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Provider Demographic Information - FAMILY CARE SERVICES INC

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	FAMILY CARE SERVICES INC
Address:	4385 EDENVILLE RD CHAMBERSBURG, PA 17202-8052
Phone:	(717) 263-2285
Fax:	(717) 263-6597
E-mail:	CRUTHRAUFF@FAMILYCARESERVICES.ORG
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header


Type:	Regional/Field Office	Counties Served:
Name:	231 Merriweather Dr
Address:	231 MERRIWEATHER DR CHAMBERSBURG, PA 17201-8786
Phone:	(717) 263-2285

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Bedford/Somerset
\|Service Name / Level	\|Rate

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$181.63 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$376.95 / 1 Day
Life Sharing-2 person-NG 1 > 30 Hrs WithDay	$128.04 / 1 Day
Life Sharing-2 person-NG 2 > 30 Hrs WithDay	$153.53 / 1 Day
Life Sharing-2 person-NG 3 > 30 Hrs WithDay	$208.88 / 1 Day
Life Sharing-2 person-NG 4 > 30 Hrs WithDay	$251.39 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day

County : Cumberland/Perry
\|Service Name / Level	\|Rate

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$181.63 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$376.95 / 1 Day
Life Sharing-1 person-NG1 > 30 Hrs WithOut	$200.90 / 1 Day
Life Sharing-1 person-NG2 > 30 Hrs WithOut	$230.47 / 1 Day
Life Sharing-1 person-NG3 > 30 Hrs WithOut	$325.99 / 1 Day
Life Sharing-1 person-NG4 > 30 Hrs WithOut	$414.65 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs WithOut	$160.45 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs WithOut	$182.70 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs WithOut	$230.61 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs WithOut	$271.93 / 1 Day
Life Sharing-2 person-NG 1 > 30 Hrs WithDay	$128.04 / 1 Day
Life Sharing-2 person-NG 2 > 30 Hrs WithDay	$153.53 / 1 Day
Life Sharing-2 person-NG 3 > 30 Hrs WithDay	$208.88 / 1 Day
Life Sharing-2 person-NG 4 > 30 Hrs WithDay	$251.39 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	Not Set
Respite-Life Sharing-Day (Level 2, 1:2)Out-of-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	Not Set
Respite-Life Sharing-Day (Level 3, 1:1)Out-of-Home	$343.22 / 1 Day
Respite-Unlic-15-min(Level 1, 1:3) Out-of-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day

County : Franklin/Fulton
\|Service Name / Level	\|Rate

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$181.63 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$376.95 / 1 Day
Life Sharing-1 person-NG1 > 30 Hrs WithOut	$200.90 / 1 Day
Life Sharing-1 person-NG2 > 30 Hrs WithOut	$230.47 / 1 Day
Life Sharing-1 person-NG3 > 30 Hrs WithOut	$325.99 / 1 Day
Life Sharing-1 person-NG4 > 30 Hrs WithOut	$414.65 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs WithOut	$160.45 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs WithOut	$182.70 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs WithOut	$230.61 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs WithOut	$271.93 / 1 Day
Life Sharing-2 person-NG 1 > 30 Hrs WithDay	$128.04 / 1 Day
Life Sharing-2 person-NG 2 > 30 Hrs WithDay	$153.53 / 1 Day
Life Sharing-2 person-NG 3 > 30 Hrs WithDay	$208.88 / 1 Day
Life Sharing-2 person-NG 4 > 30 Hrs WithDay	$251.39 / 1 Day
Respite-Base Out-of-Home 24 Hours (Level 1)-Day	Not Set
Respite-Lic-Day-1 person-NG 3	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency	$906.68 / 1 Day
Respite-Lic-Day-1 person-NG 4	$987.25 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency	$987.25 / 1 Day
Respite-Lic-Day-2 person-NG 3	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$738.67 / 1 Day
Respite-Lic-Day-2 person-NG 4	$800.99 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$800.99 / 1 Day
Respite-Lic-Day-3 person-NG 1	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$369.73 / 1 Day
Respite-Lic-Day-3 person-NG 2	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$419.25 / 1 Day
Respite-Lic-Day-3 person-NG 3	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$524.92 / 1 Day
Respite-Lic-Day-3 person-NG 4	$570.64 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$570.64 / 1 Day
Respite-Lic-Day-4 person-NG 1	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 1-Emergency	$295.27 / 1 Day
Respite-Lic-Day-4 person-NG 2	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 2-Emergency	$333.59 / 1 Day
Respite-Lic-Day-4 person-NG 3	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 3-Emergency	$411.70 / 1 Day
Respite-Lic-Day-4 person-NG 4	$447.97 / 1 Day
Respite-Lic-Day-4 person-NG 4-Emergency	$447.97 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	Not Set
Respite-Life Sharing-Day (Level 2, 1:2)Out-of-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	Not Set
Respite-Life Sharing-Day (Level 3, 1:1)Out-of-Home	$343.22 / 1 Day
Respite-Unlic-15-min(Level 1, 1:3) Out-of-Home	$3.22 / 15 min.
Respite-Unlic-15-min(Level 2, 1:2)Out-of-Home	$4.75 / 15 min.
Respite-Unlic-15-min(Level 3, 1:1)Out-of-Home	$8.59 / 15 min.
Respite-Unlic-Day (Level 1, 1:3) Out-of-Home	$128.64 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$6.12 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$12.22 / 15 min.

