Nursing Facility Sample Clauses

Nursing Facility. If Provider is a nursing facility, in addition to the other requirements set forth in the Agreement or this Appendix, Provider shall: (a) Promptly notify Subcontractor and Health Plan and/or the State as directed by the Division of TennCare, of a Covered Person’s admission or request for admission to the nursing facility regardless of payor source for the nursing facility stay, or when there is a change in a Covered Person’s known circumstances. Provider shall also notify Subcontractor and Health Plan and/or the State as directed by Xxxxxxxx, prior to a Covered Person’s discharge from the nursing facility; (b) Provide written notice to the Division of TennCare, Subcontractor and Health Plan in accordance with State and federal requirements before voluntarily terminating the Agreement. Provider shall comply with all applicable State and federal requirements regarding voluntary termination; (c) Notify Subcontractor and Health Plan immediately if Provider is considering discharging a Covered Person. Provider shall consult with the Covered Person’s Care Coordinator to intervene in resolving issues if possible. If Provider is not able to resolve such issues, Provider shall prepare and implement a discharge and/or transition plan as appropriate; (d) Notify a Covered Person and/or a Covered Person’s representative (if applicable) in writing prior to discharge in accordance with State and federal requirements; (e) Provider shall accept payment or appropriate denial made by Subcontractor or Health Plan, as applicable, (or, if applicable, payment by Subcontractor or Health Plan that is supplementary to the Covered Person’s third party payer) plus the amount of any applicable Patient Liability, as payment in full for services provided and shall not solicit or accept any surety or guarantee of payment from a Covered Person in excess of the amount of applicable Patient Liability. For purposes of this Section 4.6(e), Covered Person shall include the patient, parent(s), guardian, spouse or any other legally responsible person of the Covered Person being served; (f) Provider’s responsibilities regarding a Covered Person’s Patient Liability as specified in sections A.2.6.7 and A.2.21.5 of the CRA, which shall include but not be limited to collecting the applicable Covered Person Patient Liability amounts from CHOICES Group 1 members, notifying the Covered Person’s Care Coordinator if there is an issue with collecting a Covered Person’s Patient Liability, and making good fa...
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Nursing Facility. An entity or institution that provides organized and structured nursing care and services, and is subject to licensure under Texas Health and Safety Code, Chapter 242, as defined in 40 T.A.C. § 19.101 and 1 T.A.C. § 358.103. (Also called nursing home or skilled nursing facility).
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Nursing Facility. Any facility licensed by the State of Michigan, in accordance with the Public Health Code, 1978 PA 368, as amended, MCL 333.1101 – 333.25211, and certified by Medicare in accordance with section 42 CFR 483 et seq. to provide skilled and non-skilled nursing care.
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Nursing Facility. A licensed Medicare/Medicaid facility certified in accordance with 42 C.F.R. Part 483 to provide inpatient room, board and nursing services to Members who require these services on a continuous basis, but who do not require hospital care or direct daily care from a physician.
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Nursing Facility. 2.14.1.12.1 If a member is enrolled in CHOICES Group 1, the CONTRACTOR shall authorize and initiate nursing facility services for that member in accordance with Section 2.9.6. However, if, prior to nursing facility admission, the member chooses to receive HCBS instead of nursing facility services and is enrolled in Group 2 pursuant to Section 2.9.6, the CONTRACTOR shall authorize and initiate HCBS in accordance with Section 2.9.
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Nursing Facility. A. The Contractor shall perform NF LOC reviews for Medicaid recipients exempt from Centennial Care enrollment and are seeking hospice care in a nursing facility. B. The Contractor shall perform NF LOC reviews for Medicaid recipients exempt from Centennial Care enrollment who are receiving short term (30 days or less) rehabilitation or skilled nursing services in a nursing facility.
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Related to Nursing Facility

  • Skilled Care in a Nursing Facility This plan covers skilled nursing services in a skilled nursing facility if: • the services are prescribed by a physician: • your condition needs skilled nursing services, skilled rehabilitation services or skilled nursing observation; • the services are provided by or supervised by licensed technical or professional medical personnel; and • the services are not custodial care, respite care, day care, or for the purpose of assisting with activities of daily living.

  • Generating Facility The Interconnection Customer’s device for the production of electricity identified in the Interconnection Request, but shall not include the Interconnection Customer’s Interconnection Facilities.

  • Existing Facilities Each of the Existing Facilities shall be repaid in full and terminated and all collateral security therefor shall be released, and the Administrative Agent shall have received pay-off letters in form and substance satisfactory to it evidencing such repayment, termination and release.

