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Chapter 3

Stack #166360

ACF Acute care Facility (Hosptial)
A hospital that provides health care services to patients who have serious, sudden, or acute illnesses or injuries and/or need surgery Acute care facility (Hosptal) (ACF)
DRGs Diagnosis-related groups
They classify inpatient hospital cases into groups that are expected to consume similar hospital resources. Diagnosis-related groups (DRGs)
What are diagnostic and therapeutic services provided to inpatients and outpatients? Ancillary services
A hospital self contained and not part of a larger organization Single hospital
Two or more hospitals owned, managed, or leased by a single organization Multi-hospital hospital
Total number of inpatient beds bed size or bed count
Hospital with an average LOS of 4 to 5 days and no more than 25 Short-term or acute
Hospital with an average LOS greater than 25 days Long-term
CAHs Critical access hospitals
Hospital located more than 35 miles from any other hospital Critical access hospitals (CAHs)
Hospital that provides emergency care, performs surgery, and admits patients for a range of problems General hospital
Hospitals that concentrate on a particular population of patients or disease category Specialty hospital
Hospital that admits patients who are diagnosed with trauma or disease and need to learn how to function Rehabilitation hospitals
Hospital that specializes in treating individuals with mental health diagnoses Behavioral health care hospitals
Physicians who spend most of their time in a hospital setting admitting patients to their inpatient services from local primary care providers Hospitalists
Patients treated and released the same day and do not stay overnight in the hospital. Ambulatory patients or outpatients
Patients that undergo certain procedures on an outpatient basis Ambulatory surgery patients
Patients treated for urgent problems and are either released the same day or admitted as an inpatient Emergency care patients
Patient that stay overnight with nursing care Inpatient
Patient that receives care upon birth Newborn patient
Patient being monitored by nursing staff to determine if necessary to admit as an inpatient Observation patient
Breathing machine ventilator
Care provided in hospitals that provide specialized long-term care Subacute care
Allows patients to receive care in one day without the need for inpatient hopitalization Ambulatory care or Outpatient care
Surgery performed on an outpatient basis Ambulatory Surgical Center (ASC)
ASC Ambulatory surgical center
Stand alone clinical laboratory Clinical Lab
Provides ambulatory cardiovascular services Heart and vascular center
May be partially owned by the physicians employees, with the physicians typically functioning as employees of either the physician group or the insurer Staff model health maintenance organization (HMO)
HMO Health maintenance organization
Freestanding facility that provides radiographic and other imaging services Imaging center
Located in a business setting (factory), employee health and safety Industrial Health Clinic
Freestanding center that dispenses and administers prescribed medications by continuous or intermittent infusion to ambulatory patients Infusion Center
Health care is provided to economically disadvantaged Neighborgood health center
Provides treatment for acute and cronic pain Pain management center
Physician practicing alone Solo physician practice
Two or more physicians who provide a specific care Single-specialty group physician practice
Offers various types of medical specialty care in one organization and may be located in more than one location Multi-specialty group physician practice
Offers adult and family care medicine in internal medicine, pediatrics, and family practice Primary care center
Specializes in the care of adults Internal medicine physicians
Specializes in the care of infants, children and adolescents Pediatricians
Provide care for the whole family Family practicioners
Provides preventive medicine services Public health department
Provides occupational, physical, and speech therapy to patients Rehabilitation facility
Provides health care to full-and part-time students who become ill or injured Student health center
Immediate care is provided by an on-duty physician Urgent care center or emergency care center
Elective surgery is performed on patients who are admitted and discharged the same day Ambulatory surgery
Patient receives scheduled diagnostic and therapeutic care Client outpatient
Patient receives diagnostic or therapeutic care because such care is unavailable in the primary care. Referred outpatient
Immediate care to patients with trauma or urgent problems Emergency Dept
Program for hospital patients who regularly use the hospital facilities a substantial number of either daytime or nighttime hours Partial hospitalization program
Hospital-owned practices are at least partially owned by the hospital, and the physicians participate in a compensation plan provided by the hospital Hospital-owned physician practice
Ambulatory care centers that are established remotely from the hospital Satellite clinics
Provides 24 hour medically directed evaluation and withdrawal management in an acute care inpatient setting Chemical dependency program
Provides short term crisis intervention and treatment. Patient receives 24 hour supervision Crisis service
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
