AMENDED SCHEDULES OF ASSETS AND
LIABILITIES FOR PINNACLE HEALTH FACILITIES
XXXIII, L.P. (17-44674)
IN THE UNITED STATES BANKRUPTCY COURT
FOR THE NORTHERN DISTRICT OF TEXAS
FORT WORTH DIVISION
In re:
PREFERRED CARE INC., et. al.
Debtors.
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Chapter 11
Case No.: 17-44642
(Jointly Administered)
Case 17-44674-mxm11 Doc 18 Filed 02/20/18 Entered 02/20/18 13:53:53 Page 1 of 13
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Stephen A. McCartin (TX 13374700)
Mark C. Moore (TX 24074751)
GARDERE WYNNE SEWELL LLP
2021 McKinney Avenue, Suite 1600
Dallas, TX 75201
Telephone: (214) 999-3000
Facsimile: (214) 999-4667
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.
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Chapter 11
Case No.: 17-44642
Case No.: 17-44641
Case No.: 17-44644
Case No.: 17-44645
Case No.: 17-44646
Case No.: 17-44647
Case No.: 17-44648
Case No.: 17-44649
Case No.: 17-44650
Case No.: 17-44651
Case No.: 17-44652
Case No.: 17-44653
Case No.: 17-44654
Case No.: 17-44655
Case No.: 17-44656
Case No.: 17-44657
Case No.: 17-44660
Case No.: 17-44661
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.
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Case No.: 17-44663
Case No.: 17-44665
Case No.: 17-44666
Case No.: 17-44669
Case No.: 17-44659
Case No.: 17-44662
Case No.: 17-44664
Case No.: 17-44667
Case No.: 17-44670
Case No.: 17-44671
Case No.: 17-44673
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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.
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Case No.: 17-44674
Case No.: 17-44675
Case No.: 17-44676
Case No.: 17-44677
Case No.: 17-44678
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. 44642 (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.
Case 17-44674-mxm11 Doc 18 Filed 02/20/18 Entered 02/20/18 13:53:53 Page 3 of 13
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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
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Debtors
Debtor Last Four Digits
of Federal Tax I.D. No.
Preferred Care Inc. 7040
Kentucky LP Debtors
Bowling Green Health Facilities, L.P. 5787
Brandenburg Health Facilities, L.P. 6699
Cadiz Health Facilities, L.P. 7640
Campbellsville Health Facilities, L.P. 4207
Elizabethtown Health Facilities, L.P. 6127
Elsmere Health Facilities, L.P. 7843
Fordsville Health Facilities, L.P. 3299
Franklin Health Facilities, L.P. 7307
Hardinsburg Health Facilities, L.P. 3640
Henderson Health Facilities, L.P. 8067
Irvine Health Facilities, L.P. 7418
Morganfield Health Facilities, L.P. 8320
Owensboro Health Facilities, L.P. 8145
Paducah Health Facilities, L.P. 3350
Pembroke Health Facilities, L.P. 8209
Richmond Health Facilities - Kenwood, L.P. 8235
Richmond Health Facilities - Madison, L.P. 8216
Salyersville Health Facilities, L.P. 8263
Somerset Health Facilities, L.P. 8739
Springfield Health Facilities, L.P. 8310
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Stanton Health Facilities, L.P. 8704
New Mexico LP Debtors
Artesia Health Facilities, L.P. 5383
Bloomfield Health Facilities, L.P. 7640
Clayton Health Facilities, L.P. 3609
Desert Springs Health Facilities, L.P. 2707
Espanola Health Facilities, L.P. 2102
Gallup Health Facilities, L.P. 2562
Lordsburg Health Facilities, L.P. 1449
Pinnacle Health Facilities XXXIII, L.P. 1389
Raton Health Facilities, L.P. 6759
SF Health Facilities, L.P. 2323
SF Health Facilities-Casa Real, L.P. 0716
Silver City Health Facilities, L.P. 6972
Case 17-44674-mxm11 Doc 18 Filed 02/20/18 Entered 02/20/18 13:53:53 Page 6 of 13
Summary of Assets and Liabilities for Non-Individuals
Official Form 206Sum Summary of Assets and Liabilities for Non-Individuals 12/15
Part 1: Summary of Assets
1. Schedule A/B: Assets–Real and Personal Property (Official Form 206A/B)
1a. Real property:Copy line 88 from Schedule A/B .......................................................................................................................................... $ ________________
1b. Total personal property: Copy line 91A from Schedule A/B ........................................................................................................................................