County : Huntingdon/Mifflin/Juniata
\|Service Name / Level	\|Rate

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$181.63 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$376.95 / 1 Day
Life Sharing-1 person-NG1 > 30 Hrs WithOut	$200.90 / 1 Day
Life Sharing-1 person-NG2 > 30 Hrs WithOut	$230.47 / 1 Day
Life Sharing-1 person-NG3 > 30 Hrs WithOut	$325.99 / 1 Day
Life Sharing-1 person-NG4 > 30 Hrs WithOut	$414.65 / 1 Day
Life Sharing-2 person-Elig-NG 1 > 30 Hrs WithOut	$160.45 / 1 Day
Life Sharing-2 person-Elig-NG 2 > 30 Hrs WithOut	$182.70 / 1 Day
Life Sharing-2 person-Elig-NG 3 > 30 Hrs WithOut	$230.61 / 1 Day
Life Sharing-2 person-Elig-NG 4 > 30 Hrs WithOut	$271.93 / 1 Day
Life Sharing-2 person-NG 1 > 30 Hrs WithDay	$128.04 / 1 Day
Life Sharing-2 person-NG 2 > 30 Hrs WithDay	$153.53 / 1 Day
Life Sharing-2 person-NG 3 > 30 Hrs WithDay	$208.88 / 1 Day
Life Sharing-2 person-NG 4 > 30 Hrs WithDay	$251.39 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	Not Set
Respite-Life Sharing-Day (Level 2, 1:2)Out-of-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	Not Set
Respite-Life Sharing-Day (Level 3, 1:1)Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day

County : York/Adams
\|Service Name / Level	\|Rate

Life Sharing-1 person-Elig-NG 1 > 30 Hrs	$181.63 / 1 Day
Life Sharing-1 person-Elig-NG 2 > 30 Hrs	$216.55 / 1 Day
Life Sharing-1 person-Elig-NG 3 > 30 Hrs	$296.35 / 1 Day
Life Sharing-1 person-Elig-NG 4 > 30 Hrs	$376.95 / 1 Day
Life Sharing-2 person-NG 1 > 30 Hrs WithDay	$128.04 / 1 Day
Life Sharing-2 person-NG 2 > 30 Hrs WithDay	$153.53 / 1 Day
Life Sharing-2 person-NG 3 > 30 Hrs WithDay	$208.88 / 1 Day
Life Sharing-2 person-NG 4 > 30 Hrs WithDay	$251.39 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	Not Set
Respite-Life Sharing-Day (Level 2, 1:2)Out-of-Home	$190.26 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	Not Set
Respite-Life Sharing-Day (Level 3, 1:1)Out-of-Home	$343.22 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) Out-of-Home	$190.26 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) Out-of-Home	$343.22 / 1 Day

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