question

Activity of daily living(ADL)

answer

Services provided by a residential care facility including: Bathing, dressing, eating, toileting, walking, etc...

question

Acute care facility (ACF)

answer

Hospitals that provide health care services to patients who have serious, sudden, or acute illnesses or injuries and/or who need surgeries.

question

Acute hospital classification

answer

Same as short term hospital

question

Administration for Children and Families (ACF)

answer

DHHS programs that provide services and assistance to needy children and families.

question

Administration on Aging (AOA)

answer

DHHS program that supports a nationwide aging network, providing services to the elderly to enable them to remain independent.

question

Agency for Healthcare Research and Quality (AHRQ)

answer

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.

question

Agency for Toxic Substances and Disease Registry (ATSDR)

answer

DHHS agency that works with states and other federal agencies to prevent exposure to hazardous substances from waste sites.

question

Alzheimer's treatment facilities

answer

long-term care facility that specializes in the care of patients diagnosed with Alzheimer's disease.

question

Ambulatory care

answer

Outpatient care that allows patients to receive care in one day without the need for inpatient hospitalization; also called outpatient care.

question

Ambulatory Infusion Center (AIC)

answer

Same as infusion center

question

Ambulatory patients

answer

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 minutes, and 59 seconds; if patients require a longer stay, they must be admitted to the facility as inpatients.

question

Ambulatory surgical center (ASC)

answer

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 the nursing staff.

question

Ambulatory surgical patient

answer

Certain procedures can be performed on an outpatient basis, with the patient treated and released the same day. Length of stay is a maximum of 23 hours, 59 minutes, and 59 seconds. If patients require a longer stay, they must be admitted to the facility as inpatients.

question

Ancillary services

answer

Diagnostic and therapeutic services provided to inpatients and outpatients.

question

Assisted living facility (ALF)

answer

Combination of housing and supportive services including personal care and household management for seniors. Residents pay monthly rent and additional fees for services they require.

question

Bed count

answer

Same as bed size

question

Bed size

answer

Total number of inpatient beds for which the facility is licensed by the state; also called bed count.

question

Behavioral health care hospital

answer

Specializes in treating individuals with mental health diagnoses.

question

Bureau of prisons (BOP)

answer

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 82 institutions, each of which provides inmate ambulatory care.

question

Cafeteria plan

answer

See triple option plan

question

Capitation payment

answer

Lump sum paid by the HMO to the provider to care for a group of subscribers.

question

Centers for Disease Control and Prevention (CDC)

answer

DHHS agency that provides a system of health surveillance to monitor and prevent the outbreak of diseases.

question

Chemical dependency program

answer

Provides 24 - hour medically directed evaluation and withdrawal management in an acute care inpatient setting. Treatment services usually included detoxification and withdrawal management, chemical dependency/substance control assessment, and therapy.

question

Chemotherapy

answer

Intravenous administration of chemical agents that have specific and toxic effects upon a disease - causing cell or organism.

question

Clinical laboratory

answer

Performs testing in microbiology, clinical chemistry, and toxicology; directed by a pathologist ; and testing is performed by certified, professional technologists and technicians.

question

Clinic outpatient

answer

Hospital ambulatory care patient who receives scheduled diagnostic and therapeutic care.

question

Closed - panel HMO

answer

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.

question

Copayment

answer

Fixed amount a subscriber must pay when seeking health care services.

question

Correctional facilities

answer

Provides inmates with a secure housing environment that also offers vocational and educational advancement. Medical, dental, and mental health care services are provided to inmates according to a standard of care imposed by court decisions, legislation, accepted correctional and health care standards, and department policies and procedures.

question

Crisis service

answer

Provides short - term (usually less that 15 days) crisis intervention and treatment; patients receive 24 - hour - per - day supervision.

question

Continuing Care Retirement Communities (CCRC)

answer

Provides different levels of care on the residents needs from independent living apartments to skilled nursing care in an affiliated nursing facility.

question

Critical Access hospital (CAS)

answer

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

question

Curative care

answer

Therapeutic

question

Day treatment program

answer

Intensive treatment program provided to patients who live in the community but come to the facility up to five days per week.

question

Developmentally disabled/mentally retarded facilities

answer

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 diagnosis and evaluation of individuals with developmental disabilities.

