Making Sense of Medicare & Medicaid


Navigating medical costs and coverage can be confusing. Need some guidance? Let this overview steer you through:

Medicare and Medicaid are two separate government programs created in 1965 by President Lyndon Johnson as part of a social commitment to meeting individual health care needs.

Medicare is the federal government’s health insurance program for people age 65 or older, and those with severe disabilities. Medicare covers some services in a nursing facility. Medicare does not cover long-term care costs.

Medicare has several parts:

Part A helps pay for:

  • Hospital Care
  • Skilled Nursing or Rehabilitation Care (in a skilled nursing facility)
  • Home Health Care
  • Hospice Care

Part A provides up to 100 days per year in a skilled nursing facility if you have a 3-day qualifying stay in a hospital and require services meeting the definition of “skilled” in the Medicare guidelines. Part A pays 100% for days 1-20; there is a co-pay for days 21-100. Most Medicare co-insurance plans pay the co-pay.

Part B is an optional medical insurance for which you pay a monthly premium that covers many outpatient services. Part B insurance primarily covers outpatient services but may cover some services while a person is a Resident in a nursing facility. For example, someone who does not have a 3-day hospital stay prior to admission and is “private pay” for their room & board, can have therapy services billed under Part B.

Part C is known as Medicare Advantage, or private insurance. The cost of Advantage plans varies by carrier, county of residence, and plan selected. To enroll in a Part C plan, you must first be enrolled in both Parts A and B.  Medicare Part C is voluntary.  Many people prefer traditional Medicare supplements and do not want a Part C Medicare Advantage plan.

Part D covers prescription drugs when you choose a carrier and enroll in their drug plan. Most states have many plans to choose from and people often work with an agent to navigate the many options.

Medicaid is a public insurance program providing health care coverage to low-income families and individuals, including children, parents, pregnant women, seniors, and people with disabilities; it is funded by the state and federal government.

Each state operates its own Medicaid program within federal guidelines. Because the federal guidelines are broad, states have a great deal of flexibility in designing and administering their programs. As a result, Medicaid eligibility and benefits often vary widely from state to state.

Medicaid does not provide health care directly. Instead, it pays hospitals, doctors, nursing homes, managed care plans, and other health care providers for covered services that they deliver to eligible patients. (Health care providers are not required to participate in Medicaid, and not all do.)

  • Medicaid covers more than 60 percent of all nursing home residents and 40 percent of costs for long-term care services and supports.
  • Medicaid provides health coverage for one in five Americans, or 97 million low-income Americans annually.
  • Many of those on Medicaid are middle class individuals who spent all of their savings on care before becoming eligible.


We’re happy to help you walk through the process and coverage of your skilled facility needs. Our Executive Director and Social Services Director are happy to answer your questions. Feel free to call or drop in. Columbia Basin Care is located at 1015 Webber St in The Dalles, Oregon,  541.296.2156. 



The Pleasure of Plants



George likes to get his hands dirty. Digging deep into potting soil, he and other residents at Columbia Basin Care are making a home for small indoor plants, and boosting their own health and happiness too.

While many residents enjoy our outdoor raised-bed gardens, some prefer the cooler climate and less strenuous activity of tending to house plants. Indoor gardening offers many of the same benefits.

jean-plantingnorm-plantingbobbie-plantingResearch indicates that planting and tending to growing things is especially good for those with dementia and depression. As with pets and children, plants teach us how to be attentive and responsive to the needs of others, which improves our levels of empathy and compassion. The activity also exercises cognitive and motor skills.

Studies show that indoor plants improve air quality by filtering toxins that get trapped indoors, which can improve air quality.  That, in turn, can lower the risk of respiratory disorders, as well as chronic headaches and eye irritation.

Best, and perhaps most simply, a healthy house plant provides a sense of beauty and accomplishment.



Now, That’s Dedication!


It’s a season of celebration at Columbia Basin Care, where we’re honoring three employees who have dedicated their careers to Columbia Basin Care:


Maintenance Assistant
30 years

“I do a little bit of everything,” says Forest Cline, whose can-do disposition has led to a 30-year career at Columbia Basin Care.

He joined Columbia Basin in 1987 when he was just 19 years old. His mother worked as a bookkeeper at the facility, and he was hired to work in the kitchen. Realizing his skill with tools and machinery, Cline moved into janitorial and maintenance work — where he now plays a critical role in keeping systems running and people happy.

