Terms Used In Tennessee Code > Title 71 > Chapter 5 - Programs and Services for Poor Persons

• Account: means the nursing home assessment trust fund created under this part. See Tennessee Code 71-5-1001
• Administrative director: means the administrative director of the courts. See Tennessee Code 40-14-301
• Adult emergency dental services: means dental services for individuals twenty-one (21) years of age and older to treat a dental condition that manifests itself by symptoms of sufficient severity, including severe pain, infection or trauma, that:
  (A) A prudent layperson who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate dental attention to potentially result in:

  (i) Placing the person's, or with respect to a pregnant woman, her unborn child's, health in jeopardy. See Tennessee Code 71-5-103
• Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
• Agriculture: means :
  (i) The land, buildings and machinery used in the commercial production of farm products and nursery stock. See Tennessee Code 1-3-105
• Ambulance provider: means a public or private ground-based ambulance service, other than an ambulance service based on federal property, that bills for transports and has a base of operations within this state. See Tennessee Code 71-5-1502
• Annual coverage assessment: means the annual assessment imposed on covered hospitals as set forth in this part. See Tennessee Code 71-5-2002
• Annual coverage assessment base: means a covered hospital's net patient revenue as shown in its medicare cost report for its fiscal year that ended during calendar year 2016, on file with CMS as of September 30, 2018, subject to the following qualifications:
  (A) If a covered hospital does not have a full twelve-month medicare cost report for 2016 on file with CMS but has a full twelve-month cost report for a subsequent year, then the first full twelve-month medicare cost report for a year following 2016 on file with CMS is the annual coverage assessment base. See Tennessee Code 71-5-2002
• Applicant: means any person who has applied for benefits under this part. See Tennessee Code 71-5-103
• Applicant: means any person who has applied for benefits under this part. See Tennessee Code 71-5-303
• Area manager: means the director or manager of the county or area office of the department of human services. See Tennessee Code 71-5-303
• Assessment: means the medicaid ambulance provider assessment established by this part. See Tennessee Code 71-5-1502
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• Bail: Security given for the release of a criminal defendant or witness from legal custody (usually in the form of money) to secure his/her appearance on the day and time appointed.
• Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. ^{Source: OCC}
• Benefits: means the health care package of services available to TennCare enrollees. See Tennessee Code 71-5-2503
• Budget allowance: means the amount of money that can be directed, utilizing the services of a fiscal intermediary, by a medicaid-eligible long-term care member participating in this consumer-directed care option, to pay for home and community-based long-term care services defined under the medicaid state plan or any federal waivers or amendments thereto that are necessary to meet the member's long-term care needs and to delay or prevent institutionalization. See Tennessee Code 71-5-1403
• Bureau: means the bureau of TennCare. See Tennessee Code 71-5-1001
• Bureau: means the bureau of TennCare. See Tennessee Code 71-5-1502
• Bureau: means the bureau of TennCare. See Tennessee Code 71-5-2002
• Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
• Clerk of court: An officer appointed by the court to work with the chief judge in overseeing the court's administration, especially to assist in managing the flow of cases through the court and to maintain court records.
• CMS: means the federal centers for medicare and medicaid services. See Tennessee Code 71-5-2002
• Commissioner: means the commissioner of human services. See Tennessee Code 71-5-303
• Commissioner: means the commissioner of finance and administration or the commissioner's designee. See Tennessee Code 71-5-1403
• Commissioner: means the commissioner of finance and administration. See Tennessee Code 71-5-2503
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Continuing care retirement community: means an entity or organization that offers on a single campus setting a continuum of services and facilities for each resident including single and congregate dwellings, assisted living units, and nursing facility services, pursuant to a contract between a resident and a provider by which the resident pays a fee for the right to occupy a space in a designated facility and to receive continuing care for life. See Tennessee Code 71-5-1001
• control: means indirect or direct ownership of ten percent (10%) or more of a covered hospital. See Tennessee Code 71-5-2002
• Controlling person: means a person who, by ownership, contract, or otherwise, has the authority to control the business operations of a covered hospital. See Tennessee Code 71-5-2002
• Cost-effective: means that the total cost of services provided to an eligible elderly or physically disabled adult in the home or other community-based setting does not exceed the cost of reimbursement for institutional care in a nursing facility. See Tennessee Code 71-5-1403
• County office: means the county office of the state department of human services in the county wherein the applicant resides. See Tennessee Code 71-5-103
• County office: means the county office of the department of human services in the county where the applicant or recipient resides and in which county a food stamp program is currently in operation. See Tennessee Code 71-5-303
• Court: means any court of this state exercising jurisdiction over any criminal action which is punishable by confinement in the state penitentiary. See Tennessee Code 40-14-301
• Court reporter: A person who makes a word-for-word record of what is said in court and produces a transcript of the proceedings upon request.
