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Health Care Settings
| Question | Answer |
|---|---|
| What are the Activities of Daily Living? | Activities of Daily Living include Bathing, Dressing, Walking, Eating, and Using the Restroom etc... |
| What constitutes an Acute Care Facility? | An Acute Care Facility is a hospital that provides health care services to patients who have serious, sudden or acute illnesses or injuries. They may or may not need certain surgeries. |
| What Classifies a hospital as an Acute or Short Term Hospital? | Hospitals are considered to be acute care when the length of stay is an average of 4 to 5 days but the total length of stay is under 25 days. |
| What is the Administration for Children and Families (ACF)? | The ACF isOverseen by the PHS Commissioned Corps and is Responsible for the programs that provide assistance and services to needy children and families. |
| What is the Administration of Aging (AoA)? | The AoA isOverseen by the PHS Commissioned Corps and supports the nationwide aging network. It provides services to the elderly to enable them to remain independent. |
| What consitutes Adult Day Care? | Adult Day Care provides care and supervision to seniors with physical or mental limitations. The care is provided in a structured enviroment such as churches, hospitals, assisted living or nursing facilities. |
| What is the Agency fo Healthcare Research and Quality (AHRQ)? | The AHrQ supports research designed to improve the outcomes and quality of health care, reducing costs, addressing patient safety, medical errors, and broaden accessibility to effective services. |
| What is the Agency for Toxic Substances and Disease Registry (ATSDR)? | The ATSDR works with states and other federal agencies to prevent exposure to hazardous substances from waste sites. |
| What are Alzheimer's Treatment/ Dementia Care Facilities? | The Facilities have many of the same characteristics as assisted living facilities, there is more extensive monitoring of residents and day-to-day care. |
| What consitutes Ambulatory Care/Outpatient Care? | Ambulatory Care(Outpatient Care) allows patients to receive are in one day without the need for impatient hospitalization. |
| What is an Ambulatory Infusion Center(AIC)/ Infusion Center? | An AIC dispenses and administers predescribed medications by continuous or intermittent infusion to ambulatory patients. |
| What is an Ambulatory Patient/Outpatients? | Ambulatory patients(outpatients) are treated and released the same day and do not stay over night in the hospital. Less than 24 hours. |
| What is an Ambulatory Surgical Center (ASC)? | An ASC is a center where surgeries are performed on an outpatient basis. Patients arrive on the day of the procedure, and leave in less than 24 hours. |
| What are Ambulatory Surgery patients? | Ambulatory Surgery patients undergo certain procedures that can be performed on an outpatient basis, with the patient being treated and released on the same day. |
| What are Ancillary Services? | Ancillary Services are diagnostic and therapeutic services provided to impatients and outpatients such as laboratory, physical therapy etc.. |
| What is an Assisted-Living Facility (ALF)? | An ALF is a combination of housing and supportive services including personal care (bathing) and household management (meals) for seniors. It is not a nursing facility and cannot provide serious medical care. |
| What is Bed Count/Bed Size? | Bed Count/Bed Size is the total number of impatient beds for which a facility is licenssed by the state; They must be equipped and staffed to care for these patient admissions. |
| What is a Behavioral Health Care Hospital? | A Behavioral Health Hospital apecializes in treating individuals with mental health diagnoses. |
| What is the Bureau of Prisons (BOP)? | The Federal Bureau of Prisons provides necessary medical, dental, and mental health services to inmates by a professional staff consistant with acceptable community standards. |
| What is a Cafeteria Plan/Flexible Benefit Plan or A Triple Option Plan? | A Cafeteria Plan/Flexible Benefit Plan or A Triple Option Plan provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plan. |
| What is a Capitation Payment? | A Capitation Payment is a lump sum paid by the HMO to care for a group of subscribers. |
| What is the Center for Disease Control and Prevention (CDC)? | A DHHS agency that provides a system of health surveillance to monitor and prevent outbreak of diseases. |
| What is a Chemical Dependency Program? | A Chemical Dependency Program provides 24 hour evaluation and withdrawal management in an acute care impatient setting. |
| What i Chemotherapy? | Chemotherapy is intravenous administration of chemical agents that have specific and toxic effects upon a disease-causing cells or organisms. |
