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Chapter 3

Stack #166653

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 illness or injuries and/or who need certain surgeries.
acute hospital classification aka short-term hospital classification;P patients 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 of 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 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; aka outpatient care
ambulatory infusion center (AIC) aka infusion center; freestanding center that dispenses and administers prescribed medications by continuous or intermittent infusion to ambulatory patients
ambulatory patients treated and released the same day and do not stay overnight in the hospital; LOS is maximum of 23 hours, 59 minutes and 59 seconds;
ambulatory surgical center (ASC) surgery is performed on an outpatient basis at a free-standing ambulatory surgical center
amulatory surgical patient undergoes certain procedures that can be performed on an outpatient basis, with stay is a maximum of 23 hours, 59 minutes, and 49 seconds
ancillary services diagnostic and therapeutic services provided to inpatients and outpatients
assisted-living facility (ALF) combination of housingand supportive services including personal care and household management for seniors. Residents pay monthly rent and additional fees for services they require
bed count aka bed size; total number of inpatient beds for which the facility is licensed by the state
bed size total number of inpatient beds for which the facility is licensed by the state; aka bed count
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 and consistent with acceptable community standards. It consists of institutions each of which provide inmate ambulatory care
cafeteria plan aka triple option plan; Provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plan
capitation payment lump sum paid by the HMO to the provider to care for a group of substances
Centers for Disease Control and Prevention (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 withdrawl management in an acute care inpatient setting. Treatment services usually include detoxification and withdrawl management, chemcial dependency/substance abuse assessment, and therapy.
chemotherapy Intravenous adminstration 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; directed by a pathologist; and testing is performed by certified, professional technologists and technicians.
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
Continuing Care Retirement Communities (CCRC) Provides different levels of care based on the residents' needs from independent living apartments to skilled nursing care in an affilated nursing facility
copayment fixed amount a subscriber must pay when seeking health care services
correctional facilities provides inmates with a secure housing environment that also offers vocational and educational advancement.
crisis center provides short term (usually fewer than 15 days) crisis intervention and treatment; patients receive 24-hour-per-day supervision
critical access hospital (CAH) located more thatn 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 in the community but come to the facility up to five days per week
dementia care facilities long-term care facilities that specialize in the care of patients diagnosed with dementia
developmentally disabled/mentally retarded facilities 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 diagnosisand evaluation of individuals w
diagnosis-related groups (DRGs) classify inpatient hospital cases 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 (DME) includes canes, crutches, IV supplies, hospital beds, ostomy supplies, oxygen, prostheses, walkers, wheelchairs, and so on.
emergency care center aka urgent care center; immediate care is provided by an on-duty physician (usually salaried). The center is usually owned by private corporations in states where permitted or non-profit facilities
emergency care patient treated for urgent problems and either released the same day or admitted to the hospital as an inpatient
Exclusive Provider Organization (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 with federal law and regulation
federal medical centers (FMC) provide major medical care to federal correctional facility inmates
flexible benefit plan aka triple option plan; Provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plan
Food and Drug Administration (FDA) DHHS agency that assures that 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, based on licensing by the state.
group model HMO participating physicians who are members of an independent multi-specialty group providing health care services.
Group Practice Without Walls (GPWW) managed care contract in which physicians maintain their own offices and share services to plan members
Health Maintenance Organization (HMO) an alternative to traditional health insurance coverage; provide comprehensive health care service 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, ovverseas the nation's organ transplantation system, works to decrease infant mortalit
heart and vascular center provides ambulatory cariovascular services to include diagnosis and treatment, disease prevention, research, education, and cardoac rehablilitation
home care allows people who are seriously ill or dying to remain at home and receive treatment from nurses, social workers, therapusts and other licensed health care professionals who provide skilled care in the home
home infusion care provided by home health care agencies when intravenous adminsistration of medication is medically appropriate for the patient's condition, and treatment is administered in the home instead of on 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 providers
hospital-ownded physicain practice practices taht are at least partially owned by the hospital, and physicians participate in a compensation plan provided by the hospital
hydration therapy intravenous administration of fluids, electrolytes and other sdditives.
imaging center freestanding facility that provides radiographic and other imaging services to ambulatory patients
independent practice association (IPA) aka individual paractice association (IPA); phycicians who remain their independent office settins provides contracted health care services to subscribers
Indian Health Services (IHS) DHHA 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 nearly 1.5 million American Indians and Alaska Natives of 557 federally recogniz
Individual Practice Association (IPA) Physicians who remain in their independent office settings provide contracted health care services to subscribers.