$ ________________
1c. Total of all property: Copy line 92 from Schedule A/B ..........................................................................................................................................
$ ________________
Part 2: Summary of Liabilities
2. Schedule D: Creditors Who Have Claims Secured by Property (Official Form 206D)Copy the total dollar amount listed in Column A, Amount of claim, from line 3 of Schedule D ................................................ $ ________________
3. Schedule E/F: Creditors Who Have Unsecured Claims (Official Form 206E/F)
3a. Total claim amounts of priority unsecured claims:Copy the total claims from Part 1 from line 6a of Schedule E/F ......................................................................................... $ ________________
3b. Total amount of claims of nonpriority amount of unsecured claims: Copy the total of the amount of claims from Part 2 from line 6b of Schedule E/F ............................................................. + $ ________________
4. Total liabilities ........................................................................................................................................................................... Lines 2 + 3a + 3b
$ ________________
Debtor name _________________________________________________________________
United States Bankruptcy Court for the:________________________________________
Case number (If known): _________________________
Fill in this information to identify the case:
Check if this is anamended filing
PINNACLE HEALTH FACILITIES XXXIII, L.P.
NORTHERN DISTRICT OF TEXAS
17-44674 MXM
479,565.18
1,915,044.59
2,394,609.77
39,041,872.52
0.00
538,431.25
39,580,303.77
✘
Case 17-44674-mxm11 Doc 18 Filed 02/20/18 Entered 02/20/18 13:53:53 Page 7 of 13
O Schedule E/F: Creditors Who Have Unsecured Claims
Official Form 206E/F Schedule E/F: Creditors Who Have Unsecured Claims 12/15Be as complete and accurate as possible. Use Part 1 for creditors with PRIORITY unsecured claims and Part 2 for creditors with NONPRIORITY unsecured claims. List the other party to any executory contracts or unexpired leases that could result in a claim. Also list executory contracts on Schedule A/B: Assets - Real and Personal Property (Official Form 206A/B) and on Schedule G: Executory Contracts and Unexpired Leases (Official Form 206G). Number the entries in Parts 1 and 2 in the boxes on the left. If more space is needed for Part 1 or Part 2, fill out and attach the Additional Page of that Part included in this form.
Part 1: List All Creditors with PRIORITY Unsecured Claims
1. Do any creditors have priority unsecured claims? (See 11 U.S.C. § 507). No. Go to Part 2. Yes. Go to line 2.
2. List in alphabetical order all creditors who have unsecured claims that are entitled to priority in whole or in part. If the debtor has more than3 creditors with priority unsecured claims, fill out and attach the Additional Page of Part 1.
Total claim Priority amount 2.1 Priority creditor’s name and mailing address As of the petition filing date, the claim is:
Check all that apply. $______________________ $_________________
__________________________________________________________________
___________________________________________
Date or dates debt was incurred
_________________________________
Contingent Unliquidated Disputed
Basis for the claim: _______________________________________________
Last 4 digits of account number _______________
Is the claim subject to offset? No YesSpecify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)
2.2 Priority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply.
$______________________ $_________________ __________________________________________________________________
___________________________________________
Date or dates debt was incurred
_________________________________
Contingent Unliquidated Disputed
Basis for the claim: _______________________________________________
Last 4 digits of account number _______________
Is the claim subject to offset? No YesSpecify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)
2.3 Priority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply.
$______________________ $_________________ __________________________________________________________________
___________________________________________
Date or dates debt was incurred
_________________________________
Contingent Unliquidated Disputed
Basis for the claim: _______________________________________________
Last 4 digits of account number _______________
Is the claim subject to offset? No YesSpecify Code subsection of PRIORITY unsecured
claim: 11 U.S.C. § 507(a) (_____)
Debtor __________________________________________________________________
United States Bankruptcy Court for the: _______________________________________
Case number ___________________________________________ (If known)
Fill in this information to identify the case:
Check if this is anamended filing
PINNACLE HEALTH FACILITIES XXXIII, L.P.