| What are Chemical Laboratories? | Clinical Laboratories perform tesst in microbiology, clinical chemistry, and toxicology. The laboratory is directed by a pathologist and the tests are performed by certified professional technologists and technicians. |
| What constitutes a Clinic Outpatient? | A Clinic Outpatient receives scheduled diagnostic and therapeutic care such as chemotherapy following an inpatient stay. |
| What in a Closed Panel HMO? | A 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. |
| What are Continuing Care Retirement Communities (CCRC)? | CCRC's provide different levels of care based on the residents' needs ranging from independent living apartments to skilled nursing care in an affiliated nursing facility. |
| What is a Copayment? | A Copayment is a fixed amount a subscriber must pay whe receiving health care services. |
| What constitutes a Correctional Facility? | A Correctional Facility provides inmates with a secure housing enviroment that also offers vocational and educational advancement. They also provide medical, dental, and mental health care services. |
| What are Crisis Services? | Crisis Services provide short term (usually less than 15 days) crisis intervention and treatment. patients receive 24 hr a day supervision. |
| What are Critical Access Hospitals (CAH)? | A CAH is located more than 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. |
| What is Curative Care? | Curative Care is therapeutic care. |
| What is a Day Treatment Program? | A Day Treatment Program is an intensive treatment program provided to patients who live in the community but come to the facility up to 5 days a week. |
| What are Developmentally Disabled/Mentally Retarded Facilities? | These Facilities are sometimes catagorized as an Intermediate Care Facility (ICF), these facilities provide residential care including academic training,health care services,and diagnosis and evaluation of developmental disabilities. |
| What are Diagnosis-Related Groups(DRG's)? | DRG's are used by IPPS to classify inpatient hospital cases into groups that are expected to consume similar hospital resources. |
| What is a Direct Contract Model HMO? | In a Direct Contract Model HMO Individual Physicians in the community deliver health care services to subscribers. |
| What is Drug Therapy? | Drug Therapy is the intravenous administration of other drugs including antibiotics, antivirals and so on. |
| What is Durable Medical Equipment(DME)? | Durable Medical Equipment is Equipment used in home health care such as oxygen, hospital beds, canes, walkers etc. |
| What is an Emergency Care Center/Urgent Care Center? | It provides immediate care by an on-duty physician usually owned by private corporations or non profit facilities. |
| Who is considered an Emergency Care Patient? | An Emergency Care patient is someone who recieves treament for urgent problems and are either released the same day or admitted to the hospital. |
| What is an Exclusive Provider Organization(EPO)? | An EPO provides benefits to subscribers who receive health care srvices from network providers. |
| Who are Family Practitioners? | The are physicians that provide care for the entire family and focus on general medicine, obstetrics, pediatrics, and geriatrics. |
| What are Family Support Services? | Family Support Serrvices are provided to assist families in caring for the patient such as support groups. |
| What is Federal Certification? | Federal Certification measures the ability of health care facilities to deliver care that is safe and adequate, in accordance with federal law and regulations. |
| What are Federal Medical Centers(FMC)? | FMC's provide Major Medical Care to prison inmates. |
| What is the Food and Drug Administration(FDA)? | The FDA assures the safety of food and cosmetics, and the safety and efficacy of pharmaceuticals, biologial products, and medical services. |
| What are General Hospitals? | General Hospitals provide emergency care, perform general surgery, and admit patients for a variety of probelms, based on licensing by the state. |
| What is a Group Model HMO? | A Group Model HMO is participating physicians who are members of an independent multi-specialty group that provide services. The physicans either contract with, or they are owned or managed by the HMO. |
| What is Group Practice Without Walls(GPWW)? | A GPWW is a Managed Care contract in which physicians maintain their own offices and share services with plan members. |
| What is a Health Maintenance Organization(HMO)? | An HMO is an alternative to traditional health insurance coverage, they provide comprehensive health care to members on a prepaid basis. |
