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chapter 3

health care settings

activity of daily living (ADL) bathing, dressing, eating, toileting, walking and so on.
Acute care facility hospital that provides health care services to patients who have serious, sudden, or acute illnesses or injuries and/or need certain surgeries
accountable health plan or integrated delivery system (IDS) organization of affiliated provider sites that offer joint health care services to subscribers.
example sites of IDS ambulatory surgical centers, hospitals, physician groups
acute hospital classification or short term hospital classification patients have an avg. LOS of 4-5 days adn a total of LOS fo less than 25 days
Ambulatory infusion center (AIC) or infusion center freestanding center that dispenses and administers prescribed medications by continuous or intermitten infusion to ambulatory patients
bed count or bed size total number of inpatient beds for which the facility is licensed by the state
cafeteria plan or triple option plan or flexible benefit plan provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plan
independent practice association or individual pratice association (IPA) physicians who remain in their independent office settings provide contracted health care services to subsribers. Negotiates the HMO contract and manages the capitation payment
curative care therapeutic
emergency care center or urgent care center immediate care is provided by an on duty physician
long term hospital classification or long term care hospital (LTCH) hospitals that have an avg. inpatient LOS greater than 25 days.
nursing facility (NF) or 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 personel.
examples of SNF IV therapy, rehabilitation, wound care services
outpatients or ambulatory patients treated and released the same day and do not stay overnight in the hospital
ambulatory care or outpatient care outpatient care that allows patients to receive care in one day without the need for inpatient hospitalization
ventilator breathing machine
therapeutic group home six to ten individuals are provided with supervised housing that may be linked with a day treatment program
temporary assistance to needy families (TANF) state-federal welfare program
swing bed allows a rural hospital to admit a nonacute care patient
subscribers individuals who pays health insurance premiums
student health center provides health care to full and part time students who become ill or injured
specialty hospital concentrates on a particular population of patients or disease
single hospitals category of hospitals that are self-contained and not part of a large organization
rehabilitation hospital admits patients who are diagnosed with trauma or disease who need to learn how to function
primary care center offers adult and family care medicine in internal medicine, pediatrics, and family practice
pediatrician provides comprehensive services to infants, children, and adolescents
palliative care comfort management
pain management intravenous administration of narcotics and other drugs designed to relieve pain
network providers physicians and health care facilities under contact to the managed care plan
network model HMO two or more physician multispecialty group practices provide contracted health care services to subscribers
military treatment facility (MTF) clinic and/or hospital located on a U.S. militay base
military medical support office (MMSO) coordinates civilian health care services when military treatment facility services are unavailable.
internal medicine physician specializes in the care of adults
integrated provider organization (IPO) manages health care services provided by hospitals, physicians, and other health care organizations
inpatients remain overnight in the facility for 24 or more hours and are provided with room and board and nursing services
industrial health clinic located in a business setting, emphasis is on employee health and safety
hydration therapy intravenous admistration of fluids, electrolytes, and other additives
federal medical centers (FMC) provide major medical care to federal correctional facility inmates
federal certification measures ability of health care facilities to deliver care that is safe and adequate, in acccordance with federal law and regulation
family support services services provided to assist families in caring for the patient
family practioner provides care for the entire family and focuses on general medicine, obstetrics, pediatrics, and geriatrics
drug therapy intravenous administration of other drugs includign antibiodics, antivirals, and so on
direct contact model HMO individual physicians in the community deliver contracted health care services to subscribers
dementia care facilities long-term care facilities that specialize in the care of patients diagnosed with demntia
copayment fixed amount a subscriber must pay when seeking health care services
clinic outpatient hospital amubulatory care patient who recieves scheduled diagnostic and therapeutic care
capitation payment lump sum paid by the HMO to the provider to care for a group of subscribers
behavioral health care hospital specializes in treating individuals with mental health diagnoses
ancillary services diagnostic and therapeutic services provided to inpatients and outpatients
administration for children and families (ACF) DHHS programs that provide services and assistence to needy children and families including temporary assistence to needy families (TANF)
administration on aging (AoA) DHHS program that supports a nationwide aging network proviging services to the elderly enabling them to reamin independent
adult daycare provides care and supervision in a structured environemnt to seniors with physical or mental limitations
agency for healthcare research and quality DHHS program that supports research designed to improve the outcomes and quality of health care, reduce its costs, address patietn safety and medical errors, and broaden access to effective services
agency for toxic substances and disease registry (ATSDR0) DHHS agency that works with states and other federal agencies to prevent exposure to hazardous substances from waste sites
alzheimer's treatment facilities long-term care facility that specializes in the care of alzeihmer patients
ambulatory patients or outpatients treated and released the same day and do not stay overnight
ambulatory surgery patient undergo outpatient procedures; treated and released the same day
ambulatory surgical center (ASC) surgery is performed on an outpatient basis at a free-standing ambulatory surgical center. Patients arrive on the day of the procedure undergo surgery in an operating room and recover under the care of the nurses
assisted living facility (ALF) combination of housing and supportive services including personal care and household management for seniors. residents pay monthly rent and additional fees for services they require
bureau of prisions (BOP) federal program thtat provides necessary medical, dental, and mental services to inmates
centers for disease control and prevention (CDC) DHHS agency that provides a system of health surveillance to monitor and prevent the outbreak of diseaes
chemical dependency program provides 24 hour medically directed evaluation adn withdrawal management in an acute care inpatient setting.
