Financial / Rates
Questions? Contact Our Business Office Manager, Emilee Green, email@example.com
Frequently Asked Questions:
- Will the facility notify me when my current financial coverage ends? Yes, The facility will give at least TWO DAYS notice per regulation of the end of “skilled” service. One should know prior to that as we start discharge planning upon admission. Each case is different and has different variables as to why a patient’s length of stay is shorter or longer.
- What if I cannot go back to where I was living before going to the hospital and Whitney Oaks? The facility will assist with a proper safe discharge to an appropriate level of care, with a physician order, and the responsible party’s input. An alert Resident or Responsible Party may choose to go against the medical advice of the medical team including the physician. This is considered an Against Medical Advice or AMA discharge. The facility will still do all it can to provide appropriate referrals, as applicable, such as home health or DME. Clearly it is strongly advised to follow the physicians orders/recommendations.
- Will the facility “kick me out” if I can no longer pay? The facility will NEVER unsafely discharge a patient for financial reasons. We are happy to coordinate with the responsible party to assist in applying for Medi-Cal, if the patient qualifies and meets the medical necessity to continue at the facility. The facility does not make eligibility decisions for Medi-Cal or the amount the resident will have to pay as their Share of Cost (SOC) to continue as a long-term stay resident. The facility will collect an “estimated” share of cost based on Medi-Cal guidelines when a residents current benefit ends and he/she becomes “Medi-Cal Pending”, until the application is approved and the SOC is determined. If it is determined by Medi-Cal the resident is not eligible for state assistance, the resident is considered “private pay” and is responsible for any past due bills. Once a long-term application for Medi-Cal is sent, it is assumed the facility will be the residents long-term residence and all care needed will be provided at the facility. Resident cannot continue to pay rent, room & board, family bills, etc as those locations should be notified the resident is not able to return due to health and financial constraints.
- I have assets and I don’t know what to do. The facility cannot give advice on financial matters. We strongly recommend seeking out a qualified financial advisor to assist in ones estate planning.
Participating Insurance Companies
– Blue Cross – Blue Shield – Cigna – Health Net – Humana – Kaiser – Medicare – TRICARE
– Molina – Private Pay – Mercy Medical Group* -Sutter – UHC / Pacificare – UC Davis – Hospice Services – Medi-Cal
Medicare will cover skilled care only if all of the following are true:
- You have Medicare Part A* (Hospital Insurance) and have days left in your benefit period.
- You have a qualifying hospital stay. This means an inpatient hospital stay of 3 consecutive days or more. You must enter the SNF within a short period of time of leaving the hospital.
- Your doctor has ordered the services you need for SNF care, which require the skills of professional personnel such as registered nurses, licensed practical nurses, physical therapists, occupational therapists, speech-language pathologists, etc.
- You require the skilled care on a daily basis and the services must be ones that can only be provided in a SNF on an inpatient basis.
- You need these skilled services for a medical condition that:
– was treated during a qualifying 3-day hospital stay, or
– started while you were getting SNF care for a medical condition that was treated during a qualifying 3-day hospital stay.
Daily rate for skilled nursing care include room and board is $385 Effective June 1, 2021:
- Three meals per day served in main dining or rehabilitative dining areas
- Tray service, plus snacks
- Special diets upon physician order
- Daily assistance with activities of daily living (ADLs), i.e., dressing, bathing, ambulation, personal hygiene and needs
- Daily housekeeping service
- Bed and bathroom linens (less incontinent care linens)
- Administration of medications as prescribed by either attending/alternate physician
- 24-hour supervision by licensed nursing personnel (R.N. or L.V.N.) and Certified Nursing Assistants
- Assistance with feeding
- Planned activities
- Recreational and occupational programs
- Drug regimen review
- Social services consultation
- Discharge planning and referral service
- Rooms furnished in accordance with state and federal regulatory agencies