Financial / Rates
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.
We are contracted with various other HMO insurances:
- Community Health Group
- Primary Care Associated Medical Group (PCAMG)
- Scripps Clinic Medical Group
- Scripps Coastal Medical Center
- UCSD Medical Group
- Vantage Medical Group
- Scripps Physician Medical Group
- Mercy Physicians Medical Group
- Alignment Healthplan
- Blue Cross
- Blue Shield
- Blue Shield Promise
- Easy Choice
- Health Net
- Letter of Agreement (LOA)
- United Healthcare
- Worker’s Comp
Copayments are defined by our guest’s individual Health Insurance.
Medi-Cal recipients should be aware of the following:
- If our guests have a monthly Share of Cost, Medi-Cal will not pay until that Share of Cost is met.
- Medi-Cal pays for Room and Board and/or Medicare/HMO Coinsurance.
- Medi-Cal will not cover skilled services.
Private pay rates are as follows:
- $340 per day – Semi Private Room
- $380 per day – Private Room
- $120 per unit – Physical Therapy, Occupational Therapy, or Speech Therapy Evaluation
- $45.00 per 15 minute unit – Physical and Occupational Therapy
- $60.00 per 15 minute unit – Speech Therapy
Daily rate for skilled nursing care include room and board:
- 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.P.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