treatment services of chemical dependency program detoxification and withdrawal management, chemical dependency, substance abuse assessment, and therapy
chemotherapy intravenous administration of chemical agents that have specific and toxic effects upon a disease causing cell or organism
clinical laboratory performs testing in microbiology, clinical chemistry, and toxicology; directed by a pathologist; and testing is performed by certified professional technologists and technicians
closed panel HMO includes group and staff models that provide services at HMO-owned health centers or stellite clinics, or by physicians who belong to a specially formed medical group that serves the HMO
contiuning care retirement community (CCRC) provides different levels of care based on the residents needs form independent living apartments to skilled nursing care in an affliated nursing facility
correctional facility provides inmates with a secure housing environment that also offers vocational and educational advancement
crisis service provides ahort-term crisis intervention (usually 15 days) patients recieve 24 hour supervision
critical access hospital (CAH) located more than 34 miles away from another hospital or CAH or they are state certified as being a necessary provider of health care to residential areas
day treatment program intensive treatment program provided to patients who live in the community but come to the facility up to five days per week
developmentally disabled/mentally retarded facilities intermediate care facility; provide residential care and day programming, academic training, clinical and technical assistance, heatlh care services, and diagnosis and evaluation of individuals with developmental disabilities
diagnosis-related groups (DRGs) classify inpatient hospital cases into groups that are expected to consume similar hospital resources. Hospital inpatients are discharged once the acute phase of illness has passed
durable medical equipment (DME) includes canes, crutches, iv supplies, hospital beds, ostomy supplies, ozygen, prostheses, walkers, wheelchairs
emergency care patient treated for urgent problems and either released the same day or admitted to the hospital as an inpatient
food and drug administration (FDA) DHHS agency that assures the safety of foods and cosmetics and the safety and efficacy of pharmaceutical, biological products and medical devices
general hospitals provide emergency care, perform general surgery, and admit patients for a range of problems from fractures to heart disease based on a licensing by the state
group model HMO participating physicians who are members of an independent multi-specialty group providing health care services. physician groups either contract with the HMO or they are owned or managed by the HMO
group practice without walls (GPWW) managed care contract in which physicians maintain their own offices and share services to plan members
health maintenance organization (HMO) an alternative to traditional health insurance coverage; provide comprehensive health care services to members on a prepaid basis
health resources and servicess administration (HRSA) DHHS agency that provides health resources for medically underserved populations, works to build the health care workforce, maintains the national health service corp, oversees teh nations organ transplantation system, works to decrease infant mortality a
heart and vascular center provide ambulatory cardiovascular services to include diagnosis and treatment diseae prevention research education and cardiac rehabilitation
home care allows people who are seriously ill or dying to remain at home and receive treatment from nurses, social workers, therapists, and other licensed professionals
home infusion care provided by home health care agnecies when intravenous administration of medication is medically appropriate for the patients condition adn treatment is administered in the home
hospice care provides comprehensive medical adn supportive social emotional spiritual care to terminially ill patients and their families; pallative care
hospitalist physician who spends most of his/her time in a hospital setting admitting patients to inpatient services from local primary care providers
hospital owned physician practice practices that are at least partially owned by the hospital, adn phyicians participate in a compensation plan provided by the hospital
imaging center freestanding facility that provides radiographic and other imaging services to ambulatory patients
indain health service (IHS) DHHS agency that supports a network of 37 hospitals, 60 health centers, 3 school health centers, 46 health stations and 34 urban indian health centers to provide serviece to nealry 1.5 million american indians and alaska natives of 557 federally recognize
intensive care management specially trained individuals coordinate and or provide mental health, financial, legal, and medical services to help the patient live successfully at home and in the community
intermediate care facility (ICF) provides develoopmental diabled people with medical care and supervision, nursing services, occupational and physical therapies, activity programs, educational and recreational services, and psychological services
long term care includes a range of nursing, social, and rehabilitative services for people who need ongoing assistance; LOS greater than 30 days
managed care originally referred to the HMO which combined health care delivery with the financing of health care services; increasingly used to refer to preferred provider organizations (PPO) adn some forms of indemnity coverage that incorporate ultilization manageme
management service organization (MSO) provides practice management services includign administrative adn support services to individual physician practices
medical foundation nonprofit organization that contracts with and acquires the clinical and business assets of physician practices
medical necessity requires documentation of services or supplies taht are proper and needed for the diagnosis or treatment of a medical condition
military health systems (MHS) administers health care for active members of the uniformed services as provided by military treatment facilities and networks of civilian health care professionals
