Sliding Scale Payments

Room and board is private pay and offered on a sliding scale based on the patient's financial resources.

This includes a private room and personal bath, 24- hour on-site care, meals, laundry, activities and amenities of the home.

Financial Assistance Criteria:

• Patient must be receiving services under Frederick Health Hospice or agreeable to receive services at the time of admission to the Kline House.

In order for the Kline Hospice House to determine financial eligibility in assisting with your account you will need to provide us with proof of income, expenses, and assets. We will need the following documentation in order to make a determination. We will not determine financial assistance eligibility until we receive all documentation. The daily rate will be the full rate of $275 until we receive and process all financial documentation. Regardless of financial status, a two (2) week pre-payment is due at the time of admission. Please contact financial billing office at 240-566-3030 for financial assistance.

Income:

• Employed: last 3 pay stubs and W2 form.
• Unemployed: unemployment benefits or disability benefits.
• Social Security or Retirement Receipt: your statement of yearly earnings (either your SSA-1099 or 1099-R)
• Other Income: alimony, rental income, dividends, interest etc.

Expenses:

• Monthly mortgage or rent expense
• Utilities: electric, water, gas, oil
• Other medical bills
• Insurance: life, health, long-term
• Property Tax

Assets:

• Last 3 month bank statements starting with the most current
• House and other real estate value
• 401K, IRA
• Certificate of deposit, money market account