Skilled Nursing Facility. A Facility which mainly provides full-time Skilled Nursing Care for Ill or Injured people who do not need to be in a Hospital. It must carry out its stated purpose under all relevant state and local laws, and it must either:
Skilled Nursing Facility. An institution or a distinct part of an institution that is licensed or approved under state or local law, and which is primarily engaged in providing skilled nursing care and related services as a Skilled Nursing Facility, extended care facility, or nursing care facility approved by the Joint Commission on Accreditation of Health Care Organizations or the Bureau of Hospitals of the American Osteopathic Association, or as otherwise determined by HMO to meet the reasonable standards applied by any of the aforesaid authorities. • Specialist(s). A Physician who provides medical care in any generally accepted medical or surgical specialty or subspecialty.
Skilled Nursing Facility. An institution or a distinct part of an institution that is licensed or approved under state or local law, and which is primarily engaged in providing Skilled Nursing care and related services for residents who require medical or nursing care, or rehabilitation services for the rehabilitation of injured, disabled, or sick persons. Skilled Nursing Facility does not include institutions which provide only minimal care, Custodial Care services, ambulatory or part-time care services, or institutions which primarily provide for the care and treatment of mental illness and substance abuse. The facility must qualify as a Skilled Nursing Facility under Medicare or as an institution accredited by the Joint Commission on Accreditation of Health Care Organizations, the Bureau of Hospitals of the American Osteopathic Association, the Commission on the Accreditation of Rehabilitative Facilities, or as otherwise determined by the health insurer to meet the reasonable standards applied by any of the aforesaid authorities. Examples of Skilled Nursing Facilities include Rehabilitation Hospitals (all levels of care, e.g. acute) and portions of a Hospital designated for Skilled or Rehabilitation services. The Home Health Benefits provision under the Covered Benefits section of the Certificate is hereby deleted and replaced with the following:
Skilled Nursing Facility. A Facility which mainly provides full-time Skilled Nursing Care for Ill or Injured people who do not need to be in a Hospital. It must carry out its stated purpose under all relevant state and local laws, and it must either: be accredited for its stated purpose by The Joint Commission; or be approved for its stated purpose by Medicare. SMALL EMPLOYER. Means in connection with a Group Health Plan with respect to a Calendar Year and a Plan year, an employer who employed an average of at least 1 but not more than 50 Employees on business days during the preceding Calendar Year and who employs at least 1 Employee on the first day of the Plan Year. All persons treated as a single employer under subsection (b), (c), (m) or (o) of section 414 of the Internal Revenue Code of 1986 shall be treated as one employer. In the case of an Employer which was not in existence throughout the preceding Calendar Year, the determination of whether such employer is a small or large employer shall be based on the average number of Employees that it is reasonably expected such Employer will employ on business days in the current Calendar Year. The following calculation must be used to determine if an employer employs at least 1 but not more than 50 Employees. For purposes of this calculation:
Skilled Nursing Facility a Facility Provider approved by the state, certified by Medicare which, for compensation from its patients, is primarily engaged in providing Skilled Nursing Services on an Inpatient basis to patients requiring twenty-four (24)-hour Skilled Nursing Services but not requiring confinement in an acute care general hospital. Such care is rendered by or under the supervision of Physicians. A Skilled Nursing Facility is not, other than incidentally, a place that provides:
Skilled Nursing Facility. An institution operated alone or with a Hospital which gives care after a Member leaves the Hospital for a condition requiring more care than can be rendered at home. It must be licensed by the appropriate state agency and accredited by the Joint Commission on Accreditation of Health Care Organizations, or otherwise determined by us to meet the reasonable standards applied by any of the aforesaid authorities. Specialty Drugs High-cost, injectable, infused, oral or inhaled medications that typically require close supervision and monitoring of their effect on the patient by a medical professional. Specialty Drugs often require special handling such as temperature-controlled packaging and overnight delivery and are often unavailable at retail pharmacies. Most Specialty Drugs require Prior Authorization.
Skilled Nursing Facility. An institution (or a distinct part of an institution) that meets the criteria as set forth in § 199.6(b)(4)(vi).
Skilled Nursing Facility. Shall be defined as a specially qualified and licensed facility that:
Skilled Nursing Facility a facility with a valid license issued by the California Department of Public Health as a Skilled Nursing Facility or any similar institution licensed under the laws of any other state, territory, or foreign country. Also included in a Skilled Nursing unit within a Hospital. Special Enrollment Period – a period during which an individual who experiences certain qualifying events may enroll in, or change enrollment in, a health plan outside of the Open Enrollment Period. An individual and/or his or her Dependents has a 60-day Special Enrollment Period if any of the following occurs:
Skilled Nursing Facility. A facility that:
