Health-Care Facilities and Services Lecture Notes

These flashcards cover key vocabulary terms and their definitions from the lecture on health-care facilities and services, including healthcare laws, types of care, payment systems, and concepts related to healthcare quality and safety.

Academic Medical Centers

Large hospitals affiliated with universities that combine patient care, research, and medical education.

Hospice Care

End-of-life care focused on comfort and quality of life rather than curing illness.

Acute Care Hospital

Provides short-term treatment for severe or urgent medical conditions.

Federal Hospitals 

Hospitals operated by the federal government (e.g, VA or military hospitals)

Inpatient Services

Care that requires the patient to be admitted overnight or longer.

Outpatient Services

Medical care that does not require an overnight hospital stay.

Long-Term Care (LTC)

Continuous services for people with chronic illnesses or disabilities who need help with daily activities.

Independent Living

Housing for older adults who can live on their own but want community amenities.

Community (in health care)

Refers to local health systems or services provided at the community level.

Almshouses/Poorhouses 

Early forms of public housing that cared for the poor, elderly, or disabled before modern hospitals.

Proprietary Hospitals

For-profit hospitals owned by individuals or corporations.

Public Hospitals

Government-funded hospitals that provide services to all, often regardless of ability to pay.

Assisted-Living Facilities

Residential facilities offering personal care services (meals, medication help, etc.) for people needing some assistance but not 24-hour nursing care.

Home Care

Medical or personal care delivered in a patient’s home.

Skilled Nursing Facilities (SNFs)

Facilities providing 24-hour medical supervision and rehabilitation services by licensed nurses.

Patient Self-Determination Act

1990 law requiring health facilities to inform patients of their rights to make advance directives.

Fee-for-Service

Payment model where providers are paid for each service or procedure performed.

Managed Care Organizations (MCOs)

Groups that coordinate health services to control cost and quality.

Consumer-Driven Health Plans (CDHPs)

Insurance plans with high deductibles and tax-advantaged savings accounts.

Health Care Savings Account (HSA)

Tax-free savings account used with high-deductible health plans to pay medical expenses.

Capitation

A set payment per patient per period regardless of services provided.

Cost-Sharing

When patients pay part of health costs through deductibles, co-pays, or co-insurance.

Out-of-Network

Providers not contracted with a patient’s insurance plan, usually costing more.

Out-of-Pocket Payments

Direct payments made by patients for services not covered by insurance

Co-pays & Deductibles

Co-pay: fixed fee per service; Deductible: amount patient pays before insurance covers costs.

Prospective Payment System

Medicare’s system of paying hospitals a set amount based on diagnosis.

Retrospective Payment System

Reimburses providers after services are delivered based on actual costs.

Utilization Review (UR)

Evaluation of the necessity and efficiency of health-care services.

Hospital Readmissions Reduction Program (HRRP)

Medicare initiative penalizing hospitals with excessive readmissions for certain conditons

Medigap (Medicare Supplemental Plans)

Private insurance covering costs not paid by Original Medicare (Parts A & B) 

CMS 5-Star Rating System

Centers for Medicare & Medicaid Services rating system measuring quality of hospitals, nursing homes, and plans.

Social Security Act of 1935

Created the foundation for U.S. social welfare programs, including Medicare and Medicaid.

Medicare Parts A, B, C, D

A: Hospital insurance, B: Medical/ outpatient insurance, C: Medicare Advantage, D: Prescription drug coverage.

Medicaid

Federal-state program offering health coverage for low-income individuals.

Children’s Health Insurance Program (CHIP)

Provides low-cost health coverage for children whose families earn too much for Medicaid.

Long-Term Care Insurance

Private insurance that helps cover extended care costs not covered by health insurance.

Allied Health Professional

Trained professionals other than physicians or nurses providing diagnostic or therapeutic services.

Certified Nursing Assistant (CNA)

Provides basic patient care under nurse supervision.

Advanced Practice Registered Nurse (APRN)

Nurse with graduate-level training including NPs, nurse midwives, and nurse anesthetists.

Doctor of Medicine (MD)

Physician trained in allopathic medicine.

Osteopathic Physician (DO)

Licensed physician emphasizing holistic care and the musculoskeletal system 

Generalists

Physicians providing primary care across a broad range of conditions.

Specialists

Physicians focused on a specific area of medicine.

Licensed Practical Nurse (LPN)

Nurse providing basic care under the supervision of RNs or physicians.

Registered Nurse (RN)

Nurse who provides and coordinates patient care and education.

Community Health Workers

Public health workers connecting communities to health services.

Innovation

The introduction of new ideas, technology, or methods to improve health care.

Workarounds

Informal methods used by staff to bypass system barriers, which can improve efficiency.

Safety Culture

Shared commitment among staff to prioritize patient safety and transparency.

Just Culture

Framework balancing learning from errors with responsible discipline.

Near Misses

Incidents that could have caused harm but did not due to chance or timely intervention.

Adverse Events

Injuries or complications caused by medical care.

Sentinel Events

Unexpected occurrences involving death or serious injury that require immediate investigation.

National Patient Safety Goals

Standards set to improve patient safety in health care.

Required Reporting of Safety Violations

Mandatory reporting of serious safety breaches to regulatory bodies.

Instrumental Activities of Daily Living (IADLs)

Complex skills needed for independent living. (managing money, shopping, cooking)

Activities of Daily Living (ADLs)

Basic self-care tasks necessary for daily functioning. (bathing, dressing, eating, toileting, mobility)

Olmstead Decision

1999 ruling requiring states to provide community-based services for individuals with disabilities.

Respite Care

Short-term relief for primary caregivers of individuals needing long-term assistance.