multi-hospital systems categoryof hospitals where two or more hospitals are owned, managed, or leased by a single organization
multi-specialty group physician practices offer various types of medical specialty care in one organization and they may be located in more than one location
national commission on correctional health care (NCCHC) provides an external peer review process for correctional institutions that wish to meet its nationally accepted standards for health services
national institutes of health (NIH) DHHS research center with 17 separate institutions is the worlds premier medical research organization supporting some 35000 research projects nationwide in diseases like cancer, alzeihmers, diabetes, heart ailments
neighborhood health center health care is provided to economically disadvantaged adn treatment is family-centered because illness may result indirectly form crowded living conditions, unsanitary facilities, adn other socioeconomic factors
newborn patients recieve infant care upon birth, and if necessary they recieve neonatal intensive care either within the hospital or as the result of transfer to another hospital
observation patients receive services furnished on a hospitals premises that are ordered by a physician or other authorized individual; use of bed and monitoring
office of public health and science (OPHS) directed by the assistatn secretory for health, serves as focal point of leadership and coordinates across DHHS in public health adn science provides direction to program offices with in OPHS and provides advice counsel on public health adn science issues
office of the secretary of health and human services (OS) DHHS office that advises the president on health, welfare, and income security plans, policies, and programs of the federal government
open-panel HMO includes direct contract, 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
pain management center specializes in treatment of acute and chronic pain syndromes using proven medications and procedures
partial hospitalization program program for hospital patients who regulary use the hospital facilities for a substantial number of either daytime or nighttime hours
personal care and support services provide assistance in performing daily living activities, such as bathing, dressing, grooming, toileting, eating, traveling and accessing recreational services
physician-hospital organization (PHO) managed care contracts are negotiated by hospitals and physician groups; physicians maintian their own practices and provide services to plan members
point-of-service plan (POS) patients have the freedom to use an HMO panel of providers or to self-refer to non-HMO providers
preadmission certification (PAC) form of ultilization management that involves the review form medical necessity of inpatient care prior to inpatient admission
preferred provider organization (PPO) network of physicians and hospitals join together to contract with third party payers, employers and other organizations to provide health care to subscribers for a discounted fee
program support center (PSC) DHHS service-for-fee organization that utilizes a business enterprise approach to provide government support services throughout DHHS adn other federal agencies. administrative operations, financial management, and human resources are solution adn custom
public health department provides preventive medicine services such as well baby clinics which include immunizations adn routine checkups
public health services(PHS) uniformed service of the department of health adn human services. leadership is provided by the us. surgion general. it provides highly trained and mobile health professionals who carry out progams to promote the nations health , understand adn prevent d
referred outpatient hospital ambulatory care patient who receives diagnostic or therapeutic care b/c such care is unavailbable in the primary care providers office
residential care facility )RCF) 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 treatment facility seriously distributed patients receive intensive and comprehensive psychiatric treatment on a long-term basis
respite care care provided by specially trained individuals at a setting other than the patietns home to offer relief and rest to primary caregivers
satelliet clinics ambulatory care centers established remotely from the hospital. primary care is provided by an on-duty physicain
single-specialty group physician practices single-specialty practices that consist of two or more physicians who provide patients with oen specific type of care
skilled care includes services that are ordered by a physician and provided udner the supervision of a rn or phyical occupational or speech therapists
solo physician pratices do not have physician partners or employment affiliations with other practice organizations
staff model health maintenance organization (HMO) similar to large multi-specialty group practices it may be partially owned by the physicain employees wth the physicians typically functioning as employees of either the physician group owning the practice or the insurer
subacute care provided in hospitals that provide specialized long term acute care such as chemotheraphy injury rehabilitation ventilator support wound care and other types of health care services provided to seriously ill patients
substance abuse and mental health services administration (SAMHSA) DHHS agency that works to improve the quality and availablility of substance abuse prevention addiction treatmetn and metnal health services
total parenteral nutrition (TPN) administration of nutritional substances by peripheral or central intravenous infusion to paretns who are either already malnourished or have the potential for developing malnutrition
utlization management controls health care costs adn the quality of health care by reviewing cases for apporiatenesss adn medical necessity
veterans health administration (VHA) an agency in the department of veterans affairs that provides medical surigical and rehabilitative care to veterans of the armed services
Created by: dtrogdon6244