Financial Considerations

In a Sea of Confusing Information, We're Here to Help.

Understanding Your Options

At Grandview, we know that making decisions regarding skilled-nursing care and rehabilitative services for yourself or a loved one can be an emotional, stressful, and confusing process.  We understand that entering a skilled nursing facility is generally a once-in-a-lifetime event for which few people find themselves prepared.

We’re here to help you navigate your way through what may seem like an overwhelming maze of financial and insurance considerations associated with preparing for a skilled nursing or rehabilitative stay. You’ll find that our compassion and care begin the moment you first contact us. Our friendly, knowledgeable admissions and business-office staff have extensive experience with this process and have helped thousands of families identify the approvals and resources they need.

Grandview accepts a wide range of government and private insurance. Our skilled nursing facility is Medicare-certified. In addition, we accept Medicaid; most managed care and commercial insurance, as well as private payment. Our team will be happy to help you understand your options. Below are some brief explanations of possible forms of payment.

Questions? Call us and allow one of our experienced staff members to assist you.

Medicare

Medicare is a health-insurance program for individuals who are age 65 or older or who are under age 65 but who have certain disabilities or end-stage renal disease. Because Medicare does not cover all expenses and is not designed to pay for long-term, custodial care, it is important to understand the program.

Medicare premiums, deductibles, and co-insurance amounts change each year. Medicare pays 100 percent of days 1-20 of a qualifying, skilled-nursing stay.  However, there is a co-insurance charge for days 21-100. Our Admissions Team can review current rates and coverages with you. You may also find information about Medicare’s current rates and coverages by visiting medicare.gov.

Understanding Medicare

  • Medicare Part A—helps pay for hospital stays, skilled-nursing facility care, home-health care and hospice care.
  • Medicare Part B—helps pay for physicians’ services and outpatient care, as well as some other services such as physical and occupational therapies, some home-health care, and services and supplies that are medically necessary.
  • Medicare Part C—is Medicare’s managed-care benefit called Medicare Advantage Plan. Each plan offers different benefits and different rules than traditional Medicare.
  • Medicare Part D—is the Medicare prescription-drug-coverage program. Cost and coverage vary by plan.

Coverage

Medicare offers qualifying residents the opportunity to receive inpatient skilled-nursing and rehabilitation services. Medicare helps pay for some skilled-nursing care costs (providing you meet the Medicare Skilled Nursing Facility Coverage Guidelines) such as:

  • Semi-private room
  • All meals, including special diets
  • Use of items such as braces, splints, and adaptive equipment
  • Medications prescribed by a physician
  • Medical supplies
  • Nursing care
  • Rehabilitation services, including physical, occupational, and speech therapies

Qualifying for Medicare

A resident can qualify for Medicare benefits under most circumstances if:

  • The individual has been in the hospital for three consecutive days, not counting the day of discharge
  • The individual is transferred to a nursing center for further care of the condition for which he or she was treated in the hospital, or if the individual has other conditions requiring skilled-nursing care or rehabilitative services
  • A physician certifies that the resident requires skilled nursing or rehabilitative care after the resident has had a qualifying, three-day (excluding the day of discharge) hospital stay

Medicaid

The Medicaid program provides medical benefits to people who have no medical insurance or inadequate medical insurance and who meet the resource guidelines for Medicaid. The federal government establishes the general guidelines for the program; however, each state establishes the program’s requirements, including eligibility. For more information about Medicaid eligibility for skilled nursing and rehabilitation services in Pennsylvania, please contact our Admissions Office or visit medicaid.gov.

Managed Care and Insurance

We accept most managed care and insurance plans for post-hospital care, including Geisinger Gold and Blue Cross.

 

Private Payment

For residents who do not qualify for Medicaid or other benefits, we accept private payment. Our Patient Accounts staff can provide more information about our services and rate structure.  We accept all major credit cards.

The Patient Accounts office is located on the ground floor of our facility.
Our office hours are Monday through Friday, from 8 a.m. to 4 p.m.
Contacts:

Aleta Campbell 570-275-5240, ext. 127
Barb Yost 570-275-5240, ext. 126