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  1. Managed care
    A method of financing and delivering health care for a set fee using a network of physicians and other providers who have agreed to the set fees
  2. Marketbasket index
    an inflationary index reflecting the annual change in prices of goods and services used by providers to deliver healthcare. Similar to the consumer price index
  3. MDS (Minimum data set)
    A core set of screening and assessment elements, including common definitions and coding categories, that form the foundation of the comprehensive assessment for all patients of LTC facilities
  4. MDS Coordinator
    a facility employee, usually a licensed nurse, responsible for making sure residents' MDS forms and care plans are completed promptly and coded accurately
  5. Meals of Wheels
    A home-delivered meal service. the program is funded through the Older Americans Act to deliver one hot noontime meal five days a week to Americans aged 60 and older (and their spouses) who are unable to prepare a nutritionally balanced meal for themselves
  6. Medicaid (Title 19)
    The federally supported, state operated public assistance program that pays for health care services to people with a low income, including elderly or disabled persons who qualify.
  7. Medicaid-Certified Bed
    A nursing facility bed in a building or part of a building which has been determined to meet federal standards for serving Medicaid recipients
  8. Medical Records Director/Coordinator
    Plans and directs the activities and personnel of the department. coordinates the management of resident medical records and the clerical needs of the nursing department
  9. Medically Necessary
    Medical necessity must be established before the carrier or insurer will make payment
  10. Medicare (title 18)
    The federal program providing primarily skilled medical care and medical insurance for people aged 65 and older, some disabled persons and those with end stage renal disease
  11. Medicare part A
    Hospital insurance that helps pay for inpatient hospital care, limited skilled nursing care, hospice care, and some home health care. Most people get it automatically when they turn 65
  12. Medicare Part B
    Medical insurance that helps pay for doctors services, outpatient hospital care, and some other medical services that part A does not cover (like some home health care). A monthly premium must be paid to receive Part B
  13. Medicare-Certified Bed
    A nursing facility bed in a building or part of a building, which has been determined to meet federal standards for serving Medicare patients and requiring skilled nursing
  14. Medicare Supplemental Insurance
    This is private insurance (often called Medigap) that pays Medicare's deductibles and coinsurances, and may cover services not covered by Medicare. Most Medigap plans will help pay for skilled nursing care, but only when that care is covered by Medicare
  15. Morbidity
    The extent of illness, injury or disability in a defined population. It is usually expressed in general or specific rates of incidence or prevalence
  16. Mortality
    Death. Used to describe the relation of deaths to the population in which they occur
  17. Nasogastric Tube (NG Tube)
    A tube that passes through a patients nose and throat and ends in their stomach. This tube allows for direct "tube feeding" to maintain the nutritional status of the patient or removal of stomach acids
  18. Nursing Facility (NF)
    Nursing facilities are licensed to provide custodial care, rehabilitative care, such as physical, occupational or speech therapy or specialized care for Alzheimer's patients. Additional, nursing facilities offer residents planned social, recreational and spiritual activites
  19. Nursing Home
    A facility licensed with an organized professional staff and inpatient beds and that provides continuous nursing and other health-related, psychosocial, and personal services to patients who are not in an acute phase of illness, but who primarily required continued care on an inpatient basis
  20. Nurse, Licensed Practical (LPN)
    A graduate of a state-approve practical nursing education program, who has passed a state examination and been licensed to provide nursing and personal care under the supervision of a registered nurse or physician. An LPN administers medications and treatments and acts as a charge nurse in nursing facilities
  21. Nurse Practitioner (NP)
    A registered nurse working in an expanding nursing role, usually with a focus on meeting primary healthcare needs. NPs can conduct physical examinations, interpret laboratory results, select plans of treatment and identify medication requirements. They also can perform certain medical management activities for selected health conditions. Some NPs specialize in geriatric care
  22. Nurse, Registered (RN)
    Nurses who have graduated from a formal program of nursing education (2 year associate degree, three-year hospital diploma, or 4 year baccalaureate) and passed a state-administered exam. RNs have completed more formal training than licensed practical nurses and have a wide scope of responsibility including all aspects of nursing care.
  23. OBRA (Omnibus Budget Reconciliation Act of 1987)
    Landmark legislation, sometimes called "The Nursing Home Reform Bill" that increased emphasis on care and codified many provisions for the first time. The law requires that each resident be evaluated upon admission, receive an individualized care plan and be informed about treatment decisions
  24. Occupancy Rate
    A measure of inpatient use, determined by dividing available bed days by patient days. It measures the average percentage of a hospital's beds occupied and may be institution-wide or specific for one department or service
  25. Occupational Therapist
    Evaluate, treat, and consult with individuals whose abilities to cope with the tasks of every day living are threatened or impaired by physical illness or injury, psychosocial disability, or developmental deficits. OT work in hospitals, rehabilitation agencies, long-term-care facilities, and other health-care organizations
  26. OIG (Office of Inspector General)
    Office in HHS charged with identifying and eliminating fraud, abuse, and waste in the Medicare, Medicaid and HHS programs
  27. Older Americans Act (OAA)
    Federal legislation that specifically addresses the needs of older adults in the United States. Provides some funding for aging services (such as home-delivered meals, congregate meals, senior centers and employment programs). Creates the structure of federal, state, and local agencies that oversee aging services programs.
  28. Ombudsman
    A public/government/community-supported program that advocates for the rights of all residents in 24-hour LTCF. Volunteers visit local facilities weekly, monitor conditions of care and try to resolve problems involving meals, finances, medication, therapy, placements and communication with the staff
  29. OMRA (Other Medicare required assessment)
    An MDS used to alter the resource utilization classification to a non-rehab group from a rehab group. This is filled out 8 to 10 days after the final therapy session if a resident is going to remain under Medicare Part A coverage
  30. OPPS (Outpatient prospective payment system)
    Covers Medicare reimbursement levels for hospital outpatient services, some Part B services for inpatients with no Part A coverage and partial hospitalization services provided by community mental health centers
  31. OSCAR (Online survey, certification, and reporting)
    A Centers for Medicare and Medicaid services database that holds survey and certification information of providers certified by either Medicare, Medicaid, or both. Different types of information are required from different providers
  32. OSHA
    Occupational Safety Health administration- An agency within the U.S. Department of Labor, it is charged with distributing and enforcing rules that protect employees from workplace hazards and injuries. In rare instances, states rely on their own occupational safety and health agencies for guidance to protect workers
  33. Outliers
    Patients whose length of stay or treatment cost differ notably from most others' stays or treatment
  34. Outpatient
    A patient who receives care at a hospital or other health facility without being admitted to the facility. Outpatient care also refers to care given in organized programs, such as outpatient clinics
  35. Pallative care
    Medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than providing a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness.
  36. Patient Assessment
    Also called resident assessment. A standardized tool that enables nursing homes to determine a patient's abilities, what assistance the patient needs and ways to help the patient improve or regain abilities. Patient assessment forms are completed using information gathered from medical records, discussions with the patient and family members, and direct observation
  37. Patient days
    The number of patients in facility multiplied by the number of days spent in facility. It reflects the total accumulation of days because some entities pay on a per diem basis
Card Set
411 final
LTC final