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Ch 3
Stack #166614
| Question | Answer |
|---|---|
| Classify inpatient hospital cases into groups that are expected to consume similar hospital resources. | Diagnosis-related groups (DRGs) |
| Hospital that provides health care services to patients who have serious | Acute Care Facility (ACF) |
| Hospital is self-contained and not part of a larger organization | Single Hospitals |
| Two or more hospitals owned, managed, or leased by a single organization | Multi-Hospital system |
| Are diagnostic and therapeutic services provided to inpatients and outpatients. | Ancillary services |
| total number of inpatients beds for which the facility is licensed by the state | Bed size or Bed Count |
| with an average LOS of 4 to 5 days and a total LOS of less than 25 days | Short-term or acute |
| with an average LOS of greater than 25 days. | Long-term |
| Are located more than 35 miles from any other hospital or another ___ | Critical access hospitals (CAHs) |
| criteria allow a rural hospital to admit a nonacute care patient. | Swing-bed |
| provide emergency care, perform general surgery, and admit patients for a range of problems | General Hospitals |
| concentrate on a particular population of patients or disease category | Specialty Hospitals |
| admit patients who diagnosed with trauma or disease and need to learn how to function. | Rehabilitation hospitals |
| specialize in treating individuals with mental health diagnoses. | Behavioral health care hospitals |
| Physicians who spend most of their time in a hospital setting admitting patients | Hospitalists |
| Are treated and released the same day and do not stay overnight in the hospital. | Ambulatory patients (outpatients) |
| undergo certain procedures that can be performed on an outpatient basis, with the patient treated and released the same day. Stays no more than 23hrs. | Ambulatory surgery patients |
| are treated for urgent problems | Emergency care patients |
| stay overnight in the facility for 24 or more hours | Inpatients |
| receive infant care upon birth | Newborn patients |
| receives services furnished on a hospitals premises | obersvation patients |
| is provided in hospitals that provide specialized long-term acute care. | subacute care |
| allows patients to receive care in one day without the need for inpatient hospitalization. | Ambulatory care (outpatient care) |
| Surgery is performed on an outpatient basis at a freestanding ___. Same day of surgery they go home | Amblatory Surgical Center (ASC) |
| performs testing | Clinical Laboratory |
| Provides ambulatory cardiovascular services | Heart and vascular center |
| Similar to large, multi-specialty group practices, it may be pertially owned by the physician employees | Staff model health maintenance organication (HMO) |
| Freestanding facility that provides radiographic and other imaging services to patients. | Imaging center |
| Located in a business setting the emphasis is on employee health and safety. | Industrial health clinic |
| Freestanding center that dispenses and administers prescribed medications. | Infusion center or Ambulatory Infusion Center (AIC) |
| Health care is provided to economically disadvantaged, and treatment is family centered bc illnesses may result indirtectly from crowded living conditions. | Neighborhood health center |
| specializes in treatment of acute and chronic pain syndromes using proven medications and procedures. | Pain management center |
| do not have physician partners. | Solo Physican office |
| Offers adult and family care medicine in internal medicine, pediatries, and family practice. | Primary care center |
| Provides preventive medicine services such as well baby clinics, which include immunizations and routine checkup. | Pubic Health Department |
| 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 |
| consist of two or more physicians who provide patients with one specific type of care. | Single-specially group physician practices |
| offer various types of medical specialty care in one organization, and they be located in more than one location. | Multi-speciatly group physician practices |
| specialize in the care of adults | Internal medicine physicians |
| specialize in infants, children, and adolescents. | Pediatricians |
| provide care for the entire family and focus on general medicine. | Family Pediatricians |
| Elective surgery is performed on patients who are admitted and discharged the same day. | Ambulartory surgery |
| receives scheduled diagnostic and therapeutic care | Clinic outpatient |
| receives diagnostic and therapeutic care Bc such care is unavailable in primary care providers office. | Referred outpatient |
| Immediate care is provided | Emergency department |
| Program for hospital patients who regularly use the hospital. | Parial hospitalzation program |
| are at least partially owned by the hospital | Hospital-owned physician practice |
