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
• 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
• Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
• 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 2019, on file with CMS as of September 30, 2021, subject to the following qualifications:
  (A) If a covered hospital does not have a full twelve-month medicare cost report for 2019 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 2019 on file with CMS is the annual coverage assessment base. See Tennessee Code 71-5-2002
• Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• 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
• Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
• 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.
• Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
• 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
• Code: includes the Tennessee Code and all amendments and revisions to the code and all additions and supplements to the code. See Tennessee Code 1-3-105
• 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.
• Continuance: Putting off of a hearing ot trial until a later time.
• 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
• Contract: A legal written agreement that becomes binding when signed.
• 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
• Conviction: A judgement of guilt against a criminal defendant.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• 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 mayor: means and includes "county executive" unless the context clearly indicates otherwise. See Tennessee Code 1-3-105
• 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
• Covered hospital: means a hospital licensed under title 33 or title 68, as of July 1, 2023, but does not include an excluded hospital. See Tennessee Code 71-5-2002
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Decedent: A deceased person.
• Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
• 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.
• Deposition: An oral statement made before an officer authorized by law to administer oaths. Such statements are often taken to examine potential witnesses, to obtain discovery, or to be used later in trial.
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• Dismissal: The dropping of a case by the judge without further consideration or hearing. ^Source:
• Donor: The person who makes a gift.
• 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.
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Ex officio: Literally, by virtue of one's office.
• Excluded hospital: means :
  (A) A hospital that has been designated by CMS as a critical access hospital as of July 1, 2023. 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
• Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
• 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
• Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
• 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
• Joint resolution: A legislative measure which requires the approval of both chambers.
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• Juror: A person who is on the jury.
• Lands: includes lands, tenements and hereditaments, and all rights thereto and interests therein, equitable as well as legal. See Tennessee Code 1-3-105
• 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.
• Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). ^{Source: OCC}
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Lien: A claim against real or personal property in satisfaction of a debt.
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• 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
• 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
• Month: means a calendar month. See Tennessee Code 1-3-105
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• 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
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Office of emergency medical services: means the office of emergency medical services within the department of health. See Tennessee Code 71-5-1502
• Oral argument: An opportunity for lawyers to summarize their position before the court and also to answer the judges' questions.
• Oversight: Committee review of the activities of a Federal agency or program.
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
• Personal representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
• 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}
• Probable cause: A reasonable ground for belief that the offender violated a specific law.
• Probate: Proving a will
• Property: includes both personal and real property. See Tennessee Code 1-3-105
• Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
• 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.
• Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
• 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
• Quorum: The number of legislators that must be present to do business.
• 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
• Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in a perceivable form. See Tennessee Code 1-3-105
• 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}
• Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
• Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
• Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
• 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.
• Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
• sex: means a person's immutable biological sex as determined by anatomy and genetics existing at the time of birth and evidence of a person's biological sex. See Tennessee Code 1-3-105
• signed: includes a mark, the name being written near the mark and witnessed, or any other symbol or methodology executed or adopted by a party with intention to authenticate a writing or record, regardless of being witnessed. See Tennessee Code 1-3-105
• State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
• Statute: A law passed by a legislature.
• 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
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• 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.
• Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
• United States: includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
• 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.
• written: includes printing, typewriting, engraving, lithography, and any other mode of representing words and letters. See Tennessee Code 1-3-105
• Year: means a calendar year, unless otherwise expressed. See Tennessee Code 1-3-105