amount or value Reasons for payment or transfer SEE ATTACHED - SOFA 3 AND SOFA 11 Creditor s name 397, $ Check all that apply Secured debt Unsecured loan repayments Suppliers or vendors Services Other 3.2. Creditor s name $ Secured debt Unsecured loan repayments Suppliers or vendors Services Other 4. Payments or other transfers of property made within 1 year before filing this case that benefited any insider List payments or transfers, including expense reimbursements, made within 1 year before filing this case on debts owed to an insider or guaranteed or cosigned by an insider unless the aggregate value of all property transferred to or for the benefit of the insider is less than $6,425. (This amount may be adjusted on 4/01/19 and every 3 years after that with respect to cases filed on or after the date of adjustment.) Do not include any payments listed in line 3. Insiders include officers, directors, and anyone in control of a corporate debtor and their relatives; general partners of a partnership debtor and their relatives; affiliates of the debtor and insiders of such affiliates; and any managing agent of the debtor. 11 U.S.C. 101(31). None 4.1. Insider s name and address Dates Total amount or value Reasons for payment or transfer SEE ATTACHED - SOFA 4 42, $ Insider s name Relationship to debtor 4.2. Insider s name $ Relationship to debtor Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

9 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 9 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P. Case number (if known) MXM 5. Repossessions, foreclosures, and returns List all property of the debtor that was obtained by a creditor within 1 year before filing this case, including property repossessed by a creditor, sold at a foreclosure sale, transferred by a deed in lieu of foreclosure, or returned to the seller. Do not include property listed in line 6. None Creditor s name and address Description of the property Date Value of property 5.1. Creditor s name $ 5.2. Creditor s name $ 6. Setoffs List any creditor, including a bank or financial institution, that within 90 days before filing this case set off or otherwise took anything from an account of the debtor without permission or refused to make a payment at the debtor s direction from an account of the debtor because the debtor owed a debt. None Creditor s name and address Description of the action creditor took Date action was taken Amount Creditor s name $ Last 4 digits of account number: XXXX Part 3: Legal Actions or Assignments 7. Legal actions, administrative proceedings, court actions, executions, attachments, or governmental audits List the legal actions, proceedings, investigations, arbitrations, mediations, and audits by federal or state agencies in which the debtor was involved in any capacity within 1 year before filing this case. None Case title Nature of case Court or agency s name and address Status of case 7.1. SEE ATTACHED - SOFA 7 Case number Pending On appeal Concluded 7.2. Case title Case number Court or agency s name and address Pending On appeal Concluded Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

10 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 10 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P MXM Case number (if known) 8. Assignments and receivership List any property in the hands of an assignee for the benefit of creditors during the 120 days before filing this case and any property in the hands of a receiver, custodian, or other court-appointed officer within 1 year before filing this case. None Custodian s name and address Description of the property Value Custodian s name Case title $ Court name and address Case number Date of order or assignment Part 4: Certain Gifts and Charitable Contributions 9. List all gifts or charitable contributions the debtor gave to a recipient within 2 years before filing this case unless the aggregate value of the gifts to that recipient is less than $1,000 None Recipient s name and address Description of the gifts or contributions Dates given Value 9.1. Recipient s name $ Recipient s relationship to debtor 9.2. Recipient s name $ Recipient s relationship to debtor Part 5: Certain Losses 10. All losses from fire, theft, or other casualty within 1 year before filing this case. None Description of the property lost and how the loss occurred Amount of payments received for the loss If you have received payments to cover the loss, for example, from insurance, government compensation, or tort liability, list the total received. Date of loss Value of property lost List unpaid claims on Official Form 106A/B (Schedule A/B: Assets Real and Personal Property). $ Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

11 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 11 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P MXM Case number (if known) Part 6: Certain Payments or Transfers 11. Payments related to bankruptcy List any payments of money or other transfers of property made by the debtor or person acting on behalf of the debtor within 1 year before the filing of this case to another person or entity, including attorneys, that the debtor consulted about debt consolidation or restructuring, seeking bankruptcy relief, or filing a bankruptcy case. None Who was paid or who received the transfer? If not money, describe any property transferred Dates Total amount or value 11.1 SEE ATTACHED - SOFA 11 Address 932, $ or website address Who made the payment, if not debtor? Who was paid or who received the transfer? If not money, describe any property transferred Dates Total amount or value 11.2 Address $ or website address Who made the payment, if not debtor? 12. Self-settled trusts of which the debtor is a beneficiary List any payments or transfers of property made by the debtor or a person acting on behalf of the debtor within 10 years before the filing of this case to a self-settled trust or similar device. Do not include transfers already listed on this statement. None of trust or device Describe any property transferred Dates transfers were made Total amount or value $ Trustee Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

12 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 12 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P MXM Case number (if known) 13. Transfers not already listed on this statement List any transfers of money or other property by sale, trade, or any other means made by the debtor or a person acting on behalf of the debtor within 2 years before the filing of this case to another person, other than property transferred in the ordinary course of business or financial affairs. Include both outright transfers and transfers made as security. Do not include gifts or transfers previously listed on this statement. None Who received transfer? Description of property transferred or payments received or debts paid in exchange Date transfer was made Total amount or value $ Address _ Relationship to debtor Who received transfer? $ _ Address Relationship to debtor Part 7: Previous Locations 14. Previous addresses List all previous addresses used by the debtor within 3 years before filing this case and the dates the addresses were used. Does not apply Address Dates of occupancy From To From To Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

