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Health Care Settings
Chapter 3
| Term | Definition |
|---|---|
| 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 |
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