| Abulatory care centers that are established remotely from the hospital. | Satellite clinics |
| Provide 24-hour medically directed evaluation and withdrawal management and acute care inpatient setting. | Chemical Dependency Program |
| Provides short-term care fewer than 15 days crisis intervention and treatment.Patients receive 24hr a day supervision. | Crisis Service |
| treatment program provided to patients who live in the community but come to the facilty up to 5 days per week. | Day treatment Program |
| these facilites provide residential care and day programming | Developmentally Disabled/Mentally Retarded Facilities |
| 24 hours a day services for emergencies | Emergency Care Facilities/Family Support Services |
| A team of specially trained staff visit the patient home to develop a treatment program and care is provided at home. | Home Health Care |
| Patients receive comprehensive psychchiatric treatment on an inpatient basis in a hospital. | Hospital Treatment |
| 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. | Intensive Case Management |
| Patients receive follow-up mental health care, and visits are usually under one hour. | Outpatient Clinic |
| Patients use the facility for a substantial number of either day-time or night time hours. | Partial Hospitalization Program |
| Seriously distrubed patients | Residential Treatment Facility |
| Care is provided by specially trained individuals at a setting other than the patients home to offer relief and rest to primary caregivers. | Respite Care |
| 6 to 10 individuals are provided with supervised housing may be linked with a day treatment program. | Therapeutic Group Home |
| 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 Care |
| services that are ordered by a physician and provided under the supervision of a registered nurse, or physical, occupational, or speech therapist. | Skilled care |
| which provides assistance in performing daily living activities, such as bathing, dressing, grooming, going to the toilet, and so own. | Personal care and support services |
| is also provided by home care agencies when intravenous administration of medication is medically appropriate for the patients condition. | Home infusion care |
| the goal of hospice is to make the patient to be comfort management. | Palliative care |
| therapeutic | Curative 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 | Drug therapy |
| intravenous administration of fluids, electrolytes, and other additives. | Hydration therapy |
| intravenous administration of narcotics and other drugs desinged to relieve pain. | Pain Management |
| administration of nutritional substances. To help parents that are malnourished. | Total parenteral Nutrition (TPN) |
| provides care and supervision in a structured enviromrnt to seniors with physical or mental limitations. | Adult Day Care |
| Is a combination of housing and supportive serivces including personal care and household management for seniors. | Assisted-living facility |
| provide different levels of care based on the residents needs from independent living apertmetns to skilled nursing care in an affiliated nursing facility. | Continuing Care Retirement Communities (CCRC) |
| provides developmentally disabled people with medical care. | 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 |
| is defined in Medicare law as hospitals that have an average inpatient length of stay greater than 25 days. | long-term care hospital (LTCH) |
| provides non medical custodial care. | Residential care facility (RCF) |
| 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 (SNF) or Nursing Facility (NF) |
| originally referred to the prepaid health care sector which combined health care delivery with the financing of health care serivices. | Managed care |
| individuals who pay premiums who receive health care services from network provides | Subscribers |
| which are physicians and health care facilities under contact to the managed care plan. | Network Providers |
| Physicians maintain their own offices and share services to plan members. | Group Practice Without Walls (GPWW) |
| 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) |
| Provides practice management services. | Management Service Organization (MSO) |
| Physicians maintain their own practices and provide services to plan members. | Physician Hospital Organization (PHO) |
| An alterative to traditional health insurance coverage, provides comprehensive health care services to members on a prepaid basis. | Health Maintenance Organization (HMO) |
| includes group and staff models that provide services at HMO owned health centers or satellite clinics, or physicians who belong to a specially formed medical group that serces the HMO | closed-panel HMO |
| includes direct contract, individual practice association, and network models. | Open-panel HMO |
| Participating physicians who are members of an independent multi-specialty group provide health care services. | Group Model HMO |