| What does the Health Resources and Servies Administration(HRSA) do? | HRSA provides health resources for populations that are medially underserved, they work to build up the healthcare workforce, maintain the National Health Service Corps and oversee the nations organ transplatation system. |
| WhatKind of services does a Heart and Vascular Center provide? | They provide ambulatory Cardiovascular services including diagnosis, and treatment. They also participate in disease prevention, research, education and cardiac rehabilitation. |
| What constitutes as home care? | Home care is treatment given at home for seriously ill or dying patients. It allows them the comforts of home while receiving skilled care by nurses, therapists and social workers. |
| What is home infusion care? | Home infusion care is intravenous administration of medication at home instead of inside a hospital. |
| What is considered Hospice Care? | Hospice care can be received at home or at a hospice facility. It is pallative care to make the patient comfortable. It provides medical, social, emotional and spiritual care for terminally ill patients and their loved ones. |
| Who ae hospitalists? | Hospitalists are physicians that spend the majority of their time in a hospital setting admitting patients to receive inpatient care from local providers. |
| What is a hospital owned physician practice? | The practice is at leaset partially owned by the hospital and the physicians participate in a compensation plan provided by the hospital. |
| What is hydration therapy? | The intravenous administration on fluids, electrolytes and other additives to a patient. |
| What is an Imaging Center? | A facility that provides radiographic and other imaging services to ambulatory patients. |
| What is an Independent Practice Association(IPA)aka Individual Practice Association? | An IPA Negotiates the HMO contracts and capitation payments for physicians that work in independent offices and provide contracted health services to subscribers. |
| What is an Indian Health Service(IHS)? | It provides services to nearly 1.5 million Amerian Indians and Alaska Natives of 557 federally recognized tribes. It does this through a network of hospitals and different types of health centers. |
| What is an Industrial Health Clinic? | It is located in a business setting and emphasizes the health and safety of employees. |
| Who are impatients? | Impatients are patients that stay overnight in a facility and recieve room and board, and nursing services for a period over 24 hours. |
| What is an Integrated Delivery System(IDS)? | An organization of affliated healthcare providers that offer joint services to providers. |
| What is an Integrated Provider Organization(IPO)? | It manages health services provides by physicans, hospitals and other health care organizations. |
| What is Intensive Care Management? | Specially trained individuals that coordinate or provide medical and mental health services, finacial and legal services to enable patients to live sucessfully at home and as part of the community. |
| What is an Intermediate Care Facility(ICF)? | A facility that provides developmentally disabled people with medical care, nursing services, as well as occupational and physical therapy, and a variety of educational and recreational activities. |
| Who are Internal Medicine Physicians? | They are physicians that specialize in the medical care of adults. |
| What constitutes long term care? | Long term care includes nursing social and rehabilitative services for people that need ongoing assistance. The length of stay is typically over 30 days. |
| What is a Long Term Care Hospital(LTCH)? | A LTCH is a hospital that has an average of inpatients stay of longer than 25 days. They provide extended medical and rehabilitative care. |
| What is a long term hospital classification? | To be classified as a long term hospital the hospitals patients length of stay average is atleast 25 days. |
| What is Managed Care? | Manage Care includes HMOs that cover the prepaid health care sector. It is increasingly being used to refer to PPOs and some indemnity coverages as well. |
| What is an Mangement Services Organization(MSO)? | A organization that provides management services including administrative support to individual physician practices. |
| What is a medical foundation? | An nonprofit organization that contracts with and acquires the clinical and business assets of physician practices. |
| What consitutes as medical necessity? | Medical necessity requires the documentation of services and supplies that are proper and needed for the diagnosis or treatment of a medical condition. You have to prove the treatment matches the diagnosis and that the treatment provided was necessary. |
| What is the Military Health System(MHS)? | The MHS Administers health care to active members of the uniformed services and their dependents as provided at military treatment facilities and networks of civilian heath care professionals. |
