PRIVATE PAY STATUS. The privately paying Resident agrees to pay the applicable daily basic room rate ("private pay rate") (and pharmacy charge) after any Medicare Part A or other plan coverage has been applied or exhausted, unless and until the Resident is determined to be Medicaid eligible for chronic care. The private pay rate is owed while a Medicaid application is pending and if the Medicaid application is denied unless other insurance covers the rate. See ¶ E. below. Specifically, the Resident agrees to pay, or arrange for payment of, (1) the daily basic rate of the room occupied: $380.00 (private room), or $350.00 (semi-private room) or $ N/A , $ N/A [Short-term bed or unit rates]; (2) physician and ancillary medical services as set forth above; (3) any applicable deductibles or coinsurance, and (4) individual purchases and “extras” described below. The Resident’s currently assigned room rate is $ . Payment for all services is due by the [10th] of each month. Monthly statements include the New York State Gross Receipt Tax at the New York stated mandated rate (6.8%).
PRIVATE PAY STATUS. If the Resident does not qualify for Medicaid or Medicare coverage or have other third party coverage in place, the Resident agrees to pay the Facility (i) the daily basic rate of $ for a Semi Private Room and for a Private Room (as may be increased on sixty (60) days written notice to the Resident or the Responsible Party); (ii) items and services not covered under the daily basic rate pursuant to section 2.1 above (including prescription drugs and other ancillary services); (the total of the charges set forth in Subsections 3.2(b)(i) and (ii) referred to as the “Private Pay Rate”). The Resident agrees to pay the Private Pay Rate to the Facility after other coverage has been applied or exhausted until the month in which the Resident’s Medicaid eligibility covers such charges. The Private Pay Rate payable for a month shall be paid in full by the first day of that month. In addition, a Resident paying the Private Pay Rate is responsible for paying the amount of the New York State assessment levied on the Resident’s payments to the Facility, including the base assessment, as may be adjusted, and any additional temporary assessments imposed. (As of January 1, 2019, the current combined assessment rate is 6.8%).
PRIVATE PAY STATUS. As of the Closing Date, the Facility shall remain ineligible to receive payment, and shall not have received any payments for or on behalf of any Resident, under Medicaid or Medicaid.