13 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 13 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P MXM Case number (if known) Part 8: Health Care Bankruptcies 15. Health Care bankruptcies Is the debtor primarily engaged in offering services and facilities for: diagnosing or treating injury, deformity, or disease, or providing any surgical, psychiatric, drug treatment, or obstetric care? No. Go to Part 9. Yes. Fill in the information below. Facility name and address CLAYTON NURSING AND Facility name REHABILITATION CENTER 419 HARDING STREET CLAYTON, NM Nature of the business operation, including type of services the debtor provides SKILLED NURSING OPERATION Location where patient records are maintained (if different from facility address). If electronic, identify any service provider. AMERICAN HEALTHTECH 574 HIGHLAND COLONY PARKWAY, SUITE 200 RIDGELAND, MS If debtor provides meals and housing, number of patients in debtor s care 45 How are records kept? Check all that apply: Electronically Paper Facility name and address Nature of the business operation, including type of services the debtor provides If debtor provides meals and housing, number of patients in debtor s care Facility name Location where patient records are maintained (if different from facility address). If electronic, identify any service provider. How are records kept? Check all that apply: Electronically Paper Part 9: Personally Identifiable Information 16. Does the debtor collect and retain personally identifiable information of customers? No. Yes. State the nature of the information collected and retained. RETAINS SSN AND CREDIT CARD NUMBERS PROVIDED BY CUSTOMERS Does the debtor have a privacy policy about that information? No Yes 17. Within 6 years before filing this case, have any employees of the debtor been participants in any ERISA, 401(k), 403(b), or other pension or profit-sharing plan made available by the debtor as an employee benefit? No. Go to Part 10. Yes. Does the debtor serve as plan administrator? No. Go to Part 10. Yes. Fill in below: of plan Employer identification number of the plan Has the plan been terminated? No Yes EIN: Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

14 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 14 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P MXM Case number (if known) Part 10: Certain Financial Accounts, Safe Deposit Boxes, and Storage Units 18. Closed financial accounts Within 1 year before filing this case, were any financial accounts or instruments held in the debtor s name, or for the debtor s benefit, closed, sold, moved, or transferred? Include checking, savings, money market, or other financial accounts; certificates of deposit; and shares in banks, credit unions, brokerage houses, cooperatives, associations, and other financial institutions. None Financial institution name and address Last 4 digits of account number Type of account Date account was closed, sold, moved, or transferred Last balance before closing or transfer 18.1 XXXX Checking Savings Money market Brokerage Other $ 18.2 _ XXXX Checking Savings Money market Brokerage Other $ 19. Safe deposit boxes List any safe deposit box or other depository for securities, cash, or other valuables the debtor now has or did have within 1 year before filing this case. None Depository institution name and address s of anyone with access to it Description of the contents Does debtor still have it? No Yes Address 20. Off-premises storage List any property kept in storage units or warehouses within 1 year before filing this case. Do not include facilities that are in a part of a building in which the debtor does business. None Facility name and address s of anyone with access to it Description of the contents DINKY DEE MINI STORAGE 201 PEACH ST CLAYTON, NM CAROLYN KEAR & MOSES UNIT 12 - MEDICAL RECORDS, UNIT TRUJILLO 19&20 - FURNITURE, DESK, WHEELCHAIR, WALKERS, EXTRA DINING ROOM CHAIRS Does debtor still have it? No Yes Address Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

15 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 15 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P. Case number (if known) MXM Part 11: Property the Debtor Holds or Controls That the Debtor Does Not Own 21. Property held for another List any property that the debtor holds or controls that another entity owns. Include any property borrowed from, being stored for, or held in trust. Do not list leased or rented property. None Owner s name and address Location of the property Description of the property Value $ Part 12: Details About Environmental Information For the purpose of Part 12, the following definitions apply: Environmental law means any statute or governmental regulation that concerns pollution, contamination, or hazardous material, regardless of the medium affected (air, land, water, or any other medium). Site means any location, facility, or property, including disposal sites, that the debtor now owns, operates, or utilizes or that the debtor formerly owned, operated, or utilized. Hazardous material means anything that an environmental law defines as hazardous or toxic, or describes as a pollutant, contaminant, or a similarly harmful substance. Report all notices, releases, and proceedings known, regardless of when they occurred. 22. Has the debtor been a party in any judicial or administrative proceeding under any environmental law? Include settlements and orders. No Yes. Provide details below. Case title Court or agency name and address Nature of the case Status of case Case number Pending On appeal Concluded 23. Has any governmental unit otherwise notified the debtor that the debtor may be liable or potentially liable under or in violation of an environmental law? No Yes. Provide details below. Site name and address Governmental unit name and address Environmental law, if known Date of notice Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

16 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 16 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P. Case number (if known) MXM 24. Has the debtor notified any governmental unit of any release of hazardous material? No Yes. Provide details below. Site name and address Governmental unit name and address Environmental law, if known Date of notice Part 13: Details About the Debtor s Business or Connections to Any Business 25. Other businesses in which the debtor has or has had an interest List any business for which the debtor was an owner, partner, member, or otherwise a person in control within 6 years before filing this case. Include this information even if already listed in the Schedules. None Business name and address Describe the nature of the business Employer Identification number Do not include Social Security number or ITIN EIN: Dates business existed From To Business name and address Describe the nature of the business Employer Identification number Do not include Social Security number or ITIN EIN: Dates business existed From To Business name and address Describe the nature of the business Employer Identification number Do not include Social Security number or ITIN EIN: Dates business existed From To Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