| What is a Military Medical Support Office(MMSO)? | A MMSO coordinates civililan health care services when the MTF is unavailable. |
| What is a Military Treatment Facility(MTF)? | An MTF is a clinic or hospital located on a US military base. |
| What constitutes a multi-hospital system? | When there are 2 or more hospitals owned, managed or leased by a singles organization it is called a multi-hospital system. |
| What are multi-specialty group physician practices? | It is one organization that offers various types of medical specialties at one or more locations. |
| What is the National Commission on Correctional Health Care(NCCHC)? | The NCCHC was established to provide an external peer review process for correctional facilities that wish to meet the national standards for health services. |
| What are the National Institutes of Health(NIH)? | It includes 17 seperate institutes and is the world's premier medical research organization. It supports some 35,000 research projects nationwide. |
| What is considered a neighborhood health center? | A family care team consisting of a doctor, nurse and social worker that provides health care and a continuity of care to eonomically disadvantaged families. |
| What is a Network Model HMO? | Two or more physicians within a multi-specialty group providing contrated healthcare services to subscribers. |
| Who are Network Providers? | Network providers are physicians and healthcare facilities that are under contract with a managed care plan. |
| Who are newborn patients? | Newborn patients are babies that receive infant care upon birth, and if necessary they receive neonatal intensive care as well. |
| What is a nursing facility/skilled nursing facility(SNF)? | A nursing facility or SNF provides medically necessary care to impatients on a daily basis under the supervision of silled medical personnel. They provide IV therapy, physical and speech therapy as well as wound are and rehabilitation. |
| Who are considered observation patients? | Observation patients receive services provided on the hospitals premises, including the use of a bed and periodic monitoring by the nursing staff to evaluate the patients condition and if admission is needed. |
| What is an open panel HMO? | The HMO includes a direct contract, an individual practice association, and network models; the physicians are not employees of the HMO, and they do not belong to a specially formed medical group the serves the HMO. |
| What is an outpatient clinic? | Is where patients receive follow-up mental health care, and the visits are usually less than an hour. The number of visits per week depends on the patients needs. |
| What is pain management? | Pain management is the intravenous administration of narcotics and other drugs designed to relieve pain. |
| What is a Pain Management Center? | They specialize in the treatment of acute and chronic pain syndromes using proven medications and procedures. Involving a variety of specialists including psychiatrists, neurologists, internists and therapists. |
| What is pallative care? | Comfort Management |
| What is a partial hospitalization program? | A program for hospital patients that use the facilities for a substantial number of daytime or nighttime hours. |
| Who are pediatricians, what do they do? | Pediatricians provide comprehensive medical services for infants, children and adolescents. |
| What are personal care and support services? | Services that provide assistance in performing daily living activities and accessing recreational services as well. |
| What is a Physician-Hospital Organization(PHO)? | Managed care contracts are negotiated by hospitals adn physician groups. Physicians maintain their own practices and provide services to plan members. |
| What is a Point of Service Plan(POS)? | The patients have the freedom to use an HMO panel of providers of to self refer to a non HMO provider of their choice. |
| What is Preadmission Certification? | It is a form of utilization management that involves the review for medical necessity of inpatient care prior to inpatient admission. |
| What is a Preferred Provider Organization(PPO)? | A network of physicians and hospitals that join together to contract with third party payers to provide health care to subscribers for a discounted fee. |
| What constitutes a Primary Care Center? | A facility that offers adult and family care in internal medicine, pediatrics and family practice. |
| What is Public Health Service(PHS)? | It is one of the seven Uniformed Services of the US and provided highly trained and mobile health professionals who carry out programs to promote the nations health and to prevent disease and injury. |
