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bathing, dressing, eating, toileting, walking, and so on. activity of daily living (ADL)
Hospital that provide health care services to patients who have serious, sudden, or acute illnesses or injuries and/or who need certain surgies. acute care facility (ACF)
Patients have an average LOS of 4-5 days and a total LOS of less than 25 days. acute hospital classification(see short-term hospital classification)
DHHS programs that provide services and assistance to needy children and families, including Temporary Assistance to Needy Families (TANF) Administration for Children and Families (ACF)
DHHS program that supports a nationwide aging network, providing services to the elderly to enable them to remain independent. Administration on Aging (AoA)
Provides care and supervision in a structured environment to seniors w/physical or mental limitations. adult day care
DHHS agency that supports research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to effective services. Agency for Healthcare Research and Quality (AHRQ)
DHHS agency that works with the states and other federal agencies to prevent exposure to hazardous substances from waste sites. Agency for Toxic Substances and Disease Registry (ATSDR)
Long-term care facility that specializes in the care of patients diagnosed with Alzheimer's disease. Alzheimer's treatment facilities
Outpatient care that allows patients to receive care in one day without the need for inpatient hospitalization; also called outpatient care. ambulatory care
freestanding center that dispenses and administers prescribed medications by continuous or intermittent infusion to ambulatory patients. Supervised by a licensed health care professional. ambulatory infusion center (AIC)(see infusion center)
Treated and released the same day and do not stay overnight in the hospital; length of stay is a maximum of 23 hours, 59 min., and 59 sec.; also called outpatients. ambulatory patients
Surgery is performed on an outpatient basis at a free-standing ambulatory surgical center. Patients arrive on the day of procedure, undergo surgery in an operatin room, and recover under the care of nursing staff. ambulatory surgical center (ASC)
Undergoes certain procedures that can be performed on an outpatient basis, w/the patient treated and released the same day. Length of say is a max of 23 hrs, 59 m, and 59 s; if they require a longer stay, they must be admitted to the faciity as an inpatie ambulatory surgical patient
Documented by such departments as laboratory, radiology, nuclear medicine to assist physicians in diagnosiss and treatment of patients. ancillary services
Combo of housing and supportive services incljuding personal care and household management for seniors. Residents pay monthly rent and additional fees for services they require. assisted-living facility (ALF)
total of number of inpatient beds for which the facility is licensed by the state. (bed size) bed count
total of number of inpatient beds for which the facility is licensed by the state. (bed count) bed size
Specializes in treating individuals w/mental health diagnoses. behavioral health care hospital
Federal program that provides necessary medical, dental, and mental health services to inmates by a professional staff and consistent w/acceptable community standards. It consists of 82 institutions, each of which provide inmate ambulatory care. Bureau of Prisons (BOP)
Provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plan. cafeteria plan
Lump sum paid by the HMO to the provider to care for a group of subscribers capitation payment
DHHS agency that provides a system of health surveillance to monitor and prevent the outbreak of diseases. Center for Disease Control and Prevention (CDC)
Provides 24-hr medically directed evaluation and withdrawal management in an acute care inpatient setting. Treatment services usually include detoxification and withdrawal management, chemical dependency/substance abuse assesment, and therapy. chemical dependency program
Intravenous adminstration of chemical agents that have specific and toxic effects upon a disease-causing cell or organism. chemotherapy
Performs testing in microbiology, clinical chemistry; and toxicology; directed by a pathologist; and testing is performed by certified, professional technologists and technicians. clinical laboratory
Hospital ambulatory care patient who receives scheduled diagnostic and therapeutic care. clinic outpatient
includes group and staff models that provide services at HMO-owned health centers or satelitte clinics, or by physicians who belong to a specially formed medical group that serves the HMO. closed-panel HMO
provides different levels of care based on the residents' needs from independent living apartments to skilled nursing care in an affiliated nursing facility. Continuing Care Retirement Communities (CCRC)
Fixed amount a subscriber must pay when seeking health care services. copayment
Provides inmates w/a secure housing envirnoment that also offers vocational and education advancement. Medical, dental, and meental health services ar provided to inmates according to a std of care imposed by court decisions,legislation, accepted correcti correctional facilities
Provides short term fewer than 15 days crisis intervention and tratment; patients receive 24-hr-per-day supervision. crisis services
Located more that 35 miles from any other hospital or another CAH, or they are state certified as being a necessary provider of health care to area residents. critical access hospital (CAH)
Therapeutic. curative care
Intensive treatment program provided to patients who live in the community but come to the facility up to five days per week. day treatment program
Long-term care facilities that specialize in the care of patients diagnosed w/dementia. dementia care facilities
Sometimes categorized as an imtermediate care facilty (ICF), these facilities provide residental care and day programming, including academic training, clinical and technical assistance, healt care services, and diagnosis and evaluation of individuals w/d developmentally diasbled/mentally retarded facilities
Classify inpatient hospital cases into groups that are expected to comsume similar hospital resosurces. Hospital inpatients are discharged once the acute phase of the illness has passed, and they are transferred to other types of health care, such as outp diagnosis-related groups (DRGs)
Individual physicians in the community deliver contracted health services to subscribers. direct contact model HMO
Intravenous adminstration of other drugs including antibiotics, antivirals,and so on. drug therapy
Includes canes, crutches, IV supplies, hosptial beds, ostomy supplies, oxygen, prostheses, walkers, wheelchairs, and so on. durable medical equipment (DME)
See urgent care center. Immediate care is provided by an on-duty physician. Owned by private corp. in states where permitted or non-profit facilities. emergency care center
Treated for urgent problems and either released the same day or admitted to the hospsital as an inpatient. emergency care patient
Provides benefits to subscribers who receive health care services from network providers. Exclusive Provided Organization (EPO)
Provides care for the entire family and focuses on general medicine, obstetrics, pediatrics, and geriatrics. family practitioners
Services provided to assist families in caring for the patient. Family Support Services
Measures ability of health care facilities to deliver care that is safe and adequate, in accordance w/federal law and regulation. federal certificaion
Provide major medical care to federal corretional facility inmates. federal medical centers (FMCs)
See Triple Option Plan. Provides subscribers and employeees w/a choice of HMO, PPO, or traditional health insurance plan; also called cafeteria plan. flexible benefit plan
DHHS agency that assures the safety of food and cosmetics, and the safety and efficacy of pharmaceuticals, biological products, and medical devices. Food and Drug Administration (FDA)
Provide emergency care, perform general surgery, and admit patients for a range of problems from fractures to heart disease, based on licensing by the state. general hospitals
Participating physicians who are members of an independent multi-specialty group providing health care services. Physicians groups either contract with the HMO or they are owned or managed by the HMO. group model HMO
Managed care contract in which physicans maintain their own offices and share services to plan memebers. Group Practice Without Walls (GPWW)
An alternative to traditional health insurance coverage; provide comprehensive health services to memebers on a pre-paid basis. Health Maintenance Organization (HMO)
DHHS agency that provides health resources for medically underserved populations, works to build the health care workforce, maintains the National Health Service Corps, oversees the nation's organ transplantation sustem, works to decrease infant mortality Health Resources and Services Administration (HRSA)
Provides ambulatory cardio-vascular services to include diagnosis and treatment, disease prevention, research, education, and cardiac rehabilitation. heart and vascular center
Allows people who are seriously ill or dying to remain at home and receive treatment from nurses, social workers, therapists, and other licensed health care professionals who provide skilled care in the home. home care
Provided by home health care agencies when intravenous administration of medication is medically appropriate fo the patient's condition, and treatment is admininstered in the home instead of on an inpatient hospital basis. home infustion care
Provides comprehensive medical and supportive social, emotional, and spritual care to terminally ill patients and their families. Goal is pallative rather than curative. hospice care
Physician who spends most of his or her time in a hospital setting admitting patients to inpatient services from local primary care providers. hospitalists
