Preventable Condition definition

Preventable Condition means a condition that meets either of the following criteria: a) Is a Healthcare Acquired Condition. A Healthcare Acquired Condition is a condition listed below occurring in any inpatient hospital setting: Foreign object retained after surgery; Air embolism; Blood incompatibility; Stage III and IV pressure ulcers; Falls and trauma; including fractures, dislocations, intracranial injuries, crushing injuries, ▇▇▇▇▇, other injuries; Catheter-associated urinary tract infection (UTI); Vascular catheter-associated infection; Manifestations of poor glycemic control including diabetic ketoacidosis, nonketotic hyperosmolar coma, hypoglycemic coma, secondary diabetes with ketoacidosis, secondary diabetes with hyperosmolarity; Surgical site infection following coronary artery bypass graft (CABG)- Mediastinitis; Surgical site infection following bariatric surgery for obesity, including laparoscopic gastric bypass, gastroenterostomy, laparoscopic gastric restrictive surgery; Surgical site infection following certain orthopedic procedures including spine, neck, shoulder, and elbow; Surgical site infection following cardiac implantable electronic device (CIED); Deep vein thrombosis (DVT)/Pulmonary Embolism (PE) following total knee replacement or hip replacement with pediatric and obstetric exceptions; or Latrogenic pneumothorax with venous catheterization. b) Is an Other Provider-Preventable Condition. An Other Provider-Preventable Condition is a condition occurring in any health care setting that meets the following criteria: Is identified in the State plan; Has been found by the State, based upon a review of the medical literature by qualified professionals, to be reasonably preventable through the application of procedures supported by evidence-based guidelines; Has a negative consequence for the beneficiary; Is auditable; and At a minimum includes: • Wrong surgical or other invasive procedure performed on a patient; • Surgical or other invasive procedure performed on the wrong body part; • Surgical or other invasive procedure performed on the wrong patient.
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Examples of Preventable Condition in a sentence

  • Provider Preventable Condition means a condition that meets the definition of a Health Care- Acquired Condition or an Other Provider-Preventable condition.

  • The Contractor’s policies and procedures shall also be consistent with the following: The Contractor shall not pay a provider for a Provider Preventable Condition.

  • Provider Preventable Condition – Health care-acquired condition means a condition occurring in a hospital setting, identified as HAC in the State Plan as described in Section 1886(d)(4)(D)(ii) and (iv) of the Social Security Act; other than Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) as related to total knee replacement or hip replacement surgery in pediatric and obstetric patients.

  • Provider Preventable Condition - A hospital acquired condition or a condition occurring in any health care setting that has been found by the State, based upon a review of medical literature by qualified professionals, to be reasonably preventable through the application of procedures supported by evidence-based guidelines, has a negative consequence for the Enrollee, and is auditable.

  • The Contractor‘s policies and procedures shall also be consistent with the following: The Contractor shall not pay a provider for a Provider Preventable Condition.

  • Provider Preventable Condition - A hospital acquired condition or a condition occurring in any health care setting that has been found by SCDHHS, based upon a review of medical literature by qualified professionals, to be reasonably preventable through the application of procedures supported by evidence-based guidelines, has a negative consequence for the Enrollee, and is auditable.

  • In general, all Users in the Falls Church Contract Service Area shall be served by sewers owned, operated, and maintained by that jurisdiction, unless there is mutual agreement of the jurisdictions to the contrary.

  • A Contractor may limit reductions in Provider payments to the extent that the following apply: The identified Provider Preventable Condition would otherwise result in an increase in payment.

  • The Contractor shall not impose any reduction in payment for a Provider Preventable Condition when the condition defined as a Provider Preventable Condition for a particular Enrollee existed prior to the Provider’s initiation of treatment for that Enrollee.

  • An ICO may limit reductions in provider payments to the extent that the following apply The identified Provider Preventable Condition would otherwise result in an increase in payment; The ICO can reasonably isolate for nonpayment the portion of the payment directly related to treatment for, and related to, the Provider Preventable Condition.

Related to Preventable Condition

  • Unsafe condition as used in this clause means the actual or potential exposure of contractor or Government employees to a hazardous material as defined in Federal Standard No. 313, and any revisions thereto during the term of this contract, or any other material or working condition designated by the Contracting Officer's Technical Representative (COTR) as potentially hazardous and requiring safety controls.

  • Acute condition means that the individual is medically unstable. Such an individual requires frequent monitoring by medical professionals, such as physicians and registered nurses, in order to maintain his or her health status.

  • fair and reasonable conditions means appropriate conditions, including possible financial terms or royalty-free conditions, taking into account the specific circumstances of the request for access, for example the actual or potential value of the results or background to which access is requested and/or the scope, duration or other characteristics of the exploitation envisaged;

  • restrictive condition means any condition registered against the title deed of land restricting the use, development or subdivision of the land concerned:

  • Rating Condition has the meaning specified in Section 2.06(c)(ii).