Respite care services. Benefits for hospice inpatient, home or outpatient care are available to a terminally ill member for one continuous period up to 365 days per benefit period. For each day the member is confined in a hospice, benefits for room and board will not exceed the most common semiprivate room rate of the hospital or nursing home with which the hospice is associated. Exclusions and Limitations: Any exclusion or limitation contained in the contract regarding:
1. An injury or illness arising out of, or in the course of, employment for wage or profit;
2. Medical necessity of services or supplies, to the extent such services or supplies are provided as part of a hospice care program; or
3. Expenses for other persons, to the extent those expenses are described above, will not be applied to this provision. Medically necessary radiology services, imaging and tests performed for diagnostic reasons are a covered service (e.g., X-ray, Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan, Positron Emission Tomography/Single Photon Emission Computed Tomography (PET/SPECT), mammogram, and ultrasound imaging). Prior authorization may be required, see your Schedule of Benefits for details. Note: Depending on the service performed, two bills may be incurred - both subject to any applicable cost sharing - one for the technical component (the procedure itself) and another for the professional component (the reading/interpretation of the results by a physician or other qualified practitioner). Covered service expenses include services provided or expenses incurred for rehabilitation services or confinement in a skilled nursing facility, subject to the following limitations:
1. Covered service expenses available to a member while confined primarily to receive rehabilitation are limited to those specified in this provision.
2. Rehabilitation services or confinement in a rehabilitation facility or skilled nursing facility must be for treatment of, or rehabilitation related to, the same illness or injury that resulted in the hospital stay.
3. Covered service expenses for provider facility services are limited to charges made by a hospital, rehabilitation facility, or skilled nursing facility for:
a. Daily room and board and nursing services.
b. Diagnostic testing.
c. Drugs and medicines that are prescribed by a physician, filled by a licensed pharmacist, and approved by the U.S. Food and Drug Administration.
4. Covered service expenses for non-provider facility services are lim...
Respite care services. Services provided to enrollees unable to care for themselves furnished on a short-term basis due to the absence or need for relief of persons normally providing the care. Respite care does not substitute for the care usually provided by a registered nurse, a licensed practical nurse or a therapist. Respite care is provided in the home/place of residence, Medicaid licensed hospital, nursing facility, or assisted living facility.
Respite care services. Benefits for hospice inpatient, home or outpatient care are available to a terminally ill member for one continuous period up to 365 days per benefit period. For each day the member is confined in a hospice, benefits for room and board will not exceed the most common semiprivate room rate of the hospital or nursing home with which the hospice is associated.
Respite care services. For each day the member is confined in a hospice, benefits for room and board will not exceed the most common semiprivate room rate of the hospital or nursing home with which the hospice is associated. Benefits for hospice inpatient, home and outpatient care is subject to prior authorization as outlined in this contract.
Respite care services. Finger Lakes Health offers respite care services at two facilities: The Homestead at Soldiers & Sailors Memorial Hospital, 000 Xxxxx Xxxx Xxxxxx, Xxxx Yan, and Living Center at Geneva – North, 00 Xxxxx Xxxxxx, Geneva. Respite care is scheduled short-term care for an individual who may require nursing services for a specific period of time. The respite care program is intended to provide temporary relief to caregivers and to prolong an individual’s ability to remain in the community by allowing the caregiver planned “breaks”. Respite care is ideal for the caregiver who would like to take a much needed vacation or would like to pursue medical treatment for him or herself. The respite care program offers all of the amenities that long-term residents are afforded, but in addition, our guest is accommodated in a private room with a private bath, a television and local telephone service. Respite care offers caregivers peace of mind knowing their loved one is being cared for by a dedicated and caring staff, 24 hours a day, in a safe, comfortable environment. Short-term residents may participate in a variety of recreational activities, which they can select from the extensive calendar of events. Staff ensures that all residents are invited to attend each activity. Staff members are readily available to assist with ambulating, eating and personal hygiene. The respite patient may eat in the beautifully decorated dining rooms or have their meal served in the privacy of their own room. Respite care can be paid for privately, by Medicaid, some long- term care insurance policies or contracts with VA facilities. If you know of a family member or friends who may benefit from respite services, please call our admissions staff at (000) 000-0000 for the Living Center at Geneva program or (000) 000-0000 for the program at The Homestead in Penn Yan.