17 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 17 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P. Case number (if known) MXM 26. Books, records, and financial statements 26a. List all accountants and bookkeepers who maintained the debtor s books and records within 2 years before filing this case. None and address Dates of service 26a.1 TOM PATTERSON 10/17/2011 From PRESENT To 5420 PLANO PARKWAY 2ND FLOOR PLANO, TX and address Dates of service 26a.2 RYAN HERING 9/19/2005 From PRESENT To 5420 PLANO PARKWAY 1ST FLOOR PLANO, TX b List all firms or individuals who have audited, compiled, or reviewed debtor s books of account and records or prepared a financial statement within 2 years before filing this case. None and address Dates of service 26b.1 BKD 2012 From PRESENT To JON UNROE 2800 POST OAK BLVD. SUITE 3200 HOUSTON, TX and address Dates of service BKD 26b From PRESENT To CHRIS CLARK DALLAS PARKWAY SUITE 1100 DALLAS, TX c List all firms or individuals who were in possession of the debtor s books of account and records when this case is filed. None and address If any books of account and records are unavailable, explain why TOM PATTERSON 26c PLANO PARKWAY 2ND FLOOR PLANO, TX Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

18 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 18 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P MXM Case number (if known) and address 26c.2 RYAN HERING 5420 PLANO PARKWAY 1ST FLOOR PLANO, TX If any books of account and records are unavailable, explain why 26d List all financial institutions, creditors, and other parties, including mercantile and trade agencies, to whom the debtor issued a financial statement within 2 years before filing this case. None and address 26d.1 SEE ATTACHED - SCHEDULE AB26D and address 26d Inventories Have any inventories of the debtor s property been taken within 2 years before filing this case? No Yes. Give the details about the two most recent inventories. of the person who supervised the taking of the inventory Date of inventory The dollar amount and basis (cost, market, or other basis) of each inventory $ and address of the person who has possession of inventory records Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

19 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 19 of 28 Debtor CLAYTON HEALTH FACILITIES, L.P MXM Case number (if known) of the person who supervised the taking of the inventory Date of inventory The dollar amount and basis (cost, market, or other basis) of each inventory and address of the person who has possession of inventory records List the debtor s officers, directors, managing members, general partners, members in control, controlling shareholders, or other people in control of the debtor at the time of the filing of this case. Address Position % of interest, if any CLAYTON HEALTH FACILITIES GP, LLC GENERAL PARTNER 1.00 THOMAS D. SCOTT LIMITED PARTNER ROBERT J. RIEK MANAGER UNLIQUIDATED 29. Within 1 year before the filing of this case, did the debtor have officers, directors, managing members, general partners, members in control of the debtor, or shareholders in control of the debtor who no longer hold these positions? No Yes. Identify below. Address Position Period during which position or interest was held From To 30. Payments, distributions, or withdrawals credited or given to insiders Within 1 year before filing this case, did the debtor provide an insider with value in any form, including salary, other compensation, draws, bonuses, loans, credits on loans, stock redemptions, and options exercised? No Yes. Identify below. and address of recipient Amount of money or description and value of property Dates Reason for providing the value 30.1 Relationship to debtor Statement of Financial Affairs for Non-Individuals Filing for Bankruptcy

