Basic Service Rates. The costs for basic services in this home are: $ per month for a private room with a private bathroom + $ for personalized care = a total monthly cost of $ . A non-refundable move in fee of $ will be collected prior to move in. Other costs for services may be agreed upon by both parties and noted in the basic services rate. The personalized care rate will be determined by a level of care assessment prior to admission for private pay residents. If accepting Medicaid as payment, an assessor from the regional Medicaid room will assess and fix a daily rate based on needs. * I HAVE BEEN INFORMED OF AND UNDERSTAND ACTION I MUST TAKE, OR THAT WOULD BE REQUIRED OF ME, IN AN EMERGENCY SITUATION. * I CAN BE MOVED WITHOUT WRITTEN NOTICE TO ANOTHER HOME OR RESIDENCE IN AN EMERGENCY SITUATION. $ deposit was received on Move in date: Move-in prorated fee in the amount of $ was received on Any other fees as specified Medicaid recipient – Check here Admission Agreement Medicaid Guidelines Building: □Boise #1 □Boise #2 □Xxxxxx #1 □Xxxxxx #2 □Meridian #1 □Meridian #2 □Middleton □Mountain Home □Payette □Xxxxxx #1 □Xxxxxx #2 □Lochsa Falls Addendum Not Applicable The Cottages is a private pay assisted living provider. The monthly fee we charge is based on a level of care assessment done upon admission and quarterly thereafter. The average monthly fee for a resident at The Cottages ranges from $3,000 – $4,000 per month. Based on this expectation and your own personal financial capability, your signature below states that you, the resident/P.O.A., testify of your ability to meet all the financial requirements. For a resident who is no longer financially capable of paying the private pay rate, The Cottages may allow a resident to rollover to Medicaid status. The Cottages policy is that the resident must pay a private pay rate for a minimum of 24 months before The Cottages will consider acceptance of Medicaid funds as a method of payment. This 24 month requirement is the absolute minimum amount of time a resident must pay prior to Medicaid rollover, and it only applies after all funds have been depleted. It is the expectation that the resident will continue to pay at the private pay rate until Medicaid eligibility has been determined by Health and Welfare and the Notice of Action is received by our corporate office. Upon rollover to Medicaid, if the resident wishes to remain in a private room, there will be an additional room upgrade fee of $1400 assessed on the monthly invoice to...
Basic Service Rates. The costs for basic services in this home are: $ per month for a private room with a private bathroom + $ for personalized care = a total monthly cost of $ . A non-refundable move in fee of $ will be collected prior to move in. Other costs for services may be agreed upon by both parties and noted in the basic services rate. The personalized care rate will be determined by a level of care assessment prior to admission for private pay residents. If accepting Medicaid as payment, an assessor from the regional Medicaid room will assess and fix a daily rate based on needs. * I HAVE BEEN INFORMED OF AND UNDERSTAND ACTION I MUST TAKE, OR THAT WOULD BE REQUIRED OF ME, IN AN EMERGENCY SITUATION. * I CAN BE MOVED WITHOUT WRITTEN NOTICE TO ANOTHER HOME OR RESIDENCE IN AN EMERGENCY SITUATION. $ deposit was received on Move in date: Move-in prorated fee in the amount of $ was received on Any other fees as specified Medicaid recipient – Check here
Basic Service Rates. The costs for basic services in this home are: $ per month for a private room with a private bathroom + $ for personalized care = a total monthly cost of $ . A non-refundable move in fee of $ will be collected prior to move in. Other costs for services may be agreed upon by both parties and noted in the basic services rate. The personalized care rate will be determined by a level of care assessment prior to admission for private pay residents. If accepting Medicaid as payment, an assessor from the regional Medicaid room will assess and fix a daily rate based on needs. * I HAVE BEEN INFORMED OF AND UNDERSTAND ACTION I MUST TAKE, OR THAT WOULD BE REQUIRED OF ME, IN AN EMERGENCY SITUATION. * I CAN BE MOVED WITHOUT WRITTEN NOTICE TO ANOTHER HOME OR RESIDENCE IN AN EMERGENCY SITUATION. $ deposit was received on Move in date: Move-in prorated fee in the amount of $ was received on Any other fees as specified Medicaid recipient – Check here Building: □Boise #1 □Xxxxxx #1 □Lochsa #1 □XxXxxx □Meridian #1 □Middleton □Boise #2 □Xxxxxx #2 □Lochsa #2 □Meridian #2 □Mountain Home □Nampa □Xxxxxxx □Xxxxxx #1 □Xxxxxx #2
Basic Service Rates. Pre-Installation $85 Installation $115 Project Management $150 Engineering $250 Field Service Tech $ 115 Training $125 Programming $150 Travel Billed as incurred Firm Price - Initial quoted discount levels must remain constant throughout the term of this agreement, subject only to subsequent increased discount amounts. Xxxxxx Communications, LLC has read and agrees to comply.
