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14 Cards in this Set
- Front
- Back
Public Agency |
1. Federal - VA hospitals, public health service hospital, Indian Health Services
2. State - Correctional facilities, mental health centers, medical school hospital
3. County - county hospitals/clinics, rehab facilities
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Private Not-For-Profit |
- Receive special tax exempt - Hospitals/clinics with religious affiliations - Private teaching hospitals - Includes organizations, such as Easter Seals or United Cerebral Palsy |
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Private For Profit |
- Owned and operated by individuals or a group of investors - In business to make a profit - Includes hospitals, SNFs, out-pt. clinics |
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Continuum of Care |
Acute Subacute Long-Term Care Home-Health Outpatient |
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Diagnosis Related Groups (DRGs) |
Paid pre-determined fixed fee regardless of services provided |
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Prospective Payment System (PPS) |
- Introduced the DRG system which determined how hospitals would be reimbursed - Resulted in hospital stays being shortened |
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Minimum Data Set (MDS) |
- Core set of screening, clinical, and functional status elements reported on all residents of nursing facilities certified to participate in Medicare/Medicaid - What leve the pt. is functioning at; given a numerical value |
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Resource Utilization Groups (RUGs) |
- Based on the LTC MDS - Used to determine the amt of time in a therapy a patient will receive over the course of a week
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Units |
1 unit = 15 min block of time |
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Medicare |
Part A = Hospital Insurance
Part B = Medical Insurance
Part C = Medicare Advantage; Allows one to choose to receive all of care services through a provider organization and/or your may get extra benefits for an additional fee. Must have both parts (A & B) to enroll in Part C.
Part D: Prescription drug coverage that is voluntary |
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Biological Practice Settings |
Hospital, Clinic, & Home Health |
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Social Practice Settings |
Schools/Special Education, Day Tx Centers, Workshops |
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Psychological Practice Settings |
Insitutions/State Hospitals, Community Mental Health Centers, Supervised Living |
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All-Inclusive Settings - Non-Traditional Settings |
Correctional facilities, industrial settings, hospice, HMOs, community transition settings, therapeutic riding, aqua-therapy, senior citizen centers, etc... |