20 Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 20 of 28

21 Line Number Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 21 of 28 AMENDED SOFA 3 3. Certain payments or transfers to creditors within 90 days before filing this case. Address Description Date(s) of Payment Amount 3.1 ACC BUSINESS PO BOX , ATLANTA, GA INV /30/2017 $1, ACC BUSINESS PO BOX , ATLANTA, GA INV /28/2017 $1, ACC BUSINESS PO BOX , ATLANTA, GA INV /30/2017 $1, TOTAL: $5, AIDANT FIRE PROTECTION CO NORTH 77TH STREET, SCOTTSDALE, AZ INV /30/2017 $2, TOTAL: $2, AMANDA ANAYA ADDRESS REDACTED EXPREPORT 11/7/2017 $7.90 TOTAL: $ ARTHUR CLAYCOMB PO BOX 671, CLAYTON, NM INV /17/2017 $ ARTHUR CLAYCOMB PO BOX 671, CLAYTON, NM INV33877A 10/11/2017 $ TOTAL: $ AUTOGOV DEPT. 3867, PO BOX , DALLAS, TX INV /12/2017 $ AUTOGOV DEPT. 3867, PO BOX , DALLAS, TX INV /26/2017 $ AUTOGOV DEPT. 3867, PO BOX , DALLAS, TX INV /24/2017 $ TOTAL: $ BALL INVESTMENTS INC 7 MAIN STREET, CLAYTON, NM INV /17/2017 $ BALL INVESTMENTS INC 7 MAIN STREET, CLAYTON, NM INV /28/2017 $ BALL INVESTMENTS INC 7 MAIN STREET, CLAYTON, NM INV /30/2017 $28.50 TOTAL: $ BOWLING POWER SYSTEMS INC. PO BOX 32122, AMARILLO, TX INV5829 8/17/2017 $ TOTAL: $ BULK TV C/O ALC, PO BOX , CINCINNATI, OH UTILITIES 9/13/2017 $ BULK TV C/O ALC, PO BOX , CINCINNATI, OH UTILITIES 10/11/2017 $ TOTAL: $1, CARESOURCE PROGRAMS TH AVE., STE. 833, SEATTLE, WA INV /17/2017 $ CARESOURCE PROGRAMS TH AVE., STE. 833, SEATTLE, WA INV /28/2017 $ TOTAL: $ CAROLYN KEAR ADDRESS REDACTED EXPREPORT 8/17/2017 $ CAROLYN KEAR ADDRESS REDACTED EXPREPORT 8/30/2017 $ CAROLYN KEAR ADDRESS REDACTED EXPREPORT 9/28/2017 $ CAROLYN KEAR ADDRESS REDACTED EXPREPORT 10/30/2017 $ CAROLYN KEAR ADDRESS REDACTED EXPREPORT 11/7/2017 $ TOTAL: $ CASS INFORMATION SYSTEMS, INC. CIS # 92012, PO BOX 17617, ST. LOUIS, MO INV /30/2017 $ CASS INFORMATION SYSTEMS, INC. CIS # 92012, PO BOX 17617, ST. LOUIS, MO INV /28/2017 $ CASS INFORMATION SYSTEMS, INC. CIS # 92012, PO BOX 17617, ST. LOUIS, MO INV /30/2017 $67.50 TOTAL: $ CASSIE NEWTON ADDRESS REDACTED EXPREPORT 10/11/2017 $ TOTAL: $ CIT BANK, N.A. PO BOX , PASADENA, CA INV /23/2017 $ CIT BANK, N.A. PO BOX , PASADENA, CA INV /28/2017 $ CIT BANK, N.A. PO BOX , PASADENA, CA INV /30/2017 $ TOTAL: $ CLAYTON HEALTH SYSTEMS, INC. 300 WILSON ST, CLAYTON, NM INV /30/2017 $ TOTAL: $ CLAYTON NURSING & REHAB PETTY CASH INVPC /17/2017 $1, CLAYTON NURSING & REHAB PETTY CASH INVPC /13/2017 $ CLAYTON NURSING & REHAB PETTY CASH INVPC /28/2017 $ CLAYTON NURSING & REHAB PETTY CASH INVPC /11/2017 $ CLAYTON NURSING & REHAB PETTY CASH INVPC /30/2017 $ CLAYTON NURSING & REHAB PETTY CASH INVPC /7/2017 $ TOTAL: $3, CLAYTON VOLUNTEER FIRE & EMS ASSOC. 1 CHESTNUT ST, CLAYTON, NM INV110 8/17/2017 $ TOTAL: $ COMMUNITY CARE SERVICES INC 203 N. PATRICK, DUBLIN, TX INV /17/2017 $ TOTAL: $ DIRECT SUPPLY INC. PO BOX 88201, MILWAUKEE, WI INV /17/2017 $ DIRECT SUPPLY INC. PO BOX 88201, MILWAUKEE, WI INV /30/2017 $ DIRECT SUPPLY INC. PO BOX 88201, MILWAUKEE, WI INV /13/2017 $ DIRECT SUPPLY INC. PO BOX 88201, MILWAUKEE, WI INV /28/2017 $ DIRECT SUPPLY INC. PO BOX 88201, MILWAUKEE, WI INV /11/2017 $1, TOTAL: $3, DR. MIKE DECARDENAS 6230 SW 144 STREET, MIAMI, FL INV /29/2017 $ DR. MIKE DECARDENAS 6230 SW 144 STREET, MIAMI, FL INV /26/2017 $ DR. MIKE DECARDENAS 6230 SW 144 STREET, MIAMI, FL INV /31/2017 $ TOTAL: $ ECOLAB INC PO BOX , PASADENA, CA INV /30/2017 $ ECOLAB INC PO BOX 70343, CHICAGO, IL INV /13/2017 $ ECOLAB INC PO BOX , PASADENA, CA INV /28/2017 $ ECOLAB INC PO BOX , PASADENA, CA INV /30/2017 $83.41 TOTAL: $ FEDERAL EXPRESS CORPORATION PO BOX 94515, PALATINE, IL INV /30/2017 $ FEDERAL EXPRESS CORPORATION PO BOX 94515, PALATINE, IL INV /13/2017 $ FEDERAL EXPRESS CORPORATION PO BOX 94515, PALATINE, IL INV /11/2017 $ FEDERAL EXPRESS CORPORATION PO BOX 94515, PALATINE, IL INV /30/2017 $21.50 TOTAL: $ FIRST CHOICE MEDICAL SUPPLY HOLDING, INC PO BOX 3608, JACKSON, MS INV /17/2017 $2, FIRST CHOICE MEDICAL SUPPLY HOLDING, INC PO BOX 3608, JACKSON, MS INV /30/2017 $3, FIRST CHOICE MEDICAL SUPPLY HOLDING, INC PO BOX 3608, JACKSON, MS INV /28/2017 $1, FIRST CHOICE MEDICAL SUPPLY HOLDING, INC PO BOX 3608, JACKSON, MS INV /11/2017 $1, FIRST CHOICE MEDICAL SUPPLY HOLDING, INC PO BOX 3608, JACKSON, MS INV /30/2017 $1, TOTAL: $9, FOCUS STAFF SERVICES,LP 8848 GREENVILLE AVE, DALLAS, TX INV /17/2017 $4, FOCUS STAFF SERVICES,LP 8848 GREENVILLE AVE, DALLAS, TX INV /30/2017 $3, FOCUS STAFF SERVICES,LP 8848 GREENVILLE AVE, DALLAS, TX INV /13/2017 $2, Clayton Health Facilities, L.P Sofa - Question: 3 - SOFA 3 AND SOFA 11

22 Line Number Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 22 of 28 AMENDED SOFA 3 3. Certain payments or transfers to creditors within 90 days before filing this case. Address Description Date(s) of Payment Amount 3.64 FOCUS STAFF SERVICES,LP 8848 GREENVILLE AVE, DALLAS, TX INV /28/2017 $1, TOTAL: $12, FRANCOTTYP POSTALIA, INC PO BOX 157, BEDFORD PARK, IL INVRI /30/2017 $ TOTAL: $ FUN EXPRESS LLC PO BOX 14463, DES MOINES, IA INV /17/2017 $27.54 TOTAL: $ GEMALTO COGENT, INC PO BOX , DALLAS, TX INVCKREQ /28/2017 $ GEMALTO COGENT, INC PO BOX , DALLAS, TX INVCKREQ /2/2017 $ TOTAL: $ GENE CRUZ 200 ASPEN, APT. 28, CLAYTON, NM REFUND 8/17/2017 $ TOTAL: $ HD SUPPLY FACILITIES MAINTENANCE LTD PO BOX , SAN DIEGO, CA INV /30/2017 $ HD SUPPLY FACILITIES MAINTENANCE LTD PO BOX , SAN DIEGO, CA INV /28/2017 $ TOTAL: $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /25/2017 $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /25/2017 $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /25/2017 $4, HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /25/2017 $2, HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /25/2017 $16, HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /25/2017 $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /25/2017 $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /25/2017 $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /15/2017 $2, HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /15/2017 $2, HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /15/2017 $4, HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /15/2017 $15, HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /3/2017 $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /3/2017 $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /3/2017 $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /3/2017 $ HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /3/2017 $15, HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /3/2017 $2, HEALTHCARE SERVICES GROUP, INC 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA INV /3/2017 $4, TOTAL: $72, HEATHER MAESTAS ADDRESS REDACTED EXPREPORT 11/7/2017 $ TOTAL: $ IMPACT TELECOM PO BOX , DALLAS, TX UTILITIES 9/8/2017 $ IMPACT TELECOM PO BOX , DALLAS, TX UTILITIES 10/11/2017 $12.98 TOTAL: $ JIMMY N MCCOLLUM PO BOX 547, CLAYTON, NM INVJULY2017 8/17/2017 $ JIMMY N MCCOLLUM PO BOX 547, CLAYTON, NM INVAUG2017 9/28/2017 $ JIMMY N MCCOLLUM PO BOX 547, CLAYTON, NM INVSEPT /11/2017 $ TOTAL: $ KIRSTIE HENRY ADDRESS REDACTED EXPREPORT 9/28/2017 $ TOTAL: $ KONICA MINOLTA BUSINESS SOLUTIONS USA DEPT PO BOX , DALLAS, TX INV /30/2017 $ KONICA MINOLTA BUSINESS SOLUTIONS USA DEPT PO BOX , DALLAS, TX INV /28/2017 $38.57 TOTAL: $ LOCAL PAGES OF NEW MEXICO, LLC 4910 W AMELIA EARHART DR., STE. 1, SALT LAKE CITY, UT INV /13/2017 $ TOTAL: $ LORI DEMPSEY ADDRESS REDACTED EXPREPORT 9/13/2017 $ LORI DEMPSEY ADDRESS REDACTED EXPREPORT 10/30/2017 $ TOTAL: $ MARISA ESPINO ADDRESS REDACTED EXPREPORT 9/28/2017 $ TOTAL: $ MASS PERFECTION INC DRAWER 2579, CORRALES, NM INV /13/2017 $ TOTAL: $ MCKESSON MEDICAL SURGICAL MN SUPPLY INC PO BOX , DALLAS, TX INV /11/2017 $1, TOTAL: $1, MEDCOM, INC LOCKBOX 55486, LOS ANGELES, CA INV244460IN 8/30/2017 $ MEDCOM, INC LOCKBOX 55486, LOS ANGELES, CA INV244667IN 9/28/2017 $73.81 TOTAL: $ MEDLINE INDUSTRIES INC DEPT. 1080, PO BOX , DALLAS, TX INV /30/2017 $ MEDLINE INDUSTRIES INC DEPT. 1080, PO BOX , DALLAS, TX INV /28/2017 $ MEDLINE INDUSTRIES INC DEPT. 1080, PO BOX , DALLAS, TX INV /30/2017 $61.96 TOTAL: $ MED-PASS INC. L-3495, COLUMBUS, OH INV /30/2017 $ MED-PASS INC. L-3495, COLUMBUS, OH INV /30/2017 $49.86 TOTAL: $ MELISSA DEHERRERA ADDRESS REDACTED EXPREPORT 8/30/2017 $ MELISSA DEHERRERA ADDRESS REDACTED EXPREPORT 9/28/2017 $ MELISSA DEHERRERA ADDRESS REDACTED EXPREPORT 10/30/2017 $43.83 TOTAL: $ MICHELLE ANDERSON ADDRESS REDACTED EXPREPORT 10/11/2017 $ TOTAL: $ MOSES TRUJILLO ADDRESS REDACTED EXPREPORT 8/30/2017 $ MOSES TRUJILLO ADDRESS REDACTED EXPREPORT 9/13/2017 $ MOSES TRUJILLO ADDRESS REDACTED EXPREPORT 9/28/2017 $ MOSES TRUJILLO ADDRESS REDACTED EXPREPORT 10/30/2017 $ TOTAL: $ NATIONAL DATACARE CORPORATION PO BOX , CHANTILLY, VA INV /13/2017 $ NATIONAL DATACARE CORPORATION PO BOX , CHANTILLY, VA INVA /11/2017 $ TOTAL: $ NEW MEXICO ENVIRONMENT DEPARTMENT FIELD OPERATIONS DIVISION-RATON, 1277A SOUTH SENCOND ST., STE A, RATON, NM INVI /30/2017 $ Clayton Health Facilities, L.P Sofa - Question: 3 - SOFA 3 AND SOFA 11

