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Health Care Settings

Terminology

QuestionAnswer
Activity of Daily Living (ADL) Bathing, dressing, eating, toileting, walking and so on
Acute care facility (ACF) Hospital that provides health care services to patients who have serious, sudden, or acute illnesses or injuries and/or who need certain surgeries
Acute hospital classification Patients who have an average LOS of 4-5 days and a total LOS of less than 25 days
Administration for Children and Families (ACF) DHHS programs that provide services and assistance to needy children and families, including Temporary Assistance to Needy Families (TANF)
Administration on Aging (AoA) DHHS program that supports a nationwide aging network, providing services to the elderly to enable them to remain independent
adult day care Provides care and supervision in a structured environment to seniors with physical or mental limitations
Agency for Healthcare Research and Quality (AHRQ) 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 Toxic Substances and Disease Registry (ATSDR) 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 patients diagnosed with Alzheimer's disease
ambulatory care Outpatient care that allows patients to receive care in one day without the need for inpatient hospitalization; also called outpatient care
ambulatory infusion center (AIC) Freestanding center that dispenses and administers prescribed medications by continuous or intermittent infusion to ambulatory patients
ambulatory patients Patients who are treated and released the same day and do not stay overnight in the hospital; also called outpatients
ambulatory surgical center Surgery is performed on an outpatient basis at a free-standing ambulatory surgical center
ambulatory surgery patient Certain procedures can be performed on an outpatient basis, with the patient treated and released the same day
ancillary services diagnostic and therapeutic services provided to inpatients and outpatients
assisted-living facility(ALF) combination of housing and supportive services including personal care and household management for seniors
bed count (bed size) Total number of inpatient beds for which the facility is licensed by the state
behavioral health care hospital specializes in treating individuals with mental health diagnoses
Bureau of Prisons (BOP) Federal program that provides necessary medical, dental and mental health services to inmates by a professional staff consistent with acceptable community standards
cafeteria plan provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance lplan
capitation payment Lump sum paid by the HMO to the provider to care for a group of subscribers
CDC DHHS agency that provides a system of health surveillance to monitor and prevent the outbreak of diseases
chemical dependency program provides 24-hour medically directed evaluation and withdrawal management in an acute care inpatient setting
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
clinic outpatient hospital ambulatory care patient who receives scheduled diagnostic and therapeutic care
closed-panel HMO includes group and staff models that provide services at HMO-owned health centers or satellite clinics, or by physicians who belong to a specially formed medical group that serves the HMO
CCRC provides different levels of care based on the residents' needs from independent living apartments to skilled nursing care in an affiliated nursing facility
copayment fixed amount a subscriber must pay when seeking health care services
correctional facility provides inmates with a secure housing environment that also offers vocational and educational advacement
crisis services provides short-term crisis intervention and treatments
critical access hospital (CAH) located more than 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
curative care therapeutic
day treatment program intensive treatment program provided to patients who live int eh community but come to the facility up to 5 days a week
dementia care facilities long-term care facilities that specialize in the care of patients diagnosed with dementia
developmentally disabled/mentally retarded facilities provide residential care and day programming, including academic training, clinical and technical assistance, health care services, and diagnosis and evaluation of individuals with developmental disabilities
DRGs inpatient hospital cases classified into groups that are expected to consume similar hospital resources
direct contract model HMO individual physicians in the community deliver contracted health care services to subscribers
drug therapy intravenous administration of other drugs including antibiotics, antivirals, and so on
durable medical equipment includes canes, crutches, IV supplies, hospital beds, ostomy supplies, oxygen, prostheses, walkers, wheelchairs, ect.