Sometimes categorized as an intermediate care facility (ICF), these facilities provide residential care and day programming, including academic training, clinical and technical assistance, health care services, and diagnosis and evaluation of individuals Developmentally disabled / Mentally retarded facilities
Allows people who are seriously ill or dying to remain at home and receive treatment. Home care
Services are provided to assist families in caring for the patient Family support services
Services that are ordered by a physician and provided under the supervision of a registered nurse Skilled Care
Patients receive comprehensive phychiatric treatmnet on an inpatient basis in a hospital Intensive Case Management
Patients receive follow-up mental health care, and visits are usually under one hour. Outpatient care
Patients use the facility for a substantial number of either day-time or night-time hours Partial Hospitalization Program
Seriously disturbed patients receive intensive and comprehensive psychiatric treatment on a long-term basis Residential Treatment Facility
Care is provided by specially trained individuals at a setting other than the patient's home to offer relief and rest to primary caregivers Respite Care
Six to 10 individuals are provided with supervised housing Therapeutic Group Home
DME Durable medical equipment
Includes canes, cruthes, IV supplies, hospital beds, ostomy supplies, oxygen, prostheses, walkers, wheelchairs Durable medical equipment
Provides assistance in performing daily living activities Personal care and support services
provided by home health care agencies when intravenous administration of medication is medically appropriate for the patients condition, and treatment Home infusion care
Intravenous administration of chemical agents that have specific and toxic effects upon a disease-causing cell or organism Chemotherapy
Intravenous administration of other drugs including antibiotics, antivirals, and so on Drug Therapy
Intravenous administration of fluids, electrolytes, and other additives Hydration Therapy
Intravenous administration of narcotics and other drugs designed to relieve pain Pain management
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)
TPN Total parenteral nutrition
Provides comprehensive medical and supportive social, emotional and spiritual care to terminally ill patients and their families Hospice Care
Comfort management Palliative care
Therapeutic care Curative care
A range of nursing, social and rehabilitative services for people who need ongoing assistance Long-term care
Provides care and supervision in a structured environment to seniors with physical or mental limitations Adult day care
A combination of housing and supportive services including personal care and household managemnet for seniors Assisted-living facility (ALF)
ALF Assisted living facility
Same characteristics as ALF but with more extensive monitoring and day to day care Dementia care facilities and Alzheimer's treatment facilities
Provides different levels of care based on the resident's needs from independent living apartments to skilled nursing care in the affiliated nursing facility Continuing care retirement communities (CCRC)
CCRC continuing care retirement communities
ICF Intermediate care facility
Provides developmentally disabled people with medical care and supervision, nursing services, occupational and physical therapies, activity programs, educational and recreational services and psychological services Intermediate care facility
Measures the ability of health care facilities to deliver care that is safe and adequate, in accordance with federal law and regulations Federal certification
Hospitals that have an average inpatient length of stay greater that 25 days Long term care hospital (LTCH)
LTCH Long term care hospital
Provides non-medical custodial care. Do not provide skilled services. Residential care facility (RCF)
RCF Residential care facility
ADL Activities of daily living
Bathing, dressing, eating, and so on Activities of daily living (ADL)
SNF 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 Skilled nursing facility
Originally referred to the prepaid health care sector such as HMOs which combined helth care delivery with the financing of helth care sevices, increasingly used to refer to preferred provider organizations and some forms of indemnity coverage that incorp Managed care
EPO Exclusive Provider Organization
Provides benefits to subscribers who receive health care services from network providers Exclusive provider organization (EPO)
An organization of affiliated provider sites that offer joint health care services to subscribers Integrated Delivery System (IDS)
IDS Integrated delivery system
Managed care contract in which physicians maintain their own offices and share services to plan members Group practice without walls (GPWW)
GPWW Group practice without walls
Nonprofit organization that contracts with and acquires the clinical and business assets of physician practices Medical Foundation
Manages health care services provided by hospitals, physicians and other health care organizations Integrated Provider Organization (IPO)
IPO Integrated provider organization
Provides practice management services Management service organization (MSO)
MSO Management service organization
Managed care contracts are negotiated by hospitals and physician groups Physician-hospital organization (PHO)
PHO Physician-hospital org.
