1. How Does Medicare work?
2. Regarding Medicare, what if I do not have a three-day qualifying stay in a hospital?
3. What if I do not have means to pay the co-insurance rate per day?
4. How does Medicaid work?
5. How is my spouse to meet his/her expenses?
6. What do I need to bring to the nursing home?
7. When can I have visitors?

1. The basic information is as follows: Medicare will pay 100% for the first 20 days. During days 21-100, there is a co-insurance charge per day, and Medicare pays all remaining allowable charges if you qualify for coverage. You are eligible for Medicare payment if you have been admitted for a three-day stay in the hospital. Medicare determines compliance, based on medical necessity. Medicare IS NOT designed to pay for basic daily living skills in a nursing facility (i.e., bathing, dressing, taking medications).
   
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2. If you do not have a three-day stay, and have not had in the past 30 days, you are not eligible for Medicare to pay your nursing home costs. You would be considered either, private pay, or you may apply for Medicaid if eligible. However, if you have part B, it may cover therapy treatment if you qualify.
   
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3. The facility would be happy to help you in applying for Medicaid. Medicaid is a government-sponsored program, eligible to people who have $1500 or less in assets. Once you are eligible for Medicaid, it will pay the daily co-insurance rate per day.
   
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4. Medicaid is designed to help cover the cost of nursing home care for people with $1500 or less in assets. If you are eligible for Medicaid, it will pay a set amount each month to the nursing home. You will contribute with a designated amount of your social security and/or pension. This is called the Patient Resource Payment, and is established by Medicaid based on your income.
   EXAMPLE: if your total income, social security, and pension combined is $730 a month, you would keep $40. Your patient resource amount would be $690 due to the facility each month. Medicaid will take a total value of your income, and depending on income source, subtract $40. You are allowed to keep this money for personal needs, with the remainder being paid to the facility.
   
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5. There are separate regulations when a spouse is involved. We will be happy to provide you with some basic information, and give you a contact person at the local Medicaid office to answer your specific questions. There is protected spousal amount that your spouse is allowed to keep to meet their expenses.
   
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6. You will need to bring any insurance cards, power of attorney, living wills, ect. You will also need to bring clothing for your stay. A good rule is to pack as if you are going on a 7-10 day trip. Pack enough clothing, sleepwear, and underclothes for this period. This allows us to keep you in clean clothing while the laundering soiled ones. You do not want to over pack as there is limited storage space in the room. We have Resident Phones that can be used in the rooms if you want to make a call or if you have someone trying to call you. The aides in your units will help you with this. The T.V. can be hooked up by contacting the Maintenance Department. There is a one time T.V. hook-up fee of $12.00; then a $7.00 a month fee there after. In addition, Crestview is equipped with telephone lines that can be connected for you for a small monthly fee. The facility is also equipped with Time-Warner Cable Service and every room can get this service. Just like the telephone, you handle this directly with Time-Warner Cable Service. You are welcome to bring your television, radio, and/or telephone. Cable hook-up and private line expenses are the responsibility of the resident.
   
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7. There are no restrictions on visitors. Friends and family are welcome 24 hours per day, seven days a week. You are welcome to leave the facility for certain periods, given there are no medical restrictions. Medicare and Medicaid have specific guidelines for the number of days you may be away from the facility.
   
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The above information provides general answers to some frequently asked questions by Residents and their Families. For more specific answers, tours, or any needed assistance, please feel free to contact Crestview, anytime at (740) 654-2634 or visit us.

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