Nursing Home Certifiable (NHC Sample Clauses

Nursing Home Certifiable (NHC the determination that an Enrollee residing in the community has been found to meet the MassHealth medical eligibility criteria for payment for nursing facility care (see 130 CMR 456).
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Nursing Home Certifiable (NHC the determination that an Enrollee residing in the community has been found to meet the MassHealth medical eligibility criteria for payment for nursing facility care (see 130 CMR 456). Ombudsperson –a neutral person who assists Enrollees or their designees regarding information, issues, or concerns, related to SCO Contractor’s plan. The Ombudsman will fulfill both individual and systemic advocacy roles, as defined in the contract between EOHHS and the entity administering the Ombudsman program, for individuals enrolled in the Contractor’s plan. Ongoing Assessment - a re-evaluation of an Enrollee's health status conducted in accordance with Section 2.4.A.11 of the Contract. An Ongoing Assessment for an Enrollee identified as having Complex Care Needs must be conducted in person by a Registered Nurse. EOHHS may prescribe the Ongoing Assessment tool. Opt-In Enrollment – enrollment in a SCO plan initiated by an Eligible Individual. Opt Out – a process by which an Eligible Individual or his/her Authorized Representative chooses not to be enrolled with the Contractor via Passive Enrollment. An Eligible Individual may Opt Out at any time before the effective date of his or her Passive Enrollment.
Nursing Home Certifiable (NHC. If an Enrollee is a community resident, is limited in two or more activities of daily living (ADLs), and has a skilled nursing need three or more times per week, as recorded through the Minimum Data Set/Home Care (MDS/HC) form and approved by EOHHS, or if an Enrollee is in the first three months of a nursing facility stay, the Enrollee will be classified NHC.

Related to Nursing Home Certifiable (NHC

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