Study Questions
    • Study Questions
  2. 1a. American Medical Association (AMA)
    The AMA's stated mission is to promote the art and science of medicine for the betterment of the public health, to advance the interests of physicians and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, and to raise money for medical education.
  3. 1b. American College of Surgeons (ACS)
    The American College of Surgeons is a scientific and educational association of surgeons that was founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice.
  4. 1c. American Hospital Association (AHA)
    AHA works with its members, state, regional, and metropolitan hospital associations and other organizations to shape and influence federal legislation and regulation to improve the ability of its members to deliver quality health care.
  5. 1d. American Nurses Association (ANA)
    The American Nurses Association (ANA) is a professional organization to advance and protect the profession of nursing.
  6. 1e. Blue Cross / Blue Shield (BC/BS)
    The Blue Cross Blue Shield Association (BCBSA) is a federation of 38 separate health insurance organizations and companies in the United States. Combined, they directly or indirectly provide health insurance to over 99 million Americans.
  7. 3a. ALOS
    • Average length of stay in Acute care facilities
    • (ALOS) = less than 30 days
    • • General ACF
    • • Specialty ACF
  8. Define: 3b. acute care facility
    • Average length of stay (ALOS) = less than 30 days
    • • General ACF
    • • Specialty ACF
  9. Define: 3c. ambulatory care facility
    • Ambulatory care facilities
    • • No overnight care provided
  10. Long term care facilities
    • • ALOS = 30 days or more
    • • Independent Living Facilities
    • • Assisted Living Facilities
    • • Nursing Facilities
  11. Define: e. behavioral health facility
    • Behavioral health facilities
    • • Diagnostic and therapeutic services for patients with a mental illness or psychiatric-related illness
  12. Define: f. rehabilitation facility
    Provide restorative and adjustive services
  13. 3g. home care agency
    • Provided in-home care
    • skilled and unskilled
  14. 3h.    hospice agency
    Provide paillative and supportive care for the terminally ill
  15. 3i. patient
    patient who recives services from hospital
  16. 3j. client
    a pateint who receives mental of health servcies
  17. 3k. resident
    a patient who resides in a long term care facility
  18. 3l. payer
    an organization or individual who provides the money to pay for health care services
  19. 3m. provider
    any entity that provides health care sevices to patients, including health care organizations and health care professionals
  20. 3n. skilled nursing unit
    • Ongoing treatment (i.e., wound care, IV therapy)
    • ALOS =< 30 days
  21. 3o. satellite clinic
    a facility owned by a hospital but operated at a distant site
  22. 3p. outpatient department
    A patient who is receiving or has received health care services without being admitted as an inpatient or resident
  23. 3q. acute long term care facility
    • • Aggressive treatment in a limited setting
    • • ALOS = > 30 days
    • A long-term acute care facility is a hospital specializing in treating patients requiring extended hospitalization with an average length stay of at least 30+ days.
  24. 3r. inpatient
    A patient who is receiving health care services, room, and board in a designated nursing unit
  25. 3s. outpatient
    A patient who is receiving or has received health care services without being admitted as an inpatient or resident
  26. 3t. emergency patient
    A patient admitted through the emergency department (ED) for the services provided by that department
  27. 3u. observation patient
    • • Applies to Medicare and Medicaid patients only
    • • A patient who is admitted for further evaluation to determine the nature of the illness and to identify the appropriate level of care
    • •Medicare: 48hours
    • •Medicaid: 23hrs.59min
  28. 3v. newborn patient
    An infant born in that particular facility
  29. 3w. transfer patient
    A patient transferred from one hospital service to another within the same facility
  30. 3x. private practice
    professional who started their own business in their healthcare speciality
  31. 3y. primary care
    It refers to the work of health care professionals who act as a first point of consultation for all patients within the health care system. Such a professional would usually be a primary care physician, such as a general practitioner or family physician, or a non-physician primary care provider, such as a physician assistant or nurse practitioner.
  32. 3z. secondary care
    Secondary care is the health care services provided by medical specialists and other health professionals who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists.
  33. 3aa. contiuum of care
    • Continuity of health care (also called continuum of care)
    • is to what degree the care is coherent and linked, in turn depending on the quality of information flow, interpersonal skills, and coordination of care
  34. 3bb. continuing diagnostic unit
    • • Unit within or nearby hospital ED
    • • Provides further evaluation
  35. 3cc. critical access hospital
    • • Rural community hospitals
    • • Receive cost-based reimbursement
    • • Offer limited services (acute patient care)
  36. 3dd. community health center
    community health center is a clinic staffed by a group of general practitioners and nurses.
  37. 3ee. observation unit
    of the hospital in the unit, for observation of patient who needs assessment, evaluation, or monitoring because of a significant degree of instability or disability that does not require admission to the hospital as an inpatient.
  38. 3ff. episode of care
    managed care healthcare services provided for a specific illness during a set time period
  39. 3gg. trauma center
    A hospital equipped toprovide comprehensive emergency medical services to patients suffering traumatic injuries
  40. 3hh. tertiary care
    Tertiary care is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital.
  41. 6. Describe the three categories of non-government owned healthcare facilities.
    • Proprietary (for profit,private, investorowned)
    • • Governed by theentity(ies) which ownthem
    • • Stand-alone or multifacilitycorporations

    • Not-for-profit(voluntary)
    • • Religious-affiliated
    • • Community• Industry, unions, etc.• Universities
    • Nonprofit • 501(c)3 Charitable organization
  42. 7. Describe the three categories of government-owned healthcare facility ownership categories.
    • Federal -VA, Military finded by fed taxes
    • State - state psych hosp, funded by state
    • Local - hospitals, funded by county taxes
  43. 8. Admitting Process - Centralized
    • All patients are admitted through one central admitting department
    • • Advantages? - Patients are lobbied in one main location for hospital admit
    • • Disadvantages? - Patients may have t go to another location for specific care
  44. 8. Admitting Process - Decentralized
    • Patients report directly to the appropriate service area of the facility for admission
    • • Advantages? Streamline process for patients
    • • Disadvantages? staff needed to trained and updated
  45. 11. Define the role of each of the following in healthcare facility administration:

    A. Chief Executive Officer :day to day operations, responsibilities as a communicator, decision maker, leader, manager and executor.

    b. Chief Financial Officer :officer is also responsible for financial planning and record-keeping, as well as financial reporting to higher management.

    c. Chief Operating Officer :is responsible for ensuring that business operations are efficient and effective and that the proper management of resources, distribution of goods and services to customers, and analysis of queue systems is conducted.

    d. Chief Information Officer : responsible for the information technology and computer systems that support enterprise goals.

    e. Chief Technology Officer: is an executive-level position in a company or other entity whose occupant is focused on scientific and technological issues within an organization.
  46. 13. Name the two basic types of health care facility functions or activities, and describe the HIM department’s role in each.
    • Care of patients and business services of hospital
    • HIM role in Both
  47. 16. State the general function of each department listed on the handout, “Health Care Facility Departments.”
    •  Administration
    •  Medical Staff
    •  Nursing Department
    • • Regular Units
    • • Intensive Care / Specialized Units
    •  Ancillary Departments
    •  Support Departments (HIM Depts) &Volunteers
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