question

Diagnosis related groups (DRG

answer

Inpatient hospital cases classified into groups that are expected to consume similar hospital resources. Hospital inpatients are discharged once the acute phase of illness has passed, and they are often transferred to other types of health care, such as outpatient care, skilled care facilities, rehabilitation hospitals, home health care, and so on.

question

Dementia care facilities

answer

Long term care facilities that specialize in the care of patients diagnosed with dementia.

question

Direct contract model HMO

answer

Individual physicians in the community deliver contracted health care services to subscribers.

question

Drug therapy

answer

Intravenous administration of other drugs including antibiotics, antivirals, and so on.

question

Drug therapy

answer

Includes canes, crutches, IV supplies, hospital beds, ostomy supplies, oxygen, prostheses, walkers, wheelchairs, etc...

question

Emergency care center

answer

Same as urgent care center.

question

Exclusive Provider Organization (EPO)

answer

Provides benefits to subscribers who receive health care services from network providers.

question

Family practitioners

answer

Provides care for the entire family and focuses on general medicine, obstetrics, pediatrics, and geriatrics

question

Family Support Services

answer

Services provided to assist families in caring for the patient.

question

Federal certification

answer

Measures ability of health care facilities to deliver care that is safe and adequate, in accordance with federal law and regulation

question

Federal medical centers (FMC)

answer

Provide major medical care to federal correctional facility inmates.

question

Flexible benefit plan

answer

Same as Triple option plan.

question

Food and Drug Administration (FDA)

answer

DHHS agency that assures the safety of foods and cosmetics, and the safety and efficacy of pharmaceuticals, biological products, and medical devices.

question

General hospitals

answer

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.

question

Group model HMO

answer

Participating physicians who are members of an independent multi - specialty group providing health care services. Physician groups either contract with the HMO or they are owned or managed by the HMO.

question

Group Practice Without Walls (GPWW)

answer

Managed care contract in which physicians maintain their own offices and share services to plan members.

question

Health Maintenance Organization (HMO)

answer

An alternative to traditional health insurance coverage provides comprehensive health care services to members on a prepaid basis .

question

Health Resources and Services Administration (HRSA)

answer

DHHS agency that provides health resources for medically underserved populations, works to build the health care workforce, maintains the National Health Service Corps, oversees the nation's organ transplantation system, works to decrease infant mortality and improve child health, and provides services to people with AIDS through the Ryan Whit CARE Act programs.

question

Heart and vascular center

answer

Provides ambulatory cardio - vascular services to include diagnosis and treatment, disease prevention, research, education, and cardiac rehabilitation.

question

Home care

answer

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.

question

Home infusion care

answer

Provided by home health care agencies when intravenous administration of medication is medically appropriate for the patient's condition, and treatment is administered in the home instead of on an inpatient hospital basis .

question

Hospice care

answer

Provides comprehensive medical and supportive social, emotional, and spiritual care to terminally ill patients and their families. Goal is palliative rather than curative.

question

Hospitalist

answer

physician who spends most of his or her time in a hospital setting admitting patients to inpatient services from local primary care providers.

question

Hospital

answer

owned physician practice - Practices that are at least partially owned by the hospital, and physicians participate in a compensation plan provided by the hospital.

question

Hydration therapy

answer

Intravenous administrative of fluids, electrolytes, and other additives.

question

Imaging center

answer

Freestanding facility that provides radiographic and other imaging services to ambulatory patients. Some centers also provide training and participate in national research projects

question

Independent Practice Association - (IPA)

answer

Same as Individual Practice Association (IPA)

question

Industrial health clinic

answer

Located in a business setting, the emphasis is on employee health and safety.

question

Infusion center

answer

Freestanding center that dispenses and administers prescribed medications by continuous or intermittent infusion to ambulatory patients. Infusion is supervised by a licensed health care professional; aka ambulatory infusion center.

question

Inpatients

answer

Those who remain overnight in the facility for 24 hours or more and are provided with room and board and nursing services.

question

Integrated Delivery System (IDS)

answer

Organization of affiliated provider sites that offer joint health care services to subscribers.

question

Integrated Provider Organization (IPO)

answer

Manages health care services provided by hospitals, physicians, and other health care organizations

question

Intensive case management

answer

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.

question

Intermediate care facility (ICF)

answer

Provides developmentally disabled people with medical care and supervision, nursing services, occupational and physical therapies, activity programs, educational and recreational services, and psychological services.

question

Internal medicine physicians

answer

Specializes in the care of adults.

