Santa Anita Convalescent Hospital’s Glossary
Case Management – A system in which one individual helps the insured person and his or her family determine and coordinate necessary healthcare services and the best setting for those services.
Certificate of Medical Necessity – A document completed and signed by a physician to certify a client’s needs for certain types of durable medical equipment (i.e., wheelchairs, walkers, etc.)
Certified Nursing Assistant (C.N.A.) – The C.N.A. provides personal care to clients such as bathing, dressing, changing linens, transporting and other essential activities. C.N.A.’s are trained, tested, certified, and work under the supervision of an RN or LVN.
Chronic – A lasting, lingering or prolonged illness or symptom.
Chronic Disease – A disease which is permanent, or leaves residual disability, or is caused by nonreversible pathological alteration.
Chronic Obstructive Pulmonary Disease (COPD) – A group of chronic respiratory disorders characterized by the restricted flow of air into and out of the lungs. The most common example is emphysema.
Cognition – The process of knowing; of being aware of thoughts, the ability to reason and understand.
Cognitive Impairment – A diminished mental capacity, such as difficulty with short-term memory.
Co-morbidities – Multiple disease processes.
Companion Care – Nonmedical services that are provided in the client’s home. Examples include, but not limited to: helping the senior with everyday activities, making meals, grooming, ensuring safety, etc. No medical care is provided.
Congestive Heart Failure (CHF) – A common type of heart disease characterized by an inadequate pumping action of the heart.
Conservator – Person appointed by the court to act as the legal representative of a person who is mental or physically incapable of managing his or her affairs.
Custodial Care – Board, room and other personal assistance services (including assistance with activities of daily living, taking medicine and similar personal needs) that may not include a skilled nursing care component.
CVA – Refers to a cerebrovascular accident or stroke in which an area of the brain is damaged due to a sudden interruption of blood supply.
Decubitis – See pressure ulcers.
Dementia – a Progressive mental disorder that affects memory, judgment and cognitive powers. One type of Dementia is Alzheimer’s disease.
Developmental Disability (DD) – Refers to a serious and chronic disability, which is attributable to a mental or physical impairment or combination of mental and physical impairments. Those affected have limitations in three or more of the following areas¨ self-care, receptive and expressive language, learning, mobility, self-direction, the capacity of independent living, economic self-sufficiency. Those who have a developmental disability often require long-term treatment and care-planning.
Diagnostic Related Groups (DRGs) – DRGs are used to determine the amount that Medicare reimburses hospitals for inpatient services. The hospital is reimbursed a fixed amount based on the DRG code for the patient.
Discharge Planner – A discharge planner works with the IDT to determine discharge needs.
Distinct Parts – Separate units in a nursing facility where beds are available only for people whose care is paid for by a specific payment source, such as Medicare.
Durable Power of Attorney for Health Care (DPAHC) – A legal document in which a competent person gives another person (called an attorney-in-fact) the power to make health care decisions for him or her if unable to make those decisions. A DPA can include guidelines for the attorney-in-fact to follow in making decisions on behalf of the incompetent person.
Dysphagia – A swallowing disorder often depicted by difficulty in oral preparation for swallowing. The person has difficulty moving material from mouth to stomach.
Edema – A collection of fluid in the tissues which causes swelling.
Emergency Response Systems – Electronic monitors on a person or in a home that provides automatic response to medical or other emergencies.
End Stage Renal Disease (ESRD) – a Medical condition in which a person’s kidneys no longer function, requiring the individual to receive dialysis or a kidney transplant to sustain his or her life.
Exclusion – Any condition or expense for which a policy will not pay.
Foley Catheter – A tube which is inserted into the urinary bladder in order to drain urine. The urine drains through a tube and is collected in a plastic pouch.
Geriatrics – The branch of medicine that focuses on providing healthcare for the elderly and the treatment of a disease associated with the aging process.
G-Tube – A tube inserted surgically through an opening in the stomach. G-tubes offer another means of nutritional sustenance for those individuals unable to take these substances by mouth.
Healthcare Directive – A written legal document which allows a person to appoint another person (agent) to make healthcare decisions should he or she be unable to make or communicate decisions.
