PlayMaker CRM Educational Series

A Glossary of Home Care & CRM Terms

Whether you are new to home care or a veteran of the industry, be sure to acquaint yourself with the following terminology:

A

Account - An organization or facility that does business — or may do business — with your agency.  pm-icon.png  home-icon.png 

Account Manager - The user or marketer associated to an account (also called an Owner).  pm-icon.png

Account Sharing - Allows the owner of an account to share editing permissions with another user.  pm-icon.png

Accountable Care Organization (ACO) - An organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program.  home-icon.png 

Activities of Daily Living (ADLs) - Self-care abilities related to personal care including bathing, dressing, eating, toileting, continence, transferring, and ambulating.  home-icon.png

Adult - A person 18 years or older, or a person legally capable of consenting to his or her own medical treatment.  home-icon.png 

Advance Directive - A document in which a person either states choices for medical treatment or designates who should make treatment choices if the person should lose decisional capacity.  home-icon.png 

All Accounts - One of the view options that provides users visibility to every account loaded in an agency’s database, regardless of owner.  pm-icon.png

All Contacts - One of the view options that provides users visibility to every contact loaded in an agency’s database, regardless of owner.  pm-icon.png

Annual Wellness Visit (AWV) - A visit a Medicare patient may receive after they have been with Medicare for more than one year, or it has been at least one year since their “Welcome to Medicare” exam. At the Annual Wellness Visit, a doctor will speak to the patient about their medical history, review risk factors, and make a personalized prevention plan to keep them healthy. The visit does not include a hands-on exam, testing the doctor may recommend, nor discussion about any new or current medical problems, conditions, or medications.  home-icon.png 

Application Program Interface (API) - An interface for communication and interaction between two pieces of software.  pm-icon.png

AssessmentThe process by which a physician or other health care professional evaluates a person’s health status. Assessment is related to, but distinct from, diagnosis. It may involve the use of formal assessment instruments along with more informal interviews with the patient, the patient’s family, and other caregivers, and with observation of the patient’s behavior.  home-icon.png 

Assessment InstrumentsSpecific procedures, tests, and scales used to measure and evaluate cognitive and self-care abilities, problems, functional limitations, and other patient characteristics.  home-icon.png 

Assisted Living Facility (ALF)An out-of-home care option for elderly persons who continue to lead relatively active, healthy, and independent lives. Most ALFs feature apartment-style living and many services for the elderly.  home-icon.png 

Attending PhysicianThe physician designated by the client who is to have the most significant role in the determination and delivery of the individual’s medical care.  home-icon.png 

B

BeneficiaryRecipient of medical benefits.  home-icon.png 

BookmarkAllows users to create shortcuts to Contacts, Accounts, or Referrals that can be quickly referenced.  pm-icon.png

Business IntegrationThe unification of one or more separate business (nonclinical) functions into a single function.  pm-icon.png  home-icon.png

Business LineRefers to a segment of business for an agency. Examples include Home Health, Hospice, or Private Duty.  pm-icon.png

C

Calendar - Tool designed for users to enter activities pertaining to marketing efforts, meetings, or other events.  pm-icon.png

Care plan - A logical set of activities, steps, assessments, and expected outcomes designed to guide clinicians in making decisions about activities to perform during each visit.  home-icon.png

Caregiver - Unpaid relatives or friends who support and care for individuals with illnesses or disabilities.  home-icon.png

Case Management - Those activities necessary to determine the patient’s needs, arrange for and coordinate the appropriate services, and monitor the effectiveness of services and reassess them as needed.  home-icon.png

Centers for Medicare and Medicaid (CMS) - Federal agency overseeing administration of Medicare and Medicaid programs.  home-icon.png

Certificate of Medical Necessity (CMN) - Documentation required by certain payers, such as Medicare and Medicare Advantage plans, to maintain compliance and prove medical necessity of equipment and services.  home-icon.png

Certified Occupational Therapist Assistant (COTA) - An allied health paraprofessional who, under the direction of an occupational therapist, directs an individual’s participation in selected tasks to restore, reinforce, and enhance performance; facilitates learning of skills and functions essential for adaptation and productivity; diminishes or corrects disorders; and promotes and maintains health.  home-icon.png

