Term
|
Definition
| (1) Willful intent to cause harm. Abuse may be resident to resident or staff to resident harm.(2) Fraud committed against a public program such as Medicare or Medicaid |
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Term
| Accelerated Method of Depreciation |
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Definition
| A depreciation method that allows for larger amounts of depreciation in early years and smaller amounts in later years. The double declining-balance method is an example. (This enables the owner to receive tax and/or reimbursement benefits more quickly than using the straight line method). |
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Term
|
Definition
| The ability of a person needing services to obtain those services. |
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Term
|
Definition
| Any unexpected or unintentional incident, which may result in injury or illness to a resident. This does not include adverse outcomes from treatment or care. |
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Term
|
Definition
| The process of identifying, recording, and communicating information about the financial position and results of operations of a business entity, using principles designed to facilitiate informed decision-making by the entity's managers as well as by external groups. |
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Term
|
Definition
| Assets = Liabilities + Owners' Equity (capital). This equation states that the assets of a firm are equal to the claims of the creditors plus the claims of the owners. The balance sheet is a detailed statement of this equation. |
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Term
|
Definition
| Amounts owed to suppliers for goods and services. |
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Term
|
Definition
| Amounts owed to the facility for services or for the sale of goods. |
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Term
|
Definition
| Accreditation of a nursing facility by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) |
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Term
| Accrual Basis of Accounting |
|
Definition
| A system of accounting in which revenues are recorded in the period earned, and expenses are recorded in the period incurred even if cash is received or paid in a later or earlier time period. (Contrast with CASH BASIS of accounting) |
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Term
|
Definition
| The total depreciation from the start of the life of a plant asset to any point in time. On the balance sheet, there is a deduction for accumulated depreciation taken from the gross evaluation of depreciable plant and equipment to yield a net evaluation. |
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Term
| Acquired Immune Deficiency Syndrome (AIDS) |
|
Definition
| AIDS develops when a person infected with the human immunodeficiency virus (HIV) undergoes a breakdown and becomes susceptible to serious illness and death from other viruses, parasistes, fungi, and bacteria. |
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Term
| Acid-Test Ratio (or Quick Ratio) |
|
Definition
| Cash and other current assets that can be converted to cash right away (such as marketable securities and current receivables) divided by current liabilities. A measure of the ability of a firm to pay its current liabilities in the very short term (see also CURRENT RATIO). |
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Term
|
Definition
| Refer to any endeavor, other than routine activities of daily living, in which a resident participates that is intended to enhance his/her sense of well-being and to promote or enhance physical, cognitive, and emotional health. These include, but are not limited to, activities that promote self-esteem, pleasure, comfort, education, creativity, success, and independence. |
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Term
| Activities of Daily Living |
|
Definition
| Individual self-performance skills needed in everyday life such as ambulation/locomotion, eating, toileting, grooming/personal hygiene, and bathing. |
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Term
|
Definition
| An allied health professional trained to develop and provide leisure time activities for facility residents (patients). |
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Term
|
Definition
| The level of severity of a patient's condition. For example, patients who require intensive services are referred to as those having a higher level of acuity in relation to those who require less care. |
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Term
|
Definition
| Short-term, intense medical care for an episode of illness or injury often requiring hospitalization. |
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Term
|
Definition
| Episodic conditions that require short-term but intensive medical interventions. |
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Term
|
Definition
| Entries made at the end of an accounting period to record certain transactions or other accounting events that have not been recorded or have been improperly recorded during the accounting period. Examples include entries for depreciation expense and unused portions of prepaid expenses. |
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Term
|
Definition
| The direct application of a vaccine or prescribed drug or device, whether by injection, ingestion or any other means, to the body of a resident (patient). |
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Term
| Administrative Information System |
|
Definition
| Information technology that is designed to assist in carrying out financial and administrative support activities such as payroll, patient accounting, billing, accounts receivable, materials management, budgeting, cost control and office automation. |
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Term
|
Definition
| Rules and regulations formulated by departments or agencies of the executive branch of government to carry out the intent of statutory law. |
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Term
|
Definition
| See NURSING HOME ADMINISTRATOR/NURSING FACILITY ADMINISTRATOR |
|
|
Term
| Administrator In Training (AIT) |
|
Definition
| An internship with a certified preceptor required for an LTCA (NHA) license in some states; a person undertaking on-the-job training, or an internship, approved by a given state in preparation for licensing as a NHA. |
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Term
|
Definition
| A contract that spells out the services the nursing home will provide and the cost of those services. |
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Term
|
Definition
| A daytime program of nursing, rehabilitation therapies, supervision and socialization that enables elderly people to remain in the community and live with family. Services are generally provided on weekdays from 7 am to 6 pm to individuals who return home in the evening. |
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Term
|
Definition
| Written instructions from residents (patients) about the management and provision of care if they become incapacitated (e.g., living wills, do not resuscitate orders, durable power of attorney for healthcare). |
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|
Term
| Adverse Drug Reaction (ADR) |
|
Definition
| Any unintended response to a drug which is injurious or harmful to health and which occurs at normal doses. |
|
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Term
|
Definition
| Under the Civil Rights Act of 1964 and its amendments, adverse impact occurs whenever the selection rate for any protected group is less than 80% of the rate for the group with the highest rate. The focus is on the hiring standard used by the employer as a method of screening applicants. "The burden of proof is on the employer to show that a hiring standard is job related." |
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Term
|
Definition
| Review of a facility's hiring practices (recruiting, advertising, and data on the applicants) by the federal government to ensure conformity to the 1964 Civil Rights Act and its amendments. Legal violations can be processed if it is determined that the facility has discriminated based on age, sex, marital status, race, religion, handicap or national origin. |
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Term
|
Definition
| People who by definition in their culture have reached an advanced age during which they may become less productive. In the U.S. they are offen referred to as senior citizens, especially after reaching age 65. |
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Term
|
Definition
| Prejudicial treatment of the elderly based on stereotypes and misconceptions. |
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Term
|
Definition
| Someone authorized to act on behalf of another (a principal); for example, a corporation generally authorizes the administrator to represent it or act on its behalf. |
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Term
|
Definition
| Accommodating the changing needs of older adults while living in familiar surroundings. |
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|
Term
| Aging of Accounts Receivable |
|
Definition
| Summarizing unpaid balances in terms of age groups, such as: currently due, 1-30 days past due, 31-60 days past due each of the remaining 30-day periods through 151-180 days past due, and finally past due more than 180 days. This classification may be broken down by type of debtor. Aging receivables is a step in the collections effort, in reporting on the balance sheet a deduction from accounts receivable for estimated bad debt, and in making write-off decisions. |
|
|
Term
|
Definition
| Also called an "aging report," it shows the length of time that various amounts within each patient's account have been outstanding (not paid). |
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Term
|
Definition
| Verbal, vocal, and motor activities that are repetitive and outside of socially acceptable norms. |
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Term
|
Definition
| Medical approach--as practiced by physicians trained as doctors of medicine (MDs)--that views medical treatment as active intervention to produce a counteracting reaction in an attempt to neutralize the effects of disease. |
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Term
|
Definition
| The maximum fee that a third party will use in reimbursing or paying a provider for a service rendered. |
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|
Term
|
Definition
| Costs that are reimburseable under a third-party payment formula. |
|
|
Term
|
Definition
| A progressive degenerative disease of the brain, producing memory loss, confusion, irritability, and severe funtional decline. The disease becomes progressively worse and eventually results in death. |
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Term
|
Definition
|
|
Term
|
Definition
| Able to walk with or without difficulty or help. |
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|
Term
| Ambulatory Care (Ambulatory Services) |
|
Definition
| Services that require the patients to come and receive needed services at a community-based location. In a broader context, ambulatory care can be any outpatient services such as a visit to the physician's office or clinic or outpatient surgery. |
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Term
| Americans with Disabilities Act |
|
Definition
| Forced businesses and organizations to make significant changes in physical accessibility to their buildings and in the employment and customer service policies. |
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Term
|
Definition
| The periodic reduction of a debt by regular payments applied to both principal and interest over a scheduled period. |
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|
Term
|
Definition
| Extra charges for supplies and services, e.g., drugs and lab tests, that are not included in the per diem rate. |
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|
Term
|
Definition
| An annual assessment of a resident's (patient's) physical, mental, emotional, cognitive, and functional status. |
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Term
|
Definition
| Psychoactive medications given to reduce anxiety (e.g., Ativan, Valium, Xanax) |
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|
Term
|
Definition
| The Medicare and Medicaid Anti-Kickback Law penalizes anyone who knowingly and willfully solicits, receives, offers, or pays a remunerationin cash or in kind to induce, or in return for: A. Referring and individual to a person for the furnishing, or arranging of the furnishing, of an item or service to be paid for by the Medicare or Medicaid program; or B. Arranging or recommending the purchase, lease, or order of goods or services to be paid for under Medicare or Medicaid. Violators are subject to criminal penalties or exclusion from participation in the Medicare and Medicaid programs, or both (see also SAFE HARBORS). |
|
|
Term
|
Definition
| Removing or destroying microorganisms. |
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|
Term
|
Definition
| Impaired ability to communicate. |
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|
Term
|
Definition
| A speech disorder in which the tongue, lips, and vocal chords are unable to work together. As a result, the person is unable to say what he or she wants to say. |
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Term
|
Definition
| Utilization of a third party to resolve disputes. As used here, this concept is related to facilities that have unions. The third party hears the arguments on both sides and then makes a decision which is binding on both the union and the facility. |
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Term
|
Definition
| A zone of safety within a building that is protected from the effects of fire and smoke that provides direct access to an exit. |
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Term
|
Definition
| The blueprints or plans depicting the way the building was actually completed and approved. |
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Term
|
Definition
| Absence of harmful microorgansms called pathogens. It refers to the practice of clean procedures, such as hand-washing. |
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Term
|
Definition
| The inhaling of foreign objects, such as food or beverages if swallowed incorrectly into the lungs; results in introduction of bacteria from the mouth and stomach into the lungs which can lead to pulmonary bacterial infection known as aspiration pneumonia. |
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|
Term
|
Definition
| The process by which health care professionals attempt to reliably characterize the patient's physical health, functional abilities, cognitive functioning, psychological state, social well-being, and past and current use of formal services. |
|
|
Term
|
Definition
| Resources owned by a business that are measured in monetary terms. On a balance sheet, assets are generally classified into current and noncurrent portions. Current Assets are cash, accounts receivable, supply inventories, and prepaid expenses. Noncurrent assets include Property, Plant & Equipment (PP&E)(also referred to as fixed assets, capital assets, or plant assets) which are assets having an estimated life in excess of one year and not intended for sale in the ordinary course of operations. |
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|
Term
| Assisted Living Facility (ALF) |
|
Definition
| Term applied to broad array of residential options for frail senior who need assistance with one or more activities of daily living, such as dressing or bathing, but do not require continuous skilled nursing care. ALF's generally emphasize a homelike environment offering a maximum amount of independence, privacy, and choice. |
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|
Term
|
Definition
| A health care professional who is specially trained and licensed to provide direct clinicl services to individuals with hearing or balance disorders. |
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|
Term
|
Definition
| Examination of accounting systems, controls, and records to ascertain their conformity to legal and professional standards and their adequacy in protecting against loss of assets by fraud and waste. |
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|
Term
|
Definition
| A complex developmental disability that typically appears during the first three years of life and is the result of a brain disorder. It affects the person's social interaction and communication. |
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|
Term
|
Definition
| A cluster of notions that include self-determination, freedom, independence, and liberty of choice or actions. |
|
|
Term
|
Definition
| The average number of patients per day over a specified period of time such as a week, a month, or a year. |
|
|
Term
|
Definition
| An accident that occurred because the facility failed to identify a hazard, evaluate the hazard, implement interventions, and monitor the effectiveness. |
|
|
Term
|
Definition
| People born between 1946 and 1964. This age group constitutes approximately 70 million Americans who will start retiring around 2010. By 2030, when all the Baby Boomers will have retired, experts predict that they will severely strain the nation's health care system. |
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Term
|
Definition
| An account receivable determined to be uncollectible. |
|
|
Term
| Balance Sheet (or Statement of Financial Position) |
|
Definition
| A report summarizing a firm's assets, liabilities, and owners' equity at a specific date. |
|
|
Term
|
Definition
| Statement sent by a bank to a bank account holder showing beginning and ending balances, and all transactions in the account for a month. |
|
|
Term
| Bank Statement Reconciliation |
|
Definition
| Process of explaining and correcting any discrepancies between a bank statement balance and the depositor's record of the cash balance. |
|
|
Term
|
Definition
| Determination by the National Labor Relations Board of which workers will be grouped together for the purposes of forming or taking steps towards forming a union. |
|
|
Term
|
Definition
| When a patient is temporarily out of the facility (at a hospital or with family), but the bed is being held and must be paid for. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Non-drug interventions used to change the resident's (patient's) behavior or environment to lessen or accommodate the resident's (patient's) behavioral symptoms. |
|
|
Term
|
Definition
| Period of consecutive days during which covered services furnished to a patient, up to certain specified maximum amounts, may be paid for by an insurance plan. Each insurance carrier has its own definition of benefit period. |
|
|
Term
| Benefits (Fringe Benefits) |
|
Definition
| Compensation other than wages paid to workers, such as paid vacation/leave, paid health insurance, and retirement plans. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| The process of requesting from vendors a response (bid or offer) to provide goods or services according to written specifications. The bidding may be closed (directed to select bidders) or open (to all bidders). The bids may be negotiated (as to price, payment terms, etc.) before a contract is finalized. |
|
|
Term
|
Definition