emergency care center immediate care is provided by an on duty physician
emergency care patient one treated for urgent problems and either released the same day or admitted to the hospital as an inpatient
EPO Provides benefits to subscribers who receive health care services from network providers
family practitioners provides care for the entire family and focuses on general medicine, obstetrics, pediatrics and geriatrics
Family Support Services services provided to assist families in caring for the patient
federal certification measures ability of health care facilities to deliver care that is safe and adequate, in accordance to federal law and regulation
federal medical centers provide major medical care to federal correctional facility inmates
flexible benefit program provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plan
FDA DHHS agency that assures the safety of foods and cosmetics, and the safety and efficacy of pharmaceuticals, 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
group model HMO participating physicians who are members of an independent multispecialty group providing health care services
Group Practice Without Walls managed care contract in which physicians maintain their own offices and share services to plan members
Health Maintenance Organization an alternative to traditional health insurance coverage; provides comprehensive health care services to members on a prepaid basis
Health Resources and Services Administration (HRSA) 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 system, works to decrease infant mortality
heart and vascular center provides ambulatory cardiovascular services to include diagnosis and treatment, disease 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 health care professionals who provide skilled care in the home
home infusion care provided by home health care agencies when intravenous administration of medication is medically appropriate for the patient's condition, and treatment is administered in the home instead of an inpatient hospital basis.
hospice care provides comprehensive medical and supportive social, emotional, and spiritual care to terminally ill patients and their families. Goal is palliative rather than curative.
hospitalists physician who spends most of his or her time in a hospital setting admitting patients to inpatient services from local primary care physicians
hospital-owned physician practice practices that are at least partially owned by the hospital, the physicians participate in a compensation plan provided by the hospital
hydration therapy intravenous administration of fluids, electrolytes, and other additives
imaging center freestanding facility that provides radiographic and other imaging services to ambulatory patients
Independent Practice Association (IPA) physicians who remain in their independent office settings but provide contracted health care services to subscribers. Negotiates the HMO contract and manages the capitation payment
Indian 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 services to 1.5 million American Indians and Alaska natives
Individual Practice Association (IPA) physicians who remain in their independent office settings but provide contracted health care services to subscribers. Negotiates the HMO contract and manages the capitation payment
industrial health clinic located in a business setting, the emphasis is on employee health and safety
infusion center freestanding center that dispenses and administers prescribed medications by continuous or intermittent infusion to ambulatory patients
inpatients those who remain overnight in the facility for 24 or more hours and are provided with room and board and nursing services
Integrated Delivery System (IDS) Organization of affiliated provider sites that offer joint health care services to subscribers
Integrated Provider Organization (IPO) Manages health care services provided by hospitals, physicians, and other health care organizations
intensive case 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 provides developmentally disabled people with medical care and supervision, nursing services, occupational and physical therapies, activity programs, educational and recreational activities, psychological services
internal medicine physicians specializes in the care of adults
long-term care includes a range of nursing, social, and rehabilitative services for people who need ongoing assistance; stay average greater than 30 days
long-term care hospital defined in Medicare law as hospitals that have an average inpatient length of stay greater than 25 days.
long-term hospital classification defined in Medicare law as hospitals that have an average inpatient length of stay greater than 25 days.
managed care 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 PPOs
Management Service Organization Provides practice management services, including administrative and 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 that are proper and needed for the diagnosis or treatment of a medical condition
Military Health System administers health care for active members of the uniformed services as provided by military treatment facilities and networks of civilian health care professionals
Military Medical Support Office Coordinates civilian health care services when military treatment facility services are unavailable
military treatment facility clinic and/or hospital located on a U.S. military base
multi-hospital systems category of hospitals where two or more hospitals are owned, managed, or leased y a single organizations, these may include acute, long-term, pediatric, rehab, and/or psychiatric
multispecialty 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 Provides an external peer review process for correctional institutions that wish to meet its nationally accepted Standards for Health Services
National Institutes of Health DHHS research center, with 17 separate institutes, is the worlds premier medical research organization
neighborhood health center health care is provided to economically disadvantaged people, and treatment is family-centered because illnesses may result indirectly from crowded living conditions, unsanitary facilities, and other socioeconomic factors
network model HMO two or more physicians multi-specialty group practices provide contracted health care services to subscribers
