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Healthcare Settings

HIT 110 Health Care Settings Key Word Definitions

Activity of Daily Living (ADL) bathing, dressing, eating, toileting, walking, and so on
Acute Care Facility (ACF) hospital the provides healthcare services to patients who have serious, sudden or acute illnesses or injuries and/or who need certain surgeries
acute hospital classification patients have an average LOS of 4-5 days and a total LOS of less than 25 days: aka short-term hospital classifications
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 on Aging(AOA) DHHS program that supports a nationwide aging network, providing services to the elderly to enable the 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) DHHS agency that 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 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 are that allows patients to receive care in one day without the need for inpatient hospitalization; aka outpatient care
Ambulatory Infusion Centers (AIC) freestanding center that dispenses and administers prescribed medications by continuous or intermittent infusion to ambulatory patients, supervised by a licensed health care professional; aka infusion center
ambulatory patients patients who are treated and released the same day and do not stay overnight in the hospital; length of stay is a maximum of 23 hours , 59 mins and 59 sec; aka outpatients
Ambulatory Surgical Center (ASC) surgery is performed on an outpatient basis at a free-standing ambulatory surgical center, patients arrive on the day of procedure, undergo surgery in an operating room and recover under the care of a nursing staff
ambulatory surgery patient certain procedures can be performed on an outpatient basis, with the patient treated and released the same day, if stay is longer than 23 hrs, 59 mins, 59 sec, patient must be admitted to the facility as inpatient
ancillary services diagnostic and therapeutic services provided to inpatients and outpatients
Assisted Living Facility (ALF) combination of housing and supportive services including personal care and household management for seniors, residents pay monthly rent additional fees for services they require
bed count total number of inpatient bed for which the facility is licensed by the state; aka bed size
bed size total number of inpatient bed 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, consists of 82 institutions, each of which provides inmate ambulatory care
cafeteria plan provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plans; aka triple option plan
capitation payment lump sum paid by the HMO to the provider to care for a group of subscribers
Center for Disease Control & 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 withdrawal management in an acute care inpatient setting, treatment services usually include detoxification and withdrawal management, chemical dependency/substance abuse assessment and therapy
chemotherapy intravenous administration 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 technologies and technicians
clinical 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 services the HMO
Continuing Care Retirement Communities (CCRC) provides different levels of care based on the residents' need from independent living apartments to skilled nursing care in an affiliated nursing facility
copayment fixed amount a subscriber must pay when seeking health care services
correctional facilities provides inmates with a secure housing environment, offering vocational & educational advancement, medical, dental & mental health care services are provided to inmates according a standard of care imposed by court decisions, & legislation
crisis services provides short term (under 15 days) crisis intervention and treatment; patients receive 24-hour supervision
Critical Access Hospital (CAH) 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
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 are 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, day programming,including academic trainng, clinical & technical assistance, health care services, and diagnosis & evaluation of individuals with develo
diagnosis-related groups (DRGs) Inpatient hospital cases classified into groups, transferred to other types of healthcare, ie. outpatient care, skilled care facilities, rehab, home health, and so on
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 immediate care provided by an on duty physician, center usually owned by private corp. in states where permitted or non-profit facilities, aka urgent care center
emergency care patient one 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 a patient
federal certification measures ability of health care facilities to deliver dare that is safe and adequate, in accordance with federal law and regulations
federal medical centers (FMCs) provide major medical care to federal correctional facility inmates
flexible benefit plan provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plans, aka triple option plan & cafeteria plan
Food & Drug Administration (FDA) DHHS agency that assures the 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 healthcare services, either contracted or owned by HMOs
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; provides comprehensive health care services to members on a prepaid basis
Health Resources and Services Administration (HRSA) DHHS agency provides resources for medically under served, to build health care workforce, oversees nations organ transplant system, decrease infant mortality & improve child health, services for AIDS thru Ryan While CARE act
heart and vascular center provides ambulatory cardiovascular services to include diagnosis and treatment, disease prevention, research, education and cardiac rehab
home care allows people who are seriously ill or dying to remain at home and receive treatment from nurses, social workers, therapists and other licensed healthcare professionals who provide skilled care in the home
home infusion care home healthcare agency when intravenous admins of medication is medically appropriate for the patients condition, and treatment is administered in the home instead of as an inpatient
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
hospitialists physician who spends most of his or her time in a hospital setting admitting patients to inpatient services from local primary care providers
hospital owned physician practice practices that 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 additives.
imaging center freestanding facility that provides radiographic and other imaging services to ambulatory patients, some centers also provide training & participate in national research projects
Independent Practice Association (IPA) physicians who remain in their independent office settings but provide contracted health care services to subscribers, negotiates HMO & manages capitation payments, aka Individual Practice Association
Indian Health Association (IHS) DHHS agency that support network of 37 hospitals, 60 health centers, 3 schools health centers, 46 health stations, 34 urban Indian health centers, to provide service to 1.5 million federally recognized tribes
industrial health clnic 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 intermittent infusion to ambulatory patients, supervised by a licensed health care professional; aka ambulatory infusion center
inpatients those who remain overnight in the facility for 24 or more hours and are provided with room and board and nursing service
Integrated Delivery System (IDS) Organization of affiliated provider sites that offer joint health care services to subscribers, sites include ambulatory, surgical centers, hospitals, physician groups, etc.