| The human tendency to pay attention to, affiliate with and respond positively to nature. |
|
|
Term
|
Definition
| Pathogenic micro-organisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency Virus (HIV). |
|
|
Term
|
Definition
| Also "board of trustees" or "governing body." It has the ultimate legal responsibility for a facility's operations. |
|
|
Term
|
Definition
| A facility that offers room and board and sometimes supervision of daily activities. It does NOT offer health care. |
|
|
Term
|
Definition
| Interest-bearing notes, usually in $1,000 or $5,000 amounts, in which the issuer (borrower) promises to repay the bondholder (lender) the principal and interest of a loan according to a schedule. |
|
|
Term
|
Definition
| The clerical process of recording the financial transactions of an organization. |
|
|
Term
|
Definition
| The point at which total revenues for a firm or a program are equal to the total expenses incurred. This may be illustrated on a graph where revenues (and expenses) are plotted on the vertical axis while resident-days are plotted on the horizontal axis. Look for the point where the line representing total cost (fixed plus variable) intersects with the line representing total revenue. The number of resident-days indicated by the point on the horizontal axis directly below this intersection is the number of resident days needed for the firm or program to break even, i.e., neither incur any loss nor make any profit. |
|
|
Term
|
Definition
| A tool for exercising financial control. It sets expectations that become financial objectives that the administrator is responsible for achieving. "Budgeting" is the process of financial planning. |
|
|
Term
|
Definition
| A physician who specializes in the treatment of heart diseases. |
|
|
Term
|
Definition
| A plan designed to meet all of a resident's (patient's) identified physical, mental, emotional, cognitive, and functional needs. The care plan is generally the result of assessment and collaboration by an interdisciplinary team of provider staff (also known as the Plan of Care). |
|
|
Term
|
Definition
| Paths or promotion routes established by the organization along which employees can seek to progress, such as financial assistance and release time to CNAs who seek to become a licensed nurse, or a licensed practical nurse who seeks to become a registered nurse. |
|
|
Term
|
Definition
| Defined avenues for upward mobility available to employees within an organization (similar to career ladder) |
|
|
Term
|
Definition
| A system that uses resident (patient) attributes (e.g., functional status in ADLs or coginitive abilities) to classify residents (patients) for purposes such as reimbursement. OR A measure of the intensity of care and services used by a group of residents in a nursing facility. "Case" refers to the overall data collected and used regarding an individual person under study. "Used" describes the combination of variables (observations) used for flassifying an observation accordint to distinctive characteristics on the basis of a dependent variable, such as time or costs. |
|
|
Term
|
Definition
| Each RUG group is assigned a weight, or numeric score, which reflects the relative resources predicted to provide care to a resident. The higher the case mix index (weight), the greater the resource requirements are for the resident. Payment for each resident is made monthly to the facility based on the case mix index for the facility. |
|
|
Term
| Case-Mix-Based Payment Systems |
|
Definition
| Payment systems used by Medicare and many state Medicaid programs under which the per diem rates for each nursing facility are determined in part by some measure of the acuity, and thus the likely resource consumption, of each covered resident in the facility. Assessments are conducted to classify covered residents into defined groups based primarily on functional disability scores, but certain diagnoses, service needs and behavioral problems may also be considered. The per diem rate is different for each group, with higher rates paid for residents needing and receiving more services. |
|
|
Term
|
Definition
| A system of accounting in which revenues are recorded when cash is received, and expenses are recorded when cash is paid (contrast with accrual basis of accounting). |
|
|
Term
|
Definition
| Cash inflows from collections of revenues and other sources minus cash outflows for payments of expenses and liabilities. A cash budget of cash-flow forecast projects these amounts, whereas a cash flow report shows actual experience. |
|
|
Term
|
Definition
| Number of patients in a facility on a given day. |
|
|
Term
| Centers for Medicare & Medicaid Services (CMS) |
|
Definition
| Federal agency responsible for administering the Federal Medicare and Medicaid programs. CMS headquarters is located in Baltimore, Maryland. Formerly the Health Care Financing Administration (HCFA). Also administers Child Health Insurance Programs. |
|
|
Term
| Certificate of Need (CON) |
|
Definition
| Aimed at restraining health care facility costs and allowing coordinated planning of new services and construction. Laws authorizing such programs are one mechanism by which state governments seek to reduce overall health and medical costs. Require certain health care providers to obtain state approval before offering certain new or expanded services. |
|
|
Term
|
Definition
| The process by which federal and state governments determine if a health care facility meets Medicare and/or Medicaid standards. |
|
|
Term
| Certified Nursing Assistant (CNA) |
|
Definition
| A nurse aide who has completed at least the minimum training required by regulations. |
|
|
Term
|
Definition
| The nurse in charge or supervising a particular part of a facility for a given time shift. |
|
|
Term
|
Definition
| Care provided to a patient who does not have the capacity to pay. |
|
|
Term
|
Definition
| A list of names and numbers of all the accounts used in a business. There typically are accounts for various subcategories of each of the following: assets, liabilities, owner's equity, revenues, and expenses. |
|
|
Term
|
Definition
| A psychoactive drug used by a facility for discipline or convenience and not for medical treatment. |
|
|
Term
|
Definition
| Continuing over a long period of time or recurring frequently. Chronic conditions often begin inconspicuously and symptoms are less pronounced than in acute conditions. |
|
|
Term
|
Definition
| Care for residents (patients) who enter a nursing facility typically because they have chronic illnesses that require more assistance than they have available in their own home. The residents (patients) tend to remain in the facility for several months to years. |
|
|
Term
|
Definition
| Body of laws governing private legal affairs, such as private rights and duties, contracts, and commercial relations. |
|
|
Term
|
Definition
| The three primary sources in health care malpractice lawsuits are: (1) failure to obtain consent before intervening in the life of the resident; (2) breach or violation of a contract or promise; and (3) the rendering of substandard, poor-quality care. |
|
|
Term
|
Definition
| A per day or per instance fine resulting from deficiencies in quality of care or resident safety following a CMS Survey. |
|
|
Term
|
Definition
| A bill submitted to the fiscal intermediary claiming payment for services provided. |
|
|
Term
| Clinical Approach to Hiring Decision |
|
Definition
| A hiring technique in which the employer makes the decision after reviewing all the information in hand about the match of the applicant and the job (see also STATISTICAL APPROACH) |
|
|
Term
| Clinical Information System |
|
Definition
| Information technology that is designed to be used by various clinicians to support the delivery of patient care. |
|
|
Term
|
Definition
| A care-planning tool that outlines in a time sequence important aspects of care necessary for meeting specific outcomes. |
|
|
Term
| Clinical Practice Guidelines |
|
Definition
| Evidence-based standardized protocols indicated for the treatment of specific health conditions. |
|
|
Term
|
Definition
| Either help given by a superior to a subordinate, or personal assistance from a person who is not the employee's supervisor, but may be a manager of another division or from outside the company. |
|
|
Term
| Code of Federal Regulations (CFR) |
|
Definition
| The federal Congress passes laws for which implementing rules are written and enforced…these are the The Federal Requirements and Guidelines to Surveyors; guidelines issued by the federal government interpreting how a given law is to be administered. |
|
|
Term
|
Definition
| Number of days' worth of revenue that is accounts receivable. |
|
|
Term
|
Definition
| Bargaining by groups of workers recognized and constituted through supervised election procedures under the National Labor Relations Board. |
|
|
Term
|
Definition
| Composed of key community leaders, the community advisory board functions as the "eyes and ears" for the facility. Through their influences, the advisory board members can also assist the administrator to form meaningful partnerships with community agencies. |
|
|
Term
|
Definition
| See, similar idea, Adult Day Care |
|
|
Term
|
Definition
| The simultaneous presence of two or more health problems. |
|
|
Term
|
Definition
| Determining and administering wage, incentive, and benefit programs for a facility. |
|
|
Term
|
Definition
| Ideas or approaches to the functions of wages and benefits in motivating employees to meet the requirements of the employer (see e.g., EQUITY THEORY). |
|
|
Term
|
Definition
| Pharmacist who is contracted by the nursing home to do drug regimen reviews and provide other services. |
|
|
Term
|
Definition
| The ability to self-regulate bladder and bowel elimination. |
|
|
Term
| Continuing Care Retirement Community (CCRC) |
|
Definition
| Also called a life-care community, it is an organization that integrates and coordinates the independent living and other institution-based components of the LTC continuum. Different levels of services are generally housed in separate buildings, all located on one campus. |
|
|
Term
| Continuum of long-term care |
|
Definition
| The full range of long-term care services that increase in the level of acuity and complexity from one end to the other -- from informal and community-based services at one end of the continuum to the institutional system at the other end. |
|
|
Term
|
Definition
| The difference between the rate the facility normally charges for services to its self-pay residents, and the lower rate that the facility has agreed to receive as reimbursement from Medicare, Medicaid, or other third-party payers. For external reporting purposes, revenues are recorded as the amount to be actually collected. However, for internal reporting purposes, management may record such contractual discounts as deductions from operating revenues on the income statement and accounts receivable on the balance sheet so that the amount of discounts given to each payer class is known. |
|
|
Term
|
Definition
| A drug, substance or immediate precursor included in Schedules I to V of the Controlled Substance Act (e.g., morphine, acetaminophen with codeine, oxycodone). Except as provided under the law, their possession and use are illegal. |
|
|
Term
| Controller (or Comptroller) |
|
Definition
| The chief accountant of a firm. |
|
|
Term
|
Definition
| (as a managerial behavior) Determination by administration of how well jobs have been done and what progress is being made to achieve the organization goals, then taking necessary corrective actions to achieve these goals. It is the process of monitoring, evaluating and correcting. |
|
|
Term
| Corporate Integrity Agreement |
|
Definition
| Agreement negotiated by the Office of the Inspector General (OIG) with a health care provider as part of the settlement of a federal health care program investigation arising under the False Claims Act. To avoid worse penalties, a company may agree to such compliance activities as: hire a compliance officer or appoint a compliance committee, develop writeen standards and policies, implement an employee training program, and/or retain an independent review organiztion to review claims submitted to fderal health care programs. |
|
|
Term
|
Definition
| An organizational unit charged with responsibility for controlling its own costs, and so its costs (for salaries, supplies, etc.) are separately accumulated in the accounts. A cost center may or may not be a revenue center, i.e., a unit providing direct services to patients for which they are charged. |
|
|
Term
| Cost of Living Allowance (COLA) |
|
Definition
| Upward adjustments in wages during times of inflation to assist workers to maintain their purchasing power. |
|
|
Term
|
Definition
| Practice by health care providers of charging private-pay patients more than the actual costs of their care, in order to compensate for shortfalls in payments for patients covered by Medicaid and other government programs which may pay less than actual costs. |
|
|
Term
|
Definition
| Transfer of disease causing organisms through contact with a dirty surface, unwashed hands, or insects. |
|
|
Term
|
Definition
| The ability of service agencies to understand the world view of clients of different cultures, and adapt practices to ensure their effectiveness. |
|
|
Term
|
Definition
| The mosaic of individuals and groups with varying backgrounds, experiences, styles, perceptions, values and beliefs. |
|
|
Term
|
Definition
| A society's typical ways of behaving; its customs, mores and beliefs |
|
|
Term
| Culture Change (Cultural Change) |
|
Definition
| A course of action to move from one way of doing things to another. In long-term care, culture change is widely referred to as a process of transforming from an institutional to a homelike model. It is the integration of the three elements of person-centered care -- clinical care, socio-residential elements and human factors -- along with the enrichment of the environments in which people live and the empowerment of both clients and associates. |
|
|
Term
|
Definition
| Current assets divided by current liabilities. A measure of a firm's ability to pay current debts. A current ratio much below 1.00 (or 1:1) may indicate problems in meeting current liabilities as they become due. (see also ACID-TEST RATIO). |
|
|
Term
|
Definition
| Nonmedical care that includes routine assistance with the ADLs but does not include active nursing or rehabilitative treatments. Such care is provided to maintain function because the person's overall condition is not likely to improve. |
|
|
Term
| Data Assessment and Verification (DAVE) |
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Definition
| A program administered by CMS designed to ensure accuracy of MDS data accomplished through data analysis, off-site review, on-site review, and provider education. |
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Term
| Days in Resident Accounts Receivable |
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Definition
| The number of days during which expenses could be paid using the cash on hand. It is: Cash + Marketable Securities (Total operating expenses minus depreciation)/365 |
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Term
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Definition
| Also called "Patient Days." Cumulative census over a specified period of time. |
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Term
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Definition
| Weak and infirm, unable to care for many personal needs |
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Term
| Debt Service Coverage Ratio |
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Definition
| Projected annual cash flow (i.e., excess of cash receipts over cash expenses), divided by required annual debt payments. Measure used by potential lenders of the credit-worthiness of an entity. |
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Term
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Definition
| A measure of the relative obligations of a facility. Generally, the lower the debt ratio, the more financially sound the facility is believed to be. The ratio is calculated by: (Current Liabilities + Noncurrent Liabilities) / Total Assets |
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Term
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Definition
| Medicare rule that a hospital accredited by the Joint Commission on Accreditation of Healthcare Organizations is deemed to have met the Medicare certification criteria. |
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Term
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Definition
| A nursing facility's failure to meet any of the standards as determined by a survey. |
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Term
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Definition
| Disorders in which tissue or an organ deterioriates and vitality is diminished. |
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Term
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Definition
| A loss of the body's normal water content which can affect both physical and mental functions. Individuals with brain, kidney, or gastrointestinal disease may find it difficult to maintain a normal amount of water in the body with the aid of medications. |
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Term
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Definition
| A generic term that describes progressive and irreversible mental dysfunction that results in complex cognitive decline. These cognitive changes are commonly accompanied by disturbances of mood, behavior and personality. |
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Term
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Definition
| The makeup of a set of teeth including their kind, number, arrangement and usability. |
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Term
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Definition
| The systematic allocation of the cost of a fixed asset to expense over its useful life. |
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Term
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Definition
| An abnormal state of mind in which a person usually becomes inactive and disinterested in his environment and lacks motivation. |
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Term
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Definition
| A specialist physician who treats infections, growths, injuries, and other disorders related to the skin. |
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Term
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Definition
| A review of a resident's usual food intake patterns, including any food preferences, chewing and swallowing problems, or difficulties with self-feeding that might affect overall food intake. |
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Term
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Definition
| Sometime referred to as nutritionist, a dietitian provides nutritional information and diet-related services to residents/patients. |
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Term
| Director of Nursing (DON) |
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Definition
| A registered nurse responsible for supervising the activities, functions, and training of nursing personnel. |
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Term
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Definition
| A competitive strategy in which a facility creates distinctive features that allow customers to distinguish the facility's offer from that of its competitors. |
