Glossary of Catholic Health Care Terms

Acute Care: Treatment provided, either on an inpatient or outpatient basis, for acute, as opposed to chronic disease. Acute illness is usually of short duration, and the patient usually returns to his/her previous condition. An episode of a chronic illness (e.g., diabetic coma in a patient with diabetes) is often treated as an acute illness. An acute care (or short stay) facility is one where the average length of stay is less than 30 days.

Adult Day Care Service: Service provided for part of a day and in a congregate setting to individuals who can benefit from care but do not require institutionalization. This may include meals, personal care services, and recreational and educational activities. See also adult day health service.

Adult Day Health Service: Program of health and supporting services provided under auspices of a health care facility or freestanding adult day health care center for adults who do not require 24-hour care and, yet, due to social, physical and /or mental impairments, are not capable of full-time independent living. Supervised day health programs are designed to provide the maximum support to an elderly person who, because of mobility and/or chronic conditions, would be a great risk were it not for the program. Participants receive a complete screening to assess their needs with a defined plan of daily activities and therapies. Specific conditions of participation apply in states which license such programs. Such rules often govern staffing, physical plant, transfer requirements, and programs.

Advocacy: CHA's advocacy efforts strive to shape the impact of federal legislation and policies. Based on priorities determined collaboratively by the membership, staff, Advocacy and Public Policy Committee, and the CHA board, the advocacy team — located in Washington, DC, focuses on initiatives that not only strengthen the viability of the Catholic health ministry as not-for-profit providers but also support the ministry's emphasis on enhancing the current health care system to create a just and compassionate health care system.

Assisted Living: Special combination of housing, supportive services, personalized assistance and health care designed for elderly or impaired persons who need help with activities of daily living (e.g., shopping, meals, housekeeping, personal needs).

Bioethics: A discipline that examines ethical issues arising from the life sciences and medicine.

Catholic Health Association of the United States (CHA): Since 1915, Catholic health care organizations have come together in the Catholic Health Association of the United States to achieve collectively what they could not individually. Through CHA, the ministry raises its passionate voice advocating justice and compassionate care for people of all ages, faiths and backgrounds from conception to natural death.

Catholic Health Care: Catholic health care is a ministry of the Catholic Church continuing Jesus' mission of love and healing in the world today. The ministry is led by women and men, both religious and lay, who combine advanced technology and innovative treatment with a tradition of compassionate care. Catholic health care constitutes the nation's largest group of not-for-profit health care sponsors, systems (59) and facilities (over 600 hospitals and 1,200 continuum of care services).

Catholic Identity: The theological, ethical, and canonical underpinnings of a Catholic-sponsored organization without which the entity cannot be considered a church-related ministry (a non-canonical term).

Charism: Literally, a gift; the ideal that motivated a religious community's purpose, e.g., preaching, teaching, mercy, justice, penance; religious community's charism usually evident in founder's life and community's history.

Charity Care: Any free or discounted health services provided to persons who cannot afford to pay and are not covered by insurance.

Chronic Care Hospital: A facility that provides care for patients who require higher levels of care than that provided by skilled nursing facilities. These facilities include almost daily care or observation by a physician, preferably one who specializes in rehabilitation medicine. Also known as a chronic disease hospital or long-term care hospital.

Community benefit: Community benefit consists in programs and services designed to improve health in communities and increase access to health care. They are integral to the mission of Catholic and other not-for-profit health care organizations, and are the basis of tax exemption. For nearly 20 years, CHA has been a leader in the community benefit field, helping not-for-profit health care organizations fulfill their community benefit mission.

Congregation for the Doctrine of the Faith (CDF): The administrative and judicial body responsible for safeguarding doctrine on faith and morals throughout the Catholic world. The congregation answers all questions that touch faith and morals or are connected with the faith itself, as well as all that concerns "the privilege of the faith" both in laws and in fact.

Congregation for the Institute of Consecrated Life and Apostolic Societies: The Catholic Church's administrative office in Rome that oversees the mission and life of religious institutes and secular institutes and societies of apostolic life. This congregation is responsible for granting permission to alienate church property controlled by religious institutes when the value exceeds $3 million (the limit for the United States).

Continuing Care Retirement Community (CCRC): An organization established to provide housing and services, including health care to people of retirement age. At a minimum, the community meets each of the following criteria: 1) campus consists of independent living units: it may also contain health care facilities such as congregate housing, personal care and intermediate or skilled nursing; 2) community offers a contract that lasts for more than one year and guarantees shelter and various health care services; 3) fees for health care services are less than the full cost of such services and have been partly prepaid by the resident.

Continuum of Care Services: Entire spectrum of specialized health, rehabilitative and residential services available to the frail and chronically ill. The services focus on the social, residential, rehabilitative and supportive needs of individuals as well as needs that are essentially medical in nature.

Day Hospital: A facility designed to provide acute care services (e.g., minor surgery, chemotherapy, diagnosis and treatment) that do not require an overnight stay. While a day hospital has certain characteristics in common with an acute care hospital, it is more like an outpatient care facility, but with medical resources sufficient to provide certain services normally available only in a hospital. Day hospitals provide comprehensive assessment, rehabilitation, and specific therapy, and can be specialized for special groups such as geriatric or psychiatric clients.

Ethical and Religious Directives for Catholic Health Care Services: This is a document issued in 1971 by the bishops of the United States to provide moral guidance to Catholic health care organizations and those they serve to ensure that medical practice and spiritual services are in accord with the teachings of the Catholic Church. The Directives consist of six parts — social responsibilities, spiritual care, the patient-professional relationship, beginning of life issues, end of life and partnerships — with each having an introduction followed by specific directives.

Extended Care: In Medicare, services provided in a skilled nursing facility; specifically, nursing care requiring a professional registered nurse; room and board; physical, occupational, or speech therapy; medical social services; medication, supplies, and equipment ordinarily used in caring for skilled nursing facility patients; certain physician services; and other services necessary to patients' health.

Extended Care Facility: A nursing home or nursing center licensed to operate in accordance with all applicable state and local laws to provide 24-hour nursing care. Such a facility may offer skilled, intermediate or custodial care, or any combination of these levels of care.

Previously used in Medicare to designate a skilled nursing facility (SNF) which qualified for participation in Medicare. In 1972, the law was amended to use the more generic term "skilled nursing facility" for both Medicare and Medicaid. Medicare coverage is limited to 100 days of post-hospital extended care services during any spell of illness, when the services are related to the cause of the hospital stay. These conditions do not apply to SNF benefits under Medicaid. Thus, the continued use of the term "extended care facility benefits" is a convenient way of referring to the benefit limitations on SNF care under Medicare.

Facility Ethicist: In health care, a person with graduate education, preferably a Ph.D., who has expertise in health care ethics. Such individuals may be trained in theological or philosophical ethics, medicine or nursing, other health care related disciplines, or law, and whose job it is to help sort through difficult clinical and organizational situations in order to assist in finding ethical solutions.

Fee-For-Service: A method of paying physicians and other health care providers in which each service, such as a doctor's office visit or operation, carries a fee.

For-Profit Corporation: A corporation that is organized under the business corporation act of a state, is owned by shareholders, can pay dividends and (unless certain conditions are met) is taxed at corporate rates.

Healing or Health Care Ministry: Organized effort to manifest Christ's concern for the sick as evidenced in his healing works reported in the Gospel.

Health Care Ethics: The study of ethical issues and concerns in the delivery of health care, encompassing foundational questions like the meaning of illness, organizational issues (e.g, downsizing,starting up or closing a service line) and clinical issues (e.g., advance directives, assessing decision making capacity).

Health Care Provider: An individual or institution that provides medical services (e.g. a physician, hospital, laboratory, etc.)

Health Care System: A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations. There are approximately 64 health care systems in Catholic health care.

Home Health Agency: A facility or program licensed, certified or otherwise authorized by state and federal laws as a home health agency, and approved by the health plan to provide health services covered under the contract.

Home health care: Care provided to individuals and families in their place of residence, for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing the effects of disability and illness, including terminal illness. Service needs are determined by a multidisciplinary team or a single health professional, and are planned, coordinated, and delivered by providers organized to do so through the use of employed staff, contractual arrangements, or a combination of the two. Services my include any of the following components: medical, dental, pharmacy, or laboratory, as well as other medical equipment and supplies; home infusion therapies; homemaker service; hospice; nursing care; nutrition, physician services, social work and counseling; speech, physical, occupational, and rehabilitation therapy, and transportation services. Some home health care agencies are Medicare-certified. Medicare Part B (Supplemental Medical Insurance) will pay 80 percent of reasonable costs for covered physician services and 100 percent of reasonable charges for home health agency visits, subject to certain cost limits.