23 Line Number Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 23 of 28 AMENDED SOFA 3 3. Certain payments or transfers to creditors within 90 days before filing this case. Address Description Date(s) of Payment Amount TOTAL: $ NEW MEXICO GAS COMPANY PO BOX 27885, ALBUQUERQUE, NM UTILITIES 8/23/2017 $ NEW MEXICO GAS COMPANY PO BOX 27885, ALBUQUERQUE, NM UTILITIES 8/23/2017 $ NEW MEXICO GAS COMPANY PO BOX 27885, ALBUQUERQUE, NM UTILITIES 9/21/2017 $ NEW MEXICO GAS COMPANY PO BOX 27885, ALBUQUERQUE, NM UTILITIES 9/21/2017 $ NEW MEXICO GAS COMPANY PO BOX 27885, ALBUQUERQUE, NM UTILITIES 10/25/2017 $ NEW MEXICO GAS COMPANY PO BOX 27885, ALBUQUERQUE, NM UTILITIES 10/25/2017 $22.95 TOTAL: $ NEW MEXICO MOTOR VEHICLE DIVISION PO BOX 25129, SANTA FE, NM INVCKREQ /28/2017 $62.00 TOTAL: $ NEW MEXICO SKILLED CARE (CATHEDRAL ROCK) 306 WEST 7TH STREET, SUITE 430, FORT WORTH, TX INTEREST PAYMENT 9/1/2017 $ NEW MEXICO SKILLED CARE (CATHEDRAL ROCK) 306 WEST 7TH STREET, SUITE 430, FORT WORTH, TX INTEREST PAYMENT 9/1/2017 $1, NEW MEXICO SKILLED CARE (CATHEDRAL ROCK) 306 WEST 7TH STREET, SUITE 430, FORT WORTH, TX INTEREST PAYMENT 10/2/2017 $ NEW MEXICO SKILLED CARE (CATHEDRAL ROCK) 306 WEST 7TH STREET, SUITE 430, FORT WORTH, TX INTEREST PAYMENT 10/2/2017 $1, NEW MEXICO SKILLED CARE (CATHEDRAL ROCK) 306 WEST 7TH STREET, SUITE 430, FORT WORTH, TX INTEREST PAYMENT 11/1/2017 $ NEW MEXICO SKILLED CARE (CATHEDRAL ROCK) 306 WEST 7TH STREET, SUITE 430, FORT WORTH, TX INTEREST PAYMENT 11/1/2017 $1, TOTAL: $5, O. C. TANNER RECOGNITION COMPANY 1930 SOUTH STATE STREET, SALT LAKE CITY, UT INV /30/2017 $ O. C. TANNER RECOGNITION COMPANY 1930 SOUTH STATE STREET, SALT LAKE CITY, UT INV /28/2017 $77.35 TOTAL: $ OMEGA HEALTHCARE INVESTORS, INC 303 INTERNATIONAL CIRCLE, STE. 200, HUNT VALLEY, MD RENT 8/30/2017 $24, OMEGA HEALTHCARE INVESTORS, INC 303 INTERNATIONAL CIRCLE, STE. 200, HUNT VALLEY, MD RENT 8/30/2017 $ OMEGA HEALTHCARE INVESTORS, INC 303 INTERNATIONAL CIRCLE, STE. 200, HUNT VALLEY, MD RENT 9/28/2017 $24, OMEGA HEALTHCARE INVESTORS, INC 303 INTERNATIONAL CIRCLE, STE. 200, HUNT VALLEY, MD RENT 9/28/2017 $ OMEGA HEALTHCARE INVESTORS, INC 303 INTERNATIONAL CIRCLE, STE. 200, HUNT VALLEY, MD RENT 10/30/2017 $24, OMEGA HEALTHCARE INVESTORS, INC 303 INTERNATIONAL CIRCLE, STE. 200, HUNT VALLEY, MD RENT 10/30/2017 $ TOTAL: $73, ON HOLD MARKETING SERVICES, INC 6840 WEST 70TH STREET, SHREVEPORT, LA INV /17/2017 $ ON HOLD MARKETING SERVICES, INC 6840 WEST 70TH STREET, SHREVEPORT, LA INV /13/2017 $ ON HOLD MARKETING SERVICES, INC 6840 WEST 70TH STREET, SHREVEPORT, LA INV /11/2017 $41.95 TOTAL: $ ORKIN LLC 1700 E 14TH STREET, AMARILLO, TX INV /13/2017 $ ORKIN LLC 1700 E 14TH STREET, AMARILLO, TX INV /28/2017 $ TOTAL: $ PERFORMANCE HEALTH SUPPLY, INC PO BOX 93040, CHICAGO, IL INVIN /30/2017 $ PERFORMANCE HEALTH SUPPLY, INC PO BOX 93040, CHICAGO, IL INVIN /28/2017 $ PERFORMANCE HEALTH SUPPLY, INC PO BOX 93040, CHICAGO, IL INVIN /11/2017 $ PERFORMANCE HEALTH SUPPLY, INC PO BOX 93040, CHICAGO, IL INVIN /30/2017 $40.69 TOTAL: $ PETE J. FERNANDEZ ADDRESS REDACTED EXPREPORT 9/13/2017 $ PETE J. FERNANDEZ ADDRESS REDACTED EXPREPORT 9/28/2017 $ PETE J. FERNANDEZ ADDRESS REDACTED EXPREPORT 11/7/2017 $24.73 TOTAL: $ PHARMACY CORPORATION OF AMERICA ATTN: MIKE RODRIGUEZ, 1900 S. SUNSET UNIT 1A, LONGMONT, CO INV /30/2017 $1, PHARMACY CORPORATION OF AMERICA ATTN: MIKE RODRIGUEZ, 1900 S. SUNSET UNIT 1A, LONGMONT, CO INV /28/2017 $2, PHARMACY CORPORATION OF AMERICA ATTN: MIKE RODRIGUEZ, 1900 S. SUNSET UNIT 1A, LONGMONT, CO INV /30/2017 $4, TOTAL: $7, PINCOMPUTING COMPANY, LP 5500 W. PLANO PKWY, PLANO, TX PINCOMPUTING 8/30/2017 $ PINCOMPUTING COMPANY, LP 5500 W. PLANO PKWY, PLANO, TX PINCOMPUTING 9/28/2017 $ PINCOMPUTING COMPANY, LP 5500 W. PLANO PKWY, PLANO, TX PINCOMPUTING 10/30/2017 $ TOTAL: $1, PLATEAU PO BOX 9000, CLOVIS, NM UTILITIES 8/30/2017 $ PLATEAU PO BOX 9000, CLOVIS, NM UTILITIES 10/3/2017 $ PLATEAU PO BOX 9000, CLOVIS, NM UTILITIES 10/30/2017 $ TOTAL: $2, PNM PO BOX 27900, ALBUQUERQUE, NM UTILITIES 8/17/2017 $1, PNM PO BOX 27900, ALBUQUERQUE, NM UTILITIES 8/17/2017 $ PNM PO BOX 27900, ALBUQUERQUE, NM UTILITIES 8/17/2017 $1, PNM PO BOX 27900, ALBUQUERQUE, NM UTILITIES 9/15/2017 $1, PNM PO BOX 27900, ALBUQUERQUE, NM UTILITIES 9/15/2017 $ PNM PO BOX 27900, ALBUQUERQUE, NM UTILITIES 9/15/2017 $1, PNM PO BOX 27900, ALBUQUERQUE, NM UTILITIES 10/17/2017 $1, PNM PO BOX 27900, ALBUQUERQUE, NM UTILITIES 10/17/2017 $ PNM PO BOX 27900, ALBUQUERQUE, NM UTILITIES 10/17/2017 $ TOTAL: $8, PORTER ONE DESIGN LLC HILLS TECH DRIVE, FARMINGTON HILLS, MI INV /30/2017 $ PORTER ONE DESIGN LLC HILLS TECH DRIVE, FARMINGTON HILLS, MI INV /28/2017 $ TOTAL: $ RAY D. & STEPHANIE PURCELL 306 BRUCE AVE, DUMAS, TX INV5563 8/30/2017 $ TOTAL: $ RELIANT PRO REHAB LLC PO BOX , DALLAS, TX INV /30/2017 $25, RELIANT PRO REHAB LLC PO BOX , DALLAS, TX INV /28/2017 $20, RELIANT PRO REHAB LLC PO BOX , DALLAS, TX INV /30/2017 $25, TOTAL: $71, RICHARD G. FOUTCH 315 WASHINGTON STREET, CLAYTON, NM INVAUG2017 8/30/2017 $2, RICHARD G. FOUTCH 315 WASHINGTON STREET, CLAYTON, NM INVSEP2017 9/28/2017 $2, RICHARD G. FOUTCH 315 WASHINGTON STREET, CLAYTON, NM INVOCT /30/2017 $2, TOTAL: $6, SAGE PROPERTIES PO BOX 494, CLAYTON, NM INV302 8/17/2017 $ SAGE PROPERTIES PO BOX 494, CLAYTON, NM INV309 9/13/2017 $ SAGE PROPERTIES PO BOX 494, CLAYTON, NM INV314 10/17/2017 $ TOTAL: $ SIERRA COMMUNICATIONS INC PO BOX 67, DES MOINES, NM INV /13/2017 $ SIERRA COMMUNICATIONS INC PO BOX 67, DES MOINES, NM INV /11/2017 $37.31 TOTAL: $74.62 Clayton Health Facilities, L.P Sofa - Question: 3 - SOFA 3 AND SOFA 11