  • Facility Prudential is willing to consider, in its sole discretion and within limits which may be authorized for purchase by Prudential Affiliates from time to time, the purchase of Shelf Notes pursuant to this Agreement. The willingness of Prudential to consider such purchase of Shelf Notes is herein called the “Facility”. At any time, the aggregate principal amount of Shelf Notes stated in Section 1.2, minus the aggregate principal amount of Shelf Notes purchased and sold pursuant to this Agreement prior to such time, minus the aggregate principal amount of Accepted Notes (as hereinafter defined) which have not yet been purchased and sold hereunder prior to such time, is herein called the “Available Facility Amount” at such time. NOTWITHSTANDING THE WILLINGNESS OF PRUDENTIAL TO CONSIDER PURCHASES OF SHELF NOTES BY PRUDENTIAL AFFILIATES, THIS AGREEMENT IS ENTERED INTO ON THE EXPRESS UNDERSTANDING THAT NEITHER PRUDENTIAL NOR ANY PRUDENTIAL AFFILIATE SHALL BE OBLIGATED TO MAKE OR ACCEPT OFFERS TO PURCHASE SHELF NOTES, OR TO QUOTE RATES, SPREADS OR OTHER TERMS WITH RESPECT TO SPECIFIC PURCHASES OF SHELF NOTES, AND THE FACILITY SHALL IN NO WAY BE CONSTRUED AS A COMMITMENT BY PRUDENTIAL OR ANY PRUDENTIAL AFFILIATE.

  • Laundry Facilities Washers and dryers are installed in each apartment for the exclusive use of students in the apartment. Any other use is prohibited. The use of washers and dryers are free. LINEN: Brighton provides a mattress cover on all mattresses. Students need to bring their own bedding. All beds are regular twin size. The typical cost for replacing a mattress cover is $25.00. MAINTENANCE: Students are responsible to notify the manager in writing as soon as possible if they notice anything in an apartment that requires repair work or maintenance. See “Property Conditions” section 12 of the BYU-Idaho Student Landlord Housing Contract.

  • Working Facilities During the Term of Employment, the Company shall furnish the Executive with an office, secretarial help and such other facilities and services suitable to his position and adequate for the performance of his duties hereunder.

  • Durable Medical Equipment (DME), Medical Supplies, Prosthetic Devices, Enteral Formula or Food, and Hair Prosthesis (Wigs) This plan covers durable medical equipment and supplies, prosthetic devices and enteral formula or food as described in this section. DME is equipment which: • can withstand repeated use; • is primarily and customarily used to serve a medical purpose; • is not useful to a person in the absence of an illness or injury; and • is for use in the home. DME includes supplies necessary for the effective use of the equipment. This plan covers the following DME: • wheelchairs, hospital beds, and other DME items used only for medical treatment; and • replacement of purchased equipment which is needed due to a change in your medical condition or if the device is not functional, no longer under warranty, or cannot be repaired. DME may be classified as a rental item or a purchased item. In most cases, this plan only pays for a rental DME up to our allowance for a purchased DME. Repairs and supplies for rental DME are included in the rental allowance. Medical supplies are consumable supplies that are disposable and not intended for re- use. Medical supplies require an order by a physician and must be essential for the care or treatment of an illness, injury, or congenital defect. Covered medical supplies include: • essential accessories such as hoses, tubes and mouthpieces for use with medically necessary DME (these accessories are included as part of the rental allowance for rented DME); • catheters, colostomy and ileostomy supplies, irrigation trays and surgical dressings; and • respiratory therapy equipment. This plan covers diabetic equipment and supplies for the treatment of diabetes in accordance with R.I. General Law §27-20-30. Covered diabetic equipment and supplies include: • therapeutic or molded shoes and inserts for custom-molded shoes for the prevention of amputation; • blood glucose monitors including those with special features for the legally blind, external insulin infusion pumps and accessories, insulin infusion devices and injection aids; and • lancets and test strips for glucose monitors including those with special features for the legally blind, and infusion sets for external insulin pumps. The amount you pay differs based on whether the equipment and supplies are bought from a durable medical equipment provider or from a pharmacy. See the Summary of Pharmacy Benefits and the Summary of Medical Benefits for details. Coverage for some diabetic equipment and supplies may only be available from either a DME provider or from a pharmacy. Visit our website to determine if this is applicable or call our Customer Service Department. Prosthetic devices replace or substitute all or part of an internal body part, including contiguous tissue, or replace all or part of the function of a permanently inoperative or malfunctioning body part and alleviate functional loss or impairment due to an illness, injury or congenital defect. Prosthetic devices do not include dental prosthetics. This plan covers the following prosthetic devices as required under R.I. General Law § 27-20-52: • prosthetic appliances such as artificial limbs, breasts, larynxes and eyes; • replacement or adjustment of prosthetic appliances if there is a change in your medical condition or if the device is not functional, no longer under warranty and cannot be repaired; • devices, accessories, batteries and supplies necessary for prosthetic devices; • orthopedic braces except corrective shoes and orthotic devices used in connection with footwear; and • breast prosthesis following a mastectomy, in accordance with the Women’s Health and Cancer Rights Act of 1998 and R.I. General Law 27-20-29. The prosthetic device must be ordered or provided by a physician, or by a provider under the direction of a physician. When you are prescribed a prosthetic device as an inpatient and it is billed by a provider other than the hospital where you are an inpatient, the outpatient benefit limit will apply. Enteral formula or food is nutrition that is absorbed through the intestinal tract, whether delivered through a feeding tube or taken orally. Enteral nutrition is covered when it is the sole source of nutrition and prescribed by the physician for home use. In accordance with R.I. General Law §27-20-56, this plan covers enteral formula taken orally for the treatment of: • malabsorption caused by Crohn’s Disease; • ulcerative colitis; • gastroesophageal reflux; • chronic intestinal pseudo obstruction; and • inherited diseases of amino acids and organic acids. Food products modified to be low protein are covered for the treatment of inherited diseases of amino acids and organic acids. Preauthorization may be required. The amount that you pay may differ depending on whether the nutrition is delivered through a feeding tube or taken orally. When enteral formula is delivered through a feeding tube, associated supplies are also covered. This plan covers hair prosthetics (wigs) worn for hair loss suffered as a result of cancer treatment in accordance with R.I. General Law § 27-20-54 and subject to the benefit limit and copayment listed in the Summary of Medical Benefits. This plan will reimburse the lesser of the provider’s charge or the benefit limit shown in the Summary of Medical Benefits. If the provider’s charge is more than the benefit limit, you are responsible for paying any difference. This plan covers Early Intervention Services in accordance with R.I. General Law §27- 20-50. Early Intervention Services are educational, developmental, health, and social services provided to children from birth to thirty-six (36) months. The child must be certified by the Rhode Island Department of Human Services (DHS) to enroll in an approved Early Intervention Services program. Services must be provided by a licensed Early Intervention provider and rendered to a Rhode Island resident. Members not living in Rhode Island may seek services from the state in which they reside; however, those services are not covered under this plan. Early Intervention Services as defined by DHS include but are not limited to the following: • speech and language therapy; • physical and occupational therapy; • evaluation; • case management; • nutrition; • service plan development and review; • nursing services; and • assistive technology services and devices.

