Guest House charges depend upon the following factors:

I. The resident's level of care, or, put more simply, the answer to the question, "What types of care does this particular resident need?" It is hard to "quote" an accurate price for a resident's stay until facility staff has details on that individual's health care needs.

II. Whether the resident chooses a private room or a semi-private room.

What are the differences in private room and a semi-private?

A private room has only one bed with a private bath. The private bath consist of a toilet, lavatory and large bathtub for the resident's private use. Whirlpool baths are available to residents in private rooms. Additionally, televisions are furnished in private rooms.

A semi-private room has two beds and is shared by two residents. The bath, consisting of a toilet and lavatory, is shared among four residents in the two adjoining rooms. Private bathing takes place in a large bathing area in a central location within the facility. Whirlpool baths are available to residents in semi-private rooms.

Guest House offers many ways to pay for a resident's stay:

I. Private Pay -- Private pay residents, put simply, pay for their stay and care with private funds. Guest House services include room and board, housekeeping and laundry services, meals, a well-rounded activities and social program, and 24-hour nursing care.

II. Medicaid -- Residents who qualify for Medicaid will receive benefits from the government which pay for the resident's stay. Medicaid is "monetary assistance for those residents who cannot afford to pay privately for their stay and care." Important: Residents or their responsible party must apply for Medicaid. Medicaid applications can be taken at Guest House by our staff.

III. Medicare -- Medicare is "medical insurance for those people over 65." To qualify for Medicare, the individual must have paid in at least 40 quarters in Social Security taxes during their work history. It should be noted that for Medicare to pay what is called the "extended benefit" for nursing facility care, the individual must have spent at least three midnights in an acute care hospital bed. This is called the "three day qualifying hospital stay." The individual must also need certain types of care to receive Medicare benefits. Among these are the following:

• skin breakdown (bed sores or decubitus); or
• when receiving 100% of nutrition from a stomach tube; or
• when the individual is an insulin dependent diabetic
  (requiring insulin injections on a daily basis); or
• when the individual's physician has ordered physical, occupational, or speech therapy or a combination thereof five (5) times per week, 30 minutes per day.

It should be remembered: only those individuals who have Medicare benefits available, and meet the criteria for receiving those benefits can use Medicare to pay for a stay in a nursing facility.

How long does Medicare pay in a nursing center?

Medicare pays for 100% of a Medicare covered stay for 20 days. Medicare pays for 80% of a Medicare covered stay for the next 80 days. A co-pay is required for days 21 through 100. This means that approximately 20% must be paid by private funds, a co-pay insurance (such as Blue Cross-Blue Shield) or by Medicaid.

Medicare only pays for up to 100 days per "spell of illness." After that 100 day "spell of illness," the resident must have a 60 day "spell of wellness" in which the resident has not received a "skilled service" which would be covered under Medicare. This matter can sound complicated; however, it is simple. For more details and a further explanation, please contact Guest House.

IV. Private Insurance -- Guest House accepts private insurance which covers nursing center care. This includes the "co-pay" for Medicare.