An alternative to traditional health insurance coverage, provides comprehensive health care services to members on a prepaid basis Health Maintenance Organization (HMO)
Group and staff models that provide services at HMO owned health centers. Closed-panel HMO
Direct contact were physicians are not employees of the HMO Open-panel HMO
Participating physicians who are members of an independent multi-specialty group Group model HMO
Physicians owned by the HMO Staff model HMO
Individual physicians in the community deliver contracted health care services to subscribers Direst contract model HMO
Physicians who remain independent Individual Practice Association (IPA)
IPA Individual practice assoc.
Lump sum paid by the HMO to care for a group if subscriber Capitation payment
Two or more physician multi-specialty group practices provide contracted health care services to subscribers Network Model HMO
POS Point of service plan
Patients have the freedom to use an HMO panel of providers or self refer to non-HMO providers Point of service plan (POS)
Fixed amount a subscriber must pay when seeking health care services Copayment
A network of physicians and hospitals join together to contract with third party payers Preferred provider Organization (PPO)
PPO Preferred Provider Org.
Provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plan Triple Option Plan or Flexible Benefit Plan
Controls health care costs and the quality of health care by reviewing cases for appropriateness and medical necessity Utilization management
A form of utilization management that involves the review for medical necessity of inpatient care prior to inpatient admission Preadmission Certification (PAC)
PAC Preadmission Certification
Requires the documentation of services or supplies that are proper and needed for the diagnosis or treatment of a medical condition Medical Necessity
Provides inmates with secure housing environment Correctional facility
BOP Bureau of Prisons
Provides necessary medical, dental, and mental health services to inmates Bureau of Prisons (BOP)
Provide major medical care Federal medical centers (FMC)
FMC Federal medical centers
Provides an external peer review process for correctional institutions that wish to meet its nationally accepted standard for health services National Commission on Correctional health (NCCHC)
NCCHC National Commission on Correctional Health
Administers health care for active memebers of the uniformed services Military health system (MHS)
MHS Military health system
A clinic and or hospital located on US military base Military treatment facility (MTF)
Coordinates civilian health care services when MTF services are unavailable Military Medical Support Office (MMSO)
MMSO Military Medical Support Office
VHA Veterans health administration
An agency in the Department of Veterans Affairs, provides medical, surgical,and rehabilitative care to veterans of the armed services Veterans health administration (VHA)
Administer and provide health care services at VA medical centers and community based outpatient clinics Veterans Integrated Service Networks (VISN)
VISN Veterans Integrated Service Networks
PHS Public health service
Uniformed service of the U.S. and provides highly trained and mobile health professionals who carry out programs to promote the nation's health. Public health service
ACF Administration of Children and Families
Responsible for programs that provide services and assistance to needy chhildren and families Administration for children and families
TANF Temporary Assistance to Needy Families
New state-federal welfare program Temporary assistance to needy families (TANF)
AoA Administration on Aging
Provides services to the elderly to enable them to remain independent Administration on Aging (AoA)
AHRQ Agency for Healthcare Research and Quality
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)
ATSDR Agency for Toxic Substances and Disease Registry
Works with states and other federal agencies to prevent exposure to hazardous substances from waste sites Agency for Toxic Substances and Disease Registry (ATSDR)
CDC Center for Disease Control
Provides a system of health surveillance to monitor and prevent outbreak of diseases Center for Disease Control (CDC)
CMS Centers for Medicare and Medicaid Services (CMS)
Administers Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) and was formerly called the Health Care Financing Administration, OR HCFA Centers for Medicare and Medicaid Services (CMS)
FDA Food and Drug Administration
Assures the safety of foods and cosmetics, and the safety and efficacy of pharmaceuticals, biological products, and medical devices Food and Drug Administration (FDA)
HRSA Health Resources and Services Administration
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 and improve chil Health Resources and Services Administration (HRSA)
IHS Indian Health Services
Supports a network healthcare centers to provide services to Indians Indian Health Services (IHS)
NIH National Institutes of Health
Worlds premier medical research organization National Institutes of Health (NIH)
OPHS Office of Public Health and Science
Serves as the focal point of leadership and coordination across DHHS in public health and science Office of public health and science (OPHS)
OS Office of the Secretary of Health and Human Services
Advises the President on health, welfare, and income security plans, policies, and programs of the federal govt Office of the Secretary of Health and Human Services (OS)
PSC Program Support Center
Supports services for a fee Program support center (PSC)
SAMHSA Substance Abuse and Mental Health Services
Works to improve the quality and availability of substance abuse prevention addiction treatment, and mental health services Substance Abuse and Mental Health Services (SAMHS)
Created by: angieb1
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