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Term
| Director of Nursing Services (DNS) |
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Definition
| See DIRECTOR OF NURSING (DON). |
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Term
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Definition
| A process that includes decisions about when a patient may need to be discharged from the facility and what may be needed to make a smooth transition from one level of care to another or from the facility to living independently. |
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Term
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Definition
| The use of any selection procedure which has an adverse impact on the hiring, promotion or other employment or membership opportunities of members of any race, age, religion, marital status, sex, or national origin. |
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Term
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Definition
| To deliver a prescribed drug to an ultimate user, including the compounding, packaging, and labeling necessary to prepare the prescribed drug. |
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Term
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Definition
| A distribution of earnings to shareholders of a corporation. |
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Term
| Do-Not-Resuscitate (DNR) Order |
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Definition
| An advance directive in which a person specifies that he or she does not wish to have heartbeat or breathing restored in the event of a cardiac or respiratory arrest. |
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Term
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Definition
| The system of recording transactions that requires each transaction to be recorded at least twice: as an addition or subtraction to one account (and that is called a debit) , and as an addition or subtraction to at least one other account (and that is called a credit). This system provides a logical way to record much information. At the end of a period, after all adjusting entries are made, the sum of the debits should equal the sum of the credits. When a trial balance indicates that these two totals are equal, the "books balance" and financial statements can be prepared. Failure to find this equality is an indicator that one or more recording errors were made. |
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Term
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Definition
| Increases in asset accounts and expense accounts are recorded as debits; decreases are credits. Increases in liability, revenue, and owners' equity accounts are credits, decreases are credits. |
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Term
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Definition
| Any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease or other conditions in persons. Any substance other than a device or food intended to affect the structure or any function of the body of persons. In the survey guidelines, drug is used in most cases to mean medication. |
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Term
|
Definition
| A drug that is given without a medical reason, in an excessive or inadequate dose or duration of therapy, where side effects indicate that a dose modification or drug discontinuation is indicated, or inadequate monitoring for effect of manufacturer's recomendations for laboratory monitoring. This therapy results in potential negative outcomes or is not achieving the stated objectives of the prescriber. The consulting pharmacist should address this potential drug therapy problem at the time of their drug regimen review. |
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Term
| Drug Regimen Review (DRR) |
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Definition
| The review of drugs being used by a resident (patient) to determine effect and potential for harmful effects. |
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Term
| Drug Utilization Review (DUR) |
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Definition
| The study of drug use patterns in a facility. |
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Term
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Definition
| A facility that is dually certified as both a skilled nursing facility and a nursing facility. Such facilities can admit Medicare and Medicaid residents in any part of the facility. |
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Term
| Durable Power of Attorney |
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Definition
| Appointment of an agent who is empowered to act on behalf of the person creating the power in the case of future incompetence. (Ordinary POA ends when the person creating the power becomes incompetent). |
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Term
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Definition
| Slurred or unintelligible speech due to muscle weakness or other problem. |
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Term
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Definition
| Difficulty in swallowing due to a dysfunction in any phase of the swallowing process. |
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Term
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Definition
| Earnings before interest, taxes, depreciation, amortization, and rent. This shows cash flow available to pay interest, rent and taxes after paying operational costs. It is a measure used by potential lenders of the credit-worthiness of an entity. |
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Term
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Definition
| A cultural change that entails viewing the surroundings in facilities as habitats for human beings rather than as facilities for the frail and elderly, as well as applying the lessons of nature in creating vibrant and vigorous settings. |
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Term
| Effective Pest Control Program |
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Definition
| Measures used to eradicate and contain common household pests (e.g., roaches, ants, mosquitoes, flies, mice and rats). |
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Term
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Definition
| In a long-term care insurance plan, the initial waiting period juring which LTC services are used but not covered by insurance. |
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Term
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Definition
| A chronic condition characterized by damaged air sacs in the lungs. The resulting reduction of surface area available for gas exchange makes brething difficult and makes the heart work harder to circulate blood through the lungs. All these changes make less oxygen available to the body. |
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Term
| Employee Assistance Program (EAP) |
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Definition
| 24-hour, 7-day-a-week confidential telephone service providing assistance to employees on matters such as child and elder care, substance abuse, financial counseling, etc. |
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Term
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Definition
| A compilation of the facility policies that directly relate to work conditions. It is often treated as a binding contract by the courts. |
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Term
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Definition
| The concept of encouraging and authorizing workers to take the initiative to improve operations, reduce costs, and improve quality of services. |
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Term
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Definition
| The process in the body of breaking down calories consumed into usable energy to allow the body to perform normal body functions. |
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Term
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Definition
| A table developed by the Center for Medicare and Medicaid Services that defines severity and scope of federal deficiencies and indicates whether plans of correction and remedies are necessary. (See the SHSRA webite glossary for more detailed info). |
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Term
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Definition
| Delivery of liquid food through a tube directly into the stomach. |
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Term
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Definition
| Refers to any area outside or inside the facility that is frequented by residents, staff, and guests and areas within the facility including the residents' rooms, bathrooms, hallways, dining and activity areas and therapy areas. |
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Term
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Definition
| Excessive prevalence of a negative health condition. |
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Term
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Definition
| A brain disorder in which signals sent by nerve cells become disturbed, causing strange sensations, emotions, convulsions, muscle spasms, or loss of consciousness. |
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Term
| Equal Employment Opportunities Commission (EEOC) |
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Definition
| The organization was created by the Civil Rights Act of 1964 to carry out the provisions of that act. Also administers ADA, ADEA, Equal Pay Act, Pregnancy Discrimination, GINA, and other acts. |
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Term
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Definition
| The excess of a firm's assets over its liabilities equals the owner's equity (in a for-profit corporation). |
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Term
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Definition
| Concept that employees seek an exchange in which their wages and benefits are equal to their work effort, especially when compared to wages and benefits being paid to similarly situated co-workers. |
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Term
| Error of Central Tendency |
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Definition
| Error by supervisors using rating scales in employee evaluations when consistently giving only moderate scores to employees on performance appraisals, regardless of whether the employee is a poor or an outstanding performer. |
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Term
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Definition
| A small tube that enteres a surgical incision on the side of the neck and is generally removed after each feeding. The tube allows food to enter the esophagus and then flow down into the stomach. |
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Term
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Definition
| A multidisciplinary forum that is generally called upon to make decisions in the patient's best interest, particularly when legal avenues are not clear-cut. |
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Term
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Definition
| Delivery of services using best practices that have been established through clinical research. |
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Term
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Definition
| Salaried workers who are exempt from overtime provisions of the Fair Labor Standards Act. |
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Term
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Definition
| Belief that the level of motivation to perform (make an effort at work) is a mathematical function of the expectations individuals have about future outcomes multiplied by the value the employee places on these outcomes. |
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Term
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Definition
| A federal survey conducted within 14 days of a finding of sustandard care during a standard federal survey (see also STANDARD SURVEY). |
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Term
| Extrapyramidal Symptoms (EPS) |
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Definition
| Abnormal movements of the mouth or tongue, pill rolling, tremors, rigid movements, mask-like face, constant movement of legs or body, tics, blinking, pacing, eyes rolled up, drooling. |
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Term
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Definition
| Federal law that provide for civil or criminal penalties for individuals and entities for submitting a false claim, or causing a false claim to be submitted, to a federal health care program. False or fraudulent claims include claims for items not provided or not provided as claimed, claims for services that are not medically necessary, and claims when there has been a failure of care. Many states have a parallel law that applies to the state Medicaid and other state health care programs. |
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Term
| Federal Mediation and Conciliation Service (FMCS) |
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Definition
| A federal agency making government facilities available for conciliation, mediation and voluntary arbitration of labor disputes. |
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Term
| First In, First Out (FIFO) |
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Definition
| 1. Inventory usage ideal of using the oldest supplies first (as long as the use-by or expiration date has not been reached). To facilitate this, new supplies are shelved based on the use-by or expiration date, so that the oldest products are stored in front of, or otherwise made more accessible than, more recently acquired products. 2. Inventory costing method for balance sheet purposes that assumes that the first goods purchased (first-in) are the first goods used (first-out), so the ending inventory should be valued at the cost of the most recent goods purchased. The Last In, Last Out method assumes the opposite , and values ending inventory at the cost of the earliest goods purchased. |
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Term
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Definition
| Costs that do not vary with the number of patients. These costs are not controllable. |
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Term
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Definition
| An adjusted budget in which the budgeted costs are raised or lowered to reflect the actual census. |
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Term
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Definition
| A program allowing employees to choose the hours they work, so long as they put in the expected number of hours per time period. |
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Term
| Flexible Spending Account |
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Definition
| An optional benefit in which employees can set aside a designated amount of funds for guture medical services. As medical services are incurred, the charge is made against the account. The funds are usually a pre-tax withdrawal from the employees check. This optional benefit must be a careful calculation and is usually for persons that have consistent or relatively high medical expenses. There is an administrative fee from the processing agent and funds not used can't be carried over to the next year. |
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Term
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Definition
| Deliberate deceit by providers or consumers in obtaining payment for services that were not actually delivered or received, or in claiming program eligibility. To be distinquished from abuse, which refers to improper or excessive use of program benefits, resources, or services by either providers or consumers. Abuse is not necessarily intentional or illegal. |
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Term
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Definition
| Limitations on one's ability to function independently. |
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Term
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Definition
| The setting aside of a portion of retained earnings (equal to a depreciation expense) in a separate account designated to be used only for the purchase of replacement capital assets. |
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Term
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Definition
|
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Term
| Gastrostomy Tube (G-tube) |
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Definition
| A mechanism for delivering nutrition through a tube that passes through a surgical opening in the abdomen and into the stomach. |
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Term
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Definition
| Financial record, consisting of a collection of accounts, that summarizes all the entries in each of the journals for an accounting period, for the purpose of keeping a continuous record of account balances and arriving at a trial balance. |
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Term
| Generally Accepted Accounting Principles (GAAP) |
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Definition
| The policies, standards, and rules followed by accountants in the preparation of financial statements and in recording and summarizing transactions. |
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Term
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Definition
| Also called geriatrics. The medical knowledge of physical disability in older persons--including diagnosis, treatment, and prevention of disorders. Geriatric medicine recognizes aging as a normal process, not a disease state. |
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Term
|
Definition
| A physician with special training in geriatric medicine. In earlier years, this training was self-taught through the special attention physicians gave their older patients. Now, one- and three-year training programs, which follow the regular medical curriculum, are established in a number of teaching medical centers. |
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Term
|
Definition
| The study of aging from the broadest perspective. Gerontologists examine not only the clinical and biological aspects of aging but also psychosocial, and historical conditions. |
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Term
|
Definition
| A summary score based on the components of a performance appraisal. |
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Term
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Definition
| Setting of objectives to be achieved by an employee before the next performance appraisal. |
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Term
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Definition
| A legal term that refers to actions that are generally consistent with how a reasonable person would act under similar circumstances. |
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Term
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Definition
