Notice of Privacy Practices

Your Rights

You have the right to:

  • Get a copy of your paper or electronic medical record
  • Correct your paper or electronic medical record
  • Request confidential communication
  • Ask us to limit the information we share
  • Get a list of those with whom we’ve shared your information
  • Get a copy of this privacy notice
  • Choose someone to act for you
  • File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we:

  • Tell family and friends about your condition
  • Provide disaster relief
  • Include you in a hospital directory
  • Provide mental health care
  • Market our services and sell your information
  • Raise funds

Our Uses and Disclosures

We may use and share your information as we:

  • Treat you
  • Run our organization
  • Bill for your services
  • Help with public health and safety issues
  • Do research
  • Comply with the law
  • Respond to organ and tissue donation requests
  • Work with a medical examiner or funeral director
  • Address workers’ compensation, law enforcement, and other government requests
  • Respond to lawsuits and legal actions

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. For more information visit: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Your Rights As a Patient/Resident

Get an electronic or paper copy of your medical record

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

  • You can ask us to correct health information about you that you think is incorrect or incomplete.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.

Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can complain if you feel we have violated your rights by contacting us at (716) 826-2010.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/ privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the saturations described below, talk to us. Tell us what you want us to do and we will follow your instructions.

You have the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety

In these cases, we never share your information unless you give us written permission:

  • Marketing purposes
  • Sale of your information
  • Most sharing of psychotherapy notes

In the case of fundraising:

  • We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services

How else can we use or share your health information? We are allowed or required to share your

information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

 Help with public health and safety issues

  • We can share health information about you for certain situations such as:
  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

 Do research

  • We can use or share your information for health research.

 Comply with the law

  • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

  • We can share health information about you with organ procurement organizations.

 Work with a medical examiner or funeral director

  • We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

  • We can use or share health information about you:
  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

  • We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know if a breach occurs that may have compromised the privacy or security of your information.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. Please inquire with our staff if you have any questions.

Anti-Discrimination Disclaimers

Our organization and its facilities do not discriminate in the admission, retention or care given to patients/residents in terms of age, race, creed, color, national origin, gender, gender identity, marital status, sexual preference, handicap, blindness, disability or sponsor.

Our organization is an Equal Opportunity Employer (EOE) and considers all candidates for employment regardless of race, color, age, sex, sexual orientation, genetic history, national origin, marital status, disability, Vietnam or disabled veteran status or arrest record.

Maximum rates for residency and services

$599 per day for residency and/or services.

$725 per day for residency and/or services at our East Patchogue, NY facility.

Autumn View Health Care Facility

BCBS

Medicaid HMO – 308.95

Skilled Level 1 – 339.58

Subacute Level 2 – 445.71

Subacute Level 3 – 551.83

Wound Care (Garden Gate only) Level 4 – 551.83

Amerigroup

Custodial – 236.24

Level 1 – 309.43

Level 2 – 365.25

 

CHS Pace

Respite – 260.10

Custodial 244

Rehab – 395

 

Fallon

MLTC – 240.87

PACE – PDPM

Respite – 240.87

Humanna

Level 1 – 395
Level 2 – 465
Level 3 – 630
Level 4 – 740

iCircle

MLTC – 264.96

Kalos

MLTC – 240.87

 

Family Choice

Level 1 – 378

Level 2 – 467

ISP Stop Loss – 350

ALF Stop Loss – 400

 

IHA

Skilled – 378

Subacute – 467

Subacute – Rehab Pilot – 3,550

Custodial – 240.87

 

GHI

Level 1 Skilled – 396

Level 2 Rehab – 375

Level 3 Subacute Rehab – 425

Med Advantage:

Level 1 Skilled – 285

Level 2 Rehab – 375

Level 3 Subacute Rehab – 425

 

Magnacare

Level 1 Skilled Nursing or Restorative – 478

Level 2 Rehab Low – 478

Level 3 Rehab Medium – 478

Level 4 Rehab High – 478

 

United Healthcare

Medicare/Commercial – 457

Dual Complete (Medicare) – 457

Dual Complete (Medicaid – Americhoice) – 232.64

Medicaid – 322

 

Univera

Med Adv:

Skilled – PDPM

Subacute – PDPM

Subacute-Rehab – PDPM

Commercial/Special:

Skilled – 341/311

Subacute – 435/396

Subacute-Rehab – 495/451

 

VNA (Nascentria)

MLTC – 240.87

 

Wellcare

MLTC – 240.87

Level 1 – 300

Level 2 – 355

Level 3 – 400

Level 4 – 475

Level 5 – 600

 

Veterans

Bed Hold – 225.59

Rehab + Extensive – 677.80

Extensive – 619.62

Rehab – 494

Special Care – High – 435.38

Special Care – Low – 395

Clinically Complex 354

Psychosocial – 272

Reduced Physical Functions – 317

 

Brookhaven

Aetna

Level 1 – 375

Level 2 – 375

Level 3 – 400

Level 4 – 520

 

Empire BC

Level 1 – 375

Level 2 – 550

Level 3 – 650

Complex Care – 750

 

GHI

Commercial:

Level 1 Skilled – 295

Level 2 Rehab – 375

Level 3 Subacute Rehab – 425

Med Advantage

Level 1 Skilled – 285

Level 2 Rehab – 375

Level 3 Subacute Rehab – 425

 

Heritage HP

Level 1 – 265

Level 2 – 345

Level 3 – 375

 

HIP & VYTRA

Level 1 – 305

Level 2 – 375

Level 3 – 400

 

Magnacare

Level 1 Skilled Nursing or Restorative – 478

Level 2 Rehab Low – 478

Level 3 Rehab Medium – 478

Level 4 Rehab High – 478


Optum (part A)
MLTC – 294

Level 1 – 300

Level 2 – 350

Level 3 – 400

Level 4 – 475

Level 5 – 600


Oxford

Level 1 – 275

Level 2- 325

 

United Healthcare

Level 1 – 300

Level 2 – 380

Level 3 – 420

Level 4 – 525

 

Vytra

Level 1- 325

Level 2 – 440

 

US Fam Health Plan

Level 1 – 248

Level 2 – 396

Level 3 – 396

 

Garden Gate Health Care Facility

BCBS

Medicaid HMO – 308.95

Skilled Level 1 – 339.58

Subacute Level 2 – 445.71

Subacute Level 3 – 551.83

Wound Care (Garden Gate only) Level 4 – 551.83

 

Amerigroup

Custodial – 236.24

Level 1 – 309.43

Level 2 – 365.25

 

CHS Pace

Respite – 264.32

Custodial 249.57

Rehab – 395

 

Fallon

MLTC – 235.60

PACE – PDPM

Respite – 235.60

 

iCircle

MLTC – 259.16

 

Kalos

MLTC – 235.60

 

Family Choice

Level 1 – 378

Level 2 – 467

ISP Stop Loss – 350

ALF Stop Loss – 400

 

IHA

Skilled – 378

Subacute – 467

Subacute – Rehab Pilot – 3,550

Custodial 235.60

 

GHI

Level 1 Skilled – 295

Level 2 Rehab – 375

Level 3 Subacute Rehab – 248

Level 1 Skilled – 396

Level 2 Rehab – 396

Level 3 Subacute Rehab – 425

 

Humana

Level 1 – 395

Level 2 – 465

Level 3 – 630

Level 4 – 740

 

Magnacare

Level 1 Skilled Nursing or Restorative – 478

Level 2 Rehab Low – 478

Level 3 Rehab Medium – 478

Level 4 Rehab High – 478

 

United Healthcare

Medicare/Commercial – 457

Dual Complete (Medicare) – 457

Dual Complete (Medicaid – Americhoice) – 232.64

Medicaid – 322

 

Univera

Med Adv:

Skilled – PDPM

Subacute – PDPM

Subacute-Rehab – PDPM

Commercial/Special:

Skilled – 341/311

Subacute – 435/396

Subacute-Rehab – 495/451

 

VNA (Nascentria)

MLTC – 240.93

 

Wellcare

MLTC – 235.60

Level 1 – 300

Level 2 – 350

Level 3 – 400

Level 4 – 475

Level 5 – 600

 

Veterans

Bed Hold – 220.87

Rehab + Extensive – 726.87

Extensive – 656.86

Rehab – 501.55

Special Care – High – 439.73

Special Care – Low – 385.64

Clinically Complex – 342.20

Psychosocial – 272.74

Reduced Physical Functions – 317.61


Harris Hill Nursing Facility

BCBS

Medicaid HMO – 308.95

Skilled Level 1 – 339.58

Subacute Level 2 – 445.71

Subacute Level 3 – 551.83

Subacute Level 4 – 551.83

 