From waxing floors to wheelchair repair, Cline is a jack-of-all-trades. You’ll find him painting, bringing plants to life in 100-degree heat, and then cheerfully chatting with residents.

Over 30 years, Forest has seen a lot of changes and he’s proud to be a part of the improvements, from renovations to equipment upgrades to increased professionalism. But always, he says, it’s the people that matter most. “The important thing is the residents, and keeping them happy.”

julie-kimbell-1JULIE KIMBELL
Certified Nursing Assistant/Medication Aide (CNA/CMA)
29 years

From an early age, Julie Kimbell felt the pull to help others. She channeled that passion into nursing and joined Columbia Basin in 1988 — 29 years ago.

She provides hands-on nursing care, assisting residents with bathing, dressing, eating, toileting and more. “It’s the hardest work you’ll ever do,” she says, “but it’s the most rewarding,”

She is both a certified nursing assistant and a certified medication aide and though she’s considered moving into a leadership position, she prefers the individual care and attention her current role allows.  “As a CNA, I get more resident interaction. I can make their lives better while I’m here, while they’re here.”

“You have to love people,” she says, as she shares a laugh with a resident. “You’re important to their lives. You make a difference.”

janet-final-lightenedJANET SULLIVAN
Medical Records Manager
28 years

Janet Sullivan has worked at Columbia Basin Care for 28 years. She joined the company in 1989, and has hands-on knowledge of nearly every department. She’s worked as a certified nursing assistant, human resources director, activities director, and accounts payable. She is now the Medical Records Manager.

Organized and tidy, record management seems a perfect fit. “I like order,” says Janet. “I love to purge charts. It’s like cleaning a dirty floor and you see how nice and clean everything is when you’re done. “

But her work is more than just data. Her fondness for the residents of Columbia Basin Care is the driving force of her dedication. “I go home and I worry about them because I care about them,” she says. “You’re not just taking care of them. You’re taking care of them, their family, their emotions . . .”

Working in long-term care is not for everyone. “You must be a team player, have a heart, and be a hard worker,” says Janet. “You must be completely willing to get your hands dirty.”

Executive Director Fosters A Positive Environment



What do you want to be when you grow up? And if you’re doing it, what did you do to get there? How did you know it’s right for you?

The number of opportunities after graduation feels limitless to many students. But opportunity can also feel daunting. How do you know that your passion and abilities will translate to the real world? For many students, that answer lies not in the classroom, but in the community, where it takes the form of internships, research, service learning, and global and leadership opportunities.

It’s through these activities, dubbed Experiential Learning, that students are exposed to people and circumstances different than their own and through which they discover the relevance of learning – and more about themselves.

Public health alumna Aubree Olmstead, BS ’15, experienced this firsthand. In her final term, she completed a required 360-hour internship at Columbia Basin Care, a skilled nursing facility in The Dalles, about a half hour from where she grew up in Hood River.

For Aubree, the internship wasn’t just another box to check. “I looked at it as a chance to see if I liked the field and to hone in on my skill set.”

“I tell students to be open to all possibilities,” says Karen Elliott, who teaches a pre-internship course and assists in helping students find internships throughout the state and sometimes internationally. “When you stop thinking about a grade or credits and ask yourself, ‘What do I want to do?,  you discover amazing things about yourself, what fuels your fire and what gets you going.”

Aubree took that advice. The first Beaver alum in her family, she also credits professors and instructors, including Karen, who brought their passion and real-world experience to the classroom.

A little over halfway through her internship at Columbia Basin, Aubree was offered an Administrator in Training (AIT) position – 960 hours of training under the supervision of a preceptor – with the understanding that she would become administrator after completion. During that time, she worked to gain a diverse understanding of operations, covering areas such as leadership and management, quality of care, human resources, finance, and the physical environment.

The 22-year-old successfully completed both her internship and AIT and has served as executive director since May 2016, managing 100-plus employees in the 90-bed facility.

“My roles tie directly into what I studied while at Oregon State,” Aubree says. “I truly believe my education and degree gave me a competitive advantage and the knowledge I need to ensure I am successful as I move throughout my career.”

That’s music to Karen’s ears. “It’s truly rewarding to see students excel and be involved in this process that can be life changing,” she says.

To ensure that all students get this same opportunity to succeed, the college initiated a series of changes in 2015 that began with the creation of its Office of Student Success.That change transformed the academic advising office into a hub of services that support students, including study abroad, career and professional development, peer advisors and an internship coordinator. The team, led by Associate Dean for Student Success Vicki Ebbeck, is working to increase the college’s number of experiential learning opportunities, including new experiences in the Dominican Republic, Bangalore and Botswana. These experiences add to its existing programs, such as with Fu Jen Catholic University in Taiwan, the longest faculty-led program at Oregon State.

