Custodial Care Facility
A facility that:
– Is licensed and operated as a custodial care facility in the state in which it is located.
– Provides nursing service and custodial care under the supervision of a registered graduate professional nurse.
– It can accommodate 3 or more persons at charge.
Eligible institutions
– Skilled Nursing Facility
– Intermediate Care Facility
– Custodial Care Facility
-Assisted Living Facility
– Home Health Care Agency
– Adult Day Care Facility
Eligible institutions do not mean
– A hospital
– A place that primarily treats chemically dependent or mentally ill persons.
– A home for the aged, a community living center, or place that primarily provides domiciliary residency or retirement care in the absence of medical necessity.
Home Care
Health care services provided under a planned program for continued care and treatment that is approved in writing by the insured’s attending physician. An eligible institution or hospital must provide such health care services.
Examples of eligible health care services include assistance with:
– Ambulation.
– Appliances including wheel chairs, walker, etc.
– Colostomy care
– Medications
– Prostheses
– Catheters
– Dressings
Home Health Care Agency
An agency that is licensed and operated as a home health care agency in the state in which it is located.
Hospice Care Team
An interdisciplinary working unit composed of members of the various helping professions, including, but not limited to:
– The hospice medical director
– The patient’s attending physician.
– A registered nurse
– A social worker.
– A counselor
– A clergyperson of the patient’s family’s choice if applicable.