Amerigroup

Custodial – 222.81

Level 1 – 309.43

Level 2 – 365.25

 

CHS Pace

Respite – 249.45

Custodial – 233.17

Rehab – 395

 

Fallon

MLTC – 326.58

PACE – PDPM

Respite – 226.58

 

iCircle

MLTC – 359.24

 

Kalos

MLTC – 326.58

 

Family Choice

Level 1 – 378

Level 2 – 467

ISP Stop Loss – 350

ALF Stop Loss – 400

 

IHA

Skilled – 378

Subacute – 467

Subacute – Rehab Pilot – 3,550

Custodial – 236.58

 

GHI

Level 1 Skilled – 295

Level 2 Rehab – 375

Level 3 Subacute Rehab – 248

Level 1 Skilled – 396

Level 2 Rehab – 396

Level 3 Subacute Rehab – 425

 

Humana

Level 1 – 395

Level 2 – 465

Level 3 – 630

Level 4 – 740

 

Magnacare

Level 1 Skilled Nursing or Restorative – 478

Level 2 Rehab Low – 478

Level 3 Rehab Medium – 478

Level 4 Rehab High – 478

 

United Healthcare

Medicare/Commercial – 457

Dual Complete (Medicare) – 457

Dual Complete (Medicaid – Americhoice) – 232.64

Medicaid – 322

 

Univera

Med Adv:

Skilled – PDPM

Subacute – PDPM

Subacute-Rehab – PDPM

Special/Commercial:

Skilled – 341/311

Subacute – 435/396

Subacute-Rehab – 495/451

 

VNA (Nascentria)

MLTC – 230.62

 

Wellcare

MLTC – 326.58

Level 1 – 300

Level 2 – 350

Level 3 – 400

Level 4 – 475

Level 5 – 600

 

Veterans

Bed Hold – 204.49

Rehab + Extensive – 669.57

Extensive – 616.51

Rehab – 545

Special Care – High – 401.49

Special Care – Low – 390.96

Clinically Complex – 336.07

Psychosocial – 254.58

Reduced Physical Functions – 295.72

 

Northgate Health Care Facility

BCBS

Medicaid HMO – 308.95

Skilled Level 1 – 339.58

Subacute Level 2 – 445.71

Subacute Level 3 – 551.83

Wound Care (Garden Gate only) Level 4 – 551.83

 

Amerigroup

Custodial – 227.59

Level 1 – 309.43

Level 2 – 365.25

 

Complete Sr. Care Pace

Respite – 245

Custodial 231.35

Rehab – 400

 

Fallon

MLTC – 232.03

PACE – PDPM

Respite – 232.03

 

iCircle

MLTC – 255.23

 

Kalos

MLTC – 232.03

 

Family Choice

Level 1 – 378

Level 2 – 467

ISP Stop Loss – 350

ALF Stop Loss – 400

 

IHA

Skilled – 302

Subacute – 363

Covid Positive – 500

Subacute – Rehab Pilot – 3,550

Custodial – 232.03

 

GHI

Level 1 Skilled – 295

Level 2 Rehab – 375

Level 3 Subacute Rehab – 448

Level 1 Skilled – 396

Level 2 Rehab – 396

Level 3 Subacute Rehab – 425

 

Humana

Level 1 – 395

Level 2 – 465

Level 3 – 630

Level 4 – 740

 

Magnacare

Level 1 Skilled Nursing or Restorative – 478

Level 2 Rehab Low – 478

Level 3 Rehab Medium – 478

Level 4 Rehab High – 478

 

United Healthcare

Medicare/Commercial – 457

Dual Complete (Medicare) – 457

Dual Complete (Medicaid – Americhoice) – 232.64

Medicaid – 322

Optum – 0.01

 

Univera /RMSCO

Med Adv:

Skilled – PDPM

Subacute – PDPM

Subacute-Rehab – PDPM

Special/Commercial:

Skilled – 341/311

Subacute – 435/396

Subacute-Rehab – 495/451

 

 

VNA (Nascentria)

MLTC – 236.02

 