| The act of governing. It refers to trusteeship and stewardship of an organization's resources and capabilities to benefit is stakeholders. |
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Term
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Definition
| A small freestanding facility designed to house 7 to 10 residents who live together in a homelike setting. Generally, a number of Green Houses are arranged around a central skilled nursing facility that provides support services. |
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Term
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Definition
| The established method, and outlined in the employee handbook, by which an employee can have any decision of a supervisor reviewed by higher level management with the organization. |
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Term
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Definition
| Legal representative, appointed by a court, to make decisions for a person not competent to make their own decisions. Generally, resident (patient) guardians have all of the legal rights normally granted to competent residents (patients). |
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Term
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Definition
| Error made by supervisors using rating scales in an employee evaluation where they value one particular type of job behavior and permit the presence or absence of that one trait to color several or most other trait ratings. |
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Term
|
Definition
| Negative effect that has occurred to a resident (patient), infringement of a resident's (patient's) rights, or compromising of a resident's (patient's) ability to meet their highest practicable level of physical, mental or psychosocial well being. |
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Term
|
Definition
| One for which there is significan evidence, based on at least one study conducted in accordance with established scientfic principles, that an acute or chronic health effect may occur in exposed employees. |
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Term
|
Definition
| A fringe benefit available to many nursing facility employees. Typically the employee is covered free or shares in the cost, and can obtain family coverage for an additional periodic payment. |
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Term
| Health Insurance Portability and Accountability Act (HIPAA) |
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Definition
| Established principles of patient privacy and confidentiality regarding use and misuse of their personal medical information and records, as well as standards for communication, storage and transmission of information. |
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Term
| Health Maintenance Organization (HMO) |
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Definition
| An organization that has management responsibility for providing comprehensive health care services on a prepayment basis to voluntarily enrolled persons within a designated population. |
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Term
|
Definition
| A Research Utilization Group methodology of assessment classification where an assessment is placed in the first classification category (there are over 40 reimbursement categories) and where a match is found by evaluating resident conditions and services. They are normally ordered from highest to lowest, for example extensive services, rehabilitation, special care, clinically complex, impaired cognition, behavioral problems, and reduced physical functions. These categories vary from time to time. |
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Term
| Historical Cost (or Acquisition Cost) |
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Definition
| Cost of acquiring a depreciable asset, which includes not only the purchase price but also the cost of taxes, shipping, assembly and installation. |
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Term
|
Definition
| A philosophy that empasizes that health care delivery should focus not merely on a person's physical and mental needs, but should also emphasize well-being in every aspect of what makes a person whole and complete. |
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Term
| Home- and Community-Based Services (HCBS) Waiver |
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Definition
| Enacted under Section 1915(c) of the Social Security Act, the program allows states to offer LTC services that are not otherwise available through the Medicaid program. The latter had authorized payments for institutional care only. |
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Term
|
Definition
| Delivery of services such as nursing care and rehabilitation therapies to patients in their own homes because such patients do not need to be in an institution and yet are generally unable to leave their homes safely to get the care they need. |
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Term
|
Definition
| Use of telecommunication technology for the distance monitoring of patients and delivery of health care with or without the use of video technology. |
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Term
|
Definition
| Supportive care provided to terminally ill patients and their families in the final six months (Medicare definition) of a patient's life. This care is managed and coordinated by a certified Medicare hospice provider. It is a program for caring for the dying, in order to enhcance whatever life remains rather than battling illness or warding off death. |
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Term
| Human Immunodeficiency Virus (HIV) |
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Definition
| A virus that gradually destroys the body's natural immune system designed to fight infections and disease. |
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Term
| Human Resource Management |
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Definition
| The organizational function of planning for human resource needs, recruitment, selection, compensation, development, evaluation, and handling of grievances and labor relations. |
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Term
|
Definition
|
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Term
|
Definition
| A psychoactive medication given to sedate or calm (e.g., Sonata, Restoril, Ambien). |
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Term
|
Definition
| Complications caused by the process of medical care. |
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Term
|
Definition
| A federal certification for an Intermediate Care Facility for the Mentally Retarded. |
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Term
|
Definition
| A situation in which a provider's noncompliance with one or more regulations has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident (patient). (42 CFR Part 489.3.) |
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Term
| In Migration--Out Migration |
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Definition
| Movement of laborers into or out of the geographic area within which a facility is recruiting for specific positions. |
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Term
|
Definition
| A type of CHSRA QI that provides a description of what has taken place with a resident (patient) over the course of the last two MDS or OASIS assessments. |
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Term
|
Definition
| Any unexpected negative occurrence involving a patient, family, or employee, or visitor. |
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Term
|
Definition
| An increase in owner's equity resulting from services rendered or goods provided. |
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Term
| Income Statement (or Statement of Revenue and Expenses) |
|
Definition
| A report which lists in summary form revenues and expenses for a certain time period, such as a month or a year. A profit results from an excess of revenues over expenses for the period, and a loss occurs when expenses exceed revenues. So the income statement also shows profit or loss, and is therefore also called the profit-and-loss (or P-and-L) statement. |
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Term
|
Definition
| Lacking voluntary control over the bladder or bowel. In most people incontinence can be treated and controlled, if not cured. Specific changes in body function, often resulting from disease or the use of medications, are the cause of incontinence. |
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Term
|
Definition
| Category of persons providing services who are not considered by the IRS as employees. Therefore, employers generally do not have to withhold federal income tax or FICA taxes on payments to independent contractors. The IRS offers 20 guidelines for determining whether an individual falls into this category. The general rule is that independent contractors "follow independent trade, business or profession in which they offer their services to the general public," and those who pay for their services "have the right to control or direct only the result of the work and not the means and methods of accomplishing the result." However, employers who pay an independent contractor $600 or more during a year must issue and file a Form 1099-MISC. |
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Term
|
Definition
| Individuals with skills especially needed by a facility may be able to negotiate a higher wage than other employees in similar positions. |
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Term
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Definition
| A written statement of the services to be provided, as developed by an interdisciplinary team, and based on a comprehensive functional assessment of an individual's active treatment needs. |
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Term
|
Definition
| A catheter that remains in the bladder to drain urine into a bag. |
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Term
|
Definition
| Treating older adults as children. |
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Term
|
Definition
| A comprehensive program to prevent the transmission of infections protecting the residents, the staff, and visitors from contracting infections while in the facility. |
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Term
|
Definition
| Hazardous waste that can pose health risks from communicable infectious agents. |
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Term
|
Definition
| The person giving consent receives information necessary to make a health care decision, including information about the benefits, reasonable risks, alternatives, the right to refuse, and consequences of any treatment or service. |
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Term
|
Definition
| Physical, financial, or emotional harm. |
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Term
|
Definition
| An on-site federal survey to determine whether a provider meets the requirements to begin participating in the Medicare and/or Medicaid programs. |
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Term
|
Definition
| Seminars, online programs, DVDs, workshops, etc., offered during the work career of the employee. An "in-service" is an educational session. |
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|
Term
| Instrumental (Independent) Activities of Daily Living (IADLs) |
|
Definition
| Activities that include meal preparation, housework (e.g., cooking), managing finances (e.g., keeping a checkbook) or medications, telephone use, shopping, and transporation (e.g., how one moves up and down stairs, how one moves in and out of cars). |
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Term
|
Definition
| An item or right that has no physical substance and provides an economic benefit. The reputation of a nursing facility as the best caregiver in the community is a valuable intangible asset, for example. |
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Term
| Integrated Pest Management (IPM) |
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Definition
| A program of Serv Safe that outlines procedurs for controlling access of pests to the building. |
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Term
|
Definition
| A state of living together (symbiosis) in a mutually beneficial relationship. |
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Term
|
Definition
| A facility team which allows involvement of mulitple medical disciplines in providing patient care; can consist of all or some of the following professionals: physician, nurse, social worker/case manager, dietitian, therapists, pharmacists, etc. |
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Term
|
Definition
| A physician who specializes in treating diseases related to the internal organs of the body. |
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Term
|
Definition
| Electronic medical information that is available simultaneously to various health care providers. |
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Term
|
Definition
| The goods and materials on hand which are to be used in producing services or held for resale. |
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Term
|
Definition
| Document prepared by a seller for a buyer that describes goods sold or services rendered and the terms for payment. |
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|
Term
| Jejunostomy tube (J-tube) |
|
Definition
| A surgically placed tube that enters the small intestine for the delivery of specialized nutritional formulas. |
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Term
|
Definition
| A collection of tasks assigne to an employee. |
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Term
|
Definition
| The process of defining a position in terms of tasks or behaviors required, specifying the qualification of the employee to be assigned those duties. |
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Term
|
Definition
| The practice of posting available jobs on bulletin boards and encouraging employees to apply or bid for openings. |
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Term
|
Definition
| A statement of the tasks to be done based on the job analysis, usually including a list of duties and responsibilities of the position in order of importance. |
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Term
|
Definition
| The process of assessing and rating all jobs in an organization as a basis for the wage and salary system. |
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Term
|
Definition
| A group of two or more jobs that have similar duties, for example, the duties of the registered nurse and licensed nurse practitioners. |
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Term
|
Definition
| Same as job bidding; a form of internal recruitment in which the job opening is literally posted on the bulletin boards, inviting employees to bid. |
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Term
|
Definition
| A statement of the skills, education, and experience required to perform the work. This is derived from the job description. |
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Term
|
Definition
| Naming of the job to distinguish that job from all other jobs, often indicating level, e.g., Supervisor II. |
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Term
|
Definition
| Establishing the value of a job by comparing it to all other jobs to e accomplished by an organization. |
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Term
|
Definition
| Book of original entry, the first place in which transactions are formally recorded. Entries are in chronological order. A separate journal is generally maintained for the following categories of transactions: cash receipts, cash payments, billings, accounts payable, and payroll. A General Journal is used for entries that to not properly belong in any of the other journal s, and for adjusting entries. Adjusting entries include entries entries for depreciation, prepaid expenses, and inventory usage. |
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Term
|
Definition
| Congressional legislation that made federal funds available to states for health care for the needy. |
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Term
|
Definition
| A method of establishing wage rates for jobs, based on comparing all jobs in the organization to a touchstone job in the facility, such as nursing. |
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Term
|
Definition
| A portion of a fee, salary, or other payment that is given to a third party for having assisted--or refrained from preventing--the payment in the first place. Most types of kickbacks are unethical or illegal. |
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Term
|
Definition
| The geographic area from which applicants for positions are to be recruited. |
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Term
|
Definition
| Temporary dismissal of workers from their jobs due to lack of work, not "for cause." |
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Term
|
Definition
| The art of engaging colleagues, collaboratively toward a shared vision. As defined by Yukl, leadership is "the process of influencing others to understand and agree about what needs to be done and how to do it, and the process of facilitating individuals and collective efforts to accomplish shared objectives." Alternatively defined, it is influencing people to act for certain goals that represent the values and motivations -- wants, needs, aspirations, and expectations -- of both leaders and followers. |
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Term
|
Definition
| A psychological state in which patients believe that they can no longer do anything for themselves and must depend on others. |
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Term
|
Definition
| A contract requiring the lessee (user) to make periodic payments (rentals) for a specified period of time to the lessor (owner) for the use of an asset. Operating leases are generally for a short term or limited number of years. A capital lease is a long-term lease agreement extending generally for the entire life of equipment or property leased. Operating lease expenses are listed on the income statement. Capital leases should be reported as assets and as long-term liabilities on the balance sheet. The asset (capital lease) is amortized for depreciated based on its useful life. |
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Term
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Definition
| Consistently giving high ratings to all employees when evaluating employees in an attempt to avoid conflict. |
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Term
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Definition
| Debts owed by a firm to a persons or firms other than its owners. On a balance sheet, liabilities are classified as current if they are due within one year from the balance sheet date, and long-term (or non-current) if they are due more than one year from the balance sheet date. |
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Term
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Definition
| A duly-issued certificate that permits a person to practice or a nursing home to operate in a given state. |
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Term
| Licensed Practical Nurse (LPN) |