question

Long - term care

answer

Includes a range of nursing, social, and rehabilitative services for people who need ongoing assistance. Lengths of stay typically average greater than 30 days.

question

Long - term care hospital (LTCH)

answer

Defined in Medicare law as hospitals that have an average inpatient length of stay greater than 25 days. These hospitals typically provide extended medical and rehabilitative care for patients who are clinically complex and may suffer from multiple acute or chronic conditions.

question

Long - term hospital classification

answer

Same as long - term care hospital.

question

Managed care

answer

Originally referred to the prepaid health care sector, such as HMOs, which combined health and some forms of indemnity coverage that incorporate utilization management activities. care delivery with the financing of health care services; increasingly used to refer to preferred provider organizations

question

Management Service Organization (MSO)

answer

Provides practice management services, including administrative and support services, to individual physician practices.

question

Medical foundation

answer

Nonprofit organization that contracts with and acquires the clinical and business assets of physician practices.

question

Medical necessity

answer

requires documentation of services or supplies that are proper and needed for the diagnosis or treatment of a medical condition; are provided for the diagnosis, direct care, and treatment of a medical condition; meet the standards of good medical practice in the local area; and are not mainly for the convenience of the physician or health care facility.

question

Military Health System (MHS)

answer

Administers health care for active members of the uniformed services as provided by military treatment facilities and networks of civilian health care unavailable

question

Military Medical Support Office (MMSO)

answer

Coordinates civilian health care services when military treatment facility services are unavailable.

question

Military treatment facility (MTF)

answer

Clinic and/or hospital located ona U>S. military base.

question

Multi - hospital systems

answer

Category or 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.

question

Multi - specialty group physician practices

answer

Offer various types of medical specialty care in one organization, and they may be located in more than one location.

question

National Commission on Correctional Health Care (NCCHC)

answer

Provides an external peer process for correctional institutions that wish to meet its nationally accepted Standards for Health Services.

question

National Institutes of Health (NIH)

answer

DHHS research center, with 17 separate institutes, is the world's premier medical research organization, supporting some 35,000 research projects nationwide in diseases like cancer, Alzheimer's disease, diabetes, arthritis, heart ailments, and AIDS.

question

Neighborhood health centers

answer

Health care is provided to economically disadvantaged people, and treatment is family - centered because illnesses may result indirectly from crowded living conditions, unsanitary facilities, and other socioeconomic factors. Family care team consisting of a physician, nurse, and social worker provides continuity of care to families.

question

Network model HMO

answer

Two or more physician multi-specialty group practices provide contracted health care services to subscribers.

question

Network providers

answer

Physicians and health care facilities under contract to the managed care plan.

question

Newborn patients

answer

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.

question

Nursing facility (NF)

answer

Same as skilled nursing facility.

question

Observation patients

answer

Receive services furnished on a hospital's premises that are ordered by a physician or an the authorized individual, including use of a bed and periodic monitoring by nursing or other staff, which are reasonable and necessary to evaluate an outpatient's condition or determine the need for a possible admission as an inpatient.

question

Open - panel HMO

answer

Includes direct contract, individual practice association, and network models; physicians are not employees of the HMO and thery do not belong to a specially formed medical group that serves the HMO.

question

Outpatient care

answer

Same as ambulatory care.

question

Outpatients

answer

Same as ambulatory patients.

question

Pain management

answer

Intravenous administration of narcotics and other drugs designed to relieve pain.

question

Pain management center

answer

Specializes in treatment of acute and chronic pain syndromes using proven medications and procedures. Usually a multidisciplinary approach is used involving participating specialists such as physiatrists, psychiatrists, neurologists, neurosurgeons, internists, and physical and occupational therapists.

question

Palliative care

answer

Comfort management.

question

Partial hospitalization program

answer

Program for hospital patients who regularly use the hospital facilities for a substantial number of either daytime or nighttime hours.

question

Pediatricians

answer

Provides comprehensive services for infants, children, and adolescents.

question

Personal care and support services

answer

provide assistance in performing daily living activities, such as bathing, dressing, grooming, going to the toilet, mealtime assistance, travel training, and accessing recreation services.

question

Physician - Hospital Organization (PHO)

answer

Managed care contracts are negotiated by hospital(s) and physician groups; physicians maintain their own practices and provide services to plan members.