NORTHERN DISTRICT OF TEXAS
17-44674 MXM
✘
✘
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Debtor _______________________________________________________ Case number (if known)_____________________________________ Name
O Schedule E/F: Creditors Who Have Unsecured Claims
Part 2: List All Creditors with NONPRIORITY Unsecured Claims
3. List in alphabetical order all of the creditors with nonpriority unsecured claims. If the debtor has more than 4 creditors with nonpriorityunsecured claims, fill out and attach the Additional Page of Part 2.
Amount of claim
3.1 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed
$________________________________
Date or dates debt was incurred ___________________
Last 4 digits of account number _______________
Basis for the claim: ______________________________________
Is the claim subject to offset? No Yes
3.2 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed
$________________________________
Basis for the claim: _______________________________________
Date or dates debt was incurred ___________________
Last 4 digits of account number _______________
Is the claim subject to offset? No Yes
3.3 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed
$________________________________
Basis for the claim: _______________________________________
Date or dates debt was incurred ___________________
Last 4 digits of account number _______________
Is the claim subject to offset? No Yes
3.4 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed
$________________________________
Date or dates debt was incurred ___________________
Last 4 digits of account number _______________
Basis for the claim: ______________________________________
Is the claim subject to offset? No Yes
3.5 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed
$________________________________
Date or dates debt was incurred ___________________
Last 4 digits of account number _______________
Basis for the claim: ______________________________________
Is the claim subject to offset? No Yes
3.6 Nonpriority creditor’s name and mailing address As of the petition filing date, the claim is: Check all that apply. Contingent Unliquidated Disputed
$________________________________
Date or dates debt was incurred ___________________
Last 4 digits of account number _______________
Basis for the claim: ______________________________________
Is the claim subject to offset? No Yes
PINNACLE HEALTH FACILITIES XXXIII, L.P. 17-44674 MXM
SEE ATTACHED - SCHEDULE F538,431.25
4/7/2015
Case 17-44674-mxm11 Doc 18 Filed 02/20/18 Entered 02/20/18 13:53:53 Page 9 of 13
Debtor _______________________________________________________ Case number (if known)_____________________________________ Name
O Schedule E/F: Creditors Who Have Unsecured Claims
Part 4: Total Amounts of the Priority and Nonpriority Unsecured Claims
5. Add the amounts of priority and nonpriority unsecured claims.
Total of claim amounts
5a. Total claims from Part 1 5a. $_____________________________