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Definition
| A person licensed as a practical nurse by state statute. An LPN performs simple acts in the care of convalescent, subacute or chronically ill patients; or provides care to acutely ill patients under the specific direction of a registered nurse, physician, podiatrist or dentist. Similar to an LVN (Licensed Vocational Nurse) in some states. |
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Term
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Definition
| The granting of a license to a provider that has been determined to meet a state's requirements for operation. |
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Term
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Definition
| Some facilities offer free or shared fees for life insurance (a specific payment amount upon the death of the insured), usually term type life insurance, as a benefit. Term insurance features low premiums or high-dollar coverage, but has no cash, loan or other value. |
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Term
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Definition
| Rules and standards developed by the National Fire Protection Association to specify numerous fire safety and other elements of building construction, fixtures, and furnishings that nursing facilities must comply with. |
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Term
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Definition
| Person responsible for performing most of the personnel functions, who is delegated authority by the administrator to make decisions on his/her behalf and authority to commit facility resources. |
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Term
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Definition
| Form of financing in which a financial institution commits itself to make a loan to a company up to a specified maximum amount. The company may choose to use its line of credit, subject to the terms of credit, when and if the need arises. |
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Term
| List of Excluded Individuals/ Entities |
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Definition
| Online database maintained by the OIG (at www.hhs.gov/oig) providing information regarding over 15,000 individuals and entities that are excluded from participation in Medicare, Medicaid and other federal health care programs. Certified facilities should check (and periodically recheck) this list and must refrain from contracting with or otherwise doing business with anyone on it in the course of providing items or services for which payment may be made under a federal health care program. Providers are advised to check also the General Services Administration (GSA) monthly "List of Parties Excluded From Federal Procurement and Nonprocurement Programs" at http://epls.arnet.gov. |
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Term
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Definition
| An advance directive specifying a person's wishes regarding medical treatment in the event this person becomes incompetent. |
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Term
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Definition
| The maximum loan amount based on a percentage of the borrowing facility's appraised value. |
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Term
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Definition
| An asset with future economic benefits that are expected for a number of years. Long-term assets are reported on the balance sheet as noncurrent assets and include buildings and equipment. A new central building for a life care community may have a long-term expected asset value for perhaps 40 or more years to come. |
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Term
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Definition
| A general term used to describe care in nursing homes. This term is also used to describe a broader continuum of care for chronic and disabled persons that include nursing homes, assisted living facilities, board and care facilities, and community care such as home health agencies. It is a variety of individualized and well-coordinated total care services that promote the maximum possible independence for people with functional limitations and that are provided over an extended period of time, using appropriate current technology and available evidence-based practices, in accordance with a holistic approach while maximizing both the quality of clinical care and the individual's quality of life. |
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Term
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Definition
| An institution, commonly referred to as a nursing home, that is duly licensed to provide long-term care services. |
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Term
| Maintenance Rehabilitation |
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Definition
| Rehabilitation that is aimed at preserving the present level of function and preventing secondary complications. |
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Term
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Definition
| Negligence or carelessness in the delivery of services according to accepted standards of care so that harm is caused to the recipient of care. |
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Term
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Definition
| An approach to delivering a comprehensive array of health care services to a defined group of enrolled members through efficient management of service utilization and payment to providers. |
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Term
| Managed Care Organization (MCO) |
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Definition
| Entity that integrates the financing and delivery of health care to covered individuals by means of arrangements with a limited number of selected providers. It provides financial incentives for membership, quality assurance programs, and formal utilization management programs (i.e., processes to evaluate the necessity, appropriateness, and efficacy of health care services). (see also Medicaid MCO). |
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Term
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Definition
| Organization and coordination of the activities of a department or group of people in accordance with objectives, policies and procedures. It is what managers do to maintain an organization and to move it forward. Management is about getting things accomplished on a daily basis...as opposed to leadership, it's "things" versus "people." You lead people and manage things. |
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Term
| Management Information System (MIS) |
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Definition
| A system for managing information to assist the organization in evaluating, planning, and implementation of daily work to improve processes and resident care. |
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Term
| Management By Objectives (MBO) |
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Definition
| A system of managementthat is based on a joint agreement between supervisors and associates on what specific measurable objectives would be accomplished over a given period of time, at the end of which the supervisors evaluate individual associates on the basis of the accomplishment of these objectives. |
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Term
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Definition
| A projection of the present and future availability of qualified personnel in a number sufficient to meet facility needs. |
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Term
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Definition
| Another concept that is related to facilities that are unionized. In this case, the third party seeks to reach a settlement between the union and the facility on an issue. |
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Term
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Definition
| A state program that provides medical services to clients of the state public assistance program and, at the state's option, other needy indviduals, as well as supplements hospital and nursing facility (NF) services that are mandated under Medicaid. States may decide on the amount, duration, and scope of additional services. Generally, the only types of institutions participating solely in Medicaid are Nursing Facilities (NFs) and Intermediate Care Facilities for the Mentally Retarded (ICF/MR). Also called Title 19 of the Social Security Act, it is a jointly funded federal-state health insurance program for the indigent. |
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Term
| Medicaid Managed Care Organization (MCO) |
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Definition
| Entity that has entered into a risk contract with a state Medicaid agency to provide a specified package of benefits to Medicaid enrollees in exchange for a monthly capitation payment on behalf of each enrollee. These plans may include or carve out acute care services. Some MCOs coordinate Medicare and Medicaid services for dually eligible beneficiaries. Such arrangements may include a capitated amount for both Medicare and Medicaid services or only Medicaid with an additional fee paid to the MCO to coordinate Medicare services that are not part of the plan. |
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Term
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Definition
| Delivery of health care that places its primary emphasis on the treatment of disease, relief of symptoms, and intensive use of medical technology, with little emphasis on the promotion of optimum health in a holistic context. |
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Term
| Medical Nutrition Therapy |
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Definition
| A diet ordered by a physician as part of treatment for a disease or clinical condition, or to eliminate, decrease or increase specific nutrients in the diet. (May also be called Therapeutic Diet). |
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Term
|
Definition
| A federal insurance program providing a wide range of benefits for specific periods of time through providers and suppliers participating in the program. Providers, in Medicare, are patient care institutions such as hospitals, hospices, nursing homes, and home health agencies. Benefits are payable for most people over age 65, Social Security beneficiaries under 65 entitle to disability beneifts, and individuals needing renal dialysis or renal transplantation. Payment for services is made by the federal government through designated fiscal intermediaries (FIs) and carriers to the providers and suppliers. Title 18 of the Social Security Act to cover health care services for the elderly, certain disabled people, and those who have end-stage renal disease. |
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Term
| Medicare Data Communication Network |
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Definition
| (MDCN). A secure connection that is used to transmit MDS data to each state's repository. A user ID and password is issued for each person who requires access to the CMS MDS intranet. |
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Term
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Definition
| Medications not given as intended by the prescriber, as required by the drug manufacturer, or according to acceptable professional standards. |
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Term
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Definition
| Below-average intellectual functioning that is long term and incurable. |
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Term
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Definition
| An individual who agrees to advise a person over a set period of time. |
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Term
|
Definition
| A federally mandated resident assessment instrument used to assess resident physical, mental, emotional, cognitive, and functional limitations and strengths. The MDS must be administered to all residents in Medicare- or Medicaid-certified facilities at the time of admission, annually, quartely, and when a significant change in a resident's condition occurs. |
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Term
|
Definition
| The MDS is a resident assessment tool, utilizing computerized resident information to assess and monitor resident care. Reports are electronically transmitted to CMS, as well, to classify a resident into a resource utilization group (RUG) which sets the reimbursement level for the patient's care. It is a core set of screening, clinical, and functional status elements, including common definitions and coding categories that form the foundation for the comprehensive assessment for all residents of long-term care facilities certified to participate in Medicare and/or Medicaid. It is, simply put, a set of standardized screening elements that must be assessed for each patient admitted to a SNF. |
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Term
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Definition
| The date at which the RN assessment coordinator attests that all portions of the MDS have been completed. |
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Term
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Definition
| The deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident's (patient's) belongings or money without their consent. |
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Term
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Definition
| A written promise giving a creditor an interest in the debtor's property as security (collateral) for a debt. |
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Term
| Multidisciplinary (or interdisciplinary) |
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Definition
| A team approach to problem solving or delivery of care in which all key disciplines, such as nursing, food service, therapy, social work, and activities, participate and make joint decisions. |
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Term
| Multisensory Stimulation (MSS) |
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Definition
| Also known as "multisensory behavior therapy (MSBT)," it involves stimulation of all the primary senses through a combined effect of textured objects, soft music, colored lighting, aromas, and favorite foods. Snoezelen is the Dutch term for this. |
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Term
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Definition
| A mechanism for delivering nutrition through a tube that passes through the patient's nose and goes down into the duodenum, the first part of the small intestine. |
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Term
| Nasogastric tube (NG-tube) |
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Definition
| A method of delivering nutrition through a tube that passes through the nasal openings, down to the esophagus, and into the stomach. |
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Term
| National Institute of Occupational Safety and Health (NIOSH) |
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Definition
| Federal agency formed under the Occupational Safety and Health Act (OSHA) to establish and monitor workplace safety standards. |
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Term
| National Labor Relations Board |
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Definition
| An organized panel set up to administer the process under the National Labor Relations Act, under which unions become certified as the bargaining agents for groups of workers. |
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Term
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Definition
| The examinatin handled by NAB (National Association of Boards of Examiners of Long-Term-Care Administrators, Inc….a private organization) that an applicant must take to be a licensed NHA or ALA (two different exams). |
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Term
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Definition
| Failure to provide goods and services to prevent resident (patient) harm, mental anguish, or mental illness. |
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Term
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Definition
| Failure to exercise the degree of care that a reasonable person would exercise in similar circumstances. |
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Term
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Definition
| A physician who specializes in kidney diseases, kidney transplantation, and dialysis therapy. Nephrology is classified as an internal medicine subspecialty. |
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Term
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Definition
| Favoring one's family members in hiring practices. |
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Term
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Definition
| In corporate finance, the present value (i.e., the value of cash to be received in the future expressed in current dollars) of an investment in excess of the initial amount invested. When a proposed project, such as building a new wing has a positive net present value, it should perhaps proceed; when a proposed wing shows a negative net present value, it should perhaps be delayed or abandoned. |
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Term
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Definition
| An infection that is acquired by a person within the facility. |
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Term
| Nosocomial Infection in the LTC Facility |
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Definition
| An infection that develops after admission to the LTCF. Infections that are incubating at the time of admission, or develop within 48 to 72 hours of admission, usually are community-acquired or hospital associated if the person was transferred from the hospital. |
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Term
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Definition
| A written promise to pay a specific sum with or without interest at a fixed future date. |
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Term
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Definition
| Federal and/or state training and capability requirements needed for employment of nurse aides in nursing homes. |
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Term
|
Definition
| A listing of nurse aides who have met Federal and/or State training and competency requirements needed for employment in nursing homes. |
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Term
| Nurse Aide, Nursing Assistant (NA) |
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Definition
| An unlicensed caregiver, under professional nurse supervision, who provides nursing and professional care. |
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Term
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Definition
| A registered nurse who meets additional state requirements to meet this designation. In some states, nurse practitioners may act as physician extenders to conduct certain activities such as ordering tests and medications. |
