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Making the decision where to receive post-acute care can be challenging for you and your family, and sometimes the terminology behind it is complex. Here are some of the most common words and phrases you need to know when taking the next step in your recovery journey.

If you would like more information on any of the terms listed here or have a question about a term that is not listed, please visit the Centers for Medicare and Medicaid Services website.

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Browse Terms by Letter

A

ADL (Activities of Daily Living)

The tasks of everyday life. Basic ADLs include eating, dressing, getting into or out of a bed or chair, taking a bath or shower, etc.

Admission Date

The date the patient was admitted for inpatient care, outpatient service or start of care. For an admission notice for hospice care, enter the effective date of election of hospice benefits.

B

C

Case Manager

A nurse, doctor or social worker who arranges all services that are needed to give proper health care to a patient or group of patients.

Center for Medicare and Medicaid Services (CMS)

The U.S. Department of Health and Human Services' agency responsible for Medicare and parts of Medicaid. The Centers for Medicare and Medicaid Services has historically maintained the UB-92 institutional Electronic Media Claims (EMC) format specifications, the professional EMC NSF specifications, and specifications for various certifications and authorizations used by the Medicare and Medicaid programs. CMS is responsible for oversight of HIPAA administrative simplification transaction and code sets, health identifiers, and security standards. CMS also maintains the HCPCS medical code set and the Medicare Remittance Advice Remark Codes administrative code set.

Co-Morbid Conditions/Comorbidity

More than one disease or condition is present in the same person at the same time. Conditions described as comorbidities are often chronic or long-term conditions. Also called “multi-morbidity” or “multiple chronic conditions.”

D

Department of Health and Human Services

HHS administers many of the "social" programs at the federal level dealing with the health and welfare of the citizens of the United States. (It is the "parent" of CMS.)

Dialysis

Dialysis is a treatment that cleans your blood when your kidneys do not work. It gets rid of harmful wastes and extra salt and fluids that build up in your body. It also helps control blood pressure and helps your body keep the right amount of fluids. Dialysis treatments help you feel better and live longer, but they are not a cure for permanent kidney failure.

Disability

For Social Security purposes, the inability to engage in substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death or to last for a continuous period of at least 12 months. Special rules apply for workers aged 55 or older whose disability is based on blindness. The law generally requires that a person be disabled continuously for five months before he or she can qualify for a disabled worker cash benefit. An additional 24 months is necessary to qualify under Medicare.

Discharge Planning

A process used to decide what a patient needs for a smooth move from one level of care to another. This is done by a social worker or other health care professional. It includes moves from a hospital to a nursing home or to home care. Discharge planning may also include the services of home health agencies to help with the patient's home care.

E

F

Functional Independence

Functional Independence Measure (FIM) is an 18-item measurement tool used by health care practitioners to assess an individual's physical, psychological and social function. It is used to assess a patient's level of disability, especially in response to rehabilitation or a major medical intervention.

G

H

Home Health Agency

A public agency or private organization primarily engaged in providing skilled or paraprofessional home health care to individuals in out-of-hospital settings.

I

Inpatient Medical Rehabilitation

A highly specialized, carefully coordinated, intensive and individualized treatment program provided by inpatient rehabilitation hospitals and units that addresses the full range of medical, physical, cognitive, behavioral, social and vocational issues an individual may face.

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K

L

Licensed

This means a long-term care facility has met certain standards set by a state or local government agency.

Long-Term Care Hospital

Hospital-grade facilities for patients whose health is stable, but who still requires a high level of complex care and medical equipment to recover after their initial stay at an acute hospital.

M

Major Medical Complexity

A combination of multi-organ system involvement of chronic health condition(s) and functional limitations that requires high-level resources and use of medical technology.

Medicaid

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 you qualify for both Medicare and Medicaid.

Medicare

The federal health insurance program for: people 65 years of age and older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure with dialysis or a transplant, sometimes called ESRD).

Mortality Rate

The death rate often made explicit for a particular characteristic (e.g., gender, sex or specific cause of death). Mortality rate contains three essential elements: the number of people in a population exposed to the risk of death (denominator), a time factor, and the number of deaths occurring in the exposed population during a certain time period (the numerator).

N

O

Occupational Therapist

Occupational therapists help people participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Common occupational therapy interventions include helping people recovering from injury to regain skills and providing supports for older adults experiencing physical and cognitive changes. 

Outcome

A measure of performance (or nonperformance) of a function or process as a result of treatment. In inpatient medical rehabilitation, these outcomes include length of stay, improvement of function, increase in life expectancy and decrease in mortality rate, and decrease in readmissions and time before readmission.

P

Pain Syndrome

Complex regional pain syndrome (CRPS) is a chronic pain condition lasting more than six months that most often affects one limb (arm, leg, hand or foot), usually after an injury.

Physical Therapist

A physical therapist is a trained and licensed medical professional with experience in restoring physical function and mobility, maintaining physical function and promoting physical activity and proper function.

Physician Assistant (PA)

A person who has two or more years of advanced training and has passed a special exam. A physician assistant works with a doctor and can do some of the things a doctor does.

Post-Acute Care

Rehabilitation services that patients receive after a stay in an acute care hospital.

Pre-Existing Condition

A health problem you had before the date that a new insurance policy starts.

Provider

Any Medicare provider (e.g., hospital, skilled nursing facility, home health agency, outpatient physical therapy, comprehensive outpatient rehabilitation facility, end-stage renal disease facility, hospice, physician, non-physician provider, laboratory, supplier, etc.) providing medical services covered under Medicare Part B. Any organization, institution, or individual that provides health care services to Medicare beneficiaries. Physicians, ambulatory surgical centers and outpatient clinics are some of the providers of services covered under Medicare Part B.

Q

R

Readmission

An admission to an acute care hospital within 30 days of discharge from the same or another acute care hospital.

Rehabilitation

Rehabilitative services are ordered by your doctor to help you recover from an illness or injury. These services are given by nurses and physical, occupational and speech therapists. Examples include working with a physical therapist to help you walk and with an occupational therapist to help you get dressed.

S

Skilled Nursing Facility

A facility that provides care to patients that need assistance treating and managing minor medical conditions.

Specialist

A doctor who treats only certain parts of the body, certain health problems or certain age groups. For example, some doctors treat only heart problems.

Speech-Language Pathologist

Speech-language pathologists (SLPs) work to prevent, assess, diagnose and treat speech, language, social communication, cognitive-communication and swallowing disorders in children and adults.

T

Telemedicine

Professional services given to a patient through an interactive telecommunications system, including video conferencing, store and forward, remote patient monitoring and mobile health, by a practitioner at a distant site.

Treatment

Something done to help with a health problem. For example, medicine and surgery are treatments.

U

V

Vocational Rehabilitation

The process of assisting an individual in the choice of or return to a suitable vocation. When necessary, assisting the patient to obtain training for such a vocation. Vocational rehabilitation can also mean to preparing an individual regardless of age, status (whether U.S. citizen or immigrant) or physical condition (disability other than ESRD) to cope emotionally, psychologically and physically with changing circumstances in life, including remaining at school or returning to school, work or work equivalent (homemaker).

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