Practices that are at least partially owned by the hospital, and physicians participate in a compensation plan provided by the hospital. hospital-owned physician practice
Intravenous adminstration of fluids, electrolytes, and other additives. hydration therapy
Freestanding facility that provides radiographic and other imaging services to ambulatory patients. Some centers also provide training and particiapte in national research projects. imaging center
See individual practice association. Physicians who reamin in their independent office settings provide contracted health care services to subscribers. Negotiates the HMO contract and manages the capitation payment. Independent Practice Association (IPA)
DHHS agency that supports a network of 37 hosspitals, 60 health centers, 3 school health centers, 46 health stations, and 34 urban Indian health centers to provide services to nearly 1.5 mil American Indians and Alaska Natives of 557 federally recognized Indian Health Service (IHS)
Physicians who reamin in their independent office settings provide contracted health care services to subscribers. Negotiates the HMO contract and manages the capitation payment. (also called Independent Practice Assoc.) Individual Practice Association (IPA)
Located in a business setting, the emphasis is on employee health care an safety. industrial health clinic
Freestanding center that dispenses and administers prescribed medications by continuous or intermittent infusion to ambulatory patients. Supervised by a licensed health care professional. (also called ambulatory infusion center AIC) infusion center
Remain overnight in the facility for 24 or more hrs and are provided with room and board and nursing services. inpatients
Organization of affiliated provider sites that offer joint health care services to subscribers. Sites include ambulatory surgical centers, hospitals, phys groups, and so on; also called integrated service network, delivery system, vertically intergrated p Integrated Delivery System (IDS)
Manages health care services provided by hospitals, physicians, and other health care organizations. Integrated Provider Organization (IPO)
Specially trained individuals coordinate and/or provide mental health, financila, legal, and medical services to help the patient live successfully at home and in the community. Intensive case management
Provides developmentally disabled people with medical care and supervision, nursing services, ocupational andy physical therapies, activity programs, educational and recreational services, and psychological services. intermediate care facility (ICF)
Specializes in the care of adults. Internal medicine physicians
Includes a range of nursing, social, and rehabilitative services for people who need ongoing assistance. Lengths of stay typically average greater than 30 days. long-term care
Defined in Medicare law as hospitals that have an average inpatient length of stay greater than 25 days. These hospitals typically provide extended medical and rehabilitative care for patients who are clinically complex and may suffer from multiple acute long-term care hospital (LTCH)
See long-term care hospital (LTCH) long-term hospital classification
Originally referred to the prepaid health care sector, such as HMOs, which combined health care delivery with the financing of health care services; increasingly used to refer to preferred provider organizations (PPOs) ans some forms of indemnity coverage managed care
Provides practice management services including administrative and support services, to individual physician practices. Management Service Organization (MSO)
Nonprofit organization that contracts with and acquires the clinical and business assets of physician practices. medical foundation
Requires documentation of services or supplies that are proper and needed for the diagnosis or treatment of a medical condition; are provided for the diagnosis, direct care, and treatment of a medical condition; meet the standards of good medical practice medical necessity
Administers health care for active members of the uniformed services (and their dependents) as provided by military treatment facilities and networks of civilian health care professionals. Military Health System (MHS)
Coordinates civilian health care services when military treatment facility (MTF) services are unavailable. Military Medical Support Office (MMSO)
Clinic and/or hospital located on a U.S. military base. military treatment facility (MTF)
Category of hospitals where two or more hospitals are owned, managed, or leased by a single organization; these may include acute, long-term, pediatric, rehabilitation, and/or psychiatric care facilities. multi-hospital systems
Offer variouss types of medical specialty care in one organization, and they may be located in more than on location. multi-specialty group physician practicies
Provides an external peer review process for correctional institutions that wish to meet its nationally accepted Standards for Health Services. National Commission on Correctional Health Care (NCCHC)