Experiential learning promotes student success, Vicki says. “Research shows that students are more likely to persist with their studies and improve their academic performance, and that every student benefits – especially historically underserved students. The key is to engage all students in these high-impact practices that can be transformative.”

Aubree’s advice for current students is to see college and the path after graduation as an opportunity for growth. “Look outside your comfort zone, explore options, set goals, value your time, identify a role model or mentor and take chances,” she says, “but most of all respect yourself and those around you.”

She puts her advice into practice daily, whether it’s overseeing departments, managing employees, staying within budget, working with local hospitals and physicians, or staying on top of a stream of new rules and changing regulations.

“There is always something to be learned and something to be improved upon,” Aubree says. “I enjoy working with diverse groups and finding ways to encourage, lead and manage my staff. Knowing what makes them ‘tick’ is important, and I think that’s what excites me most. Fostering a positive environment truly creates increased success and happiness all the way to those we interact with and have the opportunity to serve.”

— by Kathryn Stroppel. Republished from Oregon State University’s College of Public Health and Human Sciences.  

Music in the Park



It’s summer. Let’s play!

Please join us for a special concert series in the new Columbia Basin Care Park & Pavilion. This event is specially created for our Residents, Staff, Volunteers & their families.

Free Outdoor Concerts

Sunday, June 25 at 6:30pm
Hardshell Harmony — traditional bluegrass

Tuesday, July 11 at 6:30pm
Harmony of the Gorge — women’s chorus

Sunday, July 23 at 6:30pm
Ted Horwitz — keyboards & voice

Sunday, August 13 at 6:30pm
Willy & Nelson —  acoustic duo

Bring a blanket or beach chair and relax in our park. 

How to Have Fun



18581512_1670333436595005_2367097537605466200_n18556129_1670333253261690_3491666600269506832_nFrom birthday parties to dress-up days. From luaus to live music, we know how to have a good time!

Columbia Basin Care has a full schedule of events and activities that bring residents and caregivers together in lighthearted fun.

What’s happening now? Check out the Columbia Basin Care Newsletter & Calendar.

What’s the Difference?


vs-assisted-livingSkilled care center? Assisted living? What’s the difference? Making the decision to move from home can be overwhelming. Let’s work through the details:

The biggest and most important difference is that nursing homes — also called skilled nursing facilities — are licensed and equipped to deliver skilled medical care. They offer the attention and care of a professionally trained medical staff, combined with the comforts of home.

Licensed doctors and nurses supervise the care of every patient. Medications are carefully administered by professional staff and are reviewed by physicians and pharmacists. At Columbia Basin Care, even nursing assistants — who help residents with daily activities such as eating, bathing, grooming, dressing, transferring, and toileting — are licensed and work under the direction of a licensed nurse. CNAs must undergo a minimum of 150 hours of state-approved training, including training in a clinical environment. Candidates must then pass the Oregon Nursing Assistant Competency Exam, consisting of a written exam and a test of manual skills.

An assisted living facility is not licensed to give nursing care and not licensed by Medicare or Medicaid to give skilled care. Many assisted living facilities do not have any licensed nurse on staff. Because they are considered non-medical facilities, in some states having a licensed nurse is not required by law. Even if a nurse is employed by the assisted living facility, the nurse cannot give hands-on care in the form of dressing a wound, administering around-the-clock insulin, administering oxygen, or other tasks that are defined by the federal and state governments as “skilled nursing care.”

Typically, assisted living facilities are places where elderly adults live in a supervised community, with some personal care services available. Meals and social activities are offered and in these communities the focus is on providing a healthy social environment and preventing residents from becoming socially isolated.

Skilled nursing facilities, however, comply with numerous complex legal regulations and requirements and are closely monitored by the State Department of Health. Assisted living facilities do not have the same safety or administrative requirements as a skilled nursing facility, and they are prohibited from giving care they are not licensed to give.

A frequent misconception is that skilled nursing facilities are a “last stop.” In fact, the opposite is often true; many go to a nursing home for short-term therapy services after surgery, injury, or illness. At a skilled nursing facility, such as Columbia Basin Care, a licensed team of physical, occupational and speech therapists provide comprehensive rehabilitation services. Patients recuperate under the care and attention of medical professionals and once recovered, return to their homes.

