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| Nursing home terminology steeped
in bureaucracy Gannett News Service WASHINGTON — Because the federal and state governments pay for nearly 60 percent of all nursing home bills, the world of nursing homes is steeped in regulatory jargon. A brief glossary of some important phrases to help a novice navigate. Actual harm: A deficiency that has harmed a nursing home resident’s health. Centers for Medicare and Medicaid Services: Formerly known as the Health Care Financing Administration (HCFA), this federal agency is responsible for administering the Medicare and several other health-related programs. Often identified by the acronym CMS. Deficiency: Violation of federal minimum standards for patient care. Immediate jeopardy: A deficiency that has caused or is likely to cause serious injury, harm, impairment or death to a resident receiving care in a nursing home. Infection: Includes pneumonia, wound infections and urinary tract or bladder infections. Medicaid: A joint federal-state health insurance program for the poor. Will pay nursing home costs for those medically and financially qualified. Medicare: Federal health care insurance for those 65 and older, some disabled, and people with end-stage kidney disease. Medicare will cover most of the cost of for a limited stay at a skilled nursing facility following a three-day hospital stay. Minimum data set: A federal form nursing homes must fill out to assess residents’ health status. Physical restraint: Any device, material or equipment that keeps a resident from moving freely. Examples: Special vests, chairs with lap trays, ankle restraints, or wrist restraints. Bed rails also can be considered physical restraints. Pain: Nursing homes record residents as suffering from pain if a resident expresses he or she experienced “very bad” pain at any time, or “moderate” pain every day, in the seven days before the assessment. Pressure sore: A skin wound commonly called a bedsore. Areas most likely to develop pressure sores are heels, elbows, shoulders and the bony parts of a person’s bottom, spots where pressure from bones is exerted against skin. To prevent pressure sores, patients should be repositioned every two or three hours so blood is allowed to flow to the endangered areas, their skin should be kept clean and dry, and they should sit or lie on ample cushioning to reduce the pressure. Scope and severity matrix: The government’s system to rate the seriousness of a violation of federal minimum standards for patient care. For each violation, a state inspector determines the harm to a resident and how widespread the problem is within a nursing home. Each violation is assigned a letter grade, A to L. A is the least serious. Survey: A nursing home inspection. Source: GNS research |
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