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Term Definition Term Definition
Activity of Daily Living (ADL) Activities of daily living refer to an individual's daily habits. ADLs are often used to help determine an individual's ability to function at home or another less-restricted environment of care. Examples of ADLs include bathing, dressing, eating, moving around, using the bathroom, and walking. Long-term care Long-term care is health care services provided for an extended period of time to patients of all ages with severe chronic diseases or disabilities involving substantial functional impairment. This care can range from skilled medical care to personal assistance with activities of daily living.
Adult nursing It refers to care provided by registered or licensed practical nurses at home for adults and seniors dealing with chronic illness, injury, or disability. This care is also sometimes referred to as private duty or adult skilled nursing. Long-term home care Long-term home care is long-term care services provided in the comfort of a person's home.
Ambulation Ambulation refers to the ability to walk from place to place independently with or without assistive devices. Managed Care Any form of health benefits plan that actively monitors health care services received by covered individuals for effectiveness, cost efficiency, or quality. Typically, managed care plans provide a higher level of benefits for a select network of contracted providers, and may require preauthorization of certain services.
Assistive Care Its services include assistance with activities of daily living (ADL) and household support services for adults and seniors. Mandate Law requiring that a health plan or insurance carrier offers a particular procedure or type of coverage.
Care management This refers to the comprehensive and coordinated process of activities that begin with the client referral. Both administrative and clinical, care management continues through admission planning, start of care, and ongoing care to the client’s discharge or transfer. Medicaid A state government program that provides health care insurance and medical assistance to people, including families and children, who meet income eligibility requirements.
Caregiver (Family) Someone who gives care to another person. Often a caregiver is a family member providing care to a loved one. Medical supplies Essential items that the home health team uses to conduct home visits or carry out services the physician has order to treat or diagnose a patient’s illness or injury.
Caregivers (Professional) Employees who provide care to clients are referred to as caregivers, care professionals, or health care professionals. Medicare The largest payor of home health care services, this federally mandated program sets the standards for many other insurers. Medicare provides health care coverage for persons age 65 and older, persons who are defined for social security purposes as "disabled" for at least two years, and certain other special cases. Some individuals who are age 65 or older may not be covered if they have not contributed to Social Security for a minimum number of quarters. Medicare part "A" (hospital insurance) coverage is provided to eligible individuals at no cost, and covers hospitalization, some inpatient care in a skilled nursing facility, home health, and hospice care. Medicare part "B" (medical insurance) coverage is optional, a premium is charged to beneficiaries who desire it, and it covers physician services, outpatient hospital services, durable medical equipment, and a number of other supplies and services not covered by Medicare part "A."
Case management Case management refers to the process of identifying individuals’ special health care needs, developing a health care strategy that meets those needs, and coordinating and monitoring care. Typically, case management is provided by a health professional in their area of practice, such as an insurance company, state Medicaid program, or hospital. Medicare Advantage Plan (aka Medicare Part C) This Medicare program gives you more choices among health plans and extends benefits beyond the Original Medicare plan. It includes private Medicare Advantage plans (such as HMOs and PPOs) that provide Part A and B benefits to enrollees, as well as Medicare prescription drug benefits beginning in 2006. Nearly everyone with Medicare Parts A and B is eligible for a Medicare Advantage plan. Medicare Advantage plans previously were called Medicare+Choice plans.
Centers for Medicare and Medicaid Services (CMS) The Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children's Health Insurance Program (SCHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, and clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments. Medicare Part A This government-supported health insurance plan helps cover inpatient hospital care, care in nursing homes, hospice care, and some home health care for qualified Americans age 65 and older and certain younger individuals with disabilities. Most people pay for Part A coverage through taxes while working and therefore do not pay a deductible or monthly premium.
Certified Intake Specialist (CIS) This certification qualifies employees to handle service request inquiries. Medicare Part B This government-supported insurance plan covers doctors' services, outpatient hospital care, medical equipment, physical and occupational therapy, and some home health care for qualified Americans age 65 and older and certain younger individuals with disabilities. Most people pay an annual deductible and a monthly premium for this health plan.
Client A client is a person receiving home health care services from Moravia Health. Non-ambulatory This refers to the condition of a person who is unable to move or walk around. If someone is non-ambulatory, they are usually required to be bedridden or hospitalized.
Dementia Dementia is a non-specific illness syndrome (set of symptoms) in which affected areas of cognition may be memory, attention, language, and problem solving. Dementia is caused by brain cell damage or injury. Nurse Aide (aka home health aide) A nurse aide is a health care professional who provides personal care including assistance with walking, bathing, dressing, and meal preparation.
Depression Depression is a psychiatric disorder marked by sadness, inactivity, feelings of hopelessness, and sometimes suicidal tendencies. Many severely depressed individuals will have some mental deficits including poor concentration and attention. When dementia and depression are present together, intellectual deterioration may be exaggerated in the depressed person. Depression, whether present, alone, or in combination with dementia, can be reversed with proper treatment. It is one of the most undiagnosed conditions among seniors. Nurse practitioner (NP or CRNP) An NP is a specialist who provides primary and/or specialty care to patients or clients. In some states, nurse practitioners do not have to be supervised by a doctor.