Columbia Basin Care, located in The Dalles, is the region’s only non-profit, community-owned, skilled rehabilitation and nursing facility. CBC offers an in-house geriatric nurse practitioner who serves as primary care physician, and a team of licensed physical, occupational and speech therapists who provide comprehensive rehabilitation services.

Columbia Basin Care is located in the Columbia River Gorge, in The Dalles, 1015 Webber St., 541-296-2156.



The Recipe for Good Health



We’ve got the recipe for good health: knowledge + nutrition.

And with our team of certified professionals, we’ve got the tools to really cook!

Jill Lindstrand, Food Service Director, recently achieved top status as a state and national Certified Dietary Manager / Certified Food Protection Professional. To earn this certification, Lindstrand completed over 250 hours in the Nutrition and Foodservice Professional Training Program before passing a comprehensive half-day exam.

With this achievement, Lindstrand has earned the highest level of professional competency in her field. Certified Dietary Manager / Certified Food Protection Professionals are nationally recognized experts at managing dietary operations and are trained and qualified in menu management, food purchase, food preparation, nutrition principles, food safety, team management, and more.

Columbia Basin Care is now cooking with double-power, offering the expertise of a Certified Dietary Manager and a Registered Dietician. Jennifer Zimmerman, RD, works closely with Lindstrand to ensure the diet and nutrition needs of each resident. She has a degree in Food and Nutrition Dietetics, and has worked with Columbia Basin for 17 years.

Meal preparation for a senior population is a complex endeavor and having seasoned professionals is critical to success. Health challenges can limit ordinary meals. Those who’ve had a stroke, for example, may have difficulty swallowing making pureed foods a necessity. Others may have salt or sugar limitations or food allergies. Not consuming adequate calories and nutrients can lead to unhealthy weight loss – a very real concern among the elderly – and put residents at greater risk for a range of health issues.

In addition, age and medication can alter the taste of food for older individuals, making it less appealing, and often more difficult to satisfy dietary desires. “For some people, food just doesn’t taste the way it used to taste,” explains Lindstrand. “We work hard to make residents happy, and keep them healthy too. “

“Combining my hands-on experience with our dietician’s knowledge reaps rewards for everyone,” says Lindstrand who has worked 20 years in the food industry, as a cook, caterer, and kitchen manager. She joined Columbia Basin Care in 2015. “With our strong team of professionals, good health is a part of every meal.”


Pretty, please


maria-manicure lee-gets-a-buff-1-web alesia-bernice-manicure-webSometimes it takes so little to lift the spirits. Our weekly, free manicures keep us looking good and feeling good. Whether it’s a buff, a polish, or just time to chat and laugh, Beauty Tuesdays brighten our days!

A Success Story



Who is that on the magazine cover?

It’s Aubree Olmstead, our executive director! The latest issue of Oregon Stater, the magazine of the Oregon State University Alumni Association, features Olmstead and her swift rise to success.

The story, “Seeking a Higher Degree of Success,” in the Spring 2017 issue, highlights Olmstead’s unique professional achievement — from college student, to intern, to executive director, in less than a year.

Olmstead grew up in Hood River and is a graduate of Oregon State University where she earned a degree in Public Health with an emphasis in Health Management and Policy, and a minor in Business.

osu-aubree-magazine-spread-copyShe was a just over halfway through her internship at Columbia Basin Care — the region’s only non-profit, community-owned, skilled rehabilitation and nursing facilitywhen she was offered 960 more hours of supervised training, with the understanding that she would become an administrator after completion. In May 2016, at the age of 22, she became executive director of the facility, managing 100 employees and overseeing the health and care of over 60 elderly residents.

“My roles tie directly into what I studied while at Oregon State,” she told the magazine. “I truly believe my education and degree gave me a competitive advantage and the knowledge I need to ensure I am successful as I move throughout my career.”

A strong but reserved leader, Olmstead doesn’t reach for the spotlight. It was her husband who, unbeknownst to her, contacted the magazine to share his wife’s success story.

“Over the course of eight months,” Zack Schreiner told the magazine, “she went from being an unpaid intern who had not yet received her diploma to the executive director of a facility with over 100 employees, and is responsible for the care of 50-plus residents. At this time she was only 22 years old. She attributes a lot of her success to the skills and education that she gained while at Oregon State.”

Olmstead’s advice for college students also echoes her leadership style: “Look outside your comfort zone, explore options, set goals, value your time, identify a role model or mentor and take chances, but most of all respect yourself and those around you.”

To read the story, go here or here.