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Health Care Settings

Chapter 3

TermDefinition
Activity of daily living (ADL) provides assistance with bathing, dressing, eating, tioleting, walking and so on
Acute care facility (ACF) A hospital that provides services to pts who have serious, sudden, or acute illnesses or injuries and/or who need certain surgeries.
Acute hospital classification hospitals which provide short but critical care to patients
Administration for Children and Families (ACF) provides srvs and assistance to needy children and families
Administration on Aging (AoA) provides srvs 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) supports research designed to improve the outcomes and quality of health care
Agency for Toxic Substances and Disease Registry (ATSDR) works with state and federal agencies to prevent exposure to hazardous substances from waste sites
Alzheimer's treatment facilities dementia care facilities, more extensive monitoring of residents and day to day care
ambulatory care aka outpatient care
ambulatory infusion center (AIC) freestanding facility that dispenses and administers prescibed medication
ambulatory patients outpts, less than 24 hr stay
ambulatory surgical center (ASC) surgery is performed on an outpt at a freestanding ASC
ambulatory surgery patient undergo a procedure as an outpt and stay less than 24 hours
ancillary services Diagnostic and therapeutic services provided to IP and OP (labs, PT, radiology)
assisted-living facility (ALF) combination of housing and supportives srvs inc personal care and household mgt for seniors
bed count or bed size, is the total number of IP beds for which a facility is licensed by the state.
bed size or bed count, is the total number of IP beds for which a facility is licensed by the state.
behavioral health care hospital specialize in treating pts with mental health diagnoses
Bureau of Prisons (BOP) provides necessary medical, dental, and mental health srvs to inmates, ambulatory care
cafeteria plan provides subscribers with a choice of HMO, PPO or traditional health ins plan
capitation payment lump sum paid by the HMO to care for a group of subscribers
Centers for Disease Control and Prevention (CDC) provides a system of health surveillance to monitorand prevent outbreak of diseases
chemical dependency program provides 24 hour medically directed eval and withdrawal mgt in an acute care IP setting
chemotherapy iv admin of chemical agents that have toxic effects upon a disease
clinical laboratory stand alone lab
clinic outpatient receives scheduled diagnostic and therapeutic care following an inpt stay
closed-panel HMO physicians who belong to a specially formed medical group that srvs the HMO
Continuing Care Retirement Communities (CCRC) provide different levels of care bsed on the resident's needs from independent living to skilled nursing
copayment A fixed amount a subscriber must pay when seeking health care srvs
correctional facilities provides inmates with a secure housing environment
crisis services provides short-term (fewer than 15 days) crisis intervention and tx. pt has 24 hr supervision
critical access hospital (CAH) located more than 35 miles away from any other hospital
curative care therapeutic management
day treatment program Intensive tx program provided to pts who live in the community but come to the facility up to 5 days/week
dementia care facilities similar to assisted living but with more extensive monitoring of residentssd
developmentally disabled/mentally retarded facilities ICF, provide residential care and day programs to the developmental disabled
diagnosis-related groups (DRGs) Used by the IPPS to classify IP hospital cases into groups that are expected to consume similar hospital resources.
direct contract model HMO individual physicians deliver contracted health care services to subscribers
drug therapy iv admin of other drugs inc antibiotics, antivirals and more
durable medical equipment (DME) medical equipment covered under home health
emergeny care center immediate care is provided by an on-duty physician to pts who have sustained trauma or who have urgent problems 24 hrs/day
emergency care patient are treated for urgent problems
Exclusive Provider Organization (EPO) provide benefits to subscribers who receive health care srvs from contracted manage care providers
family practitioners provide care for the entire family
Family Support Services srvs are provided to assist families in caring for the pt
federal certification measures the ability of health care facilities to deliver care that is safe and adequate
federal medical centers (FMCs) provide major medical care to inmates
flexible benefit plan provides subscribers with a choice of HMO, PPO or traditional health ins plan
Food and Drug Administration (FDA) assures the safety of food and cosmetics
general hospitals provide emergency care, general surgery and admit pts for a range of problems
group model HMO participating physicians who are members of a group that provide health care srvs
Group Practice Without Walls (GPWW) a managed care contract in which physicians maintain their own offices
Health Maintenance Organization (HMO) provide comprehensive health care srvs to members on a prepaid basis
Health Resources and Services Administration (HRSA) provides health resources for medically underserved populations
heart and vascular center provides ambulatory cardiovascular services
home care allows people who are seriously ill or dying to remain at home and recieve tx
home infusion care provided by home health when iv administration of meds is appropriate
hospice care comprehensive medical and supportive social, emotional, and spiritual care to terminally ill pts
hospitalists hospital based physicians
hospital-owned physician practice practices that are partially owned by the hospital and the physicians participate in a compensation plan provided by the hospital
hydration therapy iv admin of fluids, electolytes, and other additives
imaging center free standing facility that provides radiographic services
Independent Practice Association (IPA) physicians who remain in their independent office settings provide contracted health care srvs
Indian Health Service (IHS) provides services to American Indians and Alaska Natives of 557 federally recognized tribes
Individual Practice Association (IPA) physicians who remain in their independent office settings provide contracted health care srvs
industrial health clinic located in a business setting for employee health services
infusion center freestanding center that dispenses and administers prescibed medicines
inpatients stay overnight, 24 hours or more
Integrated Delivery System (IDS) an organization of affiliated provider sites that offer joint health care srvs to subscribers
Integrated Provider Organization (IPO) Manages health care srvs provided by hospitals, physicians, and other health care organizations
intensive case management specially trained individuals coordinate and provide mental health, financial, legal and medical srvs to help the pt live successfully at home and in the community
intermediate care facility (ICF) provides developmentally disabled people with medical care and supervision
internal medicine physicians specialize in adult care
long-term care LOS greater than 30 days for nursing, social and rehab srvs
long-term care hospital (LTCH) by medicare law, a hospital with an average IP stay of greater than 25 days
long-term hospital classification an average LOS of greater than 25 days
managed care refers to prepaid health care sector
Management Service Organization (MSO) provides practice mgmt services, inc admin and support services to individual physician practices
medical foundation non profit organ that contracts with and acquires the clinical and business assets of physician practices
medical necessity requires documentatio of services or supplies that are needed for dx or tx of a medical condition
Military Health System (MHS) admins health care for active members of the uniformed srvs and their dependents
Military Medical Support Office (MMSO) coordinates civilian health care srvs when MTF srvs are unavailable
military treatment facility (MTF) a clinic or hospital located on a US military base
multi-hospital systems two or more hospitals owned, managed, or leased by a single organization.
