Shepherd of the Valley Care Center

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Financial Assistant Information

 
All payment sources are accepted by the facility. There are usually five (5) payment sources for long term nursing care, or a combination of the following types of pay sources. Those sources are:

  1. Private Payment
      The resident and/or family pays all charges for the resident's care.

  2. Medicare Part A
 

"Medicare Qualifying Event"

A "qualifying event" is an inpatient three night stay in a hospital prior to admission to a nursing care facility. There is a difference in a three night stay and a three day stay. That difference is the potential resident must have been an inpatient (time in the emergency room does not count toward qualifying time) in a hospital at midnight for three nights in a row. A three day stay (three days, two nights) with discharge before midnight on the third day does not qualify the patient for Medicare Part A nursing care facility benefits..

 

Day 1 through Day 20:
Medicare will pay 100% of Medicare approved charges for the resident’s medical care for the first 20 days of care per qualifying event.

If the resident was in the hospital and was classified by the hospital as "sub-acute" care, those sub-acute care days are counted by Medicare as part of the 20 days. Example: If the resident was in the hospital for 9 days and 5 of those 9 days the resident was classified as sub-acute days, the resident will have 15 days left at 100% pay in the nursing care facility.

Day 21 through Day 100 Co-payment Required:
For days 21 through 100 Medicare Part A has a co-payment of $128 per day. This rate is set by Medicare and changes every year.

  

 

 

 

 
 3. Medicare Part B
 

After the resident has used all 100 days of Medicare Part A benefits (if the resident was qualified for Medicare Part A), and the resident still has a need for skilled nursing care, the resident may be put on Medicare Part B for therapy and some medical supplies.
 

  
4. Medicald (sometimes referred to as Title 19):
 
It is not necessary for a prospective resident to be hospitalized in order to qualify for Medicaid. Residents are admitted according to their needs as determined by their Physician and an order for admission written by the Physician.

Medicaid is used to pay for resident's care when their personal funds have been exhausted to $2000 or less for a single person. This includes any life insurance policies and other assets.

Medicaid requires a Patient Contribution (co-pay) from most residents. However, there are some circumstances that do not require this co-payment. This Patient Contribution is usually the amount of the resident's Social Security and other retirement income minus $50 each month for the resident’s personal use.

There are many records required by Medicaid before they will qualify a resident. Therefore, it is suggested that a resident start this process when personal funds are between $5000-$6000, as it often takes as long as three months to get all the required paper work & documents collected.

To apply for Medicaid, contact the Wyoming Department of Family Services at 307-473-3900.
 
  
  5. Insurance Company Payment: Shepherd of the Valley will bill your insurance for covered services.