Direct Care Services Sample Clauses

Direct Care Services. The term ‘‘Direct Care Services’’ means any health service that is provided directly by IHS or a Tribal health program. Eligible American Indian/Alaska Native (AI/AN) Veteran: The term “Eligible American Indian/Alaska Native (AI/AN) Veteran” means an AI/AN Veteran who is (1) eligible for services from IHS in accordance with 42 C.F.R. Part 136 and (2) is enrolled in VA’s system of patient enrollment in accordance with 38 U.S.C. § 1705 or is eligible for hospital care and medical services under 38 U.S.C. § 1705(c)(2) notwithstanding the Eligible AI/AN Veteran’s failure to enroll in VA’s system of patient enrollment. VA and IHS or the Tribal health program are responsible for determining eligibility for health care services within their respective programs.
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Direct Care Services. Claims for Direct Care Services reimbursement should be submitted to VA electronically unless not feasible. If electronic submission is not feasible, claims submitted in paper form shall comply with the format required for the submission of claims under title XVIII of the Social Security Act or recognized under section 1175 of such Act.
Sample 1
Direct Care Services. The Contractor shall implement Direct Care Services policies as well as the following requirements and standards: 1. The Contractor shall maintain a minimum average ratio of Direct Care Staff to residents of 1:6.5 during day and evening hours and 1:17 overnight. For purposes of calculating the ratio, Direct Care Staff includes Resident Care Coordinators, Nurse Manager, Licensed Practical Nurses (LPN), Health Unit Coordinator, Resident Services Staff and Managers, and facility Directors. 2. The Contractor shall provide the following Direct Care Services program components: a. Medical advocacy with residents’ doctors and medical care practitioners (as the treatment team determines is necessary) that ensures access and linkage to primary medical care, psychiatry, podiatry, other specialists as needed, rehabilitation therapies, hospice services, access to advanced care planning (Advanced Directives, Durable Do Not Resuscitate Orders (DDNRs)), and Physician Orders for Scope of Treatment (POSTs). This includes coordination of medical appointments and medical escorts to doctor’s appointments. Dental services will be coordinated with staff at the County Dental Clinic. The Project Officer or his or her designee will establish a protocol with Dental Clinic staff to schedule screenings and treatment appointments. b. A nursing care delivery system that provides in-house primary health care and includes diagnostic and treatment services, screening for disease risk factors and early signs of illness.
Sample 1
Direct Care Services. 1. Provide In Home Services to the Individual: a. Residential support; b. Assist with bathing, dressing and personal hygiene; c. Assist with eating; d. Assist with meal planning and preparation; e. Assist with housekeeping; f. Assist with ambulation and mobility; g. Reinforce behavioral support; h. Assist with the administration of the Individual's medication or to perform a task delegated by a registered nurse in accordance with rules of the Texas Board of Nursing at 22 TAC, Chapter 225 (relating to RN Delegation to Unlicensed Personnel and Tasks not Requiring Delegation in Independent Living Environments for Clients with Stable and Predictable Conditions) or the Human Resources Code, §161.091- .093, as applicable. i. Supervise the individual's safety and security. 2. Contractor shall provide the following hours of care and staffing protocols: a. Staff members are onsite and awake in the residence when the Individual is present in the residence. b. Staff members are available and present twenty-four (24) hours per day, seven days a week when the Individual is at home. c. Contactor may not have a Staff member work more than 16 consecutive hours. d. If a Staff member works for 16 consecutive hours, the Staff member must be off duty for at least eight hours before working another shift of any length. 3. Contractor must ensure Staff member services outside the residence. a. Staff members must facilitate inclusion in community activities, social interaction, participation in leisure activities, and development of socially valued behaviors. b. Staff members must supervise the Individual’s safety and security. 4. Contractor shall meet the following transportation needs: a. Transportation only includes the activity of transporting the Individual from one location to another. Contractor will provide a vehicle to facilitate transportation for the Individual and their needs. b. The transportation vehicle must be: i. In good repair; ii. Maintained and operated in compliance with Title 7 of the Texas Transportation Code; iii. Equipped with properly operating air conditioning and heating systems; and iv. Available to meet the transportation needs of the Individual upon effective date of contract. c. Contractor must ensure that any Service provider who provides transportation: i. Has a valid Texas driver’s license; and ii. Transports the Individual in a vehicle in accordance with state law, Title 7 of the Texas Transportation Code.
Sample 1
Direct Care Services. (i) Care management and assessment5; (ii) Personal care: e.g. transfer, food-feeding, bathing, peri-care, hair washing, hair cutting, shaving, nail cutting, changing of clothes, toileting, disposal of urine and bowel waste, etc.; (iii) Basic Nursing Care: e.g. clinical observation and monitor of xxxxx xxxxx testing including blood pressure, pulse, temperature and body weight urine testing, supervision on medications, gastric tube feedings, simple dressing, application of medical ointment dressing, prevention and management of clinical issues through individual coaching, etc; (iv) Special Nursing Care: e.g. stoma care, incontinence care, respiratory care, diabetic care, peritoneal dialysis, infection control, Xxxxx'x catheter care, etc.; (v) Restorative and maintenance rehabilitation exercises, any other therapeutic exercises or activities, environmental risk assessment and home modifications, speech therapy6 etc.; and (vi) Dementia care 7 e.g. reality orientation, sensory training, reminiscence programme and memory or cognitive training, etc. 5 Care management and assessment conducted by all professionals, including social worker, physiotherapist, occupational therapist, speech therapist, etc.
Sample 1
Direct Care Services. NOTE: For residents who are eligible for the Living Choices Assisted Living 1915 (c) home and community based services Medicaid waiver, a copy of the resident’s waiver plan of care will become a part of the Direct Care Services portion of the resident’s Occupancy Admission Agreement and is filed in the Care Plan section of the chart.
Sample 1
Direct Care Services. The facility co-workers will assist you, as needed, with dressing, grooming, bathing and other activities of daily living, to the extent allowed by applicable state law or as stated in your service plan. Direct care services that you need that are included in the basic core services are described in the Direct Care Service Plan.
Sample 1
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Related to Direct Care Services

  • Vision Care Services For purposes of coordination of benefits, vision care services covered under other plans are not considered an allowable expense, as defined in the Coordination of Benefits and Subrogation in Section 7.