| What does the Public Health Department do? | It provides preventive medicine services such as well baby check ups, routine check ups and immunizations. |
| Who is considered a referred outpatient? | A referered outpatient receives diagnostic or therapeutic care because such care is not available at the primary care providers office. |
| What is a rehabilitation facility (outpatient)? | A facility that provides occupational, physical, speech, therapy to patients with orthopedic, sports, and work related injuries. They also help with various neurological and neuromuscular conditions. |
| What is a rehabilitation hospital (inpatient)? | A hospital that admits patients that are diagnosed with trauma or disease adn need to learn how to function again. |
| What is a Residential Care Facility(RCF)? | A facility that provides non medical custodial are, taht can be provided in a family residence, a retirement home, or even a nursing home. They provide assistance with the activities of daily living but are not allowed to provide skilled services. |
| What is a Residential Treatment Facility? | A residential treatment facility treats seriously disturbed patients that receive intensive and oomprehensive psychiatric treatment on a long term basis. |
| What constitutes as Respite Care? | Respite care is provided in a setting other than the patients home. It is provided by specially trained individuals to offer relief and rest to the primary caregivers. |
| What are Satellite Clinics? | They are Ambulatory Care Centers that are located remotely from the hospital. The care provided is by an on duty physician. |
| What are single hospitals? | It is a hospital that is self-contained and not a part of a bigger organization. |
| What are single-specialty group physician practices? | It consists of 2 or more physicians that provide patients with one specific type of care. |
| What constitutes skilled care? | Skilled care includes services that are ordered by a physician and provided under the supervision of a RN, a physical or occupational therapist, or a speech therapist. |
| What are solo physician practices? | They are physician offices that do not have physician partners or affliations with other practices or organizations. |
| What are specialty hospitals? | Specialty hospitals concentrate on a particular population of patients or a specific disease category. |
| What is a Staff Model Health Maintenance Organization(HMO)? | It is similiar to a large, multi speialty group practice, it may be partially owned by the physician employees. The physicians typically function as the employees of either the physican group owning the practice or of the insurer. |
| What is a Student Health Center? | It provides health care to full and part time students what become ill or get injured. They provide health education, counseling, immunizations, lab services, screening for STDs and contraceptives along with a variety of other services. |
| What constitutes subacute care? | Subacute care is provided in hospitals that specialized in long-tem acute care such as chemotherapy, injury rehabilitation, ventilator support, wound care and other types of services provided to seriously ill patients. |
| Who are subscribers? | Subscribers are individuals that pay premiums to receive health care from network providers. |
| What is the Substance ABuse and Mental Health SErvices Administration(SAMHSA)? | SAMHSA works to improve the quality and availability of substance abuse programs for prevention, addiction, and mental health services as well. |
| What is a swing bed? | Its the criteria that allows a rural hospital to admit a nonacute care patient into the hospital for treatment. |
| What is Temporary Assistance to Needy Families (TANF)? | TANF is the new state-federal welfare program. |
| What is a therapeutic group home? | Supervised housing for 6-10 individuals that may or may not be linked to a day treatment program. |
| What is Total Parental Nutrition(TPN)? | The administration of nutritional substances by peripheral or central intravenous infusion to patients who are either already malnourished or have the potential of developing malnutrition. |
| What is Utilization Management? | Management that controls health care costs and the quality of health care by reviewing cases for appropriateness and medical necessity. |
| What is ventilator? | A breathing machine. |
| What is the Veterans Health Administration(VHA)? | An agency in the Department of Veterans Affairs, provides medical, surgical and rehabilitative care to the veterans of the armed services. |
| What is the Veterans Integrated Service Network(VISN)? | Created by the VHA regional networks administer and provide health care services at VA medical centers(VAMCs) and community based outpatient clinics. |
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