Medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than providing a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness. Sometimes incorrectly used as a synonym for hospice care, which itself may employ palliative care steps in a person’s final stages. Also, hospice is a Medicare Part A benefit, which requires a more highly regulated environment.
An organic brain disease caused by degeneration of or damage to the basal nerve cells of the brain. Usually occurs in elderly people and is characterized by tremors, muscle rigidity and a shuffling walk.
The part of the Medicare program that helps pay for inpatient hospital care, as well as inpatient care at a skilled nursing facility, home health or hospice care.
Also called supplementary medical insurance, this is the part of Medicare that helps pay for outpatient hospital services, medically necessary physician services, home health care and various other services and supplies not covered by Medicare Part A.
The federally funded prescription drug benefit, the newest addition to the Medicare program. Transferred many coverage duties from Medicaid. Requires making specific enrollment choices.
See resident assessment
See resident census
See resident days The number of patients in facility multiplied by the number of days spent in facility. It reflects the total accumulation of days because some entities pay on a per diem basis.
Generally, the evaluation by practicing physicians or other professionals of the effectiveness and efficiency of services ordered or performed by other members of the profession (peers).
Also called custodial care. Assistance with activities of daily living, as well as with self-administration of medications and preparing special diets.
Designed to restore or improve movement and strength in people whose mobility has been impaired by injury or disease. May include exercise, massage, water therapy or assistive devices. May be covered in part by Medicare.
Also known as a physician extender. A specially trained and licensed, or otherwise credentialed, individual who performs tasks that might otherwise be performed by a physician, under the direction of a supervising physician.
A plan prescribed by a licensed healthcare practitioner that identifies ways of meeting a resident’s long-term care service needs.
A formal plan that outlines a facility’s expected course of action to address survey shortcomings. This plan is the starting point for a follow-up survey.
A health insurance benefits program in which subscribers can select between different delivery systems (such as HMO, PPO and fee-for-service) when in need of medical services. This is rather than making the selection between delivery systems at time of open enrollment at a place of employment.
Also called subacute care or transitional care, it’s a type of short-term care provided by many long-term care facilities and hospitals. Might include rehabilitation services, specialized care for certain conditions (such as stroke or diabetes) and/or post-surgical care and other services associated with the transition between the hospital and home. Residents on these units often have been hospitalized recently and they typically have more complicated medical needs.
A legal document allowing one person to act in a legal matter on another's behalf for financial or real-estate transactions.
CMS’s final regulations on the skilled nursing prospective payment system.
An assessment of a person's functional, social, medical and nursing needs, to determine if the person should be admitted to a nursing facility or other available community-based care services. Trained professionals conduct screenings.
Managed care organization that operates in a similar manner to an HMO or Medicare HMO except that this type of plan has a larger provider network and does not require members to receive approval from their primary care physician before seeing a specialist. It is also possible to use doctors outside the network, although there may be a higher co-payment.
The periodic payment (such as monthly or quarterly) required to keep an insurance policy in force.
Also known as bedsores or decubitus ulcers. Breakdown of the skin, to which older, bed-ridden individuals are especially susceptible. Treatment for them may include turning every two hours, special support surfaces and other measures.
Care that has the aim of preventing disease or its consequences. It includes healthcare programs aimed at warding off illnesses (such as immunizations) and inhibiting further deterioration of the body (such as with exercise or prophylactic surgery).
Basic or general healthcare, typically referring to the first point when a patient seeks medical assistance.
Residents who pay for their own care or whose care is paid for by their family or another private third party, such as an insurance company. The term is used to distinguish patients from those whose care is paid for by governmental programs (such as Medicaid, Medicare and the Veterans Administration).
PACE - PACE programs serve individuals with long-sssssterm care needs by providing access to the entire continuum of healthcare services, including preventive, primary, acute- and long-term care. Pools an individual’s benefits to fund all healthcare services over a given period of time. Does not include funding for housing.
A regulation that CMS intends to implement after a public comment period typically lasting two or more months. Proposed rules often are enacted as final rules.
Any method of paying nursing facilities or other healthcare providers in which amounts or rates of payment are established in advance for a defined period (usually a year).
Method by which skilled nursing facilities are paid by Medicare. See also: prospective payment.
Individual or organization that provides healthcare services (such as a nursing home, doctors, hospital, physical therapists, home health aides and more).
Antidepressants, anti-anxiety drugs, and antipsychotic drugs used for delusions, extreme agitation, hallucinations or paranoia. They are often referred to as mind- or behavior-altering drugs.
The science dealing with the protection and improvement of community health by organized community effort.