• Covered hospital: means a hospital licensed under title 33 or title 68, as of July 1, 2022, but does not include an excluded hospital. See Tennessee Code 71-5-2002
• Decedent: A deceased person.
• Department: means the department of health. See Tennessee Code 71-5-103
• Department: means the department of human services. See Tennessee Code 71-5-303
• Department: means the department of finance and administration. See Tennessee Code 71-5-501
• Department: means the department of finance and administration. See Tennessee Code 71-5-2503
• Dependent: A person dependent for support upon another.
• Dismissal: The dropping of a case by the judge without further consideration or hearing. ^Source:
• Enrollee: means an individual eligible for and enrolled in the TennCare program or in any successor medicaid program in Tennessee. See Tennessee Code 71-5-2503
• Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
• Excluded hospital: means :
  (A) A hospital that has been designated by CMS as a critical access hospital as of July 1, 2022. See Tennessee Code 71-5-2002
• Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
• Fiscal intermediary: means an entity with whom the commissioner or a contractor responsible for the coordination of medicaid primary, acute and long-term care services has contracted to help a member participating in this consumer-directed care option manage the member's budget allowance. See Tennessee Code 71-5-1403
• food assistance: means food stamp coupons, free food stamps or food purchase assistance that is issued or transferred by means of food coupons, food stamps, electronic benefits transfer processes or other means as determined by the department to an eligible household or low-income family pursuant to this part. See Tennessee Code 71-5-303
• food stamps: means obligations of the United States government issued or transferred by means of food coupons or food stamps to enable the purchase of food for the eligible household. See Tennessee Code 71-5-303
• Fraud: Intentional deception resulting in injury to another.
• Fraud: means an intentional deception or misrepresentation made by a person including, but not limited to, a vendor, recipient, provider, or enrollee, with the knowledge that the deception or misrepresentation could result in some unauthorized benefit or payment to oneself or some other person. See Tennessee Code 71-5-2503
• Fund: as used in this part shall mean the nursing home assessment trust fund created under this part. See Tennessee Code 71-5-1001
• Grand jury: agreement providing that a lender will delay exercising its rights (in the case of a mortgage,
• Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
• Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies.
• Inspector general: means the person who directs the office of inspector general, who shall report directly to the commissioner of finance and administration. See Tennessee Code 71-5-2503
• Judge: means the judge of any court of this state exercising jurisdiction over any criminal action which is punishable by confinement in the state penitentiary. See Tennessee Code 40-14-301
• Lawsuit: A legal action started by a plaintiff against a defendant based on a complaint that the defendant failed to perform a legal duty, resulting in harm to the plaintiff.
• Medicaid transport: means qualifying ground ambulance services approved by CMS, and consistent with services identified in 42 C. See Tennessee Code 71-5-1502
• Medical assistance: means payment of the cost of care, services and supplies necessary to prevent, diagnose, correct or cure conditions in the person that cause acute suffering, endanger life, result in illness or infirmity, interfere with the person's capacity for normal activity, or threaten some significant handicap and that are furnished an eligible person in accordance with this part and the rules and regulations of the department. See Tennessee Code 71-5-103
• Medical assistance: means payment of the cost of care, services and supplies necessary to prevent, diagnose, correct or cure conditions in the person that cause acute suffering, endanger life, result in illness or infirmity, interfere with the person's capacity for normal activity, or threaten some significant disability and which are furnished an eligible person in accordance with the rules, regulations, and statutes governing TennCare. See Tennessee Code 71-5-2503
• Medically needy: means a class or classes of persons whose present income and financial assets are not sufficient to meet their present liabilities for health costs. See Tennessee Code 71-5-103
• Medicare cost report: means CMS-2552-10 or a subsequent form adopted by CMS for medicare cost reporting, the cost report for electronic filing of hospitals, for the period applicable as set forth in this section. See Tennessee Code 71-5-2002
• MFCU: means the medicaid fraud control unit. See Tennessee Code 71-5-2503
• Minor: means any person who has not attained eighteen (18) years of age. See Tennessee Code 1-3-105
• Mistrial: An invalid trial, caused by fundamental error. When a mistrial is declared, the trial must start again from the selection of the jury.