Community Health Accreditation Program (CHAP) - An independent US not-for-profit accrediting body created in 1965 for assessing community-based health care organizations.  home-icon.png

Chief Compliance Officer (CCO) - The officer of a company who is primarily responsible for overseeing and managing compliance issues within an organization.  home-icon.png

Chronic Disease - An illness marked by long duration or frequent recurrence.  home-icon.png

Claim - Information submitted by a health care provider or insurance beneficiary, to a payer of medical benefits (e.g., insurance company, Medicare) to establish that medical services or equipment were provided, thus justifying payment to the health care provider or beneficiary.  home-icon.png

Client Assistance Program (CAP) - Program designed to assist people with disabilities who have questions or a problem with Department of Rehabilitative Services (DRS).  home-icon.png

Completion Status - A tool within a calendar event that helps users identify which events are done and which ones are unfinished.  pm-icon.png

Conditions of Participation - The regulations under which a home health agency may be allowed to participate in Medicare and Medicaid programs.  home-icon.png

Contact - A person who refers — or may refer — to your agency.  pm-icon.png  home-icon.png

Contact Manager - The user or marketer associated to a Contact (also called an Owner).  pm-icon.png

Contact Sharing - Allows the owner of a contact to share editing permissions with another user.  pm-icon.png

Contact Type - Refers to the professional association of the related Contact.  pm-icon.png

Continuous Improvement - A philosophy or attitude of looking for methods to improve the quality of products or services.  home-icon.png

Current Procedural Terminology (CPT) - A code set that is used to report medical procedures and services to entities such as physicians, health insurance companies, and accreditation organizations.  home-icon.png

Custodial Care - Treatments or services, regardless of who recommends them or where they are provided, that could be given safely and reasonably by a person not medically skilled, and are mainly to help the patient with activities of daily living.  home-icon.png

Customer Relationship Management (CRM) - A widely implemented strategy for managing a company’s interactions with customers, clients, and sales prospects. It involves using technology to organize, automate, and synchronize business processes.  pm-icon.png  home-icon.png

D

Dashboard - A high-level summary view of the various functions and information within a software tool or data set.  pm-icon.png

Dataset - A sub-set of data from a data source such as a report or the results of a query.  pm-icon.png 

Data source - A large compilation of structural data such as a database or a large tabular data file.  pm-icon.png

Department of Health and Human Services - Federal agency overseeing administration of health care services.  home-icon.png

Discharge Planner - A nurse or social worker who assists patients and families in transitioning from the hospital to another setting.  home-icon.png

Do Not Resuscitate (DNR) - A medical order to refrain from cardiopulmonary resuscitation if the patient’s heart stops beating and breathing ceases.  home-icon.png

Drug Enforcement Agency (DEA) - Federal agency overseeing administration of controlled substances.  home-icon.png

Director of Clinical Services (DOCS) - A medical professional who oversees the management of other nurses.  home-icon.png

Duplicate - An action that can be utilized when working with a Calendar Event. An event can be duplicated if it needs to be scheduled again.  pm-icon.png

Durable Medical Equipment (DME) - Defined by Medicare as equipment that can withstand repeated use; is primarily designed to serve a medical purpose; is generally not useful to a person in the absence of injury or illness; and is appropriate for use in the home. Examples of DME are oxygen tents, wheelchairs, walkers, and suction machines.  home-icon.png

Durable Medical Equipment Regional Carrier (DMERCs) - A private company with which all claims for durable medical equipment (DMEs) is submitted. DMERC contracts with medicare to pay bills for durable medical equipment.  home-icon.png

E

e-Cards - A digital greeting card or postcard created on the Web and sent to someone via e-mail.  pm-icon.png

Electronic Protected Health Information (EPHI) - Any information that can be used to identify a patient, such as name, date of birth (DOB), social security number, policy number, address, phone number, etc. that is stored electronically.  home-icon.png

Event - Any marketing activity that has the potential to generate a referral. Examples of this can be as simple as a fax to something more complex such as a community event.  pm-icon.png

Event Owner - The user that created an event. There can only be one event owner for each event.  pm-icon.png

Event Purpose and Expected Outcome - When creating an event, this section is designed for users to enter what they hope to get from having the event.  pm-icon.png

Event Type - Determines when an event is created.  Event Types are used to help track which activities provide referrals to an agency.  pm-icon.png

Explanation of Benefits (EOB) - Document provided by insurance payers listing charges presented to them by a health care provider of services; this document includes the amount paid and/or the amount declined with a reason for the denial.  home-icon.png

F

Face-to-Face Encounter - Requirement All patients needing Medicare reimbursed home health care services are required to have a documented face-to-face encounter with an eligible health care provider within the 90-day period before or 30 days after the initiation of needed home health care services.  home-icon.png

Family Caregiver - A person who manages or provides direct assistance to a loved one who needs help with day-to-day activities because of a chronic condition, cognitive limitations, or aging.  home-icon.png

Field - A single defined unit of data within a record. When a dataset is displayed in a tabular format this is sometimes referred to as a column.  pm-icon.png

Federal Bureau of Investigation (FBI) - Investigative arm of federal government programs.  home-icon.png

Fraud - Intentional deception or misrepresentation that an individual knows to be false and untrue.  home-icon.png

Functional Limitations - Any health problem that prevents a person from completing a range of tasks, whether simple or complex.  home-icon.png

H

Health and Human Services (HHS) - The department under which the Medicare program is administered.  home-icon.png

Health Care - Care, treatment, services, or procedures to maintain, diagnose, or treat an individual’s physical condition when the individual is in a terminal condition.  home-icon.png

Health Care Decision - A decision to begin, continue, increase, limit, discontinue, or not begin any health care.  home-icon.png

Health Care Financing Administration (HCFA) - The branch of the Department of Health and Human Resources that issues rules and regulations for the Medicare program — now commonly referred to as CMS (Center for Medicare and Medicaid Services).  home-icon.png

Health Care Financing Administration (HCFA) Form 485 - Home health certification and plan of care; Initial Evaluation for Home Care to be determined; Development of the Care Plan; Goals of Home Care; Examples of Measurable Outcomes.  home-icon.png

Health Care Provider - A person, health care facility, organization or corporation that is licensed, certified, or otherwise authorized or permitted by the laws of this state to administer health care directly or through an arrangement with other health care providers.  home-icon.png

Health Insurance Portability and Accountability Act (HIPAA) of 1996 - Creates standards dealing with the privacy of health information, which helps prevent improper use of one’s medical record.  home-icon.png

Healthcare Common Procedure Coding System (HCPCS) - A standardized coding system for describing the specific items and services provided in the delivery of health care.  home-icon.png

Home Care - The provision by one or more organizations of nursing care, social work, therapies (e.g., diet, occupational, physical, psychological, speech), vocational and social services and home maker-home health aide services to disabled, sick or convalescent persons in the home. Services can range from high-tech care (e.g., administration of intravenous drugs) to relatively simple supportive care (e.g., the provision of home-delivered meals).  home-icon.png

Home Health Advance Beneficiary Notice (HHABN) - Informs beneficiaries in Original Medicare about possible non-covered charges when limitation of liability applies.  home-icon.png

Home Health Agency (HHA) - An organization that provides patients with skilled nursing and/or other therapeutic care in their homes, usually following the Medicare model of approved services (see home health care).  home-icon.png

Home Health Aide - A trained individual who works under supervision of a nurse or therapist, providing personal care and assistance with ADLs. Home Health Aides may assist home care patients with medication, exercise, and the performance of basic activities of daily living. Effective August 14, 1990, HCFA identified that Home Health Aide training and competency evaluation must be carried out before the aide renders care in the home.  home-icon.png

Home Health Resource Groups (HHRG) - A payment code which identifies 1 of 80 possible home health episodic payments under the Prospective Payment System (PPS). The HHRG is determined by measuring three factors: clinical severity, functional status, and service utilization (using the OASIS tool).  home-icon.png

Home Health Care - Services provided by a certified agency using an interdisciplinary team to meet the needs of patients being cared for in out-of-hospital settings such as private homes, boarding homes, hospices, shelters, and so on. Caregivers include professional and practical nurses, nursing assistants, physical therapists, occupational therapists, speech-language pathologists, and other professionals.  home-icon.png

Home Medical Equipment (HME) - Items necessary to facilitate independence and improve the patient’s ability to function outside the hospital environment. Home medical equipment (HME) and durable medical equipment (DME) are broad terms which include, but are not limited to, mobility aids such as canes, walkers and wheelchairs; beds and patient lifts, respiratory equipment, supplies and services; apnea monitors; continuous passive motion (CPM); orthotic and prosthetic devices; disposable supplies; and safety devices, such as bath/tub rails, elevated commode seats, and bath transfer equipment.  home-icon.png

Home Medical Equipment (HME) Providers (or Suppliers) - Home medical equipment (HME) providers supply the medical equipment, services, education and caregiver training necessary for the successful use of equipment which is prescribed by the physician for use in the home. Providers also supply follow-up services, repairs and maintenance seven days each week, 24 hours per day to provide the support each patient needs.  home-icon.png

Home Modifications and Transportation Aids - Modifications to the patient’s home which enhance mobility and independence (e.g., ramps, electric stair chairs, lowered counters, door widening) and adaptations to vehicles which enhance the functionality of motor vehicles in transportation of people with disabilities and chronic illnesses (e.g., hand controls, van lifts).  home-icon.png

Home Nursing Care - Care provided by a registered nurse, or a licensed practical or vocational nurse, under the supervision of a registered nurse, which includes observation, assessment, care planning and implementation, and evaluation of client response to care. Nursing includes care of persons experiencing changes in normal health processes, maintenance of health and prevention of illness, as well as caring for the ill.  home-icon.png

Homebound - The patient is homebound if he/she experiences a normal inability to leave home. The patient’s physical condition and/or physical limitations are such that it would be a considerable and taxing effort for the patient to leave home. That patient who has a psychiatric condition may also be considered homebound if the illness manifests in a refusal to leave home or if it would be considered unsafe for the patient to leave the home unattended.  home-icon.png

Homemaker - A person paid to help in the home with personal care, light housekeeping, meal preparation and shopping.  home-icon.png

Hospice - An organized program of interdisciplinary services for terminally ill patients and their families to provide palliative medical care and supportive services, emotional and spiritual services in the patient’s residence.  home-icon.png

I

i-Compli - A home care-specific marketing tool that safeguards an agency from sales and marketing non-compliance.  pm-icon.png

Independent Living Facility (ILF) - A housing arrangement designed exclusively for seniors, in which the resident does not need daily assistance with medical or personal care.  home-icon.png

Independent Provider - A home care worker who is hired privately, outside of a home care agency.  home-icon.png

Instrumental Activities of Daily Living (IADLS) - Activities that facilitate independence, such as the management of finances, use of the telephone, use of public transportation, meal planning and preparation, shopping and taking medications appropriately.  home-icon.png

Integrated - Refers to two or more components merged together into a single system. For example, any software product that performs more than one task can be described as integrated.  pm-icon.png

Intermediary - The organization handling claims from hospitals, nursing homes, home health agencies, and other health care providers under federal or state health coverage programs.  home-icon.png

Interim Order - An order received for a patient after the initial start of care orders.  home-icon.png

Intermittent - A qualifying criterion for Medicare home health services, meaning that continuous 24-hour/day nursing services will not be covered, but only those services — either provided or needed on fewer than 7 days each week or less than 8 hours each day and 28 or fewer hours each week for periods of 21 days or less with extensions in exceptional circumstances when the need for additional care is finite and predictable. Most Medicare home health patients do not require such intensive services.  home-icon.png

International Classification of Diseases (ICD) - The international standard diagnostic classification for all general epidemiological, many health management purposes and clinical use.  home-icon.png

L

Licensed Practical Nurse (LPN) -Individuals who can perform simple as well as complex medical procedures, but must operate under the supervision of either a Registered Nurse (RN) or a physician, depending on state laws. Some states use the term LVN.  home-icon.png

Licensed Vocational Nurse (LVN) - Individuals who can perform simple as well as complex medical procedures, but must operate under the supervision of either a Registered Nurse (RN) or a physician, depending on state laws. Some states use the term LPN.  home-icon.png