Healthcare Power of Attorney – The appointment of a health care agent to make decisions when the principal becomes unable to make or communicate decisions.
Health and Human Services, Department of – An executive department of the Federal Government that is responsible for the oversight of the Medicare and Medicaid programs.
Hospice –Hospice/palliative care is provided to enhance the life of the dying person. Often provided in the home by health professionals, today there are many nursing facilities and adult care settings that also offer hospice services. Hospice care, typically offered in the last six months of life, emphasizes comfort measures and counseling to provide social, spiritual and physical support to the dying patient and his or her family.
Hospice Care – The provision of short-term inpatient services for pain control and management of symptoms related to terminal illness.
Incompetence – Determine by a legal proceeding. Requires that the individual is incapable of handling assets and exercising certain legal rights.
Incontinent – Partially or totally unable to control bladder and/or bowel functions.
IV/Infusion Therapies – The way that liquid solutions or liquid medications are administered directly into the bloodstream through an intravenous catheter inserted in a vein in the body. Infusion therapies can include total parenteral nutrition, antibiotics or other drugs, blood and chemotherapy.
Length of Stay – The time a patient stays in a hospital or other health facility.
Living Will – A legal document in which a competent person directs in advance that artificial life-prolonging treatment not to be used if he or she has or develops a terminal and irreversible condition and becomes incompetent to make healthcare decisions.
Long-Term Care (LTC) – The broad spectrum of medical and support services provided to persons who have lost some or all capacity to function on their own due to a chronic illness or condition, and who are expected to need such services over a prolonged period of time. Long-term care can consist of care in the home by family members who are assisted with voluntary or employed help, adult day health care, or care in assisted living or skilled nursing facilities.
Long-Term Care Facilities – A range of institutions that provide healthcare to people who are unable to manage independently in the community. Facilities may provide short-term rehabilitative services as well as chronic care management.
Medicaid – The federally supported, state-operated public assistance program that pays for healthcare services to people with a low income, including elderly or disabled persons who qualify. Medicaid pays for long-term nursing facility care, some limited home health services, and may pay for some assisted living services, depending on the state.
Medical Records Director/Coordinator – Plans and directs the activities and personnel of the department. Coordinates the management of client medical records and the clerical needs of the nursing department.
Medically Necessary – Medical necessity must be established (via diagnostic and/or other information presented on the claim number under consideration) before the carrier or insurer will make payment.
Medicare – 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.
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 Medicare Part A automatically when they turn 65.
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). Part B helps pay for these covered services and supplies when they are medically necessary. A monthly premium must be paid to receive Part B.
Medicare-Certified Bed – A nursing home bed in a building or part of a building, which has been determined to meet federal standards for servicing Medicare patients requiring skilled nursing care.
Nasogastric Tube (NG Tube) – A tube that passes through a patient’s nose and throat and ends in the stomach. This tube allows for direct “tube feeding” to maintain the nutritional status of the patient or removal of stomach acids.
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 residents who are not in an acute phase of illness, but who primarily require continued care on an in-patient basis.
Nurse, Licensed Practical (LPN) – A graduate of a state-approved 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.
Nurse, Registered (RN) – Nurses who have graduated from a formal program of nursing education (two-year associate degree, three-year hospital diploma, or four-year baccalaureate) and passed a stated administered exam. RN’s have completed more formal training than licensed practical nurses and have a wide scope of responsibility including all aspects of nursing care.
Occupational Therapist – Occupational Therapists evaluate, treat, and consult with individuals whose abilities to cope with the tasks of everyday living are threatened or impaired by physical illness or injury, psychosocial disability, or developmental deficits. Occupational Therapists work in hospitals, rehabilitation agencies, long-term care facilities, and other healthcare organizations.
Ombudsman – The Ombudsman is a public/governmental / community / supported program that advocates for the rights of all residents in 24-hour long-term facilities. Volunteers visit local facilities weekly, monitor conditions of care and try to resolve problems involving meals, finances, medication, therapy, placements, and communications with the staff.
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.