network providers physicians and health care facilities under contact to the managed care plan
newborn patients those who 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
nursing facility provides medically necessary care to inpatients on a daily basis that is performed by or under the supervision of, skilled medical personnel; provide IV therapy, rehab, and wound care services
observation patients receive services furnished on a hospital's premises that are ordered by a physician or other authorized individual which are reasonable and necessary to evaluate an outpatient's condition or determine the need for possible admission as an inpatient
open-panel HMO includes direct contract, individual practice association, and network models; physicians are not employees of the HMO and do not belong to a group that serves the HMO
outpatient care outpatient care that allows patients to receive care in 1 day without the need for inpatient hospitalization
outpatient clinic
outpatient patients who are seen and treated the same day and do not stay overnight in the hospital
pain management intravenous administration of narcotics and other drugs designed to relieve pain
pain management center specializes in treatment of acute and chronic pain syndromes using proven medications and procedures
palliative care comfort management
partial hospitalization program program for hospital patients who regularly use the hospital facilities for a substantial number of either daytime or nighttime hours
pediatricians provides comprehensive services for infants, children, and adolescents
personal care and support services provide assistance in performing daily living activities, such as bathing, dressing, grooming, going to the toilet, mealtime assistance, travel training and accessing recreation services
Physician-Hospital Organization managed care contracts are negotiated by hospital(s) and physician groups; physicians maintain their own practices and provide services to plan members
Point-of-Service plan patients have the freedom to use an HMO panel of providers or to self-refer to non-HMO providers
preadmission certification form of utilization management that involves the review for medical necessity of inpatient care prior to inpatient admission
Preferred Provider Organization 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
primary care center offers adult and family care medicine in internal medicine, pediatrics, and family practice
Public Health Service Uniformed Service of the Department of Health and Human Services. Leadership provided by the Surgeon General--promote the nation's health
public health department provides preventative medicine services such as well baby clinics, which include immunizations and routine checkups
referred outpatient hospital ambulatory care patient who receives diagnostic or therapeutic care because such care is unavailable in the primary care physician's office. Followup is done at the PCP office
rehabilitation facility (outpatient)
rehabilitation hospital (inpatient) admits patients who are diagnosed with trauma or disease and who need to learn how to function
residential care facility 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 disturbed patients receive intensive and comprehensive psychiatric treatment on a long-term basis
respite care care provided by specially trained individuals in a setting other than the patient's home to offer relief and rest to primary caregivers
satellite clinics ambulatory care centers established remotely from the hospital. Primary care is provided by an on-duty physician
short-term (acute) hospital classification patients have an average LOS of 4-5 days and total LOS of less than 25 days
single hospitals category of hospitals that are self-contained and not part of a larger organization
single specialty group physician practices consist of 2 or more physicians who provide patients with one specific type of care
skilled care services that are ordered by a physician and provided under the supervision of a registered nurse, or physical, occupational, or speech therapist
skilled nursing facility provides medically necessary care to inpatients on a daily basis that is performed by, or under the supervision of, skilled medical personnel
solo physician practices organizations that do not have physician partners or employment affiliations with other practice organizations
specialty hospitals concentrates on a particular population of patients or disease
staff model HMO it may be partially owned by the physician employees, with the physicians typically functioning as employees of either the physician group owning the practice or the insurer
student health center provides health care to full- and part-time students who become ill or injured
subacute care provided in hospitals that provide specialized long-term acute care such as chemotherapy, injury rehab, ventilator support, wound care, and other kinds of care
subscribers individuals who pay health insurance premiums
Substance Abuse and Mental Health Services Administration DHHS agency that works to improve the quality and availability of substance abuse prevention, addiction treatment, and mental health services
swing bed allows a rural hospital to admit a nonacute care patient
Temporary Assistance to Needy Families State-federal welfare program
therapeutic group home 6 to 10 individuals are provided with supervised housing that may be linked with a day treatment program
total parenteral nutrition administration of nutritional substances by peripheral or central intravenous infusion to patients who are either already malnourished or have the potential for developing malnutrition
triple option plan provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plan
urgent care center immediate care is provided by an on-duty physician. Usually owned by private corporations in states where permitted or non-profit facilities
utilization management controls health care costs and the quality of health care by reviewing cases for appropriateness and medical necessity
ventilator breathing machine
Veterans Health Administration an agency in the Department of Veterans Affairs that provides medical, surgical and rehab care to veterans of the armed services
Veterans Integrated Service Network administers and provides health care services at VA Medical Centers and community-based outpatient clinics
Created by: ascott0150
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