Common use of Health Care Facility Services Clause in Contracts

Health Care Facility Services. Covered Services include the following accommodations, services and supplies received during an admission to a Hospital, Ambulatory Surgical Facility, Skilled Nursing Facility, Residential Treatment Center or Hospice Care Facility. Accommodations:  Semiprivate (or multibed unit) room, including bed, board and general nursing care.  Private room including bed, board, and general nursing care, but only when treatment of the Insured's condition requires a private room. The semiprivate room rate will be allowed toward the private room rate when an Insured receives private room accommodations for any reason other than Medical Necessity.  Inpatient accommodations provided in connection with the birth of a child shall be provided for a minimum of forty-eight (48) hours following an uncomplicated vaginal delivery or a minimum of ninety-six (96) hours following an uncomplicated delivery by cesarean section. This provision does not require an Insured to deliver in a Hospital or other healthcare facility or to remain therein for the minimum number of hours following delivery.  Intensive care unit (including Cardiac Care Unit), including bed, board, general and special nursing care, and ICU equipment.  Observation unit, including bed, board, and general nursing care not to exceed twenty-three (23) hours per day.  Nursery charges for newborns. Services and Supplies. Covered Services and supplies provided by a Hospital, Ambulatory Surgical Facility, Skilled Nursing Facility, Residential Treatment Center or Hospice Care Facility include:  non-surgical Provider visits;  operating, recovery, and treatment rooms and equipment (Hospital and Ambulatory Surgical Facility only);  delivery and labor rooms and equipment (Hospital and Ambulatory Surgical Facility only);  anesthesia materials and anesthesia administration by Hospital staff (Hospital and Ambulatory Surgical Facility only);  clinical pathology and laboratory services and supplies;  services and supplies for diagnostic tests required to diagnose Insured's Illness, Injury or other conditions but only when charges for the services and/or supplies are made by the facility (Hospital, Skilled Nursing Facility and Ambulatory Surgical Facility only);  drugs consumed at the time and place dispensed which have been approved for general marketing in the United States by the Food and Drug Administration (FDA);  dressings, splints, casts and other supplies for medical treatment provided by the Hospital from a central sterile supply department;  oxygen and its administration;  non-replaced blood, blood plasma, blood derivatives, and their administration and processing;  intravenous injections and solutions;  private duty nursing subject to the benefit limitation for such services;  supportive services for a Hospice patient's family, including care for the patient which provides a respite from the stresses and responsibilities that result from the daily care of the patient and bereavement services provided to the family after the death of the patient (Hospice Care Facility only); and  Sterilization procedures.

Health Care Facility Services. Covered Services include the following accommodations, services and supplies when received during an admission to a Hospital, Ambulatory Surgical Facility, Skilled Nursing Facility, Residential Treatment Center or Hospice Care Facility. Accommodations:  • Semiprivate (or multibed unit) room, including bed, board and general nursing care.  • Private room including bed, board, and general nursing care, but only when treatment of the Insured's condition requires a private room. The semiprivate room rate will be allowed toward the private room rate when an Insured receives private room accommodations for any reason other than Medical Necessity.  Inpatient accommodations provided in connection with the birth of a child shall be provided for a minimum of forty-eight (48) hours following an uncomplicated vaginal delivery or a minimum of ninety-six (96) hours following an uncomplicated delivery by cesarean section. This provision does not require an Insured to deliver in a Hospital or other healthcare facility or to remain therein for the minimum number of hours following delivery.  • Intensive care unit (including Cardiac Care Unit), including bed, board, general and special nursing care, care and ICU equipment.  • Observation unit, including bed, board, and general nursing care not to exceed twenty-three (23) hours per dayhours.  • Nursery charges for newbornsroutine care of newborn children regardless of whether or not an Injury or Illness exists. Services and Supplies. Covered Services and supplies provided by a Hospital, Ambulatory Surgical Facility, Skilled Nursing Facility, Residential Treatment Center or Hospice Care Facility include:  • non-surgical Provider visits;  • operating, recovery, and treatment rooms and equipment (Hospital and Ambulatory Surgical Facility only);  delivery and labor rooms and equipment (Hospital and Ambulatory Surgical Facility only);  • anesthesia materials and anesthesia administration by Hospital staff (Hospital and Ambulatory Surgical Facility only);  • clinical pathology and laboratory services and supplies;  • services and supplies for diagnostic tests required to diagnose Insured's Illness, Injury or other conditions but only when charges for the services and/or supplies are made by the facility (Hospital, Skilled Nursing Facility and Ambulatory Surgical Facility only);  • drugs consumed at the time and place dispensed which have been approved for general marketing in the United States by the Food and Drug Administration (FDA);  • dressings, splints, casts and other supplies for medical treatment provided by the Hospital from a central sterile supply department;  • oxygen and its administration;  • non-replaced blood, blood plasma, blood derivatives, derivatives and their administration and processing;  • intravenous injections and solutions;  • private duty nursing subject to the benefit limitation for such servicesnursing;  • supportive services for a Hospice patient's family, including care for the patient which provides a respite from the stresses and responsibilities that result from the daily care of the patient and bereavement services provided to the family after the death of the patient (Hospice Care Facility only); and  Sterilization • sterilization procedures.