  • Banking Facilities Schedule 3.25 sets forth a complete and correct list of: (a) each bank, savings and loan or similar financial institution in which the Company or any of its Subsidiaries has an account or safety deposit box and the numbers of such accounts or safety deposit boxes maintained thereat; and (b) the names of all persons authorized to draw on each such account or to have access to any such safety deposit box, together with a description of the authority (and conditions thereto, if any) of each person with respect thereto.

  • Employee Facilities Employee Facilities. Restrooms and attendant facilities shall be provided as required in the orders and regulations of the State of Washington Department of Labor and Industries. A good faith effort will be made by the Employer to provide facilities for employees’ personal belongings.

  • TEACHER FACILITIES A. The Board shall provide for each actively employed teacher: 1. A serviceable desk, chair and computer. 2. Access to a dining table. 3. A lockable desk, file cabinet or closet in which teachers may store instructional materials and supplies. 4. An appropriately furnished room to be reserved for the exclusive use of staff as a faculty lounge. Said room will be regularly cleaned by the custodial staff and will be in addition to the other teacher work areas. However, staff will be expected to keep the lounge reasonably neat and orderly. 5. Access to well-lighted and clean employee restrooms, separate from the students' restrooms with appropriate supplies. 6. Storage facilities for special instructional personnel. 7. In accordance with applicable food and nutrition guidelines, the principal, at request by a majority of the teachers, may arrange for the installation of a maximum of two faculty vending machines in each faculty lounge. All proceeds from the machines shall be used in such manner as the majority of teachers and educational support employees of that building shall determine. Cost, if any, of installation shall be borne by the teachers and educational support employees of each school. B. Where feasible in existing buildings, and in all new buildings, the following will be provided. 1. A teacher work area containing adequate equipment and supplies to aid in the preparation of instructional materials. 2. A communication system so that teachers can communicate with the main office from their classrooms, provided that such system is used only for emergency announcements during class periods. 3. Space for teachers' dining in a faculty lounge or other room unavailable to students with tables and chairs sufficient to accommodate teachers during their lunch period. C. Teachers shall report in writing to the principal any condition considered unsafe or hazardous. The principal shall take action(s) as appropriate and shall notify the teacher in writing of such action(s) taken within five (5) days. D. A telephone will be made available for teachers to use for school business. Teachers and principals shall arrange this use to provide reasonable privacy during the call. During the workday, teachers may make personal phone calls only if the calls cannot be made at any other time. E. Teachers who need access to a telephone for school business after the workday ends shall arrange this access with the principal. Teachers with supervisory responsibilities will also have access to the building. F. An adequate portion of the parking lots at each school will be reserved for teacher parking. Effective July 1, 2012, newly hired employees assigned to the South East Street Central Office location will be required to pay a fee of $45 per month if they elect to park in designated BOE parking areas. Twelve-month employees may elect payroll deduction to allocate payments over 24 equal paychecks. Eleven-month employees may elect payroll deduction to allocate payments over 22 equal paychecks. Ten-month employees may elect payroll deduction to allocate payment over 20 equal paychecks. G. The Board will take steps to ensure teachers have access to their classrooms when custodians unlock the buildings in the morning and up to one (1) hour before custodial shifts end on weekdays during the school year, provided rooms are not being utilized by outside user groups. Teachers shall have access to their rooms during summer operating hours during summer months unless there is scheduled maintenance, outside user groups or FCPS programs occurring.

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