The first sheet of a resident’s chart, which provides basic information and vital statistics such as the resident’s name, birth date, responsible party, name of the physician and additional basic data.
False Claims Act (FCA)
Carries civil liability to anyone who submits false claims for payment to the U.S. government. Comes into play for long-term care in particular if a provider attempts to collecting funding, such as Medicare or Medicaid reimbursements, for services not rendered. A person or entity found in violation of this act is required to repay the government three times the amount of damages plus a civil penalty of no more than $10,000 per fraudulent claim, but no less that $5,000.
Family and Medical Leave Act (FMLA)
A 1993 federal law requiring employers with more than 50 employees to provide eligible workers up to 12 weeks of unpaid leave for birth, adoptions, foster care placement, and illnesses of employees and their families.
A rate at which Medicare prospective payments are paid to SNFs. All facilities will eventually transfer from a facility-specific rate to the federal rate. During an interim, some nursing homes employ a blended rate that was a combination of the federal rate and the facility-specific rate.
Federally insured reverse mortgage
A reverse mortgage guaranteed by the federal government so the holder will always get what the loan promises. Also called a Home Equity Conversion Mortgage (HECM).
Fee for service
The manner in which a healthcare provider bills for each separate service or episode of care. Most physicians prefer to use this method.
A list of accepted charges or established allowances for specific medical, dental or other procedures or services. The list usually represents either a physician's or third party's standard or maximum charges for stated procedures.
See fiscal intermediary
Fiscal intermediary (FI)
A private health insurance company under contract with the Centers for Medicare & Medicaid Services to handle claims processing for Medicare Part A.
A tube that is inserted into the urinary bladder in order to drain urine into a plastic pouch.
A list of drugs covered by an insurance plan or program.
An organization or company in which profits are distributed to shareholders or private owners.
A person with a physical or mental impairment that limits the individual's capacity for independent living.