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Activities of Daily Living include activities as basic as eating, bathing, toileting, dressing walking, and breathing. Cooking, shopping and money management are called instrumental activities of daily living. Measurement of these functions determines the appropriate level of required assistance such as:
- Determining the need for a guardian
- Nursing home placement and care
- Work accommodations
- Finding appropriate housing
- Determining the level of service required for long-term care
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| Individual assessment is critical to quality care. A skilled health care practitioner appraises critical factors that are important to the patient’s care. Demographic data, physician’s orders, medications, treatments, nursing and medical diagnosis, goals and prognosis, family and community resources, functional limitations and activities are reviewed and evaluated. This information is incorporated into the patient’s plan of care. |
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| A congregate residential setting that provides or coordinates personal services, 24-hour supervision and assistance, activities, and health related services. Assisted living facilities offer living units, which sometimes include a kitchen, housekeeping services, meals, transportation to doctors and activities, and various levels of personal assistance - all for a monthly fee. |
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| An experienced nurse or social worker who works with the patient’s provider and family to coordinate all services deemed necessary to provide the patient with a plan of necessary and appropriate care. Case
managers are skilled in evaluating needs, formulating care plans, locating appropriate services, arranging and coordinating care. |
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| This concept refers to the offer of residential arrangements ranging from independent living units to nursing facilities at one site. Movement between the various sections can be on a temporary or permanent basis
depending upon the current need for help with activities of daily living. Most CCRC’s require a large initial fee in addition to monthly fees. |
| Medical or non-medical services which do not seek to cure, are provided during periods when the medical condition of the patient is not changing, or do not require continued supervision and/or administration by medical personnel. |
| Equipment which can stand repeated use, is primarily and customarily used to serve a medical purpose, generally is not useful to a person tin the absence of illness or injury, and is appropriate for use at home. Examples of durable medical equipment include hospital beds, wheelchairs and oxygen equipment. |
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| A nursing home or nursing center licensed to operate in accordance with all applicable state and local laws to provide 24-hour nursing care. Such a facility may offer skilled, intermediate or custodial care, or any combination of these levels of care. |
| The federal agency responsible for administering Medicare and overseeing the state’s administration of Medicaid. |
| Health or supportive services provide within the home. Nurses, their assistants, rehabilitation specialists (physical therapists, occupational therapists or speech therapists) or personal care attendants are hired
through a Medicare-certified agency, a licensed home health agency or a registry. |
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| A facility or program licensed, certified or otherwise authorized pursuant to state and federal laws to provide health care services in the home. |
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| A facility or program engaged in providing palliative and supportive care of the terminally ill. |
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| Health care providers provide information to the patient to help them understand their condition and proposed treatments and the patient consents to the course of treatment before it starts. |
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| When an individual is admitted to a hospital and is receiving services under the direction of a physician for at least 24-hours. |
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| A facility providing a level of care that is less than the degree of care and treatment that a hospital or skilled nursing facility (SNF) is designed to provide but greater than the level of room and board. |
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| A private, not-for-profit organization that evaluates and accredits hospitals and other health care organizations providing home care, mental health care, ambulatory care and long term care services. |
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| Assistance and care for persons with chronic disabilities. Long-term care’s goal is to help people with disabilities be as independent as possible; thus it is focused more on caring than curing. Long-term care is needed by a person who requires help with the activities of daily living (ADLs) or who suffer from cognitive impairment. |
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| A joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are covered if an individual qualifies for both Medicare and Medicaid |
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Services or supplies that:
- Are proper and needed for the diagnosis or treatment of your medical condition;
- Are used for the diagnosis, direct care and treatment of your medical condition;
- Meet the standards of good medical practice in the local community; and
- Are not mainly for the convenience of the patient or doctor.
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A nationwide, federally administered, health insurance program which covers the costs of hospitalization,
medical care, and some related services for eligible persons. Medicare has two parts:
- Part A Hospital insurance which helps cover inpatient care in hospitals and skilled nursing facilities (after a related 3-day hospital stay). Part A also covers hospice care and some home health care.
- Part B Medical insurance which helps cover medically necessary doctors services, outpatient hospital care and some other medical services that Part A does not cover, such as some of the services of physical and occupational therapists and some home health care.
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| A person who receives health care services without being admitted to a hospital. |
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| A written plan of care detailing the services and specific tasks that will be provided as an overall design to maintain the highest practicable physical, mental and emotional well-being. The plan of care should address both medical and non-medical issues including daily schedules, staff, personal care, medications and activities. |
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| A physician, hospital, group practice, nursing home, pharmacy or an individual or group of individuals that
provides a health care service. |
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| A physician-sponsored organization charged with reviewing the services provided patients. The purpose of the review is to determine if the services provided patients. The purpose of the review is to determine if the services rendered are medically necessary: provided in accordance with professional criteria, norm and standards; and provided in the appropriate setting. |
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| A formal set of activities used to review and affect the quality of services provided. Quality assurance includes a quality assessment and related corrective actions to remedy any deficiencies identified in direct patient, administrative and support services. |
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| Doing the right thing, at the right time, in the right way, for the right person and getting the best possible results. |
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| A level of care that must be given or supervised by licensed nurses. Examples include intravenous injections, tube feedings oxygen to help breathing, medication supervision and management, or changing sterile
dressings on a wound.
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| A facility, either freestanding or a part of a hospital that accepts patients in need of rehabilitation and/or medical and nursing care that is of lesser intensity than that received in a hospital. |
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