Long Term Care Facility - A facility that cares for people with chronic conditions and/ or those unable to be left alone.  home-icon.png

Low Utilization Payment (LUPA) - Home health 4 or fewer visits.  home-icon.png

M

Marketer Snapshot - Allows managers to quickly select any marketer they manage and view real-time statistics including a 3-month referral and event trend chart for the top five contacts.  pm-icon.png  

Marketing Compliance - In home care, staying within the OIG-mandated spending limits of non-monetary expenditures for referral sources and patients.  pm-icon.png  home-icon.png

Medicaid (Title XIX) - A state/federal program designed to provide medical benefits to indigent persons of all ages.  home-icon.png

Medicaid Fraud Control Unit (MFCU) - Investigative arm of state Medicaid agency.  home-icon.png

Medicaid Programs - State health insurance programs for the medically indigent.  home-icon.png

Medical Necessity - Services required and medically appropriate for the treatment of an illness or injury. Such services must be consistent with recognized standards of care and should not involve excessive costs in comparison with alternative services that would be effective for the treatment of the patient.  home-icon.png

Medically Necessary Care (under Medicare) - To be considered reasonable and necessary, services must be consistent with the nature and severity of the patient’s illness or injury, his or her particular medical needs, and the accepted standards of medical and nursing practice, without regard as to whether the illness or injury is acute, chronic, terminal or expected to last a long time.  home-icon.png

Medical Social Services - Social services in home care are directly related to the treatment of the patient’s medical condition, and most recently, Medicare will allow two to three visits for family intervention directly related to the patient’s health and safety.  home-icon.png

Medical Social Worker (MSW) - Individuals who assess patients in order to determine any physical, mental or emotional needs. MSWs assess the family support system and link the patient with services to help with care, if needed.  home-icon.png

Medicare - A federally funded system of health and hospital insurance for persons aged 65 and older and for disabled persons.  home-icon.png

Medicare Certified - A home health agency or organization that is found by the Health Care Financing Administration (HCFA) to meet Medicare’s Conditions of Participation, is certified by HCFA, and is thus allowed to participate in the Medicare program.  home-icon.png

Medicare Criteria for Skilled Services - To be considered a skilled service, the service must be so inherently complex that it can be safely and effectively performed only by, or under the supervision of, professional or technical personnel.  home-icon.png

Medicare Intermediary - Claims processors of the Medicare Part A program.  home-icon.png

Mini-Mental State Examination (MMSE) - A simple screening test to detect dementia; it assesses a range of cognitive abilities such as memory, calculations, language, and spatial ability.  home-icon.png

Mobile CRM - A version of the primary CRM software designed and configured for PDAs and internet accessible phones, which allows user to access certain resources from the primary CRM software most needed when working in the field.

Monthly Top Ten List - List that resides on the dashboard and provides real time visibility to top referring contacts and accounts.  pm-icon.png

My Accounts - One of the view options that provides users visibility to accounts that they own.  pm-icon.png

My Contacts - One of the view options that provides users visibility to contacts that they own.  pm-icon.png

My Home Care Sales Coach - A home care-specific online community that offers coaching, strategies, resources and templates from home care sales and marketing experts.  pm-icon.png

My To-do List - List that provides an area for users to place reminders of tasks that need to be completed. This area is not tied into any other area within PlayMaker.  pm-icon.png

N

National Association of Home Care (NAHC) - The nation’s largest trade association representing the interests and concerns of home care agencies, hospices, home care aide organizations, and medical equipment suppliers.  home-icon.png

National Committee for Quality Assurance (NCQA) - Founded in 1979, the NCQA performs external review of quality assurance programs in prepaid health plans.  home-icon.png

National League for Nursing (NLN) - National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The Nation League for Nursing Accrediting Commission (NLNAC) is a subsidiary of the NLN and responsible for all activities related to the accreditation of nursing programs.  home-icon.png

National Provider Identifier (NPI) - The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of a standard unique identifier for health care providers. The National Plan and Provider Enumeration System (NPPES) collects identifying information on health care providers and assigns each a unique National Provider Identifier (NPI).  pm-icon.png  home-icon.png

