3890 (Cont.),,,CMS FORM-1984-99,,,,,04-99
,,,,PROVIDER NO:,,PERIOD:,WORKSHEET A-7,
ANALYSIS OF CHANGES IN CAPITAL ASSETS BALANCES,,,,,,FROM,,
,,,,,,TO,,
,,,,Acquisitions,,Disposals,,
,,Beginning,,,,and,Ending,
,Description,Balances,Purchases,Donation,Total,Retirements,Balance,
,,1,2,3,4,5,6,
1 ,Land,,,,,,,1 
2 ,Land Improvements,,,,,,,2 
3 ,Buildings and Fixtures,,,,,,,3 
4 ,Building Improvements,,,,,,,4 
5 ,Fixed Equipment,,,,,,,5 
6 ,Movable Equipment,,,,,,,6 
7 ,Subtotal (sum of lines 1-6),,,,,,,7 
8 ,Reconciling Items,,,,,,,8 
9 ,Total (line 7 minus line 8),,,,,,,9 
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"FORM CMS-1984-99 (4/99) (INSTRUCTIONS FOR THIS WORKSHEET ARE PUBLISHED IN CMS PUB. 15-II, SECTIONS 3817)",,,,,,,,
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36-114,,,,,,,,Rev. 1