Hospice: A comprehensive philosophy of care for people in the final phase of a terminal illness, hospice affirms life and regards dying as a normal process. It emphasizes controlling pain and symptoms (palliative care) in order to enhance the quality of life as death approaches. The purpose of hospice is to allow patients and their families to live each day as fully and comfortably as possible and to assist in dealing with the stress caused by illness, dying and grief.

The hospice movement began in the 1970s at St. Christopher's Hospice near London. One of the first hospice programs in the United States was begun at the Yale-New Haven Hospital. In October 1983, Medicare expanded its hospital insurance benefits to include hospice care for terminally ill Medicare beneficiaries.

International Outreach: International outreach is a humanitarian effort to provide resources to the needy without regard to race, religion, creed, sex or color on a charitable not-for-profit basis.

CHA's international outreach supports members, partnering organizations and the church in a global mission of healing through research, education, consultation and collaboration. Our goal is to foster the development of best practices and expansion of international initiatives that create effective, sustainable programs that reduce human suffering and improve health outcomes.

Juridic Person: Roughly the equivalent of a civil law corporation. It is established either automatically by operation of canon law or by drafting statutes that correspond to a corporation's bylaws and then getting the bishop's recognition. It can be either a private juridic person or a public juridic person. A private juridic person's property is not church property, so ecclesiastical permission is not needed to alienate its property. Its connection to the church lies in an ongoing relationship with the bishop, without whose approval it cannot be considered Catholic. The private juridic person's purpose is "congruent with the mission of the church and ... transcends the purpose of the individuals that make [it] up." A public juridic person's property is church property, and thus ecclesiastical permission is necessary for significant alienation transactions. The most common examples of public juridic persons are dioceses, religious institutes, and the Holy See. (See Code of Canon Law,cc.113-123.)

Juridical Person: Group of people who come together for common purpose or property designated for a religious purpose, e.g., a religious congregation, a health care corporation; in the old Code of Canon Law, the term moral person was used. This term is still used in civil law.

Local Ordinary: See diocesan bishop.

Long-Term Care: Diagnostic, preventive, therapeutic, rehabilitative, supportive and maintenance services designed for individuals who have chronic physical and/or mental impairments in a variety of institutional and non-institutional health settings, including the home. The objective of long-term care is to improve or maintain the health of the patients, to make them as functionally independent as possible or, in the case of terminally ill patients, to permit them to die peacefully.

Ministry: The service of the members of a Christian community to each other and to the world around them performed in the name of Christ, e.g., education, health care, social services. Ministerial responsibility is conferred on Christians at baptism.

Mission: The fundamental purpose of a person, institution or community, usually communicated in a mission statement.

Not-For-Profit Corporation: An entity that (1) is organized under the "not-for-profit" or "nonprofit" corporation act of a state, (2) has either members who elect the board of directors or a self-perpetuating board of directors, and (3) cannot pay dividends to its members.

Nursing Homes: Any one of a wide range of institutions, other than hospitals, that provide various levels of maintenance and personal or nursing care to those who are unable to care for themselves and who may have health problems ranging from minimal to very serious. The term includes freestanding institutions, as well as identifiable components of other health facilities which provide nursing care and related services, personal care and residential care. Nursing homes include skilled nursing facilities, intermediate care facilities and extended care facilities, but not boarding homes.

Pontifical Council for Health Pastoral Care: This Vatican agency was founded to provide educational support for the sick and those caring for them. They focus on three areas of development; The word, sanctification and communion.

Primary Care Physicians: A physician whose practice is devoted to internal medicine, family/general practice and pediatrics. An obstetrician/gynecologist may also be considered a primary care physician.

Private Juridic Person: See juridic person.

Provider: Any health care professional or institution that renders a health service or provides a health care good.

Public Juridic Person: See juridic person.

Religious Congregation: Group of women or men living in Christian community under a specific rule (e.g., Rule of St. Benedict or St. Francis) with a distinctive spirituality and apostolate. A diocesan congregation is one approved only by a diocesan bishop; a pontifical congregation is one approved by the Sacred Congregation of Religious and Secular Institutes (SCRSI). Pontifical congregations have more autonomy in regard to internal government, choice of specific apostolic works and financial administration.

Religious Institute: A collegial public juridic person, properly recognized by the competent ecclesiastical authority, consisting of individual members who live a common life and take temporary, then perpetual, vows of poverty, chastity and obedience in accordance with the institute's constitution. The canonical administrators of a religious institute are the supreme moderator and council. Also called "pontifical congregation."

Religious Order: A term used in the Pio-Benedictine Code to refer to a collegial public juridic person, consisting of members of a religious institute. The 1983 Code of Canon Law uses the term "religious institute" to refer to both religious orders and religious congregations.

Reserved Powers: In a membership corporation, the powers that the corporate members keep for their own exercise and do not delegate to the board of trustees.

Senior Housing: Age-restricted multiunit housing with self-contained living units for older adults who are able to care for themselves.

Skilled Nursing Facility (SNF): Under Medicare and Medicaid, an institution (or a distinct part of an institution) which has in effect a transfer agreement with one or more participating hospitals, and which is primarily engaged in providing skilled nursing care and related services for patients requiring medical or nursing care or rehabilitation services for injured, disabled or sick persons; has formal policies developed with the advice of a group of professionals, including one or more physicians and registered nurses, to oversee the skilled nursing care and related medical or other service provided; has a physician, a registered nurse or a medical staff responsible for the execution of such policies; requires that the health care of every patient be supervised by a physician, and provides for having a physician available to furnish necessary medical care in case of an emergency; maintains medical records on all patients; provides 24-hour nursing service and has at least one full-time registered nurse; provides appropriate methods and procedures for the dispensing and administering of drugs and biological; has a utilization review plan which meets legal requirements; is duly licensed, where this is required, or otherwise approved by the appropriate agency; has an overall plan and budget, including an operating budget and a 3-year capital expenditure plan; and meets other requirements related to the ownership of the facility, independent medical review of patients, provisions of the Life Safety Code and other applicable fire and safety codes and is managed by a licensed nursing home administrator.

Social Accountability: A process used by not-for-profit health care organizations to plan, track, and report community benefits they provide.

Sponsor: The public juridic person that has founded and sustained an incorporated apostolate and that has reserved certain corporate powers in the structure of the incorporated apostolate that enables it to exercise its canonical faith and administrative responsibilities in regard thereto. Sometimes referred to as a "religious sponsor" or canonical sponsorship.

Sponsoring Group: Juridical person (usually a religious congregation, sometimes a diocese) that has ultimate responsibility to control property, establish philosophy and set policy of a health care facility.

Sponsorship: A noncanonical term used to describe the reservation of canonical control by a church entity, usually a religious institute, that founded or sustains an incorporated apostolate. This retention of control need not be such as to create civil law liability on the part of the institute for corporation acts or omissions, but should be enough for the sponsoring institute to meet its canonical obligations of faith and administration regarding the activities of the incorporated apostolate. Sponsorship involves the reservation of the following corporate powers: 1.) To establish the corporation's operating philosophy, 2.) To amend the corporate charter and bylaws. 3.)To appoint or to approve the appointment of the board of trustees, 4.) To lease, sell or encumber corporate real estate in excess of $1 million, 5.) To merge or dissolve the corporation.

System Ethicist: A system ethicist is usually located in the corporate office of a health care system and focuses on ethical issues that relate to the system as a whole. These are often organizational/business ethics issues, but they can also be clinical issues that involve system-wide policies and/or practices. Some system ethicists are part of the executive team, while others are not. In addition to providing ethical input on system issues, system ethicists most often provide ethics education and develop ethics resources for system entities.

Stable Patrimony: The immovable property (land and buildings) and fixed capital (capital assets "fixed" or dedicated in a particular purpose to a donor of competent ecclesiastical authority such as a trust fund) of a public juridic person. Property that is part of stable patrimony is subject to the canonical alienation procedures, whereas non-stable property is not.

Taxable Not-For-Profit Corporation: A not-for-profit corporation that has not, or cannot, meet the standards for tax exemption under the Internal Revenue Code and is therefore subject to the same corporate tax as a for-profit corporation.

Tax-Exempt Organization: For purpose of this book, and organization recognized by the Internal Revenue Service as exempt under Section 501 (c) (3) of the Internal Revenue Code.

Tertiary Care: Hospital-based diagnostic and therapeutic services, often provided by highly specialized medical professionals (neurosurgeons, thoracic surgeons, etc.) whose services involve expensive technologies or technology-assisted procedures that are housed, maintained and paid for by hospitals.

United States Conference of Catholic Bishops (USCCB): Assembly of hierarchy of United States and its territories to foster these bishops' collegial concern for Church and society in United States and throughout the world.