Integrated Provider Organization (IPO) manages healthcare services provided by hospitals, physicians, and other health care organizations
intensive case management 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
Intermediate Care Facility (ICF) provides developmentally disabled people with medical care and supervision nursing services, occupational and physical therapies, activity programs, educational & recreational services & phycological services
internal medicine 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, length of stay typically average greater than 30 days
Long-term Care Hospital (LTCH) defined in medicare law as hospitals that have an average inpatient length of stay greater than 25 days, typically provide extended care for patients who may suffer multiple acute, chronic conditions
long-term care hospital classification same as (LTCH)
managed care originally referred to the prepaid healthcare sector, such as HMOs, combined healthcare deliver with financing of health care services, also referred to PPOs for some forms of indemnity coverage
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 for medical services and supplies for proper diagnosis & treatment and to meet standards and not mainly for the convenience of physicians or healthcare facilities
Military Health Systems (MHS) Administers healthcare for active members of the uniformed services & their dependents as provided by military treatment facilities & networks of civilian healthcare professionals
Military Medical Support Office (MMSO) coordinates civilian healthcare 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 y a single organization; may include acute, long term, rehab &/or psychiatric care facilities
multi-specialty group physician practices offer various types of medical specialty care in one organization, and they may be located in more than one location
National Commission on Correctional Health Care (NCCHC) Provides an external peer review process for correctional institutions that wish to meet its nationally accepted Standards for Health Safety
National Institutes of Health (NIH) DHHS research center, with 17 separate institutes, is the world premier medical research organization, supporting some 35K research projects nationwide in diseases like cancer,Alzheimer's, diabetes, arthritis, heart ailments, & AIDS
neighborhood health center healthcare provided to economically disadvantaged,treatment is family-centered, living condition focused, team consist of physician, nurse, social worker, provides continuity of care to family
network model (HMO) two or more physician multi-specialty group practices provide contracted healthcare services to subscribers
network providers physicians and healthcare facilities under contact to the managed care plan
newborn patients those who 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 receive services on hospital premises ordered by physician, includes use of bed and periodic monitoring by nursing staff to evaluate outpatients possible need to be admitted as an inpatient
open-panel HMO includes direct contract, individual practice association and network models, physicians are not employees of the HMO and do not belong to specially formed medical group that serves the HMO
pain management intravenous administration of narcotics and other drug designed to relieve pain
pain management center specializes in treatment of acute & chronic pain syndromes using proven medications & procedures
palliative care comfort management
partial hospitalization program program for hospital patients who regularly use the hospital facilities for a substantial number of either daytime or nighttime hours
pediatricians provides comprehensive services for infants, children & adolescents
personal care and support services provide assistance in performing daily living activities, such as bathing, dressing, grooming, going to the toilet, mealtime assistance, travel training, and accessing recreation services
Physician-Hospital Organization (PHO) managed care contracts are negotiated by hospital and physician groups; physician maintain their own practices & 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 inpatient care prior to inpatient admission
Preferred Provider Organization (PPO) network of physicians and hospitals join together to contract with third-party payers, employers and other organizations to provide healthcare to subscribers for a discounted fee
primary care center offers adult and family care medicine in internal medicine, pediatrics, and family practices
Public Health Services (PHS) Uniformed Service of the Dept of Health & Human Services, leadership is provided by the US Surgeon General, promotes the nations health, understand & prevent disease & injury, assure safe & effective drugs & medical devices to federal beneficiaries in war
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 care is unavailable in the primary care providers office, follow up is done in the primary care providers office
rehabilitation hospital 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 patients home to offer relief and rest to primary caregivers
satellite clinics ambulatory care centers established remotely from the hospital, primary care is provided by an on duty physician (usually salaried)
short term (acute) hospital classification patients have an average LOS of 4-5 days and a total LOS of less than 25 days
single hospitals category of hospitals that are self-contained and not part of a larger organization
single specialty group physician practices single-specialty practices that consists 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 supervision of skilled medical personnel, SNFs provide IV therapy, rehab, & wound care
solo physician practice organization that do not have physician partners or employment affiliations with other practice organizations
specialty hospital concentrates on a particular population of patients or diseases
staff model health maintenance organization (HMO) similar to large multispecialty group practices, may be partially owned by physician employees, with physicians functioning as employees of physician group owning the practice or the insurer
student health center provides healthcare to full-and part-time students who become ill or injured
subacute care provided in hospitals that provide specialized long-term acute care such as chemotherapy, injury rehab, ventilator support, wound care, and other types of healthcare services provided to seriously ill patients
subscribers individual who pay health insurance premiums
Substance Abuse and Mental Health Services Administration (SAMHSA) DHHS agency that works t 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 6 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 malnourished 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 are 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
utilization manager responsible for coordinating patient care to ensure the appropriate utilization of resources, delivery of health care services, and timely discharge or transfer, aka case manager
ventilator breathing machine
Veterans Health Administration (VHA) An agency in the Department of Veterans Affairs that provides medical, surgical, and rehab care to veterans of the armed services
Veterans Integrated Service Network (VISN) Administers and provides healthcare services at VA Medical Centers (VAMCs) and community-based outpatient clinics
Created by: doates8631