Common use of Days or Less Clause in Contracts

Days or Less. The Contractor shall provide care for Enrollees in skilled nursing facilities, Intermediate Care Facilities, and Long Term Acute Care (LTAC) hospitals and then reimburse such facilities when the plan of care includes a prognosis of recovery and discharge within 30 days. It is the responsibility of a Network Provider to make the determination whether the Enrollee shall require the service of a nursing facility, Intermediate Care Facility, or LTAC for more or less than 30 days.

Days or Less. The Contractor shall provide care for Enrollees in skilled nursing facilities, Intermediate Care Facilities, and Long Term Acute Care (LTAC) hospitals and then reimburse such facilities when the plan of care includes a prognosis of recovery and discharge within 30 days. It is the responsibility of a Network Participating Provider to make the determination whether the Enrollee shall require the service of a nursing facility, Intermediate Care Facility, or LTAC for more or less than 30 days.