5b. Total claims from Part 2 5b. + $_____________________________
5c. Total of Parts 1 and 2 Lines 5a + 5b = 5c.
5c. $_____________________________
PINNACLE HEALTH FACILITIES XXXIII, L.P. 17-44674 MXM
0.00
538,431.25
538,431.25
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Schedule E/F3. List All Creditors with NONPRIORITY Unsecured Claims
Line
Num
ber
Creditor Name Address Basis for Claim Con
tinge
nt
Unl
iqui
date
d
Dis
pute
d
Claim Amount3.1 AMANDA ANGEL ADDRESS REDACTED ACCRUED VACATION/PTO X $2,179.91
3.2 AMANDA HERNANDEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $589.72
3.3 AMERICAN LINEN SUPPLY OF NM INC 550 NO. CHURCH ST, LAS CRUCES, NM 88001 TRADE $56.50
3.4 ANDINA RODRIGUEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $36.71
3.5 ANGELA BARBER ADDRESS REDACTED ACCRUED VACATION/PTO X $56.65
3.6 ANGELICA HERRERA ADDRESS REDACTED ACCRUED VACATION/PTO X $130.64
3.7 ANTOINETTE E YOUNG ADDRESS REDACTED ACCRUED VACATION/PTO X $389.91
3.8 APRIL DEBRY ADDRESS REDACTED ACCRUED VACATION/PTO X $896.34
3.9 AURELIANO A MONSIVAIZ ADDRESS REDACTED EXPENSE REIMBURSEMENT X $310.96
3.10 BARBARA C BANEGAS ADDRESS REDACTED ACCRUED VACATION/PTO X $1,125.02
3.11 BRANDY D GONZALEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $321.11
3.12 CARESOURCE PROGRAMS 2200 6TH AVE SUITE 833, SEATTLE, WA 98121 TRADE $299.00
3.13 CASS INFORMATION SYSTEM INC CIS#92012, PO BOX 17617, ST. LOUIS, MO 63178 TRADE $270.00
3.14 CHAD WAHRMAN ADDRESS REDACTED ACCRUED VACATION/PTO X $10,037.74
3.15 CHIGUSA BARRETT ADDRESS REDACTED ACCRUED VACATION/PTO X $275.49
3.16 CONFIDENTIAL PATIENT REFUND $2,611.95
3.17 CONFIDENTIAL PATIENT REFUND $4,034.32
3.18 CONFIDENTIAL PATIENT REFUND $8,337.00
3.19 CONFIDENTIAL PATIENT REFUND $496.52
3.20 CONFIDENTIAL PATIENT REFUND $95.57
3.21 CONFIDENTIAL PATIENT REFUND $185.73
3.22 CONFIDENTIAL PATIENT REFUND $389.08
3.23 CONFIDENTIAL PATIENT REFUND $810.87
3.24 CONFIDENTIAL PATIENT REFUND $91.20
3.25 CONFIDENTIAL PATIENT REFUND $118.24
3.26 CONFIDENTIAL PATIENT REFUND $1,120.00
3.27 CONFIDENTIAL PATIENT REFUND $1,781.00
3.28 CONFIDENTIAL PATIENT REFUND $5,992.00
3.29 CONFIDENTIAL PATIENT REFUND $107.00
3.30 DAGOBERTO GARCIA ADDRESS REDACTED ACCRUED VACATION/PTO X $476.15
3.31 DARRELL A SILK ADDRESS REDACTED ACCRUED VACATION/PTO X $587.67
3.32 DAVID ULLOA ADDRESS REDACTED ACCRUED VACATION/PTO X $666.40
3.33 DIANA RUBALCAVA ADDRESS REDACTED ACCRUED VACATION/PTO X $34.09
3.34 DIRECT SUPPLY PO BOX 88201, MILWAUKEE, WI 53288 TRADE $14,998.48
3.35 DIXON, SCHOLL, CARRILLO, P.A. 6700 JEFFERSON NE, BLDG. B, STE. 1, ALBUQUERQUE, NM 87109 TRADE $86.00
3.36 DOROTHY MORA ADDRESS REDACTED ACCRUED VACATION/PTO X $40.10
3.37 ECOLAB INC 26252 NETWORK PLACE, CHICAGO, IL 60673 TRADE $234.84
3.38
EDITH HOUSMAN, DECEASED, BY THE PERSONAL
REPRESENTATIVE OF THE WRONGFUL DEATH
ESTATE, RACHEL HIGGENS
DUSTI HARVEY AND JENNIFER FOOTE, HARVEY & FOOTE LAW FIRM, 201
BROADWAY SE, ALBUQUERQUE, NM 87102-3424LITIGATION X X X UNLIQUIDATED