Health Care Facility Services. Covered Services include the following accommodations, services and supplies when received during an admission to a Hospital, Ambulatory Surgical Facility, Skilled Nursing Facility, Residential Treatment Center Facility or Hospice Care Facility. Accommodations:  • Semiprivate (or multibed unit) room, including bed, board and general nursing care.  • Private room including bed, board, and general nursing care, but only when treatment of the Insured's condition requires a private room. The semiprivate room rate will be allowed toward the private room rate when an Insured receives private room accommodations for any reason other than Medical Necessity.  Inpatient accommodations provided in connection with the birth of a child shall be provided for a minimum of forty-eight (48) hours following an uncomplicated vaginal delivery or a minimum of ninety-six (96) hours following an uncomplicated delivery by cesarean section. This provision does not require an Insured to deliver in a Hospital or other healthcare facility or to remain therein for the minimum number of hours following delivery.  • Intensive care unit (including Cardiac Care Unit), including bed, board, general and special nursing care, care and ICU equipment.  • Observation unit, including bed, board, and general nursing care not to exceed twenty-three (23) hours per dayhours.  • Nursery charges for newbornsroutine care of newborn children regardless of whether or not an Injury or Illness exists. Services and Supplies. Covered Services and supplies provided by a Hospital, Ambulatory Surgical Facility, Skilled Nursing Facility, Residential Treatment Center or Hospice Care Facility include:  non-surgical Provider visits;  • operating, recovery, and treatment rooms and equipment (Hospital and Ambulatory Surgical Facility only);  delivery and labor rooms and equipment (Hospital and Ambulatory Surgical Facility only);  • anesthesia materials and anesthesia administration by Hospital staff (Hospital and Ambulatory Surgical Facility only);  • clinical pathology and laboratory services and supplies;  • services and supplies for diagnostic tests required to diagnose Insured's Illness, Injury or other conditions but only when charges for the services and/or supplies are made by the facility (Hospital, Skilled Nursing Facility and Ambulatory Surgical Facility only);  Form No. SHL-Ind_AOC(2015) Page 8 • drugs consumed at the time and place dispensed which have been approved for general marketing in the United States by the Food and Drug Administration (FDA);  • dressings, splints, casts and other supplies for medical treatment provided by the Hospital from a central sterile supply department;  • oxygen and its administration;  • non-replaced blood, blood plasma, blood derivatives, derivatives and their administration and processing;  • intravenous injections and solutions;  • private duty nursing subject to the benefit limitation for such servicesnursing;  • supportive services for a Hospice patient's family, including care for the patient which provides a respite from the stresses and responsibilities that result from the daily care of the patient and bereavement services provided to the family after the death of the patient (Hospice Care Facility only); and  Sterilization • sterilization procedures.. Covered Services include services which are generally recognized and accepted non-surgical procedures for diagnosing or treating an Illness or Injury, performed by a Physician in his office, the patient's home, or a licensed healthcare facility. Medical Services include: • direct physical examination of the patient; • examination of some aspect of the patient by means of pathology laboratory or electronic monitoring procedure which is a generally recognized and accepted procedure for diagnostic or therapeutic purposes in the treatment of an Illness or Injury; • procedures for prescribing or administering medical treatment; • Treatment of the temporomandibular joint including Medically Necessary dental procedures, such as dental splints, subject to the maximum benefit limitation; • Anesthesia services; • Manual Manipulation (except for reductions of fractures or dislocations); and • Family planning services including sterilization procedures; and • Limited diagnostic and therapeutic infertility services determined to be Medically Necessary and Prior Authorized by SHL’s Managed Care Program. Covered Services do not include those services specifically excluded herein, but do include limited:  Laboratory studies;  Diagnostic procedures; and  Artificial insemination services, up to six