Wellcare

MLTC – 232.03

Level 1 – 300

Level 2 – 350

Level 3 – 400

Level 4 – 475

Level 5 – 600

 

Veterans

Bed Hold – 219.24

Rehab + Extensive – 677.80

Extensive – 616

Rehab – 494

Special Care – High – 443.59

Special Care – Low – 392.98

Clinically Complex – 354

Psychosocial – 272

Reduced Physical Functions – 317


Seneca Health Care Center

BCBS

Medicaid HMO – 308.95

Skilled Level 1 – 339.58

Subacute Level 2 – 445.71

Subacute Level 3 – 551.83

Level 4 – 551.83

 

Amerigroup

Custodial – 224.25

Level 1 – 309.43

Level 2 – 365.25

 

CHS Pace

Respite – 249.27

Custodial 234.38

Rehab – 395

 

Fallon

MLTC – 232.29

PACE – PDPM

Respite – 232.29

 

iCircle

MLTC – 255.52

 

Kalos

MLTC – 232.29

 

Family Choice

Level 1 – 378

Level 2 – 467

ISP Stop Loss – 350

ALF Stop Loss – 400

 

IHA

Skilled – 378

Subacute – 467

Subacute – Rehab Pilot – 3,550

Custodial – 232.29

 

GHI

Level 1 Skilled – 295

Level 2 Rehab – 375

Level 3 Subacute Rehab – 248

Level 1 Skilled – 396

Level 2 Rehab – 396

Level 3 Subacute Rehab – 425

 

Magnacare

Level 1 Skilled Nursing or Restorative – 478

Level 2 Rehab Low – 478

Level 3 Rehab Medium – 478

Level 4 Rehab High – 478

 

United Healthcare

Medicare/Commercial – 457

Dual Complete (Medicare) – 457

Dual Complete (Medicaid – Americhoice) – 232.64

Medicaid – 322

 

Univera /RMSCO

Med Adv:

Skilled – PDPM

Subacute – PDPM

Subacute-Rehab – PDPM

Commercial/Special:

Skilled 341/311

Subacute 435/396

Subacute-Rehab 495/451

 

VNA (Nascentria)

MLTC – 240.16

 

Wellcare

MLTC – 232.29

Level 1 – 300

Level 2 – 350

Level 3 – 400

Level 4 – 475

Level 5 – 600

 

Veterans

Bed Hold – 201.38

Rehab + Extensive – 643.78

Extensive – 623.88

Rehab – 501.75

Special Care – High – 430.50

Special Care – Low – 395.70

Clinically Complex – 354

Psychosocial – 270.74

Reduced Physical Functions – 317

Facility

VS Servicer at Beacon LLC DBA Taconic Rehabilitation and Nursing at Beacon

Owners

Michael Farbenblum
Stephen Eaton-Mercurio

Landlord

CCP St. Francis 1742 LLC

Landlord Address

c/o Sabra Health Care REIT, Inc.
18500 Von Karman Avenue, Suite 550
Irvine, California 92612

VS Servicer at Fishkill LLC DBA Taconic Rehabilitation and Nursing at Hopewell

Michael Farbenblum
Stephen Eaton-Mercurio

CCP Dutchess 1741 LLC

c/o Sabra Health Care REIT, Inc.
18500 Von Karman Avenue, Suite 550
Irvine, California 92612

VS Servicer at Ulster LLC DBA Taconic Rehabilitation and Nursing at Ulster

Michael Farbenblum
Stephen Eaton-Mercurio

CCP Ulster 1743 LLC

c/o Sabra Health Care REIT, Inc.
18500 Von Karman Avenue, Suite 550
Irvine, California 92612

Summary of all contracts for the provision of goods and services for which the facility pays with any portion of Medicaid or Medicare funds or other agreements entered by the facility within 30-days of execution:

Ulster Beacon Dutchess
Analytics Nicholas Aguilera WHC
Copiers, fax Eastern Mang. Print
Dental Dentserv
Dermatology
Electrical PM Duffy/Costa
Emergency Generator PM National Stanby Repair
Environmental and Dietary Services Health Care Service Group Health Care Service Group Health Care Service Group
Fire Alarm Monitoring Empire Alarm
Generator PM H.O. Penn
Inspection – sprinkler system Mid-Hudson Sprinkler
Kitchen Vent System Guardian
Kitchen Vent System Haight
Lab Mid-Hudson Sprinkler
Lab
Lab
Lease – Parking
Life Protection Service Agreement
Life Safety Systems
Medical Director/Physician Services Dr. Chili St Louis Dr. Chili St Louis Dr. Imtiaz Mallick
Pulmonologist
Medical Equipment Hill-Rom Hill-Rom Hill-Rom
Optometry Dr. Jacob Shafran
Patient Monitoring
Pest Control Ehrlich
Pesticide Ehrlich
Pharmacy Consultant Omnicare Omnicare Omnicare
PM – Gas (O2) Systems O2 Solution O2 Solution O2 Solution
Podiatry Dr. Seigel
Portable X-Ray Precision Health, Inc.
Postage Meter Pitney Bowles
Psychiatric Services Dr. Weidel
Referrals Allscripts Allscripts Allscripts
Service Agreement
Snowplow Red Cedar
Staffing – Nursing Ethan Allen
Supplies Medline Medline Medline
Telemedicine
Trash Royal Carting
Utilities – Natural Gas Central Hudson
Phamary Services Omnicare Omnicare Omnicare
Elevator Repair Excel Elevator
Emergency Water supply Troncillitto Brothers
Nuerology Dr. Burshtein
Psychology Dr. Michele Speranza
Woung Care Dr. Allyne Fraser

Beacon Rates

LOC Rev Care Level Rate Effective
Aetna Level 1 191 L1            245.00 11/1/14
Level 2 192 L2            325.00
Level 3 193 L3            425.00
CDPHP Level 1 191 L1            270.00
Level 2 192 L2            512.00
Level 3 193 L3            542.00
Cigna Level 1 191 L1            335.00 9/1/19
Level 2 192 L2            435.00
Level 3 193 L3            525.00
Level 4 194 L4            575.00
Elderplan Level 1 L1            317.28 5/1/18
Level 2 L2            424.36
Level 3 L3            503.93
Empire BC Level 1 191 L1            325.00 5/1/18
Level 2 192 L2            500.00
Level 3 193 L3            600.00
Empire Medicaid Level 1 191 L1            290.00 5/1/18
Level 2 192 L2            340.00
Level 3 193 L3            440.00
Level 4 194 L4            540.00
Level 4 Custodial 120 C  MCD
Evercare (Elant) BM BM
Fidelis Level 1 191 L1  Medicaid 8/1/16
Level 2 192 L2            300.00
Level 3 193 L3            400.00
Hamaspik Level 1 191 L1            325.00 1/1/20
Level 2 192 L2            400.00
Level 3 193 L3            475.00
Level 4 101 L4            650.00
Humana Level 1 191 L1            345.00 1/1/21
Level 2 192 L2            415.00
Level 3 193 L3            590.00
MediNcrease 6/15/18
Commercial % of Charges 90%
Comp or No Fault % of Charges 85%
Multiplan % of Charges 80% 1/1/18
MVP (Commercial) Level A 191 L1            371.83 8/1/18
Level B 192 L2            451.14
Level C 193 L3            530.45
Level D 194 L4            584.01
Medicare pays by PDPM Level E 199 L5            796.19
United Healthcare Medicare/Commercial 120 L1            475.00 5/1/21
Dual Complete (Medicare) 120 L1            475.00
Dual Complete (Mcd) 120 L1            285.00
Captitation ($375) 120
Wellcare Level 1 191 L1            275.00 9/1/16
Level 2 192 L2            325.00
Level 3 193 L3            375.00
Level 4 194 L4            425.00
Level 5 199 L5            600.00