3.39 FEDERAL EXPRESS COPRORATION PO BOX 371461, PITTSBURGH, PA 15250 TRADE $117.93
3.40 FELIX AGOSTO ADDRESS REDACTED ACCRUED VACATION/PTO X $1,696.95
3.41 FELIX R AGOSTO ADDRESS REDACTED ACCRUED VACATION/PTO X $89.63
3.42 FIRETROL PROTECTION SYSTEMS, INC 8401 AVENUE F, LUBBOCK, TX 79404 TRADE $731.12
3.43 FIRST CHOICE MEDICAL SUPPLY HOLDING INC PO BOX 3608, JACKSON, MS 39207 TRADE $31,805.16
3.44 FUN EXPRESS PO BOX 14463, DES MOINES, IA 50306 TRADE $767.56
3.45 HD SUPPLY FACILITIES MAINTENANCE LTD PO BOX 509058, SAN DIEGO, CA 92150 TRADE $430.13
3.46 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE, SUITE 300, BENSALEM, PA 19020 TRADE $134,606.47
3.47 HEATHER SAENZ ADDRESS REDACTED ACCRUED VACATION/PTO X $640.98
3.48 HENRY MEDINA ADDRESS REDACTED EXPENSE REIMBURSEMENT X $142.97
3.49HERBERT JOSLIN
MICHAEL DURAN AND FELEZ A. RAEL, KELLER & KELLER, 505 MARQUETTE
NW #1300, ALBURQUERQUE NM 87102 LITIGATION X X X UNLIQUIDATED
3.50 HILDA LERMA ADDRESS REDACTED ACCRUED VACATION/PTO X $332.52
3.51 HUGO N RODRIGUEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $2,015.28
3.52 IDALIA GUTIERREZ ADDRESS REDACTED ACCRUED VACATION/PTO X $672.73
3.53 JAIME PACHECO ADDRESS REDACTED ACCRUED VACATION/PTO X $1,119.86
3.54 JASMINE PANTOJA ADDRESS REDACTED ACCRUED VACATION/PTO X $41.85
3.55 JOERNS WOUNDCO HOLDINGS INC KEYBANK-LCKBOX 713222, 895 CENTRAL AVENUE, CINCINNATI, OH 45202 TRADE $3,938.84
3.56 JULIE BEJARANO ADDRESS REDACTED ACCRUED VACATION/PTO X $431.72
3.57 KONICA MINOLTA BUSINESS SOLUTIONS USA INC, DEPT. CH 19188, PALATINE, IL 60055 TRADE $88.38
3.58 LAURA P ARRIAGA ADDRESS REDACTED ACCRUED VACATION/PTO X $2,409.56
3.59 LORENA VASQUEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $342.72
3.60 LORRAINE HARKER ADDRESS REDACTED ACCRUED VACATION/PTO X $86.26
3.61
MARC GRANO, AS WRONGFUL DEATH PERSONAL
REPRESENTATIVE OF THE ESTATE OF
FRANCISCA MARMOLEJO LITIGATION X X X UNLIQUIDATED
3.62 MARIA K FLORES ADDRESS REDACTED ACCRUED VACATION/PTO X $313.25
3.63 MARISA VASQUEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $230.07
3.64 MARTHA GAYTAN ADDRESS REDACTED ACCRUED VACATION/PTO X $325.79
3.65 MARY TORRES ADDRESS REDACTED ACCRUED VACATION/PTO X $3,963.02
3.66 MCCLAUGHERTY & SILVER, P.C. PO BOX 8680, SANTA FE, NM 87504 TRADE $38,765.97
3.67 MEDLINE INDUSTRIES DEPT 1080, PO BOX 121080, DALLAS, TX 75312 TRADE $991.97
3.68 MED-PASS INC L-3495, COLUMBUS, OH 43260 TRADE $69.63
3.69 MED-PASS INC. L-3495, COLUMBUS, OH 43260 TRADE $194.97
3.70 MEGAN PARNELL ADDRESS REDACTED ACCRUED VACATION/PTO X $553.08
3.71 MIKE LOPEZ PO BOX 533, MESILLA, NM 88046 TRADE $1,000.00
3.72 MIRIAM M CHITOLIE ADDRESS REDACTED ACCRUED VACATION/PTO X $310.85
3.73 MONICA DUTCHOVER ADDRESS REDACTED ACCRUED VACATION/PTO X $218.50
3.74 MONIQUE BUSTAMANTES ADDRESS REDACTED ACCRUED VACATION/PTO X $281.67
3.75 NEW MEXICO DEPT OF REVENUE PO BOX 8485, ALBUQUERQUE, NM 87198 TRADE $39,037.25
Pinnacle Health Facilities XXXIII, L.P.
