Skilled Nursing Care Sample Clauses

Skilled Nursing Care. All Skilled Nursing Care services, except home infusion and related services, require Prior Authorization by the Company in order to be eligible for benefits. If prior approval is not obtained, the Company has the right to request medical records to review to determine whether services are eligible under this Contract.
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Skilled Nursing Care. Skilled supervision and management of a complicated or extensive plan of care for a CDCR/CCHCS patient and/or DJJ youth initiated and monitored by a physician in which there is a significantly high probability that complications would arise without the skilled supervision or implementation of the treatment program by a licensed nurse or therapist.
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Skilled Nursing Care. Riverview shall provide ten (10) days of skilled nursing care, hereafter referred to as “Skilled Nursing Care,” per year for you in Riverview Care Center when such care is prescribed by your physician and if the Care Center can meet your needs. If space is not immediately available at Riverview Care Center, you shall be admitted to Riverview Care Center as soon as possible in accordance with the admission policies of Riverview Care Center. If space at the Care Center is not available, Riverview will provide the benefits described in this Section 3.2 at a comparable facility in the Spokane area at a daily rate which is not more than the median care rate charged by Riverview Care Center. Riverview will assist you in locating an alternate health care facility. You shall be responsible for payment of all transportation costs to and from Riverview and the alternate health care facility. Prior to utilizing the ten (10) days of Skilled Nursing Care offered by Riverview, you shall first use your U.S. Government or State medical benefits, if applicable. The Skilled Nursing Care in Riverview Care Center provided in this Agreement is secondary to such coverage. You are responsible for the payment of all doctor, special nursing care, dental, drugs, ancillary services, hospital care, and other care you may require during the term of this Agreement. The ten (10) days of Skilled Nursing Care are limited to each twelve (12) month period, commencing upon the Occupancy Date. The Skilled Nursing Care is not cumulative from one twelve (12) month period to the next. Any fraction of a day of such Skilled Nursing Care shall be considered one (1) day. The right to Skilled Nursing Care is not transferable or assignable by you. The Skilled Nursing Care has no cash value, and you are not entitled to any payment for Skilled Nursing Care not used during any twelve
Sample 1
Skilled Nursing Care. Skilled Nursing Care is defined as care within the limitations to the equipment and staff of a Skilled Nursing Facility and includes services and items such as nursing care; room and board (including semi-private rooms); medical social services; medical supplies; and durable medical equipment ordinarily furnished by a Skilled Nursing Facility; and external prosthetic devices and braces ordinarily furnished by a Skilled Nursing Facility. Medicare guidelines are used to determine when care in a Skilled Nursing Facility is covered, except that a prior three day stay in an acute care hospital is not required. Up to 120 days of prescribed Skilled Nursing Care per Accumulation Period are provided or arranged at approved facilities (including Hospitals or Skilled Nursing Facilities) without charge. kpgroup_snf_0d_120accum_16.doc 01/2016 EMERGENCY DEPARTMENT SERVICES RIDER – $75 IN AND OUT OF THE SERVICE AREA The Group Medical and Hospital Service Agreement is amended by deleting sections S-1(a) and S-1(b) (Emergency Department Services) of the benefit schedule and substituting a new sections S-1(a) and S-1(b) as follows:
Sample 1
Skilled Nursing Care. When determined appropriate pursuant to the Medical Care Contract, you may receive 24-hour nursing care at Villa Marin's Nursing Facility on a priority access basis over nonresidents. As part of the admissions process, you agree to sign a separate Skilled Nursing Facility Admission Agreement in its then current form. The current version of this document is attached as Appendix D. The services you receive and certain additional rights and obligations will be set forth in the Skilled Nursing Facility Admission Agreement. The terms of this Agreement shall continue to apply, and in the event of a conflict between the terms of the two agreements, this Agreement shall govern.
Sample 1

Related to Skilled Nursing Care

  • Skilled Nursing Facilities a. The following Health Care Services may be Covered Services when you are a patient in a Skilled Nursing Facility: i. room and board;

  • 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.

  • Urgent Care This plan covers services received at an urgent care center. For other services, such as surgery or diagnostic tests, the amount that you pay is based on the type of service being provided. See Summary of Medical Benefits for details. Follow-up care (such as suture removal or wound care) should be obtained from your primary care provider or specialist.

  • Child Care A. Employees employed as of March 1 who meet the following criteria shall be eligible for a lump sum payment each year. Eligible employees may apply for this payment between March 1 and April 15 of each year. Payment shall be made within thirty (30) days of receipt of the completed application. Any application received after April 15 will be considered on a case by case basis and shall not be arbitrarily rejected.

  • Newborn Care A newborn child will be covered from the moment of birth provided that the newborn child is eligible for coverage and properly enrolled. Covered Services will consist of coverage for injury or illness, including the necessary care or treatment of medically diagnosed congenital defects, birth abnormalities, premature birth and transportation costs to the nearest facility appropriately staffed and equipped to treat the newborn's Condition, when such transportation is Medically Necessary. Circumcisions are provided for up to one year from the date of birth.

  • Therapist Availability Therapist’s office is equipped with a confidential voice mail system that allows Patient to leave a message at any time. Therapist will make every effort to return calls within 24 hours (or by the next business day), but cannot guarantee the calls will be returned immediately. Therapist is unable to provide 24-hour crisis service. In the event that Patient is feeling unsafe or requires immediate medical or psychiatric assistance, he/she should call 911, or go to the nearest emergency room.

  • Family Care Employees may use vacation leave for care of family members as required by the Family Care Act, WAC 296-130.

  • Dental Care a. Dental Care for Members over age 19 is limited to the following:

  • Hospice Care If you have a terminal illness and you agree with your physician not to continue with a curative treatment program, this plan covers hospice care services received in your home, in a skilled nursing facility, or in an inpatient facility.

  • Long Term Care The City may offer an option for employees to purchase a new long-term care benefit for themselves and certain family members.

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