DHHS research center, with 17 separate institutes, is the world's premier medical research organization, supporting some 35,000 research projects nationwide in disease like cancer, Alzheinmer's disease, diabetes, arthritis, heart ailments, and AIDS. National Institutes of Health (NIH)
Health care is provided to economically disadvantaged, and treatment is family-centered because illnesses may result indirectly from crowded living conditions, unsanitary facilities, and other socioeconomic factors. Family care team consisting of a physic neighborhood health center
Two or more physicians multi-specialty group practices provide contracted health care services to subscribers. network model HMO
Physicians and health care facilities under contract to the managed care plan. network providers
Receive infant care upon birth, and if necessary they receive neonatal intensive care either within the hospital or as the result of transfer to another hospital. newborn patients
See skilled nursing facility (SNF). Provides medically necessary care to inpatients on a daily basis that is performed by; or under the supervision of, skilled medical personnel. SNFs provide IV therapy, rehabilitation, and wound care services. nursing facility (NF)
Receive services furnished on a hospital'ss premises that are ordered by a physician or other authorized individual, including use of a bed and periodic monitoring by nursing or other staff, which are reasonable and necessary to evaluate an outpatient's c observation patients
Directed by the Assistant Secretary for Health, serves as focal point of ladership and coordination across DHHS in public health and science, provides direction to program offices within OPHS, and provides advice and counsel on public health and science i Office of Public Health and Science (OPHS)
DHHS office that advises the President on health, welfare, and income security plans, policies, and programs of the federal government. Office of the Secretary of Health and Human Services (OS)
Includes direct contact, individual practice association, and network models; physicians are not employees of the HMO and they do not belong to a specially formed medical group that serves the HMO. open-panel HMO
See ambulatory care. Outpatient care that allows patients to receive care in one day without the need for inpatient hospitalization. outpatient care
Patients receive follow-up mental health care, and visits are usually under one hour. The number of visits per week depends on the patient's needs. outpatient clinic
Treated and released the same day and do not stay overnight in the hospital; length of stay is a maximum of 23 hours, 59 min., and 59 sec.; also called outpatients. outpatients
Intravenous adminstration of narcotics and other drugs designed to relieve pain. pain management
Specializes in treatment of acute and chronic pain syndromes using proven medications and procedures. Usually a multi-disciplinary approach is used, involving participating specialist such as physiatrists,psychiatrists, neurologistss, neurosurgeons, inter pain management center
Comfort management. palliative care
Program for hospital patientss who regularly use the hospital facilities for a substantial number of either daytime or nighttime hours. partial hospitalization program
Provides comprehensive services for infants, children, and adolescents. pediatricians
Provide assistance in performing daily living activities, such as bathing, dressing, grooming, going to the toliet, mealtime assistance, travel training, and accessing recreation services. personal care and support services
Managed care contracts are negotiated by hospital(s) and physician groups; physicians maintain their own practices and provide services to plan members. Physicians-Hospital Organization (PHO)
Patients have the freedom to use an HMO panel of providers (for which a copayment is paid) or to self-refer to non-HMO provider (for which is greater out-of-pocket expenses apply). Point-of-Service plan (POS)
Form of utilization management that involves the review for medical necessisty of inpatient care prior to inpatient admission. preadmission certification (PAC)
Network of physicians and hospitals join together to contract w/third-party payers, employers, and other organizations to provide health care to subscribers for a discounted fee. Preferred Provider Organization (PPO)
Physician of choice that you receive health care primary care provider
DHHS service-for-fee organization that utilizes a business enterprise approach to provide government support services throughout DHHS and other federal agencies. Adminstrative operations, financial management, and human resources are solution- and custome Program Support Center (PSC)
Uniformed Service of the Dept of Health and Human Services. Leadership is provided by the US Ssurgeon General. It provides highly trained and mobile health professionals who carry out programs to promote the nation's health, understand and prevent disease Public Health Service (PHS)
