Chapter 3 Green
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| Diagnosis related group- DRG | calssify inpatient hospotal cases into groups thar are expected to comsume similare hospital resourses.
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| Acute Care Facility- ACF | a hospital that provide health services to patients who have serious, sudden or acute illness or who need certin surgeries
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| Anciallary Service | diagnositce and theraputic serviesd provided to inpatients and outpatients.
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| single hospitals | are not contained within a larger organization
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| multi-hospital systems | are two or more hospitals owned, managed or leased by one organization
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| bed size/bed count | the total number of inpatient beds for which a facility is liscensed by the state
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| short term | length of stay 4 to 5 days with a total of 25 days
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| long term | average stay over 25 days
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| crutucal access hospitals CAH | located more than 35 mles away from any other hospital or another CAH or they are state cartified as being a necessary provider to area residents
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| swing bed | criteria that allows a rural hospital to admit a nonacute care patient
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| general hospital | provides emergency care, general surgery, admit patients by being liscensed with the state
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| speciality hospitals | concentrate on a particular population of patients or disease categories
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| rehabilitation hospitals | admit patients who are diagnosed wit trauma
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| behavorial health hospitals | specialize in treating individuals with mental health diagnoses
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| HOSPITALISTS | physcians who spend most of their time in a hospital setting admitting patients to their inpatient services from local primary care providers
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| ambulatory patients- outpatients | treated and released the same day and do not stay overnight or past the 24 hour mark
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| ambulatory surgery patients | undergo a certin procedure thaty can performed on an outaptient basus with them being there up to the 24 hour mark
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| emergency care patients | are treated for urgent problems and are either released or admitted to the hospital
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| inpatients | are admitted into the hosptaland stay over 24 hours
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| newborn patients | recieve infant care upon birth and if necessary they recieve neonatal intensive care at the hopital or are transfered to another facility
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| observation patients | recieve services futnished on a hospitals premises that are prdered by a physcian ro authorized person.this includes the use of a bed and periodic nurse monorting
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| subacute care | is provided in hospitals that provide specialized long term acute care such as chemotherapy, rehab, venilator support
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| ventilator support | breathing machine
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| ambulatory surgical center ASC | outpatient surgery center stnd alone facility
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| clinical laboratory | stand alone lab tht performas kab test
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| heart and vascular center | provides ambulatory cardiovascular services that include diagnosis and treatment, disease preventiopn, research, education, rehabilitation
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| staff model health managed organization | similar to large group practices that may be partially owned by a physcian or employees
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| imaging center | free standing facility that does xrays and other imaging services
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| industrial health clinic | located on a business setting that emphizes employee saftey
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| unfusion center | freestanding center that dispenses medication that is perscribed my a liscensed physican
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| neighboorhood health clinic | healht care is provided to fininacially disadvantages families and treatment is given because illnesses my be cause by crowded oving conditions.
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| pain management center | specializes in treatment of acute and chronic pain syndromes using proven medications and procedures
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| solo physcian practices | are a one doctor office, they ahve no partners or aren't affiliaed with any other organizations
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| single speciality group physcian practices | comsists of 2 or more physcians that specialize in one certin type of care
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| multi speciality group physcian practices | various types of medical specilizations in one organization
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| internal medicine physcians | specialize in the care of adults
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| peditricians | specialize in the care of children
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| family practicioners | provide care for the entire family
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| primary care center | offers adults and family care medicine in the listed areas above
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| public health department | provides preventitive medicines such as vaccinations and baby well clinics
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| student health center | health center that offers wellness clinics to students
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| urgent care | gives emergency care to anyone and is provided y an on site ohyscian.
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| clinic outpatient | recieves scheduled diagnositce and theraputic care
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| reffered outpatient | recieves diagnositc and theraputic care because primary care provides can't provide the care needed
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| partial hospitalization | program for hospital patients who regurlary use the hospital facilities for a large amount of hours during a day or night
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| hospital owned physcian practice | are partially owned by a hospital and the physcians particiapte in a compensation plan
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| satellite clinics | ambulatory care clinics that are established remotely from the hospital primary care is provided by and on duty physcian
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| chemical dependancy programs | provides 24 hour medically directed evaluation and withdrawl management in an acute care setting
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| crisis services | provides short term crisis intervention and treatment
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| day treatment program | intensive treatment program provided to patients who live in the community
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| developmentally disabled faciities | these facilites give treatment and provide care to those who are disabled
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| family support services | services are provided to assist familes in caring for a patient
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| intensive case management | specially trained individuals that coordinate and provide serices to those in the community
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| residential treatment facility | disturbed patients recieve intensive and comprhensive psychatric care
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| respite care | care is provided by specially trained individuals in a setting other that the patients home to offer relief and rest for family
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| theraputic group home | 6 to 10 individuals are provided with supervised houseing
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| skilled care | includes services that are ordered by a physcian and provided under supervision
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| durable medical equipment | medical equipment such as canes, walkers, wheel chairs etc...