multi-specialty group physician practices offer many types of medical specialties in one organization
National Commission on Correctional Health Care (NCCHC) est in 1970 to provide an external peer review process for correctional institutions that want to meet nationally accepted Standards for Health Srvs
National Institutes of Health (NIH) the world's premier medical research organization
neighborhood health center health care is provided to the economically disadvantaged
network model HMO two or more physicians in a multi-specialty group that provide contracted srvs to subscribers
network providers physicians and health care facilities under contract to the managed care plan EPO
newborn patients infant care upon birth
nursing facility (NF) aka, skilled nursing facility
observation patients receive services furnished on the hospital premises for evaluation of their condition
open-panel HMO Physicians are not employees of the HMO
outpatient care aka ambulatory care, allows pts to receive care in one day without the need for IP hospitalization
outpatient clinic pts receive f/u mental health care, and visits are usually under 1 hr
outpatients aka ambulatory pt, stay of less than 24 hrs
pain management iv admin of narcotics and other drugs designed to relieve pain
pain management center specializes in tx of acute and chronic pain syndromes
palliative care comfort management
partial hospitalization program program for hospital pts who regularly use the hospital facilities daytime or nighttime
pediatricians provide care for infants, children and adolescents
personal care and support services provides assistance in daily living activities
Physician-Hospital Organization (PHO) Managed care contracts are negotiated by hospitals and physician groups.
Point-of-Service Plan (POS) pts have the freedom to use HMO providers or to self refer to non HMO providers
preadmission certification (PAC) a form of utilization mgt that involves the review for medical necessity of ip care prior to ip admission
Preferred Provider Organization (PPO) a network of physicians and hospitals join together to contract with a 3rd party payor to provide medical srvs at a discounted fee
primary care center family practice medicine
Public Health Service (PHS) Commissioned corps, is one of seven Uniformed Services of the US provides highly trained and mobile health professionals who carry out programs
public health department provides preventive medicine
referred outpatient receives diagnostic and therapeutic care because it is not available in the PCPs office
rehabilitation facility (outpatient) provides OT, PT, speech therapy as an outpt
rehabilitation hospital (inpatient) provides OT, PT, speech therapy as an inpt
residential care facility (RCF) provides non medical custodial care
residential treatment facility Seriously disturbed pts receive intensive and comprehensive psychiatric tx on a long term basis
respite care care is provided by spacially trained individuals at a setting other than the pts home to offer relief to the primary care giver
satellite clinics Ambulatory care centers that are established remotely from the hospital.
short-term (acute) hospital classification LOS from 4 to 25 days
single hospitals Hospitals that are self-contained and not part of a larger organization.
single-specialty group physician practices consist of two or more physicians who provide primary care
skilled care srvs ordered by a physician and provided under a registered nurse or therapist
skilled nursing facility (SNF) provides medically necessary care to IP on a daily basis that is preformed by skilled medical personnel
solo physician practices do not have physician partners or employment affiliations with other practices
specialty hospitals concentrate on a particular population of pts
staff model health maintenance organization (HMO) partially owned by physician employees and paid a salary
student health center provides care to part-time and full-time students
subacute care specialized long-term acute care such as chemo, injury rehab, wound care...
subscribers people who receive benefits from an EPO
Substance Abuse and Mental Health Services Administration (SAMHSA) works to improve the quality and availability of substance abuse prevention, addiction tx , and mental health srvs
swing bed criteria that allows a rural hosp to admit a non acute care pt
Temporary Assistance to Needy Families (TANF) the new state-federal welfare program
therapeutic group home 6-10 individuals are provided with supervised housing
total parenteral nutrition (TPN) admin of nutritional substances by peripheral or central iv infusion to malnurished pts
triple option plan provides subscribers with a choice of HMO, PPO or traditional health ins plan
urgent care center (emergency care center) immediate care is provided by an on-duty physician
utilization management controls health care costs and the quality of health care by reviewing cases for medical necessity
ventilator breathing machine
Veterans Health Administration (VHA) under the Dept of VA, provides medical, surgical, and rehab care to vets
Veterans Integrated Service Network (VISN) admins and provides health care srvs at VA medical cntrs
Created by: lneri2518