Provides preventive medicine services such as well baby clinics, which include immunizations and routine checkups. public health department
Hospital ambulatory care patient who receives diagnostic or therapeutic care because such care is unavailable in the primary care provider's office. Follow-up is done at the primary care provider's office. referred outpatient
Provides occupational, physical, and speech therapy to patients w/orthopedic injuries, work-related injuries, sports-related injuries, and various neurological and neuromusclar conditions. Patient goes to the facility. rehabilitation facility (outpatient)
Provides occupational, physical, and speech therapy to patients w/orthopedic injuries, work-related injuries, sports-related injuries, and various neurological and neuromusclar conditions. Patient goes to the facility. rehabilitation facility (inpatient)
Provides non-medical custodial care, which can be provided in a single family residence, a retirement residence, or in any appropriate care facility including a nursing home. residential care facility (RCF)
Seriously disturbed patients receive intensive and comprehensive psychiatric treatment on a long-term basis. residential treatment facility
Care provided by specially trained individuals at a setting other than the patient's home to offer relief and rest to primary caregivers. respite care
Ambulatory care centers established remotely from the hospital. Primary care is provided by an on-duty physician (usually salaried). satellite clinics
Patients have an average LOS of 4-5 days and a total LOS of less than 25 days; also called acute hospital classification. short-term (acute) hospital classification
Category of hospitals that are self-contained and not part of a larger organization. single hospitals
Single-specialty practices that consist of two or more physicians who provide patients with one specific type of care. single-specialty group physician practices
Includes services that are orderd by a physician and provided under the supervision of a registered nurse, or physical, occupational, or speech therapist. skilled care
Provides medically necessary care to inpatients on a daily basiss tht is sperformed by, or under the supervision of, skilled medical personnel. SNFs provid IV therapy, rehabilitation, and wounmd care services; also called nursing facility (NF). skilled nursing facility (SNF) (nursing facility)
Do not have physician partners or employment affiliations w/other practice organizations. solo physician practices
Concentrates on a particular population of patients or disease. specialty hospital
Similar to large, multi-specialty group practices, it may be partially owned by the physician employees, w/the physicians typically functioning as employees of either the physician group owning the practice or the insurer. Most physicians in the type of H staff model health maintenance organization (HMO)
Provides health care to full- and part-time students who become ill or injured. student health center
Provided in hospitals that provide specialized long-term acute care such as chemotherapy; injury rehabilitation, ventilator support, wound care, and other types of health care services provided to seriously ill patients. subacute care
Individuals who pays health insurance premiums. subscribers
DHHS agency that works to improve the quality and availability of substance abuse prevention, addiction treatment, and mental health services. Substance Abuse and Mental Health Services Adminstration (SAMHSA)
Allows a rural hospital to admit a nonacute care patient. swing bed
State-federal welfare program. Temporary Assistance to Needy Families (TANF)
six to 10 individuals are provided with supervised housing that may be linked with a day treatment program. therapeutic group home
Administration of nutritional substances by peripheral or central intravenous infusion to patients who are either already malnourished or have the potential for developing malnutrition. total parenteral nutrition (TPN)
Provides subsribers and employees with a choice of HMO, PPO, or traditional health insurance plan; also called cafeteria plan. triple option plan
Immediate care is provided by an on-duty physician (usually salaried). The center is usually owned by private corporations in states where permitted or non-profit facilities; also called emergency care center. urgent care center (emergency care center)
Controls health care costs and the quality of health care by reviewing cases for appropriateness and medical necessity. utilization management
breathing machine ventilator
An agency in the Dept of Veterans Affairs that provides medical, surgical, and rehabilitative care to veterans of the armed services. Veterans Health Adminstration (VHA)
Administers abd provides health care services at VA Medical Centers (VAMCs) and community-based outpatient clinics. Veterans Integrated Service Network (VISN)
Department of Health and Human Services DHHS
Created by: dnoplis