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Term
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Definition
| A nursing home that meets the requirements for Medicaid certification as defined in 1919(a) of the Federal Social Security Act. |
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Term
|
Definition
| A facility licensed to provide assistance with activities of daily living such as bathing, dressing, eating (often referred to as custodial care) in addition to providing general nursing and medical care. A nursing facility must be certified to receive Medicaid reimbursement. |
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Term
| Nursing Home Administrator - NHA (Nursing Facility Administrator - NFA, AKA LTCA or Long-Term Care Administrator) |
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Definition
| The person charged to operate a nursing homeand licensed by the state. "As the nursing home evolved, the title of the person was changed from operator to nursing home administrator. Since then the term nursing home has changed to nursing facility. A few states changed nursing HOME administrator to nursing FACILITY administrator. However, the term nursing facility has not become popular. Predominantly they are called nursing HOMES, so the title nursing homes administrator (NHA) is likely to remain in vogue." (Townsend, et al, page 7). |
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Term
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Definition
| A public website, www.medicare.gov, which includes facility information and previous survey results from the Online Survey Certification and Reporting data (OSCAR)and other facility performance measures from the Minimum Data Set (MDS) for consumer review. |
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Term
| Nursing Home Quality Improvement Initiative |
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Definition
| A program of the CMS and U.S. Department of Health and Human Services that compiles information about nursing home residents on eight situations/conditions called quality measures (QMs) and makes the information available to consumers. |
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Term
|
Definition
| The ratio of actual number of resident days to the total possible resident days, usually expressed as a percentage. Alternatively, the ratio of occupied beds to available licensed beds. For example, if a facility has 100 beds and 80 are occupied for a day, the occupancy rate is 80/100 or 80%. This may be reported as the average of the daily occupancy rates for a period , such as 30 days or a year. A particular resident's bed may be considered an occupied bed in calculating this rate even though that resident is in the hospital or temporarily discharged for some other reason, if the facility is receiving a "bed-hold" or "bed-reserve" rate and/or is reserving the bed for that resident. |
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Term
| Occupational Therapist (OT) |
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Definition
| A person licensed, certified, or registered under state statutes to perform as an occupational therapist. Generally these individuals are certified by the American Occupational Therapy Association (AOTA). |
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Term
|
Definition
| Specializes in the adaptive use of the upper extremities for performing various tasks…evaluating and treating funcitonal impairments in the ADLs. Ocuupational therapists (OTs)also play a vital role in evaluating the independent living environment when the patient is scheduled for discharge to home. |
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Term
| Office of Inspector General (OIG) |
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Definition
| Office in the US Department of Health and Human Services charged with identifying and eliminating fraud, abuse and waste in the Medicare, Medicaid, and othe DHHS programs. The OIG carries out this mission through a nationwide program of audits, inspections, and investigations, and through issuance of Special Fraud Alerts. |
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Term
|
Definition
| Paid or voluntary staff that investigate nursing home complaints from residents and their families and act as resident advocates addressing concerns of nursing home residents. Many Ombudsman programs are associated with state department or boards of aging. An ombusdman is a trained professional who works independtly with area nursing home residents and their families to resolve concerns they may have about their lives in a facility. |
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Term
| Omnibus Budget Reconciliation Act of 1987 (OBRA) |
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Definition
| Changes to the Federal Social Security Act that significantly changed how nursing homes and home health agencies are regulated for Medicare and Medicaid certification. A law that enacted reforms in nursing facility care and provided the statutory authority for the MDS. |
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Term
|
Definition
| A medical specialty dealing with cancers and tumors. |
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Term
|
Definition
| Refers to programming provided to residents who will not, or cannot, effectively plan their own activity pursuits, or residents needing specialized or extended programs to enhance overall daily routine and activity pursuit needs. |
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Term
| Online Survey/ Certification and Reporting (OSCAR) |
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Definition
| CMS database that includes Medicare and Medicaid certified facility demographic information, results of on-site surveys, and aggregate nursing home resident characteristics for comparision with state and national peer information. |
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Term
| Online Survey/ Certification and Reporting (OSCAR) |
|
Definition
| A database of facility characteristics and previous inspection results related to nursing facility performance. The OSCAR 3 report summarizes a facility's regulatory compliance history . The OSCAR 4 reports the facility's recent survey results and provides an opportunity for benchmarking by comparing those results to other facilities, statewide and nationwide. |
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Term
|
Definition
| Assignment of employee to one staff member who assists the employee to acquire the capabilities required in a position in the facility. |
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Term
|
Definition
| Total profit (or loss) as a percent of total revenue. |
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Term
|
Definition
| A physician who specializes in the treatment of diseases and injuries of the eye. |
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Term
|
Definition
| The value of the benefits sacrificed when money or other asset is used one way rather than in an alternative way. It is the net benefits that might have been obtained had the money been spent on the next best use. For example, if $1,000 is spent for activity program supplies, the opportunity cost of NOT having the benefits of $1,000 worth of food or landscaping services, or of not earning the interest had the money simply been left in the bank. |
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Term
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Definition
| An optical technician who generally hold an associate's degree in opticianry. An optician dispenses and fits eyeglasses. |
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Term
|
Definition
| A licensed professional who holds a doctor of optometry (OD) degree and is trained to diagnose and treat vision problems and other eye disorders. They most commonly prescribe eyeglasses and contact lenses. |
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Term
|
Definition
| (a managerial behavior) The grouping of activities and people who will carry them out, assigning roles and delegating authority. |
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Term
|
Definition
| A physician who specializes in correcting deformities of the skeletal system and may surigally repair bones and joints. |
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Term
|
Definition
| Medical approach -- practiced by doctors of osteopathic medicine (DOs) -- that emphasizes the musculoskeletal system of the body such as correction of joints and tissues. |
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Term
|
Definition
| The status of care provided to a resident (patient). |
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|
Term
|
Definition
| Term coined to suggest giving employees a proprietary sense of participation in the facility and its goals through treating employees as members of a team. |
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Term
|
Definition
| Medical care that is focused on relieving unpleasant symptoms such as pain, discomfort, and nausea. |
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Term
|
Definition
| Management and support provided for the reduction or abatement of pain, for other physical symptoms and psychosocial and spiritual needs of individuals with terminal illness and includes physician services, skilled nursing care, medical services, social services, services of volunteers and bereavement services, but does not mean treatment provided to cure a medical condition or disease to artificially prolong life. It is the alleviating of suffering where "cure" of underlying disease is no longer possible. |
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Term
|
Definition
| Delivering a special liquid nutritional formulation directly into the blood stream, when the gastrointestinal tract is not functioning properly. |
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Term
|
Definition
| A progressive disorder of the central nervous system. Clinically, the disease is characterized by a decrease in spontaneous movements, gait difficulty, postural instability, rigidity and tremor. Parkinson's diseas is caused by the degeneration of certain neurons in the brain. |
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Term
|
Definition
| A decline in human emotions, withdrawal from interactions with others and surroundings, and a decrease in motor activity. |
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Term
|
Definition
| Disease-causing organism. |
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Term
|
Definition
| Human waste that may contain human tissue, blood, or body fluids. |
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Term
|
Definition
| A simple device for comparing investment proposals. It is the time in years for the net cash inflow from a capital investment to be equal to its cost, that is for the item to "pay for itself." It is criticized for failure to consider the time value of money, expected net cash flows after the payback period, and some key benefits from use of an item. If the estimated net cash receipts are the same amount each year, the payback period is calculated by dividing the total investment by the expected annual savings or increase in net cash inflow. Depreciation does not affect cash flow, so it is ignored. EXAMPLE: A machine is purchased for $30,000 to replace a worker earning $20,000 per year. Payback period = Total Investment Annual savings or increased net cash flow = $30,000 $20,000 = 1.5 years |
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Term
|
Definition
| For the CHSRA QIs,a means of ranking providers based on how they compare with each other on each separate QI. The higher a provider's percentile ranking, the more apt the provider is to have a care concern. |
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Term
|
Definition
| Usually an annual evaluation of employees in which the performance of the employee is formalized into written appraisals or rating scales by the administrator and given to the employee prior to a face-to-face meeting to review the evaluation and allow the employee to respond to the comments or rating. This evaluation is based on clear measures and goals set the previous year. Setting work goals for the next evaluation period is also part of this evaluation process. |
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Term
|
Definition
| Same as performance evaluation; comments by the employee on the employee on the evluation by the administrator. |
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Term
| Performance-Centered Objectives |
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Definition
| Stating training goals in terms of behaviors that can be learned and observed by supervisors or others, e.g., ability to demonstrate proper procedures for turning a residnet suffering from pressure ulcers. |
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Term
| Person Appropriate Activities |
|
Definition
| Refers to the idea that each resident has a personal identity and history that involves more than just his/her medical illnesses or functional impairments. (Miller, cited in The Long Term Care Survey, 2008, page 86). |
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|
Term
| Person-Centered / Person-Directed Care |
|
Definition
| A philosophy of care in which the focus of the community is on meeting the expressed desires of the residents. |
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Term
|
Definition
| A staff function. Assists line managers in record keeping, recruitment, selection, training and retaining employees as well as compensation management and performance evaluation. This person is most responsible for the human resources function. |
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Term
|
Definition
| A physician who has specialized in physical medicine and rehabilitation. |
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Term
|
Definition
| One for which there is scientifically valid evidentce that it is combustible liquid, a compressed gas, explosive, flammable, or organic peroxide, an oxidizer, pyrophoric, unstable (reactive) or water-reactive. |
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Term
|
Definition
| Devices that prevent or restrict resident (patient) movement. A device or manual method that works to treat a medical symptom(s) but is attached to or adjacent to the individual's body so that freedom of movement or normal access to one's body is restricted. |
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Term
|
Definition
| A person licensed, certified, or registered by state statute to perform as a physical therapist. Generally, these individuals are certified by the American Physical Therapy Association (APTA). |
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Term
|
Definition
| Focuses on evaluating and treating musculoskeletal disorder… geared toward improving ambulation, joing mobility, and balance; strength training; fitting and using artificial limbs; training to use canes and walkers. (Singh, 2008, page 296). |
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Term
|
Definition
| A person licensed or certified by state statute to perform as a physician assistant. It is a trained professional who can perform physical examinations, diagnose and treat illnesses, order and interpret laboratory tests, and make rounds at LTC facilities under the direction of a physician. |
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Term
|
Definition
| A national organization that began as a grassroots movement of caregivers, consumer advocates, and other who were concerned abou thte quality of life in nursing homes. The organiztion advocates cultural change in nursing facilities through educating, sharing of ideas, and forming coalitions with stakeholders such as regulators, ombudsmen, consumers, and care professionals. |
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Term
|
Definition
| A provider;s plan for how and when it will correct federal deficiencies and/or state violations. |
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Term
|
Definition
| A written plan developed by the facility, outlining steps the facility has taken or will take to correct deficiencies found during licensure or other surveys. |
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Term
|
Definition
| (as a managerial behavior) Deciding what is to be done, setting short- and long-term objectives, then identifying the means for achieving them. Requires forecasting the economic, social, and political environment anticipated for the organization and the resources that will be available to it. |
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Term
| Pledging of Accounts Receivable |
|
Definition
| Use of receivables as security or collateral for a loan. When this is done "with recourse," the borower remains responsible for collecting the receivables but promises to use the proceeds for repaying the debt. In contrast, factoring of receivables is the sale of receivables as a means of short-term financing. When this is done "without recourse," the seller transfers not only the receivables but also the risk of default. |
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Term
|
Definition
| A physician who treats patients with diseases or deformities of the feet. |
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Term
|
Definition
| The responsibilities and duties performed by one individual. There are as many positions as there are employees. |
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Term
|
Definition
| Care for residents (patients) who are admitted to a facility following an acute care hospitalization. Care may involve high-intensity rehabilitation or clinically complex care. Most post-acute stays are for less than 30 days. Some post-acute stays lead to long term admissions for chronic care. |
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Term
|
Definition
| A step the accounting process when journal entries are transferred (posted) to accounts in the general ledger in order to summarize information such as cash on hand. |
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Term
|
Definition
| An on-site provider visit intended to verify correction of deficiencies and/or violaitons cited during a survey. |
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|
Term
| Preadmission Screening/ Annual Resident Review (PASARR) |
|
Definition
| Federally required screening of all nursing home residents, prior to admission, to determine if the individual residents are mentally ill or mentally retarded. |
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Term
|
Definition
| A LTC administrator who meets prescribed qualifications and has been certified to mentor interns in an AIT program. |
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Term
|
Definition
| A short questionnaire and interview used by some facilities to help screen out unsuitable applicants for a position. |
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Term
|
Definition
| Expenses paid in advance for several months, e.g., building rental payments, journal subscriptions, insurance premiums. These expenses are allocated to the months by adjusting entries. |
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Term
|
Definition
| An inflamed lesion of the skin or internal mucous tissue caused by pressure or friction. Pressure sores are classified (Stages 1 - 4) for increasing severity. |
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Term
|
Definition