Discharge planner A discharge planner is a social worker or other health care professional who assists hospital patients and their families in BACK TO TOP transitioning from the hospital to another level of care or facility. This transition includes rehabilitation in a skilled nursing facility, home health care in the patient’s home, or long-term care in a nursing home. Observed tasks of daily living (OTDL) The OTDL is performance-based test of everyday problem solving administered to older adults. The OTDL's purpose is to assure ability to properly use medication, to self-feed, and to prepare foods. These are among the most important tasks for independent living for older adults.
Elder abuse Elder abuse refers to the mistreatment and/or harm to an elderly person by someone in a position of trust, such as a family member, spouse, friend, neighbor, or other professional or family caregiver. Occupational therapy (OT) OT services are given either on an in- or outpatient basis to help a person regain ability to perform activities of daily living (ADL), such as dressing, bathing, toileting, and eating or meal preparation. OT is needed if a patient has suffered an injury or illness that has affected motor skills, reasoning abilities, or other loss of function.
Elder Care Services provided to the elderly at home, in residential or assisted living facilities, or in the community. These services may include health-related skilled nursing, rehabilitative therapies, and palliative care. Typically elder care is provided over an extended period of time to people who need another person’s assistance with activities of daily living. Palliative care Any treatment or medical care focused on reducing symptoms of a disease, rather than curing the disease itself. The goal is to improve the quality of life for those with serious, complex illnesses.
Homebound Being homebound refers to the state of when a person's physical health prevents him or her from leaving the home for more than short periods of time. To be eligible for home health care services through Medicare, the patient must be homebound or deemed in a homebound status. Physical Therapy (PT) PT Is needed if a patient has suffered an injury or illness, which has affected motor skills or function. This may consist of evaluation, therapeutic exercises, gait training, adaptive equipment recommendations, massage, heat, and cold or electrical treatments. The service is geared toward helping the patient or client attain his/her maximum functional motor potential. Typically, this service is considered skilled care.
Home health Home health refers to short-term nursing, rehabilitative, therapeutic, and assistive home health care services. These services are provided to adults and seniors who are recovering after a hospital or facility stay or need additional support to remain safely at home and avoid unnecessary hospitalization. Through the Medicare Home Health benefit, a limited amount of up-to-one-hour visits are provided by registered nurses, physical therapists, occupational therapists, speech language pathologists, home health aides, and medical social workers. Plan of care Written doctor’s orders for home health services and treatments based on the patient’s condition. The plan of care is developed by the doctor, the home health team, and the patient. The home health team keeps the doctor up-to-date on the patient’s condition and updates the plan of care as needed. It is the doctor, and not the home health team, that authorizes what services are needed and for how long.
Home Health Aide (HHA) A HHA is a nurse aide who has been tested and proven competent in home health skills. Home Health Aides are able to work in the private home. Provider A provider is an individual, facility, or institution that provides medical care. This may include a hospital, home health care agency, skilled nursing facility, or intensive care facility.
Home health aide services HHA services are part time or intermittent services to help with BACK TO TOP activities of daily living. Qualified Individual (QI) Program The QI is a state program that helps pay Part B premiums for people who have Medicare Part A.
Home health care Medical or non-medical services that safely support people in the comfort of home. Qualified Medicare Beneficiary Program (QMB) The QMB is a state program that pays for Medicare Part A and Part B premiums, as well as other cost-sharing (e.g., deductibles, coinsurance, and co-payments) for people who have Medicare Part A and limited income and/or resources.
Incapacity A mental, physical, temporary, or permanent inability to manage one’s own affairs. Can also be defined as a legal disqualification “subject to incapacity.” Referral A referral is a written order from a person's primary care doctor to see a specialist.
Incontinence An inability to control urination and/or bowel movements. Rehabilitative services Rehabilitative services are health care services that help a person keep, reattain, or improve skills and functioning for daily living that has been lost or impaired because of injury or illness. These services may include physical and occupational therapy, speech-language pathology, and psychiatric rehabilitation services in a variety of inpatient and/or outpatient settings.
Intermittent care Skilled nursing and home health aide services provided for up to 28 hours per week, any number of days per week, so long as they are less than 8 hours per day. Skilled nursing care Skilled nursing care is medical care provided at home or in a facility by a registered nurse, licensed practical nurse, doctor, or technician.
Licensure The granting of a license that gives the office of home health agencies permission to open, operate, and provide services. Urgent care Urgent care is care for an illness or injury serious enough to require immediate attention, but that does not require an emergency department or trauma center.
Limitations A “cap” or limit to the amount of services that may be provided. It may be the maximum cost or number of days that a service or treatment is covered. Waiting period (job-based coverage) The waiting period is time that must pass before coverage will become effective for an employee or dependent who is otherwise eligible for a job-based health care plan.
Live-in care Care provided by a non-relative living in the client or patient’s home.
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