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| personal care and support services | provides assistance in performing daily activities
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| home infusion care | provided by home health care agencies when intravenous administration od medication is approiate
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| chemotherapy | IV administration of chemical medications that have toxic effects and are used to kill diseases
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| drug therapy | UV admin of other drugs
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| hydration therpay | IV admin of fluids, electrolytes, and other additvatives
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| pain management | IV admin of narcotics and other drugs used to relieve pain
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| total parenatal nutrition | admin of nutritional substances by pheriphal or central IV infusion
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| hospice care | proveides comprehensive medical and supportive care to patients and their families when a patient is seriously ill
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| palliative care | comfort care for family and patient in the last link of time
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| curative care | theraputic car provided in the home
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| long term care | care facilites that prvide care and service for a wide range of people usually elderly for long periods of time over 30 days
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| adult day care | provides care an supervision in a structured manner to seniors with physcial or mental limitations
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| assisted living facilities | a combonation of housing and supportative services including personal care and household management
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| dementia care facilities// alzheimers treatment canters | they ahve the same characteristics as assisted living facilities but the are specialized for patients with dementia and alzhimers
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| continuing care retirement communities | differenmt levels of care based o the residents needs from independent living apartments to skilled nursing facilites
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| intermediate care facility | provides developmentally disabled people with medical care and supervision, nursing services and therapy
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| federal certification | measures the ability of health care faciliteies to deliver care that is safe and adequate
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| long term care hospital | is defined in medicare alws as hospitals that have an average stay greater than 25 days
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| residential care facility | provides non-medical custodial care which can be provided in a single family residence, a retirement place, and any other care facility that is approiate
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| activites of daily living` | daily activities such as bathing, dressing, eating, walking
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| skilled nursing facility | provides medically necessary care to onpatients on a daily basis that is performed by or under supervision of medical personnel
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| managed care | orginally refered to as prepaid health care sectors such as HMOs which combined health care delivery with the financing of health care services
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| exclusive provider organization | provides benefits to subscribers ho receive health care services from network providers
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| subscrubers | individuals who pay premiums
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| network providers | physcians and health care facilities inder contact to the managed care plan
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| integrated delivery system | organization of affiliated provider sites that offer joint health services to subscribers
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| group practice withour walls | managed care cintract in which physcians maintain their own offices and share services with plan members
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| medical foundation | non profit organization that contracts with and acquires the clinical and business assets of physcian offices
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| integragted provider organization | manafe health care serives provided by hospitalsm ohyscians, and other health care organizations
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| managemtnt services organizations | provides oractice management services including support services to individual physcian practices
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| phyhscian hospital organization | managed care contracts are neogatied by hospitals and physcian groups. physcians maintain their own practices and orivide services to plan memners
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| health maintence organization | alternative to traditional health insurance coverage. they provide comprehensive health care services to members on a prepaid basis/
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| closed pannel HMO | includes groups and staff models that provide services at HMOowned health centers
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| open pannel HMO | includes direct contract, individual practice sassociations and network models
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| group model HMO | participating physcians who are members of an independant multi speciality group that provides health care services
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| direct contract model HMO | individual physcians in the community deliver contracted health services
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| individual practive association | physicans who remain in the independent office setting proveide contracted health care services to subscribers
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| network model HMO | 2 or more physcians multi speciality group practices proveide contracted services
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| point of service plan | patients have the freedom to use an HMO panel of providers or to self refer to non HMO providers
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| coepayment | a fixed amount a subscriber must pay when seeking medical treatment
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| perferred provider organization | a network of ohyscians and hospitals join together to contract with third part payers to proved health care to subscrubers at a discount
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| triple option plan | provides subscribers and employees with a choise of HMO, PPO< or traditional health insurance plan
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| utilization management | controls health care costs and the quality of care by reviweing cases
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| preadmission certification | is a form of utilization management that involves the review for medical necessity of inpatient care prior to admission.
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| medical necessity | rewuires the documentation of services or supplies that are proper and needed for the daignosis, direct care and treatment of a medical condition
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| correctional facilities | provide inamtes with medical care, secure hpuding and an enviromnet that offers educational and vocational advancment
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| bureau of prisions | provides necessary medical, dental and mental care to inmates on a professional level
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| federal medicine centers | provide major medical care to inmates
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| national commission on correctional health care | was established in the 1970s to provide and external peer review process for correctional instutitions that wish to meet its nationall accepted standards for health services
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| militay health system | administers health care for active members of the uniformaed service and provided by military treatment facilities and networks of civilian health care professionals
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| military treatment centers | a clinic orhospial located on a US military base
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| militay medical support office | coordinates civilian health care services when the MTF service aren't available
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| veterns health administration | an agency in the department of vetrans affairs, provides medical care to veterans of the armed services
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| veterans integrated service networks | administer and provide health care at VA medical centers and community based outpatient clinics
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| public health service | commissions corps is one of seven inofromed services of the US and provides highly trained health professionals who carry out programs to promote the nations health
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| administration for children and families | is responsible for service that ssist needy children and familes
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| temporary assistance to needy families | welfare
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| administration on aging | supports a nationwide aging network providing services to the elderyly
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| agency for healthcare research and quality | supports research designed to omprove the outcomes and quality of health care, reduce costs and address patient safety and quality of care
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| agency for toxic substances and disease registry | works with states and other fedral agencies to prevent exposure to hazardour materai l
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| centers for disease control and prevention | provides a systems of health surveillance to monitior and prevnet outbreak of diseases
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| centers for medicare and medicaid | administers medicare and medicaid and childrens health insurance
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| food and druf administration | assures the safety of food, drugs cosemetics, and other medicaldevices
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| health resources and services administration | provides heakth resources for medically inderdeserved populations, works to build health care workforces, maintains the national health serives corps
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| indian health services | supports a network of hospitals, clinics, schools, to american indian tribes
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| national instutites of health | with seperate instutites its the worlds premier medical research organization, supporting research projects on diseases
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| office of pyblic health and science | directed by the assistance secretary for health serves as a focal point of leaderships and coordinates progams across the US
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| office of the secretary of health and human services | advises the president on health, welfare, income security plans, etc
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| program support centers | a service for free organizations that utilizes business enterprose approach to provide governemnt support services
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| substane abuse and mental health administration | works to improve the quality and availability of substance abuse preventions, addictions, and treatments
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| capitation payment | lump sum payment
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