Next Action Step - When an event is completed, users can add call notes to this section of the event.  pm-icon.png

Nurse Practitioner - A Registered Nurse (RN) with at least a master’s degree in nursing and advanced education in the primary care of particular groups of clients, capable of independent practice in a variety of settings.  home-icon.png

Nursing Home - A generic term for a Skilled Nursing Facility (SNF).  home-icon.png

O

Occupational Therapist - A therapist who is trained to evaluate patients with joint conditions, such as arthritis, to determine the impact the disease has on their activities of daily living. Occupational therapists can design and prescribe assistive devices that can improve the quality of the activities of daily living for patients with arthritis and other conditions of the muscles and joints.  home-icon.png

Occupational Therapy Services - Therapy that assists the patient to attain the maximum level of physical motor skills, sensory testing, adaptive or assistive devices, ADLs and specialized upper extremity/hand therapies. While occupational therapy does not, in itself, constitute a basis for entitlement to Medicare reimbursement, a beneficiary of home health services (i.e., skilled nursing care, physical and/or speech therapy) is also covered for occupational therapy.  home-icon.png

Office - A location that can be assigned to a region and have users associated to it.  pm-icon.png

Office of the Inspector General (OIG) - The OIG conducts independent investigations, audits, inspections, and special reviews of United States Department of Justice personnel and programs to detect and deter waste, fraud, abuse, and misconduct, and to promote integrity, economy, efficiency, and effectiveness in Department of Justice operations.  home-icon.png

Outcome and Assessment Information Set (OASIS) - An assessment and data collection instrument for purposes of outcome-based quality improvement, developed for use in Medicare-certified home health agencies and organizations.  home-icon.png

Outcome-Based Quality Improvement (OBQI) - A systematic approach that home health agencies can implement and follow to continuously improve the quality of care they provide. Quality is measured against patient outcomes.  home-icon.png

P

Parent Account - The relationship formed when associating two or more accounts. The idea behind this association is to provide users with a more granular view of an account.  pm-icon.png

Partial Episode Payment (PEP) - Discharge and return within 60 day episode; prorated based on a partial episode date of service.  home-icon.png

Patient Care System - An electronic documentation system offering care providers interdisciplinary Plans of Care required for a patient-focused care delivery system.  pm-icon.png  home-icon.png

Patient Self-Determination Act - A federal statute which requires, among other things, that health care facilities provide patients with written information about their written policies regarding advance directives and the patient’s right to formulate advance directives.  home-icon.png

Personal Care - Assistance with activities of daily living, including bathing, toileting, dressing, grooming, transfer to and from bed, and feeding.  home-icon.png

Personal Care Assistant (PCA) - Often referred to as caregivers, personal care assistants help persons who are disabled or chronically ill with their activities of daily living whether within the home, outside the home, or both.  home-icon.png

Physical Therapist (PT) - A therapist who treats injury or dysfunction with exercises and other physical treatments of the disorder.  home-icon.png

Physical Therapy Assistant (PTA) - A person who, under the supervision of a physical therapist, assists in carrying out patient treatment programs, providing treatment that improves mobility, relieves pain, and prevents or lessens physical disabilities of patients. An assistant usually has an associate’s degree and in some states is licensed.  home-icon.png

Physical Therapy Services - Therapy that aims to restore movement and function, relieve pain, and prevent further injury. Treats people with musculoskeletal disorders such as back and neck strains or knee injuries; neurological deficits such as stroke patients or cerebral palsy children, and skin disorders such as wounds, burns, or diabetic foot ulcers.  home-icon.png

Physician’s Assistant (PA) - Advanced practice clinicians licensed to practice medicine with the supervision of a licensed physician.  home-icon.png

Plan of Care (POC) Medicare - A formal treatment plan for a home health Medicare patient delineated by the treating physician based on knowledge of the patient’s medical condition.  home-icon.png

Plan of Treatment - Written document that outlines the progression of therapy for a patient.  home-icon.png

PlayMaker CRM - A Web-based home care-specific customer relationship management solution to automate and manage sales and marketing activities.  pm-icon.png  home-icon.png