17-44674
ScheduleF - SCHEDULE F
Case 17-44674-mxm11 Doc 18 Filed 02/20/18 Entered 02/20/18 13:53:53 Page 11 of 13
Schedule E/F3. List All Creditors with NONPRIORITY Unsecured Claims
Line
Num
ber
Creditor Name Address Basis for Claim Con
tinge
nt
Unl
iqui
date
d
Dis
pute
d
Claim Amount3.76 NEW MEXICO HUMAN SERVICES DEPARTMENT PO BOX 2348, SANTA FE, NM 87504 PATIENT REFUND X $42,261.75
3.77 O.C. TANNER COMPANY 1930 SOUTH STATE STREET, SALT LAKE CITY, UT 84115 TRADE $199.77
3.78 OFELIA PINEDA ADDRESS REDACTED ACCRUED VACATION/PTO X $252.26
3.79 OMAR VELAZQUEZ ADDRESS REDACTED EXPENSE REIMBURSEMENT X $476.56
3.80 ON HOLD MARKETING SERVICES 6840 WEST 70TH STREET, SHREVEPORT, LA 71129 TRADE $41.95
3.81 PERFORMANCE HEALTH SUPPLY INC PO BOX 93040, CHICAGO, IL 60673 TRADE $371.08
3.82 PHARMACY CORPORATION OF AMERICA ATTN: MIKE RODRIGUEZ, 1900 S SUNSET UNIT 1A, LONGMONT, CO 80501 TRADE $58,330.06
3.83 PINCOMPUTING COMPANY LP 5500 W. PLANO PKWY SUITE 210, PLANO, TX 75093 TRADE $3,450.00
3.84 PORTER ONE DESIGN 37680 HILLS TECH DRIVE, FARMINGTON HILLS, MI 48331 TRADE $258.85
3.85 PROSPERO G QUINONES ADDRESS REDACTED ACCRUED VACATION/PTO X $1,412.11
3.86 RAMONA NUNEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $611.70
3.87 RAYLYNN S SELLERS ADDRESS REDACTED ACCRUED VACATION/PTO X $270.59
3.88 REALVIEW PUBLISHING, LLC PO BOX 550, LAS CRUCES, NM 88004 TRADE $145.42
3.89 REGINA S WINNER ADDRESS REDACTED ACCRUED VACATION/PTO X $149.49
3.90 RELIANT REHABILITATION PO BOX 671181, DALLAS, TX 75267 TRADE $78,375.36
3.91 REYNA HARBARGER ADDRESS REDACTED ACCRUED VACATION/PTO X $668.63
3.92 RITO NELSON J DAAN ADDRESS REDACTED ACCRUED VACATION/PTO X $4,640.00
3.93
ROBERT NARVAEZ, DECEASED, BY THE
PERSONAL REPRESENTATIVE OF THE
WRONGFUL DEATH ESTATE, SARA CRECCA
DUSTI HARVEY AND JENNIFER FOOTE, HARVEY & FOOTE LAW FIRM, 201
BROADWAY SE, ALBUQUERQUE, NM 87102-3424LITIGATION X X X UNLIQUIDATED
3.94 ROSA SOLIS ADDRESS REDACTED ACCRUED VACATION/PTO X $2,669.66
3.95 RUBI BEARD ADDRESS REDACTED ACCRUED VACATION/PTO X $261.82
3.96 RUBY HERNANDEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $292.50
3.97 SAYRA VAZQUEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $172.33
3.98 SCHRYVER MEDICAL SALES & MARKETING LLC 12075 E 45TH AVE., SUITE 600, DENVER, CO 80239 TRADE $5,579.84
3.99 SONIA YANAGA ADDRESS REDACTED ACCRUED VACATION/PTO X $31.42
3.100 SPECIALIZED MEDICAL SERVICES INC 7237 SOLUTION CENTER, CHICAGO, IL 60677 TRADE $1,780.92
3.1 STAPLES CONTRACT & COMMERCIAL INC DEPT DAL, PO BOX 83689, CHICAGO, IL 60696 TRADE $1,621.91
3.102 STEPHANIE SAMANIEGO ADDRESS REDACTED ACCRUED VACATION/PTO X $389.56
3.1 SUJEY ROMERO ADDRESS REDACTED ACCRUED VACATION/PTO X $94.39
3.104 SYLVANA HERNANDEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $751.04
3.11 THE SHERWIN WILLIAMS CO. 2100 LAKESIDE BLVD STE 400, RICHARDSON, TX 75082 TRADE $249.89
3.106 TRICOM INC PO BOX 2019, LAS CRUCES, NM 88004 TRADE $178.56
3.11 TRI-STATE FLEET MANAGEMENT LLC PO BOX 162659, FT WORTH, TX 76161 TRADE $887.11
3.108 WILLIAM SANTILLAN-HOPPERT ADDRESS REDACTED ACCRUED VACATION/PTO X $2,347.47
3.11 YVONNE HERNANDEZ ADDRESS REDACTED ACCRUED VACATION/PTO X $172.70
$538,431.25TOTAL:
Pinnacle Health Facilities XXXIII, L.P.
17-44674
ScheduleF - SCHEDULE F
Case 17-44674-mxm11 Doc 18 Filed 02/20/18 Entered 02/20/18 13:53:53 Page 12 of 13
Case 17-44674-mxm11 Doc 18 Filed 02/20/18 Entered 02/20/18 13:53:53 Page 13 of 13