Respite care services. Contractor shall provide Respite Care Services to allow Family Caregiver and/or Grandparent/Relative Caregiver Clients to have a temporary period of relief or rest from caregiving responsibilities.
3.3.1 Contractor shall provide Respite Care Services to allow Family Caregiver and/or Grandparent/Relative Caregiver Clients temporary respite on an intermittent, occasional, or emergency basis in a manner that responds to the individual needs and preferences of a Client and their Care Receivers, rather than a pre-established set amount offered on a “first come, first served” waiting list basis. Contractor shall evaluate a Family Caregiver and/or Grandparent/Relative Caregiver Client’s needs and coordinate Services to be provided by Contractor's designated personnel and/or sub-contractor(s) (provided Contractor has been authorized by County to sub-contract (Paragraph 8.40 – Subcontracting)). Contractor shall conduct background checks with fingerprinting and ensure that all Respite Care workers are appropriately trained, and experienced, certified, and/or licensed as determined by the needs of the caregiver. Types of Respite Care Services:
3.3.2 Respite Care Services shall be provided only to Family Caregiver and/or Grandparent/Relative Caregiver Clients who care for a Care Receiver having two (2) or more ADL limitations or a cognitive impairment, or to a Client who is the Grandparent or older adult relative caring for a Child.
3.3.3 In providing Respite Care Services, Contractor shall utilize the County’s Universal Intake Form, and input the information into the HFA system. A new form shall be used for each Family Caregiver and/or Grandparent/Relative Caregiver Client each year a Client participates in the Program.
3.3.4 In providing Respite Care to a Family Caregiver and/or Grandparent/Relative Caregiver Client, Contractor must provide at least one (1) Service from the Respite Care categories below:
Respite care services. In-Home 3.b .79. Respite Care Services - Out-Of-Home 3.c .79. Respite Care Services - Overnight 3.d .79. Respite Care Services - Other 4 .79.4. Supplemental Services a .79.4. Supplemental Services - Assistive Technology/DME/PERS b .79.4. Supplemental Services - Consumable Supplies Supplemental c .79.4. Services - Home Modifications/Repairs Supplemental Services d .79.4. - Legal/Financial Consultation Supplemental Services - e .79.4.f Homemaker/Chore/Personal Care Supplemental Services - .79.4.g . Transportation 79.4.h . Supplemental Services - Nutrition Services Supplemental 79.5 .79 Services - Other .6 .84 .8 Services to Grandparents/Relatives 8 .89 Memory Care and Wellness (King only) Health Appliance/Limited Health Care Long Term Care Ombudsman Newsletters .90 OTHER ACTIVITIES 0 0 12,612 0 0 0 0 0 12,612 0 12,612
Respite care services. Opportunities are being explored around the need to commission respite care services that are currently part of the contract with BUPA or which cannot be provided within the BUPA managed care homes. This will be referred to in the tender documents and when the Council is ready to proceed providers on the framework agreement will be approached to discuss how best to set up these services. There are also current discussions with the Bedfordshire Clinical Commissioning Group to include the purchasing of CHC beds for older people within the framework agreement. Issues include which service specification should be used and the contract price to be charged. The purchase of CHC beds will be referred to in the tender documents and when the Council and the CCG are ready the providers on the framework agreement will be approached to discuss the future arrangements for commissioning CHC services. This could also allow the Council to purchase CHC places for older people on behalf of the NHS. This will take longer to organise with issues around organisational arrangements, budgets and contractual agreements needing to be resolved.