PlayMaker Enterprise - An edition of PlayMaker CRM (a Web-based customer relationship management solution) designed for unlimited users and allowing for integration with patient care system.  pm-icon.png  home-icon.png

PlayMaker LITE - An edition of PlayMaker CRM (a Web-based customer relationship management solution) designed for the single user to help manage their sales and marketing activities.  pm-icon.png  home-icon.png

PlayMaker PRO - An edition of PlayMaker CRM (a Web-based customer relationship management solution) designed for up to 20 users to help manage sales and marketing activities.  pm-icon.png  home-icon.png

Primary Family Caregiver or Care Partner - Relative or significant other who assumes many of the tasks involved in caring for a home care patient.  home-icon.png

Private Duty Nursing - Nursing, chore service, housekeeping and other types of patient care administered in a hospital, in a nursing home or by a home health agency. Private-duty nursing is covered by some private-pay insurers or is self-pay.  home-icon.png

Prospective Payment System (PPS) - A payment mechanism for reimbursing hospitals for inpatient health care services in which a predetermined rate is set for treatment of specific illnesses.  home-icon.png

Protected Health Information (PHI) - Any information that can be used to identify a patient, such as name, date of birth (DOB), social security number, policy number, address, phone number, etc.  home-icon.png

Provider - An entity, organization or individual which provides health care services, such as a physician, a hospital or a home health care company.  home-icon.png

Psychiatric Nursing - The specialty of nursing that cares for people of all ages with mental illness or mental distress, such as schizophrenia, bipolar disorder, psychosis, depression or dementia. Nurses in this area receive more training in psychological therapies, building a therapeutic alliance, dealing with challenging behavior, and the administration of psychiatric medication.  home-icon.png

Q

Query - A specification for pulling a customized dataset from a data source. Generally queries are specified in Structured Query Language (SQL).  pm-icon.png

R

Rating - Refers to a value based on the number of admissions a Contact provides an agency. All contacts will have an A,B,C, or D rating.  pm-icon.png

Recertification - The attending physician certifies that the beneficiary requires continued skilled services after the expiration date of the initial certification, and then periodically thereafter.  home-icon.png

Record - A single unit of related information from a report or dataset. When a dataset is displayed in a tabular format this is sometimes referred to as a row.  pm-icon.png

Recurrence - Refers to options that are available when scheduling events that will occur multiple times.  pm-icon.png

Referral - The act of referring someone or something for consultation, review, or further action.  pm-icon.png  home-icon.png

Referral Source Database - A feature of PlayMaker CRM (a Web-based customer relationship management solution) that includes a fully-integrated listing of contact information for potential referral sources per desired market.  pm-icon.png

Region - Allows measurable boundaries within the agency. Examples of Region include Cities, States, or even Geographical areas.  pm-icon.png

Registered Nurse (RN) - Health care professionals who are responsible for implementing the practice of nursing in concert with other health care professionals. RNs assess, plan, implement and evaluate nursing care of the sick and injured.  home-icon.png

Reminder - Used with an event when the event owner wishes to get notification about an upcoming event prior to its start.  pm-icon.png

Report - A formatted and sometimes summarized view of a dataset. Generally presented in either a tabular or graphical format.  pm-icon.png

Report Automation - The process of automatically scheduling, producing and delivering reports.  pm-icon.png

Residential Care Facility (RCF) - An out-of-home care option for elderly persons who are no longer able to live alone and independently but still not requiring skilled nursing care. Typical care includes assistance with personal hygiene, grooming, and other activities of daily living, recreational and social services.  home-icon.png

Respiratory Care Services - Required by patients who suffer from a variety of chronic pulmonary or heart-related problems. Home respiratory care treatment is covered under Medicare Part B, based on medical necessity.  home-icon.png

Respiratory Therapist (RT) - Individuals who evaluate, treat and care for patients with breathing or other cardio pulmonary disorders; also referred to as respiratory care practitioners.  home-icon.png

Respite Care - Services provided on a short-term basis to individuals unable to care for themselves. Respite care provides a relief (respite) for those persons normally providing care to the individual, allowing these caregivers to attend to their own needs or the needs of other family members.  home-icon.png

