Accounts Receivable - ANSWER Patient bills for services that have already been provided
that legally are due to a facility.
Autopsy Rates - ANSWER 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.
Average Length of Stay (ALOS) - ANSWER The total number of patient days in a period di-
vided by the number of patients; for example, the ALOS for cardiology services in February
was 6.1 days.
Benchmarks - ANSWER Goals or metrics a facility wants to meet; for example, if the in-
dustry standard is 90% of patients should have advance directives entered into their patient
record within 24 hour of admission, and a hospital was only meeting this for 45% of the pa-
tients, they would use the external benchmark of 90% as a goal and track performance to-
ward that goal by month or quarter.
Centers for Disease and Control and Prevention (CDC) - ANSWER A division of the Depart-
ment of Health and Human Services.
Chief Executive Officer (CEO) - ANSWER Leader of a facility who reports to the Board of
Directors.
Chief Financial Officer (CFO) - ANSWER Leader who oversees all financial and fiscal deci-
sions and issues for a facility; generally reports to the CEO.
1
,Commercial Insurers - ANSWER Private, non-government insurers; these are often the in-
surance options available through employers.
Comorbidity - ANSWER Disease that exists at the same time as a primary disease that a
patient is being treated for at the time; for example, a patient who has cancer is receiving
cancer specific treatment and is also a diabetic - diabetes mellitus would be considered the
comorbid condition.
Complications - ANSWER 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.
Copayment - ANSWER Money the patient must pay toward the bill as contracted be-
tween 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.
Daily Census - ANSWER The count of how many patients are in beds by patient care unit
for an inpatient facility.
Department of Health and Human Services (HHS) - ANSWER Principle agency for protect-
ing Americans' Health
Institute of Medicine (IOM) - ANSWER Non-governmental, independent, and nonprofit
organization that provides unbiased, expert advice to governmental and private decision-
makers, as well as the public.
Morbidity - ANSWER Refers to disease
Mortality (death) Rate - ANSWER The percentage of all discharged patients who are dis-
charged due to death within a prescribed period; for example, if a hospital has discharged 30
2
, 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%.
National Ambulatory Medical Care Survey (NAMCS) - ANSWER Collects data on ambula-
tory medical care provided in the U.S.; the data is collected from visits to office based pro-
viders who provide direct patient care.
National Center for Health Statistics (NCHS) - ANSWER Nation's primary statistics organi-
zation; 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.
National Health Inpatient Quality Measures - ANSWER A set of specific data that hospi-
tals must collect and report to CMS and the Joint Commission to document quality patient
care.
Occupancy Rate - ANSWER The percentage of licensed beds in a hospital that have a pa-
tient assigned to them, and thus are generating revenue.
Patient Care Unit (PCU) - ANSWER For the purpose of census data, a PCU has a defined
number of beds and is staff assigned; also called floors, units, or wards.
Prospective Payment System (PPS) - ANSWER System initially implemented by Medicare
in the early 1980's that replaced fee-for-service payments for the provision of health ser-
vices with predetermined payments based on the principal diagnosis of the patient.
Service Lines - ANSWER Groups of patient services by specialty; hospitals define these in-
dividually, and they vary by facility with some similarities, such as obstetrics; examples in-
clude cardiology, neurology, thoracic surgery, general surgery, and the gynecology; some fa-
cilities choose to combine similar or related lines, such as obstetrics and neonatology, ob-
stetrics and gynecology, and cardio-thoracic surgery; they are useful for compiling financial,
compliance, and other in-house reports.
3
that legally are due to a facility.
Autopsy Rates - ANSWER 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.
Average Length of Stay (ALOS) - ANSWER The total number of patient days in a period di-
vided by the number of patients; for example, the ALOS for cardiology services in February
was 6.1 days.
Benchmarks - ANSWER Goals or metrics a facility wants to meet; for example, if the in-
dustry standard is 90% of patients should have advance directives entered into their patient
record within 24 hour of admission, and a hospital was only meeting this for 45% of the pa-
tients, they would use the external benchmark of 90% as a goal and track performance to-
ward that goal by month or quarter.
Centers for Disease and Control and Prevention (CDC) - ANSWER A division of the Depart-
ment of Health and Human Services.
Chief Executive Officer (CEO) - ANSWER Leader of a facility who reports to the Board of
Directors.
Chief Financial Officer (CFO) - ANSWER Leader who oversees all financial and fiscal deci-
sions and issues for a facility; generally reports to the CEO.
1
,Commercial Insurers - ANSWER Private, non-government insurers; these are often the in-
surance options available through employers.
Comorbidity - ANSWER Disease that exists at the same time as a primary disease that a
patient is being treated for at the time; for example, a patient who has cancer is receiving
cancer specific treatment and is also a diabetic - diabetes mellitus would be considered the
comorbid condition.
Complications - ANSWER 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.
Copayment - ANSWER Money the patient must pay toward the bill as contracted be-
tween 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.
Daily Census - ANSWER The count of how many patients are in beds by patient care unit
for an inpatient facility.
Department of Health and Human Services (HHS) - ANSWER Principle agency for protect-
ing Americans' Health
Institute of Medicine (IOM) - ANSWER Non-governmental, independent, and nonprofit
organization that provides unbiased, expert advice to governmental and private decision-
makers, as well as the public.
Morbidity - ANSWER Refers to disease
Mortality (death) Rate - ANSWER The percentage of all discharged patients who are dis-
charged due to death within a prescribed period; for example, if a hospital has discharged 30
2
, 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%.
National Ambulatory Medical Care Survey (NAMCS) - ANSWER Collects data on ambula-
tory medical care provided in the U.S.; the data is collected from visits to office based pro-
viders who provide direct patient care.
National Center for Health Statistics (NCHS) - ANSWER Nation's primary statistics organi-
zation; 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.
National Health Inpatient Quality Measures - ANSWER A set of specific data that hospi-
tals must collect and report to CMS and the Joint Commission to document quality patient
care.
Occupancy Rate - ANSWER The percentage of licensed beds in a hospital that have a pa-
tient assigned to them, and thus are generating revenue.
Patient Care Unit (PCU) - ANSWER For the purpose of census data, a PCU has a defined
number of beds and is staff assigned; also called floors, units, or wards.
Prospective Payment System (PPS) - ANSWER System initially implemented by Medicare
in the early 1980's that replaced fee-for-service payments for the provision of health ser-
vices with predetermined payments based on the principal diagnosis of the patient.
Service Lines - ANSWER Groups of patient services by specialty; hospitals define these in-
dividually, and they vary by facility with some similarities, such as obstetrics; examples in-
clude cardiology, neurology, thoracic surgery, general surgery, and the gynecology; some fa-
cilities choose to combine similar or related lines, such as obstetrics and neonatology, ob-
stetrics and gynecology, and cardio-thoracic surgery; they are useful for compiling financial,
compliance, and other in-house reports.
3
