REPORTING

Question 1

patient bills for services that have already been provided that legally are due to a facility

Answer 1

ACCOUNTS RECEIVABLE

Question 2

the percent of autopsies performed on patients who die in the hospital; reasons for not performing an autopsy in the hospital may include legal inquiry or family preference

Answer 2

AUTOPSY RATES

Question 3

the total number of patient days in a period divided by the number of patients; for example, the ALOS for cardiology services in February was 6.1 days

Answer 3

(ALOS) AVERAGE LENGTH OF STAY

Question 4

goals or metrics a facility wants to meet; for example, if the industry standard is 90% of patients should have advance directives entered into their patient record within 24 hours of admission, and a hospital was only meeting for 45% of the patients, they would use the external benchmark for 90% as a goal and track performance toward that goal by month or quarter

Answer 4

BENCHMARKS

Question 5

a division of the Department of Health and Human Services

Answer 5

(CDC) CENTERS FOR DISEASE CONTROL AND PREVENTION

Question 6

leader of a facility who reports to the Board of Directors

Answer 6

(CEO) CHIEF EXECUTIVE OFFICER

Question 7

leader who oversees all financial and fiscal decisions and issues for a facility; generally reports to the CEO

Answer 7

(CFO) CHIEF FINANCIAL OFFICER

Question 8

private, non-government insurers; these are often the insurance options available through employers

Answer 8

COMMERCIAL INSURERS

Question 9

disease that exists at the same time as a primary disease that a patient is being treated for at that time; for example, a patient who has cancer is receiving cancer-specific treatment and is also a diabetic- diabetes mellitus would be the co-morbid condition

Answer 9

CO-MORBIDITY

Question 10

unexpected events or circumstances that happen to a patient during the course of his care; hospital acquired infections, such as those involving MRSA, are considered to be complications, as are reactions to medications or an adverse response to any treatment

Answer 10

COMPLICATIONS

Question 11

money the patient must pay toward the bill as contracted between the insurer and provider; amounts range from 5$ to 50$ and 75$ for emergency room and specialist visits; provider’s office visits are often in the 10$ to 35$ range

Answer 11

CO-PAYMENT

Question 12

the count of how many patients are in beds by patient care unit for an inpatient facility

Answer 12

DAILY CENSUS

Question 13

principle agency for protecting American’s health

Answer 13

(HHS) DEPARTMENT OF HEALTH AND HUMAN SERVICES

Question 14

refers to disease

Answer 14

MORBIDITY

Question 15

non-governmental, independent, and not for profit organization that provides unbiased, expert advice to governmental and private decision-makers, as well as the public

Answer 15

(IOM) INSTITUTE OF MEDICINE

Question 16

the percentage of all discharged patients who are discharged due to death within a prescribed period; for example, if a hospital has discharged 30 patients in a month, and of those 5 were deaths, the mortality rate for the month would be expressed as 5/30 or 16.7%

Answer 16

MORTALITY RATE aka DEATH RATE

Question 17

collects data on ambulatory medical care provided in the US; the data is collected from visits to office-based providers who provide direct patient care

Answer 17

(NAMCS) NATIONAL AMBULATORY MEDICAL CARE SURVEY

Question 18

nation’s primary statistics organization; it works to compile, analyze, and disseminate information on the nation’s health to influence and guide health policy and practice in a manner that best serves the population

Answer 18

(NCHS) NATIONAL CENTER FOR HEALTH STATISTICS

Question 19

a set of specific data that hospitals must collect and report to CMS and the Joint Commission to document quality patient care

Answer 19

NATIONAL HOSPITAL INPATIENT QUALITY MEASURES

Question 20

the percentage of licensed beds in a hospital that have a patient assigned to them, and thus are generating revenue

Answer 20

OCCUPANCY RATE

Question 21

for the purpose of census data, a PCU has a defined number of beds and is staff assigned; also called floors, units, or wards

Answer 21

(PCU) PATIENT CARE UNIT

Question 22

system initially implemented by Medicare in the early 1980s that replaced fee for service payments for the provision of health services with predetermined payments based on the principal diagnosis of the patient

Answer 22

(PPS) PROSPECTIVE PAYMENT SYSTEM