24 Line Number Case mxm11 Doc 17 Filed 02/20/18 Entered 02/20/18 16:36:13 Page 24 of 28 AMENDED SOFA 3 3. Certain payments or transfers to creditors within 90 days before filing this case. Address Description Date(s) of Payment Amount SIMPLE LTC (SOFTWARE) 2435 N. CENTRAL EXPRESSWAY, STE 1510, RICHARDSON, TX INV /6/2017 $ SIMPLE LTC (SOFTWARE) 2435 N. CENTRAL EXPRESSWAY, STE 1510, RICHARDSON, TX INV /3/2017 $ SIMPLE LTC (SOFTWARE) 2435 N. CENTRAL EXPRESSWAY, STE 1510, RICHARDSON, TX INV /7/2017 $88.77 TOTAL: $ SPECIALIZED MEDICAL SERVICES INC 7237 SOLUTIONS CENTER, CHICAGO, IL INV /17/2017 $1, SPECIALIZED MEDICAL SERVICES INC 7237 SOLUTIONS CENTER, CHICAGO, IL INV /28/2017 $1, TOTAL: $2, STAPLES CONTRACT & COMMERCIAL, INC DEPT DAL, PO BOX 83689, CHICAGO, IL INV /17/2017 $ STAPLES CONTRACT & COMMERCIAL, INC DEPT DAL, PO BOX 83689, CHICAGO, IL INV /30/2017 $ STAPLES CONTRACT & COMMERCIAL, INC DEPT DAL, PO BOX 83689, CHICAGO, IL INV /13/2017 $ STAPLES CONTRACT & COMMERCIAL, INC DEPT DAL, PO BOX 83689, CHICAGO, IL INV /28/2017 $ STAPLES CONTRACT & COMMERCIAL, INC DEPT DAL, PO BOX 83689, CHICAGO, IL INV /30/2017 $ TOTAL: $ STATE OF NEW MEXICO PROGRAM OPERATIONS BUREAU, PO BOX 26110, SANTA FE, NM INVCKREQ /26/2017 $ TOTAL: $ STERICYCLE INC PO BOX 6578, CAROL STREAM, IL INV /23/2017 $ STERICYCLE INC PO BOX 6578, CAROL STREAM, IL INV /15/2017 $81.70 TOTAL: $ TAYLOR CORPORATION PO BOX , DALLAS, TX INVV /30/2017 $ TAYLOR CORPORATION PO BOX , DALLAS, TX INVV /28/2017 $ TAYLOR CORPORATION PO BOX , DALLAS, TX INVV /11/2017 $ TAYLOR CORPORATION PO BOX , DALLAS, TX INVV /30/2017 $ TOTAL: $ TEAM TSI (QAPI COMPLIANCE) PO BOX 1547, ALBERTVILLE, AL INV /29/2017 $ TEAM TSI (QAPI COMPLIANCE) PO BOX 1547, ALBERTVILLE, AL INV /26/2017 $ TEAM TSI (QAPI COMPLIANCE) PO BOX 1547, ALBERTVILLE, AL INV /31/2017 $ TOTAL: $ PCPMG CONSULTING 5420 W. PLANO PKWY, PLANO, TX MGMT FEES 8/29/2017 $9, PCPMG CONSULTING 5420 W. PLANO PKWY, PLANO, TX MGMT FEES 10/6/2017 $9, PCPMG CONSULTING 5420 W. PLANO PKWY, PLANO, TX MGMT FEES 10/31/2017 $9, PCPMG CONSULTING 5420 W. PLANO PKWY, PLANO, TX MGMT FEES 11/10/2017 $9, TOTAL: $39, THOMAS D. SCOTT 5500 W.PLANO PKWY, PLANO, TX NOTE INTEREST 11/10/2017 $ THOMAS D. SCOTT 5500 W.PLANO PKWY, PLANO, TX NOTE INTEREST 11/10/2017 $ THOMAS D. SCOTT 5500 W.PLANO PKWY, PLANO, TX NOTE INTEREST 11/10/2017 $ THOMAS D. SCOTT 5500 W.PLANO PKWY, PLANO, TX NOTE INTEREST 11/10/2017 $ THOMAS D. SCOTT 5500 W.PLANO PKWY, PLANO, TX NOTE INTEREST 11/10/2017 $ THOMAS D. SCOTT 5500 W.PLANO PKWY, PLANO, TX NOTE INTEREST 11/10/2017 $ TOTAL: $83, TONY NARANJO 116 CHERRY ST, CLAYTON, NM INV281 8/17/2017 $ TONY NARANJO 116 CHERRY ST, CLAYTON, NM INV287 9/13/2017 $ TONY NARANJO 116 CHERRY ST, CLAYTON, NM INV100 10/11/2017 $ TOTAL: $ TOWN OF CLAYTON 1 CHESTNUT STREET, CLAYTON, NM UTILITIES 9/6/2017 $ TOWN OF CLAYTON 1 CHESTNUT STREET, CLAYTON, NM UTILITIES 9/6/2017 $ TOWN OF CLAYTON 1 CHESTNUT STREET, CLAYTON, NM UTILITIES 9/6/2017 $ TOWN OF CLAYTON 1 CHESTNUT STREET, CLAYTON, NM UTILITIES 10/3/2017 $ TOWN OF CLAYTON 1 CHESTNUT STREET, CLAYTON, NM UTILITIES 10/3/2017 $ TOWN OF CLAYTON 1 CHESTNUT STREET, CLAYTON, NM UTILITIES 10/3/2017 $ TOWN OF CLAYTON 1 CHESTNUT STREET, CLAYTON, NM UTILITIES 11/2/2017 $ TOWN OF CLAYTON 1 CHESTNUT STREET, CLAYTON, NM UTILITIES 11/2/2017 $ TOWN OF CLAYTON 1 CHESTNUT STREET, CLAYTON, NM UTILITIES 11/2/2017 $ TOTAL: $1, TRI-STATE FLEET MANAGEMENT, LLC PO BOX , FT WORTH, TX INV /30/2017 $ TOTAL: $ SUB TOTAL: $397, Clayton Health Facilities, L.P Sofa - Question: 3 - SOFA 3 AND SOFA 11