  • Core Services The Company agrees to provide to the Municipality the Core Services set forth in Schedule “A”. The Company and the Municipality may amend Schedule “A” from time to time upon mutual agreement.

  • Software Services If elected by Customer, the following Software Services will be made available for Customer’s use. 2.1. Core HR Software Service is a system of interactive web pages to assist Customer in its human resource related recordkeeping and reporting. Customer shall ensure the accuracy of its Customer Data. The HR Software Services shall function in accordance with the Documentation, as may be amended from time to time, and provide features to aid Customer with its compliance with federal and state laws and regulations applicable to Human Resources (except as stated otherwise in the Documentation). 2.2. Recruiting Software Service is a system of interactive web pages to assist Customer in posting job requisitions, storing candidates, recording job applications, and the related recordkeeping and reporting. Customer shall ensure the accuracy of its Customer Data. The Recruiting Software Service shall function in accordance with the Documentation which may be amended from time to time.

  • Hospice Services Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.

  • COVERED HEALTHCARE SERVICES This section describes covered healthcare services. This plan covers services only if they meet all of the following requirements: • Listed as a covered healthcare service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered healthcare service under this plan. • Medically necessary, consistent with our medical policies and related guidelines at the time the services are provided. • Not listed in Exclusions Section. • Received while a member is enrolled in the plan. • Consistent with applicable state or federal law. We review medical necessity in accordance with our medical policies and related guidelines. Our medical policies can be found on our website. Our medical policies are written to help administer benefits for the purpose of claims payment. They are made available to you for informational purposes and are subject to change. Medical policies are not meant to be used as a guide for your medical treatment. Your medical treatment remains a decision made by you with your physician. If you have questions about our medical policies, please call Customer Service. When a new service or drug becomes available, when possible, we will review it within six (6) months of one of the events described below to determine whether the new service or drug will be covered: • the assignment of an American Medical Association (AMA) Current Procedural Terminology (CPT) code in the annual CPT publication; • final Food and Drug Administration (FDA) approval; • the assignment of processing codes other than CPT codes or approval by governing or regulatory bodies other than the FDA; • submission to us of a claim meeting the criteria above; and • generally, the first date an FDA approved prescription drug is available in pharmacies (for prescription drug coverage only). During the review period, new services and drugs are not covered. For all covered healthcare services, please see the Summary of Medical Benefits and the Summary of Pharmacy Benefits to determine the amount that you pay and any benefit limits.

  • Hosting Services 13.1 If Supplier or its subcontractor, affiliate or any other person or entity providing products or services under the Contract Hosts Customer Data in connection with an Acquisition, the provisions of Appendix 1, attached hereto and incorporated herein, apply to such Acquisition. 13.2 If the Hosting of Customer Data by Supplier or its subcontractor, affiliate or any other person or entity providing products or services under the Contract contributes to or directly causes a Data Breach, Supplier shall be responsible for the obligations set forth in Appendix 1 related to breach reporting requirements and associated costs. Likewise if such Hosting contributes to or directly causes a Security Incident, Supplier shall be responsible for the obligations set forth in Appendix 1, as applicable. 14 Change Management

  • Voice Services In lieu of any other rates and discounts, Customer will pay fixed per-minute rates ranging from $0.000 to $0.000 for the following Voice Services: Domestic Voice Service: Domestic Outbound Voice Service, including Calling Card and Domestic Inbound Voice Service based on origination and termination type. Data Services:

  • Collection Services General 5-1 5.02 Solid Waste Collection 5-1 5.03 Targeted Recyclable Materials Collection 5-3

  • Marketing Services The Manager shall provide advice and assistance in the marketing of the Vessels, including the identification of potential customers, identification of Vessels available for charter opportunities and preparation of bids.

  • Program Services a) Personalized Care Practice agrees to provide to Program Member certain enhancements and amenities to professional medical services to be rendered by Personalized Care Practice to Program Member, as further described in Schedule 1 to these Terms. Upon prior written notice to Program Member, Personalized Care Practice may add or modify the Program Services set forth in Schedule 1, as reasonably necessary, and subject to such additional fees and/or terms and conditions as may be reasonably necessary. b) Program Member acknowledges that the Program Services are services that are not covered services under any insurance contract to which Program Member may be a party, including, without limitation, Medicare, and are not reimbursable by Program Member’s insurer, health plan or any governmental entity, including Medicare. Program Member agrees to bear sole financial responsibility for the Member Amenities Fee and agrees not to submit to Program Member’s insurer, health plan or governmental entity any xxxx, invoice or claim for payment or reimbursement of such Member Amenities Fee. c) Personalized Care Practice or its designated affiliate will separately charge Program Member or Program Member’s insurer, health plan or governmental entity for medical, clinical, diagnostic or therapeutic services rendered by Personalized Care Practice or its designated affiliate to Program Member, and Program Member may seek payment or reimbursement from Program Member’s insurer or health plan for any such service to the extent covered by Program Member’s insurer, health plan or governmental entity. d) Program Member understands, agrees and covenants that this Agreement is a service contract, and not a contract for insurance.

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