Care Center Rates and Payments

Traditional Medicare Coverage:
Traditional Medicare will cover skilled care if:

• 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 three consecutive overnights or more. You must also enter the Skilled Nursing Facility within a certain period of time after leaving the hospital.
• Your doctor has ordered the services you require for Skilled Nursing Care, these services require the skills of professional personnel such as; registered nurses, licensed practical nurses, physical/occupational therapists, speech language pathologists, etc.
• You require the skilled care on a daily basis, and the services must be that which can only be provided in a Skilled Nursing Facility on an inpatient basis.
• You require these skilled services for a medical condition that:
  • Was treated during a qualifying three day hospital stay, or
  • Started while you were getting skilled nursing care for a medical condition that was treated during a qualified three day hospital stay.

Traditional Medicare will cover 100% of the first 20 days of your benefit coverage, as long as patient is participating in skilled services and able to show progression.

If a patient has a secondary insurance (to include Medicaid) it may cover all or part of the patient co-pay.

When therapies are completed, or patient is discharged from therapy for absence of progression, payer source will change from Traditional Medicare to Self-Pay, Private Insurance, or Medicaid.

Self Pay:
Room/board, care, supplies, meals, laundry, housekeeping and recreational programs (all inclusive stay) at $320.74/day

**Medications as prescribed by a physician will be paid for under Medicare Part D (depending on insurance, patient may have a co-pay)

Private Insurance:
Applicable if insurance covers long term care in a Skilled Nursing Facility.

Medicaid:
We do accept patients on “Medicaid Pending,” however, a self-pay bill will be sent until the patient is approved, via Medicaid and paid retroactive per date of submitted application. Failure to complete the Medicaid process may result in discharge from the Care Center.

Individuals or family must apply for Medicaid through:

Garfield County Department of Social Services
195 West 14th Street, Rifle, CO 81650
970.945.9191
http://coloradopeak.secure.force.com

Grand River Health – Care Center Social Services staff or Financial Services will be happy to assist you with this process.

End of Life Care is provided as an additional layer of support services for both the residents and family, through an independent Hospice service, in conjunction with care center staff. End of Life care includes support from additional groups of volunteers, nursing staff, social workers, and Chaplain to provide individualized cares tailored to a person’s wishes during end of life.

• If a patient has Traditional Medicare only, End of Life services can be paid for with Medicare funding, however the room/board rate of $324.49/day will be self-pay.
• If a patient has both Traditional Medicare and Medicaid; Traditional Medicare will cover End of Life services, while Medicaid covers room and board at 100%.