2023 Archdiocese of Atlanta Meritain Group Plan Doc - Manual / Resource - Page 80
FMLA means the Family and Medical Leave Act of 1993, as may be amended from time to time.
Genetic Information means information about genes, gene products and inherited characteristics that may derive
from the individual or a family member. This includes information regarding carrier status and information derived
from laboratory tests that identify mutations in specific genes or chromosomes, physical medical examinations,
family histories and direct analysis of genes or chromosomes. Genetic Information will not be taken into account
for purposes of (1) determining eligibility for benefits under the Medical Plan (including initial enrollment and
continued eligibility) and (2) establishing contribution or premium accounts for coverage under the Medical Plan.
Health Care Professional: A Physician or other Health Care Professional licensed, accredited, or certified to
perform specified health services consistent with State law.
HIPAA means the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as may be amended from
time to time.
Home Health Care Agency means a public or private agency or organization that specializes in providing medical
care and treatment in the home. Such a provider must meet all of the following conditions, it: (1) is duly licensed, if
such licensing is required, by the appropriate licensing authority to provide skilled nursing services and other
therapeutic services; (2) qualifies as a Home Health Care Agency under Medicare; (3) meets the standards of the
area-wide healthcare planning agency; (4) provides skilled nursing services and other services on a visiting basis
in the patient's home; (5) is responsible for administering a home health care program; and (6) supervises the
delivery of a home health care program where the services are prescribed and approved in writing by the patient's
attending Physician.
Hospice means an agency that provides counseling and incidental medical services and may provide room and
board to terminally ill individuals and which meets all of the following requirements: (1) has obtained any required
state or governmental Certificate of Need approval; (2) provides 24-hour-a-day, 7 days-a-week service; (3) is under
the direct supervision of a duly qualified Physician; (4) has a nurse coordinator who is a registered nurse (R.N.)
with 4 years of full-time clinical experience, at least 2 of which involved caring for terminally ill patients; (5) has a
social-service coordinator who is licensed in the jurisdiction in which it is located; (6) is an agency that has as its
primary purpose the provision of hospice services; (7) has a full-time administrator; (8) maintains written records of
services provided to the patient; (9) the employees are bonded and it provides malpractice and malplacement
insurance; (10) is established and operated in accordance with the applicable laws in the jurisdiction in which it is
located and, where licensing is required, has been licensed and approved by the regulatory authority having
responsibility for licensing under the law; (11) provides nursing care by a registered nurse (R.N.), a licensed
practical nurse (L.P.N.), a licensed physical therapist, certified occupational therapist, American Speech Language
and Hearing Association certified speech therapist or a certified respiratory therapist; and (12) provides a home
health aide acting under the direct supervision of one of the above persons while performing services specifically
ordered by a Physician.
Hospital means a facility which: (1) is licensed as a Hospital where licensing is required; (2) is open at all times;
(3) is operated mainly to diagnose and treat Illnesses or Injuries on an inpatient basis; (4) has a staff of one or more
Physicians on call at all times; (5) has 24-hour-a-day nursing services by registered nurses (R.N.'s); and (6) has
organized facilities for major Surgery.
However, an institution specializing in the care and treatment of Mental Disorders which would qualify as a Hospital,
except that it lacks organized facilities on its premises for major Surgery, shall be deemed a Hospital.
In no event shall "Hospital" include an institution which is primarily a rest home, a nursing home, a clinic, a Skilled
Nursing Facility, a convalescent home or a similar institution.
The definition of “Hospital” shall be expanded to include those services rendered to a priest by the following facilities:
(a) Guest House; (b) St. Luke Institute; (c) St. John Vianney; (d) Ridgeview Institute of Atlanta, or others as
approved by the Archbishop or his designee.
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