• Mobile dental services: means an intact comprehensive dental services unit operated on-site at a long-term care facility, interfacing with the facility's common electrical and water sources. See Tennessee Code 71-5-103
• Net patient service revenue: means gross inpatient revenues from services provided to nursing home patients less reductions from gross inpatient revenue resulting from an inability to collect payment of charges. See Tennessee Code 71-5-1001
• Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
• Nursing facility: means any entity defined as a nursing home under §. See Tennessee Code 71-5-1001
• Office of emergency medical services: means the office of emergency medical services within the department of health. See Tennessee Code 71-5-1502
• Plaintiff: The person who files the complaint in a civil lawsuit.
• Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
• Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
• Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. ^{Source: OCC}
• Provider: means an institution, facility, agency, person, corporation, partnership, unincorporated organization, nonprofit organization or any person or entity directly or indirectly providing benefits, goods or services to a TennCare enrollee. See Tennessee Code 71-5-2503
• Public defender: Represent defendants who can't afford an attorney in criminal matters.
• Qualified entity: means an entity with which the commissioner has contracted to assess the needs of persons determined medically eligible for long-term care services and to develop care plans to address their identified needs. See Tennessee Code 71-5-1403
• Rebalance: means reaching a more equitable balance between the proportion of medicaid long-term care expenditures used for institutional, i. See Tennessee Code 71-5-1403
• Recipient: means any person who has been determined eligible to receive benefits under this part and who has received such benefits. See Tennessee Code 71-5-103
• Recipient: means any person who has been determined to be eligible to receive benefits under this part and who has received such benefits. See Tennessee Code 71-5-303
• Recipient: means any person who has been determined eligible to receive benefits under part 1 of this chapter, and who has received such benefits. See Tennessee Code 71-5-2503
• Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. ^{Source: FDIC}
• Resident: means any individual who is living within the state, with the intent that such person's permanent home be within the state, and not temporarily. See Tennessee Code 71-5-103
• Resident day: means a calendar day of care provided to a nursing home resident, including the day of admission and excluding the day of discharge. See Tennessee Code 71-5-1001
• Responsible parties: means the following representatives and relatives of recipients of medical assistance pursuant to this part who are not financially eligible to receive benefits under this part: parents, spouses, children, and guardians. See Tennessee Code 71-5-103
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
• Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
• Subpoena: A command to a witness to appear and give testimony.
• Summons: Another word for subpoena used by the criminal justice system.
• Taxable transports: means the total ground ambulance transports reported during the base period by a provider to the office of emergency medical services that qualify as a permissible service to impose a healthcare-related provider assessment pursuant to 42 C. See Tennessee Code 71-5-1502
• TennCare: means the program administered by the single state agency, as designated by the state and CMS, pursuant to Title XIX of the Social Security Act ( 42 U. See Tennessee Code 71-5-2503
• Testify: Answer questions in court.
• Title XIX: means Title XIX of the Social Security Act as amended (P. See Tennessee Code 71-5-103
• Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
• Transcript: A written, word-for-word record of what was said, either in a proceeding such as a trial or during some other conversation, as in a transcript of a hearing or oral deposition.
• Upper payment limit: means the limitation established pursuant to 42 C. See Tennessee Code 71-5-1001
• Vendor: means any person, institution, agency, or business concern providing medical care services or goods authorized under this part, holding, where applicable, a current valid license to provide such services or to dispense such goods. See Tennessee Code 71-5-103
• Vendor: means any person, institution, agency, other entity or business concern providing services or goods authorized under chapter 5, part 1 of this title, and includes, but is not limited to, any health maintenance organization, managed care organization, managed care contractor, administrative services organization, pharmacy benefit manager, prepaid limited health service organization, contractor or subcontractor. See Tennessee Code 71-5-2503
• Venue: The geographical location in which a case is tried.
• Verdict: The decision of a petit jury or a judge.