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 intermitted infusion to ambulatory patients
inpatients 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 specialty trained individuals coordinate and/or provide mental health, financial, legal, and medical services to help the patient live succeddfully at home and in the community.
intermediate care facility (ICF) provides developmentally disabled people with medical care and supervision, nursing services, occupational and physical therapies, activity programs, educational and recreational services, and psychological services
internal medicince 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
long-term care hospital (LTCH) Defined in Medicare law as hospitals that have an average inpatient length of stay greater than 25 days
long-term hospital classification managed care aka long-term care hospital (LTCH);Defined in Medicare law as hospitals that have an average inpatient length of stay greater than 25 days
Management Service Organization (MSO) 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 taht are proper and needed for the diagnosis or treatment of a medical condition
Military Health System (MHS) 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 (MMSO) Coordinates civilian health care services when military treatment facility (MTF) services are unavailable
military treatment facility (MTF) Clinic and/or hospital located on a US military base
multi-hospital systems category of hospitals where two or more hospitals are owned, managed, or leased by a single organization; these may include acute, long-term, pediatric, rehabilitation, and/or psychiatric care facilities
multi-specialty group physician practices offer various types of medical speciality care in one organization, and they may be located in more than one location
National Commission on Correctional Health Care (NCCHC) Federal agency responsible for maintaining official vital statistics, while registration of vital events is a state funcition
National Institutes of Health (NIH) DHHS research center with 17 separate institutes, is the worlds premier medical research organization, supporting some 35,000 research projects nationwide in diseases like cancer, Alzheimer's disease, diabetes, arthritis, heart ailments, and AIDS
neighborhood health center Health care is provided to economically disadvantaged, and treatment is family centered because illnesses may result indirectly from crowded conditions, unsanitary facilities and other socioeconomic factors
network model HMO two or more physician multispeciality group practices provide contracted health care services to subscribers
network providers Physicians and health care facilities under contract to the managed care plan
nursing facility (NF) aka skilled nursing facility; provides medically necessary care to inpatients on a daily basis that is performed by or under the supervision of, skilled medical personel
newborn patients 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
observation patients recieve services furnished on a hospital's premises that are ordered by a physician or other authorized individual, including use of a bed and periodic monitoring by nursing or other staff, which are resonable and necessary to evaluate an outpatient's con
Office of Public Health and Science (OPHS) Directed by the Assistant Secretary for Health, serves as focal point of leadership and coordination across DHHS in public health and science, provides direction to program offices within OPHS, and provides advice and counsel on publc health and science i
Office of the secretary of Health and Human Services (OS) DHHS office that advises the President on health, welfare, and income security plans, policies, and programs of the federal government
open-panel HMO includes direct contract, individual practice association, and network models
outpatient care aka ambulatory care; outpatient care that allows patients to receive care in one day without the need for inpatient hospitalization
outpatients aka ambulatory care; outpatient care that allows patients to receive care in one day without the need for inpatient hospitalization
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 hospitialization program Program for hospital patients who regulary 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 ans support services Provide assistance in performing daily living activities, such as bathing dressing, grooming, going to the toliet, mealtime assistance, travel training, and accessing recreation services
Physician-Hospital Organization (PHO) managed care contracts are negotiated by hospitals and physician groups; physicians maintain their own prectices and provide services to plan members
Point-of-Service plan (POS) Patients have the freedom to use an HMO panel of providers or to self-refer to non-HMO providers
preadmission certification (PAC) form of utilization management that involves the review for medical necessity of impatient
Preferred Provider Organization (PPO) 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, pediatrics, and family practice
Program Support Center (PSC) DHHS service-for-fee organization that utilizes a business enterprise approach to provide government support services throughout DHHS and other federal agencies
Public Health Service (PHS) Uniformed Service of the Department of Health and Human Services.
public health department Provides preventive 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 provider's office
rehabilitation hospital (inpatient) Admits patients who are diagnosed with trauma or disease and who need to learn how to function
residential care facility (RCF) 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 at 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
short-term (acute) hospital classification Patients have an average LOS of 4-5 days and a total LOS of less than 25 days; aka acute hospital classification
single hospitals category of hospitals that are self-contained and not part of a larger organization
single-speciality group physicians practices single-sepciality practices that consist of two or more physicians who provide patients with one specific type of care
skilled care Includes 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(SNF) 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 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 health maintenance organization (HMO) Similar to large, multi-speciality group practices, it may be partially owned by the physicain employees, with the physicians typically functioning as employees of either the physicain group owning owning the practice or the insurer
student health center Provides health care to full-and part-time students who become ill or injured
subacurate care provided in hospitals that provide specialized long-term acute care such as chemotherapy, injury rehabilitation, ventilator support, wound care, and other types of health care services provided to seriously ill patients
subscribers individuals who pays health insurance premiums
Substance Abuse and Mental Health Services Administration (SAMHSA) 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 (TANF) State-federal welfare program
therapeutic group home six to 10 individuals are provided with supervised housing that may be linked with a day treatment program
total parenteral nutrition (TPN) administration of nutritional substances by peripheral or central intravenous infusion to patients who are either already malnurished 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; aka cafeteria plan
urgent care center (emergency care center) immediate care is provided by an on-duty physician (usually salaried). The center is usually owned by private corporations in states where permitted or non-profit facilities; aka emergency care center
utilization management controls health care costs and the quality of health care by reviewing cases for appropriateness and medical necissity
ventilator breathing machine
Veterans Health Administration (VHA) An agency in the Department of Veterans Affairs that provides medical, surgical, and rehabilitative care to veterans of the armed services
Veterans Intergrated Service Network (VISN) Administers and provides health care services at VA Medical Centers (VAMCs) and community-based outpatient clinics
Created by: Stephaniey06