| The wages paid by the predominant number of facilities in a community. Most businesses indicate they pay the prevailing wage rate or a competitive rate. |
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Term
|
Definition
| A type of QI or QM that provides a description of a resident or patient at a point. |
|
|
Term
| Preventive Labor Relations |
|
Definition
| Maximizing the communicaiton and facility accpetance by non-unionized employees in hope that they will feel no need to form a union to achieve their work goals. |
|
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Term
|
Definition
| A prgram to assure that equipment and components operate in optimal conditions. This includes inspections of all systems and equipment on a scheduled basis and planned performance of certain tasks aimed at prevening unexpected equipment failures. |
|
|
Term
|
Definition
| Basic, routine, continuous, and coordinated medical care rendered by a primary care physician or a mid-level provider such as a physician's assistant or nurse practitioner. |
|
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Term
|
Definition
| The assessment that occurs in the most recent four months (46-165 days) preceding the target assessment (See Assessment and Target Assessment). |
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Term
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Definition
| Includes a combination of large and small group, one-to-one, and self-directed activities; and a system that supports the development, implementation, and evaluation of the activities provided to the residents in the facilities. |
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Term
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Definition
| Use of a specified number of verbal, then more stern written warnings for each offense of the same rule before suspending or firing an employee. |
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Term
| Prospective Payment System (PPS) |
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Definition
| A payment system developed for Medicare for skilled nursing facilities that pays facilities an all-inclusive rate for all Medicare Part A beneficiary services. Payment is determined by a case mix classification system (RUGs). |
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Term
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Definition
| Practice by Medicare and most state Medicaid programs of using predetermined rates to reimburse nursing facilities without adjusting payment to cover actual costs. The states use a wide variety of methodologies to develop these rates. If the provider can keep costs below the formula determined rate, a profit can be made. If the provider's costs exceed the rate, a loss is incurred. |
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Term
| Provider Initiative Project (PIP) |
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Definition
| A quality indicator information system for long term care developed by the Center for Health Systems Research and Analysis (CHSRA) at the University of Wisconsin-Madison that utilizes MDS assessment data. |
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Term
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Definition
| Medications used to change, modify, or alter an individual's behavior or mood. This general term includes antianxiety, antidepressant, antipsychotic, and hypnotic medications. |
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Term
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Definition
| Psychoactive medications used to change, modify, or alter an individual's behavior or mood. This general term includes antianxiety, antidepressant, antipsychotic, and hypnotic medications. |
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Term
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Definition
| The personal user ID (PUID) is an individual logon that is unique to each staff member who uses the ePIP system. New IDs can be requested at any time by contacting the ePIP help desk. |
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Term
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Definition
| Document from a prospective purchaser requesting a seller to provide certain quantities of described goods or services at a given price, with payment to be made later. |
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Term
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Definition
| For the CHSRA QIs,the broad areas of care that represent the common conditions and important aspects of care and life to nursing home residents. Each domain is represented by one or more QIs. |
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Term
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Definition
| A provider program to monitor and study the quality of the services it delivers, and to make recommendations for improvement. A designated quality assurance committee usually coordinates this activity. |
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Term
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Definition
| CHSRA's indicators of provider level and resident (patient) level status derived from MDS (OASIS) information. The QIs are pointers or signposts of resident (patient) and/or provider care problems. QIs are used by surveyors to help structure the survey process and can be used by the provider to help monitor and improve their own performance. |
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Term
| Quality Initiative Survey (QIS) |
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Definition
| CMS intends to move surveys in the facilty to a process of doing surveys on laptops using wireless technology. This will enable the surveyors to communicate with each other via laptop throughout the survey process itself. |
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Term
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Definition
| Publicly reported information made available by CMS to help consumers assess the quality of nursing home care. There are two categories of quality measures: (1) conditions relevant primarily to long-term residents (patients) (chronic care), including decline in late loss ADLs, pressure sores, residents with pain, physical restraints, and prevalence of infections; and (2) short-stay (temporary) residents (patients) (post-acute care), specifically prevalence of delirium, residents with pain, and improvements in walking. Many of the QMs are based on, and virtually identical to, QIs. |
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Term
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Definition
| General area of the federal nursing home requirements that addressess specific issues. |
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Term
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Definition
| General area of the federal nursing home regulations that addresses residnet (patient) life issues such as dignity, participation in activities, social services, accommodation of needs, and the facility's environment such as lighting, sound, temperature and homelike environment. |
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Term
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Definition
| MDS assessments required each quarter for all residents (patients) in Medicare and/or Medicaid facilities. |
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Term
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Definition
| The extent or magnitude of a resident's (patient's) joint movement. |
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Term
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Definition
| The pay variation permitted within a class or grade of jobs. |
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Term
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Definition
| Listing a number of characteristics, traits and/or requirements of an employee's position on a line or scale which is checked off by the rater as the degree to which the employee does or does not possess a specified characteristic or trait, or fulfill a stated requirement. |
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Term
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Definition
| Requirement by a government agency that an employer increase the proportion of women or minority persons in the employer's workforce. |
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Term
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Definition
| A form of therapy for confused or disoriented individuals that consists of reiteration of the person's idnetity, orientation to time and place, and reinforcement of consistency in daily routine. Repeated attempts are made to draw the person into conversation, using simple questions, pictures, or whatever may spark their interest. |
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Term
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Definition
| Actions such as alteration of facilities and the work environment as well as job restructuring to focus on the essential functions, and altering or eliminating nonessential aspects of a job in order to accommodate a disabled employee. |
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Term
| Recreational Therapist (RT) |
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Definition
| A person certified, by a recognized certifying organization, to perform as a recreational therapist. |
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Term
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Definition
| Recommendations by others of a person for a position at a facility. |
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Term
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Definition
| The health professional designated to oversee food and nutrition services in acute and long-term care settings by both the Centers for Medicare and Medicaid Services and the Joint Commission on Accreditation of Healthcare Organizations; the professional has received a degree in nutrition science, completed a 1,000-hour dietetic internship, and passed a comprehensive national registration examination - a minimum of 15 continuing education hours must be obtained and approved by the Commission on Dietetic Registration for the registered dietitian credentials to be maintained. |
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Term
| Registered Dietitian (RD) |
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Definition
| A person registered as a dietitian by state statute or the American Dietetics Association. |
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Term
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Definition
| A person registered as a nurse by state statute. |
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Term
| Registered Pharmacist (RPh) |
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Definition
| A person registered as a pharmacist by state statute. |
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Term
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Definition
| Federal requirements promulgated to "flesh out" the statutory requirements in the Social Security Act (see also Rules and Statutory Requirement). |
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Term
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Definition
| Funds set aside to meet some future obligation. |
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Term
| Resident Assessment Instrument (RAI) |
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Definition
| A tool to help facilities identify residents' needs and strengths and develop an appropriate care plan. The federal RAI system includes: the MDS, RAPS, and utilization guidelines. It is the designation for the complete resident assessment process mandated by CMS, including the comprehensive MDS, RAPS, and care planning decisions. |
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Term
| Resident Assessment Protocols (RAPs) |
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Definition
| Eighteen problem-oriented guides for care planning with "trigger" conditions to signal the need for additional assessment and review (e.g., activities RAP, mood state RAP, pressure ulcer RAP, etc.). Checking certain boxes or combination of boxes upon filling out the MDS form trigger the requirement for that resident's care plan to address condition(s) identified as in need of special attention. |
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Term
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Definition
| Practices that encourage residents to be involved in making decisions about their care and daily activities; examples of resident-centered dietary functions include cook-to-order eating schedules, resident-involved menu planning, and buffet style or family dining meal service. |
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Term
| Resource Utilization Group (RUG) |
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Definition
| Group based on MDS information; utilized to determine reimbursement rates. |
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Term
| Resource Utilization Groups (RUGS) |
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Definition
| A collection of nursing facility resident classification systems used in a variety of case mix indexed reimbursement systems. Using assessment tools like the MDS 2.0, these systems group residents by expected level of resource utilization, usually based upon staff time measurements per resident per day. Relative resource utilization is reflected in a case mix index (CMI) value assigned to each RUG cell. |
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Term
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Definition
| Any temporary long-term care service (adult day care, home health, or temporary institutionalization) that focuses on giving family caregivers time off while the patient's care is taken over by the respite care provider. |
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Term
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Definition
| Funds established to account for assets with uses limited by the requirements of donors or grantees. For example, a fund may be restricted to plant replacement. If the donor has specified that the principal must be maintained perpetually, and only the investment income it generates may be expended, the principal is accounted for as an endowment fund. |
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Term
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Definition
| (or earned surplus, undistributed profits): The income left to a company after taxes and dividends have been paid and that are a major source of funds for the company's expansion. |
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Term
|
Definition
| A means of assessing a company's profitability. It is calculated by dividing the firm's annual net income by total shareholder's equity. |
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Term
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Definition
| Income earned from carrying out the activities of a firm. Revenues of health care institutions are typically reported in terms of these three components: a. Patient service revenues may be divided into the "room, board, and general nursing services" covered by rates billed to all patients; and ancillary services, such as physical therapy or pharmacy, which are billed to only some patients. Patient service revenues accounts may also be segregated by level of care (skilled, intermediate) or by payer status (self-pay, Medicare, Medicaid, commercial insurance). b. Other operating revenuesare revenues earned incidental to the main purpose of rendering patient care, such as revenues from teh employee cafeteria, beauty shop, and other concessions. c. Non-operating revenues may include separate line items for interest and other investment income, unrestricted gift income or gains (or losses) on sales of property. |
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Term
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Definition
| A form of upcoding under the Medicare prospective Payment System for SNFs which occurs when the SNF falsely or fraudulently completes the MDS, and this results in incorrect assignment of a resident to a higher-paying RUG category. |
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Term
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Definition
| Federal regulations that define practices that, if fully followed, will not be considered violations of the federal anti-kickback. There are regulations, for example, that describe conditions under which discounts may be received from equipment suppliers, and conditions under which payments may be made to operators of referral services. |
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Term
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Definition
| The extent or magnitude of deficient facility practice on resident (patient) outcome. There are three levels of scope as described in the Federal Enforcement Grid (see also ENFORCEMENT GRID) |
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Term
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Definition
| Employment agency which usually focuses its efforts on middle and upper level positions, often conducting national searches, charging the employer for the services. |
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Term
|
Definition
| An alternative to purchased insurance. An entity assumes its own expenses relative to a specific risk of loss by periodically setting aside an actuarially determined amount of money, which may be held by a trustee. |
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Term
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Definition
| Significant conditions or events that exist for only a single case or a few cases. For the CHSRA QI, they may represent a significant problem that needs to be investigated (e.g., fecal impaction, dehydration, pressure ulcers--low risk). |
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Term
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Definition
| Also called "blood poisoning," it is a rapidly progressing and lfe threatening infection due to the presence of bacteria in the blood. |
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Term
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Definition
| Leadership in which the focus is on serving others. |
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Term
|
Definition
| The effect of seriousness of deficient facility practice on residnet (patient) outcome. There are four levels of severity as described in the Federal Enforcement Grid (see also ENFORCEMENT GRID). |
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Term
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Definition
| A term used to describe medical devices such as needles, lancets and syringes, which put individuals at risk for "needle sticks," or the transmission of blood and bodily fluids from the device to an individual. |
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Term
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Definition
| Preserved (often canned or boxed) food which is able to be stored at room temperature for long periods and made ready for service in an emergency situation without the use of electricity. |
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Term
|
Definition
| Admission and discharge of a nursing home resident (patient) that occurs in less than 14 days. |
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Term
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Definition
