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Long-term Acute Care Facility
A long-term acute care hospital (LTACH), also known as a long-term care hospital (LTCH), is a hospital specializing in treating patients requiring extended hospitalization. Hospitals specializing in long-term care have existed for decades in the form of sanatoriums for patients with tuberculosis and other chronic diseases. The modern hospital known as an LTACH came into existence as a result of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999. The Act defines an LTACH as “a hospital which has an average inpatient length of stay (as determined by the Secretary of Health and Human Services (the Secretary)) of greater than 25 days.” Traditionally, LTACHs provide care for patients receiving prolonged mechanical ventilation. LTACHs have a diverse set of characteristics which influence the ways in which they operate. Physically, LTACHs exist in two models, hospital within hospital or free-standing. Hospital within hospital LTACHs are physically located inside ...
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Sanatorium
A sanatorium (from Latin '' sānāre'' 'to heal, make healthy'), also sanitarium or sanitorium, are antiquated names for specialised hospitals, for the treatment of specific diseases, related ailments and convalescence. Sanatoriums are often located in a healthy climate, usually in the countryside. The idea of healing was an important reason for the historical wave of establishments of sanatoriums, especially at the end of the 19th- and early 20th centuries. One sought for instance the healing of consumptives, especially tuberculosis (before the discovery of antibiotics) or alcoholism, but also of more obscure addictions and longings, of hysteria, masturbation, fatigue and emotional exhaustion. Facility operators were often charitable associations such as the Order of St. John and the newly founded social welfare insurance companies. Sanatoriums should not be confused with the Russian sanatoriums from the time of the Soviet Union, which were a type of sanatorium resor ...
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Medicare, Medicaid, And SCHIP Balanced Budget Refinement Act Of 1999
The Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (also called the Balanced Budget Refinement Act or BBRA) is a federal law of the United States, enacted in 1999. The BBRA was first introduced into the House as H.R. 3075 on October 14, 1999, by Rep. William M. Thomas (R-CA) with 75 cosponsors. It was read twice and then referred to the Senate Committee on Finance. The bill was then slightly altered and reintroduced by Thomas as H.R. 3426 on November 17, 1999. After referral to the House committees on Ways and Means and Commerce, it was incorporated by cross-reference in the conference report into H.R. 3194 on November 18, 1999. The H.R. 3194 bill had been introduced by Rep. Ernest J. Istook, Jr. (R-OK) on November 2, 1999, and was enacted with official title: ''Making consolidated appropriations for the fiscal year ending September 30, 2000, and for other purposes''. The State Health Insurance Trial (SCHIP or S. H. 1 - T) was administered by the United St ...
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Mechanical Ventilation
Mechanical ventilation, assisted ventilation or intermittent mandatory ventilation (IMV), is the medical term for using a machine called a ventilator to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, with the main goal of helping the delivery of oxygen and removal of carbon dioxide. Mechanical ventilation is used for many reasons, including to protect the airway due to mechanical or neurologic cause, to ensure adequate oxygenation, or to remove excess carbon dioxide from the lungs. Various healthcare providers are involved with the use of mechanical ventilation and people who require ventilators are typically monitored in an intensive care unit. Mechanical ventilation is termed invasive if it involves an instrument to create an airway that is placed inside the trachea. This is done through an endotracheal tube or nasotracheal tube. For non-invasive ventilation in people who are conscious, face or nasal ...
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Diagnosis-Related Group
Diagnosis-related group (DRG) is a system to classify hospital cases into one of originally 467 groups, with the last group (coded as 470 through v24, 999 thereafter) being "Ungroupable". This system of classification was developed as a collaborative project by Robert B Fetter, PhD, of the Yale School of Management, and John D. Thompson, MPH, of the Yale School of Public Health.Fetter RB, Shin Y, Freeman JL, Averill RF, Thompson JD (1980) Case mix definition by diagnosis related groups. Medical Care 18(2):1–53 The system is also referred to as "the DRGs", and its intent was to identify the "products" that a hospital provides. One example of a "product" is an appendectomy. The system was developed in anticipation of convincing Congress to use it for reimbursement, to replace "cost based" reimbursement that had been used up to that point. DRGs are assigned by a "grouper" program based on ICD (International Classification of Diseases) diagnoses, procedures, age, sex, dischar ...
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