| Physicians are employed by the HMO | staff Model HMO |
| Individual physicians in the community deliver contracted health care services to subscribers. | Direct Contract Model HMO |
| Physicians who remain in their independent office settings provide contracted health care services to subscribers. | Individual Practice Association (IPA) or Independent Practice Association, IPA |
| lump some paid by the HMO to care for a group of subscribers. | Capitation payment |
| 2 or more physician multi-specialty group practices provide contracted health care services to subscribers. | Network Model HMO |
| Patients have the freedom to use an HMO panel of providers or to self-refer to non-HMO providers. | Point of service Plan (POS) |
| is a 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) |
| Provides subscribers and employees with a choice of HMO,PPO, or traditional health insurance plan. | Triple Option Plan or Cafeteria Plan or Flexible Benefit Plan |
| controls health care costs and the quality of health care | Utilization management |
| is a form of utilization management that involves the review for medical necessity of inpatient care prior to inpatient admission. | Preadmission certification (PAC) |
| requires the documention of services or supplies that are proper and needed for the diagnosis or treatment. | Medical necessity |
| provides necessary medical,dental, and mental health services to inmates by a professional staff and consistent with acceptable community standards. | Bureau of Prisons (BOP) |
| provide inmates with a secure housing environment that also offers vocational and educational advancement. | Correctional facilites |
| admins=isters health care for active members of the uniformed services as provided by military treatment facilites and networks of civilian health care professionals. | Military Health Systems (MHS) |
| is a clinic and/or hospital located on the US military base | Military treatment facility (MTF) |
| coordinates civilian health care services when MTF services are unavailable. | Military Medical Support Office (MMSO) |
| which administer and provide health care services at VA medical centers and community-based outpatient clinics. | Veterans Integrated service Networks (VISN) |
| Commission Corps is one of seven Uniformed Services of the US and provides highly trained and mobile health professionals. | Public Health Servcice (PHS) |
| is responsible for programs that provide services ans assistance to needy children and families. | Administration for Children and Families (ACF) |
| is a new state-federal welfare program | Temporary Assistance to Needy Families |
| supports a nationwide aging network, providing services to the elderly to enable them to remain indendent. | Administration on Aging (AoA) |
| supports research designed to improve the outcomes and quality of health care, reduced its costs, address patient safety and medical errors, and broaden access to effective services. | Agency for Healthcare Research and Quality (AHRQ) |
| works with states and other federal agencies to prevent exposure to hazardous substances from waste sites. | Agency for Toxic Substances and Disease Registry (ATSDR) |
| provides a system of health sureillance to montitor and prevent outbreak of dicseases. | Centers for Disease Control and Prevention (CDC) |
| administers Medicare, Madicaid, and the children's Health Insurance Program. | Centers for Medicare and Medicaid Services (CMS) |
| assures the safty of foods and cosmetics, and the safty and efficacy of pharmaceuticals, biological products, and medical devices. | Food and Drug Administration (FDA) |
| provides health resourses for medically underserved populations, works to build the health care workforce, maintains the National Health service Corps. | Health Resources and services Administration (HRSA) |
| supports a network of 37 hospitals , 60 health centers 3 school health centers, 46 health stations, and 34 urban Idian Health centers | Indian Health Service (IHS) |
| with 17 separate institutes, is the worlds premier medical research organization, supporting some 35,000 research nationwide in disease. | National Institutes of Health (NIH) |
| directed by the Assistance Secretary for Health, services as the focal point of leadership and coordination across DHHS in pubic health and science | Office of Public Health and Science (OPHS) |
| advises the President on health, welfare and income security plans, policies ans programs of the federal government. | Office of the Secretary of Health and Human Services (OS) |
| is a service for fee organization that utilizes a business enterprise approach to provide gov't support services throughout the Department of Health and Human Services (DHHS) | Program support Center (PSC) |
| works to improve the quality and availbility of substance abuse prevention, addiction treatment, and mental health services. | Substance Abuse and Mental Health Services Administration (SAMHSA) |
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