| Undesirable effect of a medication that causes minimal discomfort in some people. |
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Term
|
Definition
| A major decline or improvement in a resident's status that will not normally resolve itself without further intervention by staff or by implementing standard disease-related clinical interventions, that has an impact on more than one are of a resident's health status and requires interdisciplinary review or revision of the care plan, or both. |
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Term
| Significant Change in Condition |
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Definition
| A substantial modification in a resident's (patient's) physical, mental, emotional, cognitive, or functional status that requires a new assessment using the MDS instrument, and also generally requires notification of the resident's (patient's) attending physician, family, or guardian. |
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Term
| Significant Medication Error |
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Definition
| Medication error that cause a resident (patient) discomfort and/or jeopardizes his/her health and safety. |
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Term
|
Definition
| The threshold used to determine when intervention and documentation is required to prevent under-nutrition from excessive weight loss; in the long term care setting, significant weight loss is 5% in 30 days, 7.5% in 90 days and 10% in 180 days. |
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Term
| Skilled Nursing Facility (SNF) |
|
Definition
| A nursing home that meets the requirements for Medicaid certification as defined in 1819(a) of the Federal Social Security Act. Also the term used by most states to define the type of nursing home that is licensed to provide the highest level of care. |
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Term
| Skilled Nursing Facility (SNF) |
|
Definition
| A facility licensed to provide nursing and medical care requiring a certain level of training and experitse. To qualify as a Medicare provider and receive Medicare reimbursement, a facility must be certified as a SNF. |
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Term
|
Definition
| Federal statutory law that includes the requirements for participation in the Medicare and Medicaid programs. |
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Term
|
Definition
| Statements issued by the Office of Inspector General (OIG) to the general health care community addressing national trends of health care fraud and providing guidance relative to violations of the anti-kickback statute and other federal laws. |
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Term
| Speech Language Pathology |
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Definition
| Encompasses evaluation and treatment of speech, language, and cognitive disorders…treats several kinds of disorders such as aphasia, dysarthria, and dysphagia. |
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Term
|
Definition
| A person licensed, certified, or registered by state statute to perform as a speech pathologist. |
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Term
|
Definition
| A person licensed, certified, or registered by state statute to perform as a speech therapist. |
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Term
|
Definition
| Involves such activities as recruiting, orienting, training, rating, disciplining and terminating employees. |
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Term
|
Definition
| The duty to have and to use the degree of knowledge and skill that is usually possessed and used by competent, prudent similar health care providers in like or similar circumstances. |
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Term
|
Definition
| (SPs) General infection control precautions to be used when delivering hands-on care to any patient, or when handling soiled articles of linen and clothing. It requires the use of gloves, gowns, and masks as necessary to avoid contact with body fluids. |
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Term
|
Definition
| An on-site federal survey of nursing homes conducted every 9-15 months to determine compliance with federal regulations for Medicare and/or Medicaid. |
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Term
|
Definition
| Common name for a set of laws, including the Ethics in Patient Referrals Act of 1989, that prohibits the practice of "self-referral" by physicians, that is, referrals of Medicare and Medicaid patients to a provider of services paid for by government programs, when the physician has a direct or indirect ownership or investment interest in that provider. "Saf harbors" is the name given to permissable referral practices, as outlined in laws. Some states have a law limiting "self-referral" regardless of payer source. |
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Term
| State Operations Manual (SOM) |
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Definition
| The title given to the current set of requirements and guidelines to surveyors. Current edition with changes in red can be downloaded from the CMS web site, www.cms.gov |
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Term
|
Definition
| Financial statement that displays how the cash balance has changed during a fiscal period. Cash increases and decreases are reported in three categories of activities: operating, investing, and financing. This information can be useful in assessing the entity's ability to generate positive future net cash flows, meet its financial obligations, and pay dividends. |
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Term
| Statement of Changes in Owners' Equity (or Fund Balance) |
|
Definition
| A financial statement that reflects the beginning owner's equity, the profit or loss of the current period, and the ending owner's equity as of the Balance Sheet date. Not-for-profits use "fund balance" instead of "owner's equity." |
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Term
| Statement of Deficiency (SOD) |
|
Definition
| A written summary of noncompliance with regulations found during a federal provider survey or complaint investigation (see also VIOLATION). Statements of deficiency are written on a CMS 2567 form. |
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Term
| Statistical Approach to Hiring |
|
Definition
| Identifying the most valid predictors of job success, then using weights in a formula to choose among applicants for a position (see also CLINICAL APPROACH). |
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Term
|
Definition
| An artificially created opening in the body. |
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Term
| Straight-line Method of Depreciation |
|
Definition
| A depreciation method that allocates equal amounts of depreciation expense to each full period of the asset's life: Annual Depreciation Expense = (Historical cost) / (Years of estimated useful life) |
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Term
|
Definition
| A sudden interruption in the blood supply of the brain. Most strokes are caused by an abrupt blockage of arteries leading to the brain (ischemic stroke). Other strokes are caused by bleeding into brain tissue when a blood vessel bursts (hemorrhagic stroke). |
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Term
|
Definition
| Type of nursing home care that is generally considered above skilled nursing but below acute hospital care. |
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Term
|
Definition
| As defined by the American Health Care Association, this is: "a comprehensive inpatient prgram designed for the individual who: (1) has had an acute event as a result of an illness, injury or exacerbation of a disease process: (2) has a determined course of treatment; and (3) does not require intensive diagnostice and/or invasive procedures." Subacute medical and rehabilitative care programs in nursing facilities may include specialty programs for : Post operative recovery, extensive wound care, ventilator support, brain injury care, hospice care, and respiratory or pulmonary management. |
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Term
|
Definition
| Substandard quality of care is any deficiency in 42 CFR 483.13 -- Resident Behavior and Faciility Pracice, 42 CFR 483.15 -- Quality of Life or 42 CFR 483.25 -- Quality of Care that constitutes immediate jeopardy to resident (patient) health or safety; or a pattern of or widespread actual harm that is not immediate jeopardy; or a widespread potential for more than minimal harm that is not immediate jeopardy, with no actual harm. On the Federal Enforcement Grid, substandard care equates to boxes F, H, I, J, K and L, and also results in imposition of penalties (see also ENFORCEMENT GRID). Four elements are required for a civil lawsuit: (1) duty owed, (2) breach or violation of that duty, (3) damage or injury, and (4) causation. |
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Term
| Substandard Quality of Care |
|
Definition
| One or more requirements were not met, resulting in immediate jeopardy to resident health or safety, and a scope or pattern of widespread actual harm, or a widespread potential for more than minimal harm. |
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Term
|
Definition
| Minor deficiencies or violations, but a facility generally meets the intent of federal or state regulations. On the Federal Enforcement Grid, Substantical Compliance is equated to boxes A-C (see also ENFORCEMENT GRID). |
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Term
|
Definition
| Items consumed in the normal course of business operations, e.g., bandages and soap. Projected supply expenses are included in the operating budget, not the capital budget. |
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Term
|
Definition
| An inspection to verify compliance with state and federal standards. |
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Term
|
Definition
| Practice of a supplier giving a nursing facility excessive discounts on Medicare Part A items and services in return for the ability to service and bill nursing facility residents with part B coverage. This may be considered an illegal inducement. |
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Term
|
Definition
| The most recent full or quarterly assessment that is available for the time in which the QM score is calculated (see ASSESSMENT and PRIOR ASSESSMENT). |
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Term
|
Definition
| A coordinated and aggregated series of work elements used to produce an output (e.g., making beds). |
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Term
|
Definition
| Review of job descriptions and activities essential for performing each job (step two of establishing training needs). |
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Term
|
Definition
| The temperature range of 40F (5C) and 140F (60C) in which food bacteria thrive and multiply rapidly. |
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Term
|
Definition
| Care provided to a dying resident (patient) that may or may no include hospice care (see also HOSPICE CARE). |
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Term
|
Definition
| Changing the consistency of food offered to a resident to help accommodate difficulties in chewing or swallowing; textures can include chopped food (the size of green peas), ground food (the size of apple seeds), and pureed food (the consistency of smooth mashed potatoes). |
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Term
|
Definition
| A diet ordered by a physician as part of treatment for a disease or clinical condition, or to eliminate, decrease or increase specific nutrients in the diet. (May also be called Medical Nutrition Diet). |
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Term
|
Definition
| Commercial insurer or other private or pulbic entity (such as Medicare and Medicaid) which pays for all or part of the charges for a resident. |
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Term
|
Definition
| A set point for each CHSRA QI at which the likelihood of a problem is sufficient to warrant further investigation. There may also be a concern below the threshold especially if the percentile rank is close to the threshold. Generally, the threshold point is set at the 90th percentile (see also PERCENTILE RANK). |
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Term
|
Definition
| (1) Movement of a patient from one surface to another, such as from a bed to a chair, or from a wheelchair to a car seat. (2) Movement of a patient from one facility to another. |
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Term
|
Definition
| The act or process of major or complete change. |
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Term
| Transformational Leadership |
|
Definition
| A participatory, holistic, organizationally driven leadership model where the focus is on educating, supporting and caring for one another. |
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Term
| Transitional Care Unit (TCU) |
|
Definition
| A skilled nursing unit located within a hospital. |
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Term
| Transmission-based Precautions |
|
Definition
| Infection control precautions to follow when caring for patients who have communicable disease. These precautions are used in addition to standard precautions. |
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Term
|
Definition
| An accident occurring despite the facility's efforst to identify a hazard, evaluate the hazard, implenet interventions, and monitor the effectiveness. |
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|
Term
| Uniform Guidelines on Employee Selection Procedures |
|
Definition
| A publication of four federal agencies in 1987 setting standards by which federal agencies determine the acceptability of validation procedures used for written tests and other selection devices. |
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Term
|
Definition
| Measures taken to prevent transmission of infection from contact with blood or other body fluids or materials having blood or other body fluids on them, as recommended by the U.S. Public Health Services Centers for Disease Control and adopted by the US Occupational Safety and Health Administration (OSHA) as 29 CFR 1910.1030. |
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|
Term
|
Definition
| Any of the following: drug that is given without a medical reason; drug given in excessive does; drug given for an excessive amount of time; drug without adequate monitoring; drug given with side effects and/or adverse drug reactions indicate the drug should be reduced or discontinued. |
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Term
|
Definition
| The selection, when a claim is submitted to a third-party payer, of a billing code that is not the most appropriate descriptor of a service or condition and that may result in an overpayment to the provider. One type of upcoding is RUG creep. |
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|
Term
| Useful Life (or Service Life) |
|
Definition
| The period of time a fixed asset (such as a building, piece of equipment, or vehicle) can be used by its owner in the production or sale of other assets or services. In order to allocate depreciationover time, total service life must be estimated when a fixed asset is purchased. |
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Term
|
Definition
| Intended to ensure that the Medicare system did not pay for care beyond that which was determined to be necessary. In recent years, has seen increased involvement of other payers and the compressing of allowable lengths of stay. |
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Term
|
Definition
| A type of therapy in which a person's belief that he or she is actually living in the past is accepted and validated by staff members working with the patient. |
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|
Term
|
Definition
| A cost that varies with the change in the number of patients. |
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|
Term
|
Definition
| The granting of an alternate requirement in place of a federal or state regulation. |
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|
Term
|
Definition
| A control technique that evaluates significant differences between budgeted and actual revenues and expenses. |
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|
Term
|
Definition
| A small machine that takes over the breathing function by automatically moving air into and out of the patient's lungs. |
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|
Term
|
Definition
| A written summary of noncompliance with regulations found during a state provider survey or complaint investigation (see also STATEMENT OF DEFICIENCY). The written document is generally called a Notice of Violation. |
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Term
|
Definition
| Generally, body temperature, pulse rate, blood pressure, and respiratory rate are referred to as vital signs. Any abnormalities in these measures triggers further clinical evaluation. |
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|
Term
|
Definition
| A mental image or dream of what an organization is trying to create and become. |
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Term
|
Definition
| Form that the IRS requires an employer to give each employee by January 31 that shows the employee's earnings and income tax and FICA tax deductions for the past year. |
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|
Term
|
Definition
| Form that the IRS requires an employer to allow each employee to submit on which the employee indicates marital status and number of withholding allowances claimed. This information must be used by the employer in determining amount of income tax to withhold. |
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|
Term
|
Definition
| Establishment of pay grades and rates by employers to both achieve equity and offer some flexibility to supervisors in setting an employee's wage. |
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|
Term
|
Definition
| Determination of wage rates by considering the labor market, prevailing wage rates, cost of living, ability to pay, collective bargaining agreements, individual bargaining agreements, and value of the job. |
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|
Term
|
Definition
| Decisions by management on the rate of pay for the facility staff, the amount of discretion supervisors may use in setting individual salaries, the spread between pay rates for long-time and new employees, and the periods between pay raises together. |
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|
Term
|
Definition
| The granting of an exemption from a federal or state regulation (see also VARIANCE). |
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|
Term
|
Definition
| The excess of current assets over curreent liabilities. Working capital management is the effort to increase this desirable excess by increasing current assets in various ways and decreasing current liabilities in various ways. |
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|
Term
|
Definition
| Removing an uncollectible account from the accounts receivable. Bad debts expense is increased and the asset, account receivable, is decreased when the account receivable is written off. |
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