Hopewell Rates

LOC Rev Care Level Rate Effective
Aetna Level 1 191 L1            245.00 11/1/14
Level 2 192 L2            325.00
Level 3 193 L3            425.00
CDPHP Level 1 191 L1            270.00
Level 2 192 L2            512.00
Level 3 193 L3            542.00
Cigna Level 1 191 L1            335.00 9/1/19
Level 2 192 L2            435.00
Level 3 193 L3            525.00
Level 4 194 L4            575.00
Elderplan Level 1 L1            317.28 5/1/18
Level 2 L2            424.36
Level 3 L3            503.93
Empire BC Level 1 191 L1            325.00 5/1/18
Level 2 192 L2            500.00
Level 3 193 L3            600.00
Empire Medicaid Level 1 191 L1            290.00 5/1/18
Level 2 192 L2            340.00
Level 3 193 L3            440.00
Level 4 194 L4            540.00
Level 4 Custodial 120 C  MCD
Evercare (Elant) BM BM
Fidelis Level 1 191 L1  Medicaid 8/1/16
Level 2 192 L2            300.00
Level 3 193 L3            400.00
Hamaspik Level 1 191 L1            325.00 1/1/20
Level 2 192 L2            400.00
Level 3 193 L3            475.00
Level 4 101 L4            650.00
Humana Level 1 191 L1            345.00 1/1/21
Level 2 192 L2            415.00
Level 3 193 L3            590.00
MediNcrease 6/15/18
Commercial % of Charges 90%
Comp or No Fault % of Charges 85%
Multiplan % of Charges 80% 1/1/18
MVP (Commercial) Level A 191 L1            371.83 8/1/18
Level B 192 L2            451.14
Level C 193 L3            530.45
Level D 194 L4            584.01
Medicare pays by PDPM Level E 199 L5            796.19
United Healthcare Medicare/Commercial 120 L1            400.00 5/1/21
Dual Complete (Medicare) 120 L1            400.00
Dual Complete (Mcd) 120 L1            285.00
Captitation (NA) 120
Wellcare Level 1 191 L1            275.00 9/1/16
Level 2 192 L2            325.00
Level 3 193 L3            375.00
Level 4 194 L4            425.00
Level 5 199 L5            600.00

Ulster Rates

LOC Rev Care Level Rate Effective
Aetna Level 1 191 L1            245.00 11/1/14
Level 2 192 L2            325.00
Level 3 193 L3            425.00
Level 4 Vent 194 L4            610.00
CDPHP Level 1 191 L1            270.00
Level 2 192 L2            512.00
Level 3 193 L3            542.00
Level 4 Vent 199 L4            663.00
Elderplan Level 1 L1            317.28 5/1/18
Level 2 L2            424.36
Level 3 L3            503.93
Level 4 Vent L4            668.37
Empire BC Level 1 191 L1            325.00 5/1/18
Level 2 192 L2            500.00
Level 3 193 L3            600.00
Level 4 Vent 194 L4            650.00
Empire Medicaid Level 1 191 L1            290.00 5/1/18
Level 2 192 L2            340.00
Level 3 193 L3            440.00
Level 4 194 L4            540.00
Level 5 Vent 169 V            625.00
Level 4 Custodial 120 C  MCD
Fidelis Level 1 191 L1  Medicaid 8/1/16
Level 2 192 L2            300.00
Level 3 193 L3            400.00
Level 4 Vent 101 L4            500.00
Hamaspik Level 1 191 L1            325.00 1/1/20
Level 2 192 L2            400.00
Level 3 193 L3            475.00
Level 4 101 L4            650.00
Humana Level 1 191 L1            345.00 1/1/21
Level 2 192 L2            415.00
Level 3 193 L3            590.00
Level 4 Vent 101 L4            700.00
MediNcrease 6/15/18
Commercial % of Charges 90%
Comp or No Fault % of Charges 85%
Multiplan % of Charges 80% 1/1/18
MVP (Commercial) Level A 191 L1            371.83 8/1/18
Level B 192 L2            451.14
Level C 193 L3            530.45
Level D 194 L4            584.01
Medicare pays by PDPM Level E 199 L5            796.19
United Healthcare Medicare/Commercial 120 L1            400.00 5/1/21
Dual Complete (Medicare) 120 L1            400.00
Dual Complete (Mcd) 120 L1            285.00
Captitation (NA) 120
Wellcare Level 1 191 L1            275.00 9/1/16
Level 2 192 L2            325.00
Level 3 193 L3            375.00
Level 4 194 L4            425.00
Level 5 199 L5            600.00

Facility

Agency

Taconic Rehabilitation and Nursing at Beacon

Ethan Allen Staffing
Norman Staffing
Staff NY LLC

Taconic Rehabilitation and Nursing at Hopewell

Ethan Allen Staffing
Norman Staffing
Staff NY LLC

Taconic Rehabilitation and Nursing at Ulster

Ethan Allen Staffing
Norman Staffing
Staff NY LLC