question

Point - of - service plan (PSO)

answer

Patients have the freedom to use an HOM panel of providers (for which a copayment is paid) or to self - refer to non - HMO providers (for which greater out - of - pocket expenses apply).

question

Preadmission certification (PAC)

answer

form of utilization management that involves the review for medical necessity of inpatient care prior to inpatient admission.

question

Preferred Provider Organization (PPO)

answer

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.

question

Primary care center

answer

Offers adult and family care medicine in internal medicine, pediatrics, and family practice.

question

Public Health Service (PHS)

answer

Uniformed Service of the DHHS. Leadership is provided by the U.S. Surgeon General. It provides highly trained and mobile health professionals who carry out programs to promote the nation's health, understand and prevent disease and injury, assure safe and effective drugs and medical devices, deliver health services to federal beneficiaries, and furnish health expertise in time of war or other national or international emergencies.

question

Public health department

answer

Provides preventive medicine services such as well baby clinics, which include immunizations and routine checkups.

question

Referred outpatients

answer

Hospital ambulatory care patient who receives diagnostic or therapeutic care because such care is unavailable in the primary care provider's office. Follow - up is done at the primary care provider's office.

question

Rehabilitation hospital

answer

Admits patients who are diagnosed with trauma or disease and who need to learn how to function.

question

Residential care facility (RCF)

answer

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.

question

Residential treatment facility

answer

Seriously disturbed patients receive intensive and comprehensive psychiatric treatment on a long - term basis.

question

Respite care

answer

care provided by specially trained individuals at a setting other than the patient's home to offer relief and rest to primary caregivers.

question

Satellite clinics

answer

Ambulatory care centers established remotely from the hospital. Primary care is provided by an on - duty physician.

question

Short - term hospital classification

answer

Patients have an average LOS of 4 - 5 days and a total LOS of less than 25 days; also called acute hospital classification.

question

Single hospitals

answer

Category of hospitals that are self - contained and not part of a larger organization.

question

Single - specialty group physician practice

answer

Single - specialty practice that consists of two or more physicians who provide patients with one specific type of care.

question

Skilled care

answer

Includes services that are ordered by a physician and provided under the supervision of a registered nurse, or physical, occupational, or speech therapist.

question

Skilled nursing facility (SNF)

answer

Provides medically necessary care to inpatients on a daily basis that is performed by, or under the supervision of, skilled medical personnel. SNF's provide IV therapy , rehabilitation, and wound care services; also called nursing facility.

question

Solo physician practices

answer

Organizations that do not have physician partners or employment affiliations with other practice organizations.

question

Specialty hospitals

answer

concentrate on a particular population of patients or disease.

question

Staff model Health maintenance organization (HMO)

answer

Similar to large, multispecialty group practices, it may be partially owned by the physicians employees, with the physicians typically functioning as employees of either the physician group owning the practice or the insurer. Most physicians in this type of HMO are paid a salary.

question

Student health center

answer

Provides health care to full and part - time students who become ill or injured.

question

Subacute care

answer

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.

question

Subscribers

answer

Individuals who pay health insurance premiums.

question

Substance and Mental Health Services Administration (SAMHSA)

answer

DHHS agency that works to improve the quality and availability of substance abuse prevention, addiction treatment, and mental health services.

question

Swing bed

answer

Allows a rural hospital to admit a nonacute care patient.

question

Temporary Assistance to Needy Families (TANF)

answer

State federal welfare program.

question

Therapeutic group home

answer

6 to 10 individuals are provided with supervised housing that may be linked with a day treatment program.

question

Total parenteral nutrition (TPN)

answer

Administration of nutritional substances by peripheral or central intravenous infusion to patients who are either already malnourished or have the potential for developing malnutrition.

question

Triple Option plan

answer

Provides subscribers and employees with a choice of HMO, PPO, or traditional health insurance plan; also called cafeteria plan.

question

Urgent care center

answer

Immediate care is provided by an on - duty physician. The center is usually owned by private corporations in states where permitted or non - profit facilities; also called emergency care center.

question

Utilization management

answer

Controls health care costs and the quality of health care by reviewing cases for appropriateness and medical necessity.

question

Ventilator

answer

Breathing machine.

question

Veterans Health Administration (VHA)

answer

An agency in the Department of Veterans Affairs that provides medical, surgical, and rehabilitative care to veterans of the armed services.

question

Veterans Integrated Service Network (VISN)

answer

Administers and provides health care services at FA Medical Centers and community based outpatient clinics.

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