Financial/ Rates

Admission into a rehabilitation or skilled nursing facility can be overwhelming. Usually it’s sudden and out of one’s control. In these situations, understanding Medicare and insurance coverage can be difficult. It is important to be educated on what you are entitled to under your insurance policies, so you can focus on healing and not stress over finances.

Our Business Office and Clinical Nurse Liaison work closely with patients’ insurance companies, and they explain to our patients and/or patients’ authorized representatives how their insurance will cover their stay at our facility. We accept Medicare as well as several managed care plans. We can determine what secondary or supplemental insurances will cover and can offer advice on the policy benefits and restrictions.

Listed below are guidelines regarding Medicare coverage in skilled nursing. There are specific requirements that a patient must meet before admitting to our facility:

• A patient must have a three (3) day qualifying stay in the hospital. This means that the hospital must admit the patient, and the patient must stay for at least three (3) consecutive nights in the hospital. If the patient is discharged home from the hospital, he or she has up to 30 days where he or she can be admitted to a skilled nursing facility.
• The patient’s doctor must order services that require one to be in a skilled nursing facility. These services include but are not limited to: a requirement for skills of professional personnel such as registered nurses, licensed practical nurses, physical therapy, occupational therapy, speech-language pathology, etc.
• A patient requires skilled care daily and the services must be ones that can only be provided in a skilled nursing facility.
• Individuals who are Medicare eligible have up to 100 days of Medicare coverage. However, once the resident reaches his or her baseline or has plateaued in rehabilitation, Medicare will no longer cover the resident’s stay.
• Medicare will only cover short-term rehabilitation. Medicare does not cover long term/custodial nursing care.

The daily rate for skilled nursing care includes the following:

PLEASE NOTE OUR DAILY RATE DOES NOT INCLUDE THE FOLLOWING: PHYSICIAN VISITS, DENTAL VISITS, MEDICATION, MEDICAL SUPPLIES, INCONTINENT CARE SUPPLIES, SPECIAL PHYSICIAN ORDERED THERAPIES SUCH AS PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, RESPIRATORY THERAPY, DIAGNOSTIC TESTS, AND OTHER SPECIALIZED CARE PROCEDURES.

Need some help or have some questions before you make a decision? Our staff are here to answer any concerns you may have. Please reach out to us and we’ll work hard to put your mind at ease.