Role-Based Security - An approach to restricting system access to authorized users based on customized roles such as administrator, executive, manager, etc.  pm-icon.png

S

Sales Zone System™ - PlayMaker tool that allows sales staff to follow industry-specific, and customizable, sales steps that haven been designed for the home care industry, guaranteeing continuity and best practice in the sales cycle. This structure and guidance allows them to optimally perform their jobs, resulting in increased job satisfaction and reduced sales force turnover. In addition, sales training and forecasting are improved by management’s ability to monitor each phase of the pipeline.  pm-icon.png

Sandbox - Where users can manipulate settings in PlayMaker CRM without negatively impacting the settings in their regular PlayMaker CRM area.  pm-icon.png

Show Time As - Refers to options that are available for displaying the status of users when scheduling an event.  pm-icon.png

Skilled Nursing Facility (SNF) - A facility that accepts patients in need of rehabilitation and medical care that is of a lesser intensity than that received in a hospital setting.  home-icon.png

Skilled Nursing Services - Occurs when a registered nurse uses knowledge as a professional nurse to execute skills, render judgments and evaluate process and outcomes. The skills allowed in home health are assessment and observation, teaching, training, direct procedures and management and evaluation of the care plan.  home-icon.png

Social Services - The activities of social workers and other professionals in promoting the health and well-being of people and in helping people to become more self-sufficient; preventing dependency; strengthening family relationships; and restoring individuals, families, groups, or communities to successful social functioning. Specific kinds of social services include helping people obtain adequate financial resources, evaluating the capabilities to care for children or dependents, counseling, mediation, advocating for social causes, forming organization of their obligations, facilitating health care provisions and linking clients to resources.  home-icon.png

Speech-Language Pathologist (SLP) - A specialist who evaluates and treats communication disorders and swallowing problems.  home-icon.png

Speech Therapy (ST) - The treatment of speech and communication disorders. The approach used depends on the disorder. It may include physical exercises to strengthen the muscles used in speech (oral-motor work), speech drills to improve clarity, or sound production practice to improve articulation.  home-icon.png

Stark II - The purpose of this law is to prohibit physician self-referrals. The law applies to any physician who provides care to Medicare, Medicaid or other federal health program recipients and says that the physician cannot refer the patient for certain designated health services to any entity with which the physician has a financial interest.  pm-icon.png  home-icon.png

Sub-Acute Care - Specifies a level of maintenance care where there is no immanent or life-threatening condition which requires medical treatment. Sub-acute care may include long-term ventilator care or other care provided on a routine basis either at home or by trained staff at a skilled nursing facility.  home-icon.png

Subject - Refers to a description of a scheduled event. An example would be “Meeting with Dr. Smith to discuss referrals”.  pm-icon.png

Support Groups & Networks - Groups of individuals who are available to provide emotional and other support for home care patients and their caregivers.  home-icon.png

Surrogate Decision Maker - A person appointed to make decisions for someone else.  home-icon.png

T

Terminal Condition - An incurable condition caused by an injury, disease, or illness which, regardless of the application of life-sustaining procedures, would within reasonable medical judgement produce death, and where the application of life-sustaining procedures only postpones the moment of death of the patient.  home-icon.png

The Joint Commission (TJC) - Formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Management and evaluation of the care plan: Skilled nursing where underlying conditions or complications require that only a registered nurse can ensure that essential non-skilled care is achieving its purpose. The complexity of the necessary unskilled services that are a necessary part of the medical treatment must require the involvement of skilled nursing personnel to promote the patient’s recovery and medical safety in view of the patient’s overall condition.  home-icon.png

Three-Month Referral Trend - Resides on the Dashboard and provides users visibility to track their performance within a current week against the previous 11 weeks.  pm-icon.png

U

User - Indicates an individual license holder.  pm-icon.png

V

View - A customized sub-set of a dataset where some data is temporarily hidden from being visible.  pm-icon.png

W

Written Confirmation of a Verbal Order (WCVO) - A complete physician order for Home Medical Equipment (HME) signed by the ordering physician after providing a verbal order for equipment or services.  home-icon.png

To learn more about how PlayMaker CRM can help you grow your business, request a demo or contact us today!

Request a Demo
Contact Us