Chapter 1: The Health Care System Vocabulary

Vocabulary terms and comprehensive definitions covering Chapter 1: The Health Care System.

Holistic care

An approach to health care that focuses on the care of the whole person, addressing physical, emotional, social, and spiritual needs rather than just a medical condition.

Humanistic care

An approach to health care centered on the person receiving care, considering their unique qualities, acting with empathy and compassion, and addressing emotional, social, spiritual, and physical needs.

Mission

The primary purpose or central goal of a health care organization.

Hospital

A type of acute care setting that provides intensive care, close monitoring, and medical treatment for severe or unstable illnesses.

Acute care setting

A health care facility, such as a hospital, that provides immediate, short-term care for individuals with severe, urgent, or unstable conditions.

Patients

Individuals who receive medical services and care within a hospital or acute care setting.

Inpatient care

Health care treatment provided to a patient who is formally admitted to stay in a facility for one or more nights.

Outpatient care

Health care services provided to a patient who receives treatment at a facility and returns home on the same day.

Subacute care unit

A unit within a facility or a stand-alone building (also called a skilled nursing facility) focused on rehabilitation to help patients transition from acute hospital care to home care.

Long-term care facility

A facility (commonly known as a nursing home) that provides ongoing care for people who are unable to care for themselves at home but do not require acute hospitalization.

Residents

People who live in and receive care from a long-term care facility, where the facility serves as their temporary or permanent home.

Assisted-living facility

A long-term care facility where individuals live in private apartments and maintain independence while receiving limited help with medications, transportation, meals, and housekeeping.

Home health care agency

An agency that delivers skilled health care services directly in a person's home.

Clients

Individuals who receive skilled health care services in a home health care setting.

Hospice organization

An organization dedicated to caring for terminally ill individuals and their families by relieving pain and providing emotional and spiritual support.

Health care team

A group of health care workers with varied specialized knowledge and skill levels who collaborate to provide holistic care focused on the patient or resident.

Board of trustees

A governing body composed of community members responsible for setting policies to ensure a health care organization delivers safe, high-quality care that satisfies community needs.

Director of Nursing (DON)

The leader of the nursing services division (also referred to as Chief Nursing Officer) who oversees all aspects of patient or resident care.

Department of Health and Human Services (DHHS)

The primary government agency in the United States responsible for protecting the nation's health and overseeing federal health services.

National Institutes of Health (NIH)

A agency under the DHHS that funds and supports thousands of research projects for diseases such as cancer, Alzheimer disease, heart problems, diabetes, and AIDS.

Agency for Healthcare Research and Quality (AHRQ)

An agency under the DHHS that supports research regarding health care quality and costs, offering evidence-based information on outcomes.

Food and Drug Administration (FDA)

An agency under the DHHS responsible for ensuring the safety and effectiveness of drugs, medical devices, foods, and cosmetics.

Centers for Disease Control and Prevention (CDC)

An agency under the DHHS that tracks health statistics, monitors disease outbreaks, and establishes prevention strategies.

Centers for Medicare and Medicaid Services (CMS)

An agency under the DHHS that provides oversight and administration of government-funded insurance programs.

Omnibus Budget Reconciliation Act (OBRA) of 1987

Federal legislation enacted to improve the quality of life for long-term care residents by establishing mandatory standards of care and nursing assistant training requirements.

The Joint Commission

An independent, nonprofit organization that sets national standards for health care facilities and offers voluntary accreditation to organizations that meet them.

Accreditation

Official recognition granted to a health care organization that successfully demonstrates compliance with established standards of quality and safety.

Survey

An onsite inspection and evaluation of a health care facility conducted by a team of officials to verify compliance with government and organizational standards.

Deficiency citations

Written statements in a survey report that document specific standards a health care facility failed to meet during an inspection.

Occupational Safety and Health Administration (OSHA)

A government agency under the U.S. Department of Labor created by the Occupational Safety and Health Act of 1970 to protect worker health and safety.

Group insurance

Health insurance coverage purchased at group rates by an employer or corporation on behalf of its employees or members.

Patient Protection and Affordable Care Act of 2010

Federal legislation expanding access to affordable health insurance through state and federal marketplaces for individuals without coverage through an employer, Medicare, or Medicaid.

Precertification

A preapproval process requiring health care providers to verify medical necessity with an insurance provider before carrying out a recommended treatment.

Managed care system

A system that manages health care delivery and controls costs by contracting with specific health care providers and requiring preauthorizations.

Preferred Provider Organization (PPO)

A managed care plan in which network providers agree to accept standard payments for services, enabling insured individuals to obtain care at reduced costs.

Health Maintenance Organization (HMO)

A managed care organization where providers deliver health care services for a prepaid fee, focusing heavily on preventative care and routine screenings to control total costs.

Medicare

A federally funded health insurance program administered by CMS under Social Security, available to individuals aged 65 and older and certain younger people with disabilities.

Minimum Data Set (MDS)

A mandatory assessment report used in Medicare-funded long-term care facilities to evaluate and track each resident's degree of required assistance and health status.

Prospective Payment System (PPS)

A Medicare cost-control mechanism that sets fixed payment amounts for specific hospitalizations and medical procedures, resulting in reduced hospital lengths of stay.

Medicaid

A federally funded and state-administered plan designed to help low-income individuals, as well as qualifying elderly adults and individuals with disabilities, pay for medical care.