MRIS 101 ch. 2

acute care

in hospitals inpatient care- patient stays less that 25 days

short term care provided to diagnose or
treat illness or injury

continuous monitoring by health professional

acute care facilities

hospital, urgent care, short term rehabilitation centers

long term care

refers to a variety of services that meet an individual health or personal care needs when they are no longer able to preform everday activities.

long term care facilities

nursing homes, rehabilitation hospitals, skilled nursing facilites, assisted living, long term acute hospitals

clinical privileges

Integrated Delivery System

offer a full range of health care services

ex.hospitals, nursing home, physicians, health agencys, hospice to ensure that patients get the right care at the right time

Integrated Delivery Network

a network of health entities under the same ownership, who provider services across different settings

IDN goal to deliver high quality and cost effective care in the most appropriate setting (reduce cost and maximize efficency)

Critical Access Hospital

25 > or fewer inpatient bed

is located more than 35 miles from another hospital or 15 miles in a mountainous terrain or only secondary roads

maintain a ALOS(average length of stay) of 96hr or less for acute care

provides 24/7 emergency care

funded by medicare rural hospital flex program

Managed Care

Maintenace organization or preferred provider organizations. can provide care but also can recommend place and doctors patients can visit to go get their care

health care reimburstment system that manages cost quality and access to services- contracts

Inpatients

patients inside the hospital that needs care

recevies room and board services in addition to continuous nursing and service for more than 24-hrs on a hospital

out patients

patients who receives hospital services without being admitted for inpatient or overnight care

ambulatory care

ambulatory “means walk in and walk out“

emergency and trauma service

emcompasses a;; health services provided to an indivdual without the requirment of staying overnight in a medical ddacility

medicare

for 65 year or old expanded to include disabled and those with chronic liver disease

Part A
- Inpatient, home healthcare, and nursing homes
- Funded through payroll taxes
Part B
-Monthly premiums
Physician services, outpatient hospital care, medical services and supplies, and other services not covered under Part A
Part C – Managed Care
Part D – medication coverage

Medicaid

for indignious, poor children very poor adults and pregnant women

Medicaid joint program with state and federal
governments

mission statement

Statement of the organization purpose and who it serves

hospital ownership

Inpatient Prospective Payment System

patient stays in hospital receives care then gets bill.

patient is put into a group receives money for that group if patient stays longer loses money if they stay less earn money

Outpatient Prospective Payment System

patients stays out of hospital receives care and then gets bill

patient is grouped into outpatient services hospital paid for those services if use more less loose or earn money.

Organization Chart

1) board of directors

2) executive staff

3) medical staff

Governing Body or Board of Trustees

Primary responsibility for setting direction of hospital (governing not manage)
o Strategic direction
o Mission
o Values
o Establish bylaws based on legal and licensing
requirements
o Select qualified administrator
o Approve organization and makeup of clinical staff
o Monitoring quality of care

made up of nonhospital employe to overlook the hospital (ppl interested in the wellfare of the community)

CEO

CEO = chief executive officer

“the president“

the person that is employed by the hospital and is there on a daily basis

works closes with adminsitrative staff

CIO

chief informative officer

senior manager responsible for managment of the hospital information resources

oversee information wings of hospital- HMI, information systems, patient registration

CFO

chief Fianacial office

senior manager responsible for the fiscal mangement of an organization

oversee Finacial wings of the hospital- business office, revenue cycle, material management

president

CEO

Vice president

part of the board of trustees