| Nursing Home Abuse Legal Glossary
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Participating Physician: A doctor
who agrees to accept assignment on all Medicare claims. A participating
physician may only bill you for the Medicare deductible and/or
coinsurance amounts.
Participating Supplier: A medical
supplier who agrees to accept assignment on all Medicare claims. A
participating supplier may only bill you for the Medicare deductible
and/or coinsurance amounts.
Peer Review Organization: Groups
of doctors and other health-care experts paid by the federal government
to check and improve upon the care provide to Medicare patients. Peer
Review Organizations must review complaints concerning the quality of
care given by hospitals, nursing homes, and home health care agencies.
Personal Representative: One who
stands in the place of another.
Physical Therapy: Treatment given
for an injury or a disease by mechanical means, such as exercise or
massage.
Physician's Assistant: A person
with two or more years advanced training and who has passed a specific
exam. Physician's assistants work with doctors and can do some of the
things that a doctor can do.
Plaintiff: In civil law, the
person who brings an action or starts a lawsuit.
Plan of Care: Under the federal
Nursing Home Reform Act of 1987, nursing homes are required to develop
comprehensive individualized care plans for residents. This is a written
plan stating what kinds of services and care a person needs for a
specific health-care problem. The assessment must be completed within 14
days of admission. A periodic review is done.
Pleading: A document filed in a
court that pertains to a case.
Power of Attorney: Written
document authorizing one person to take certain legal actions on behalf
of the person giving the power of attorney.
Precedent: Decision by a court
that provides an example or authority for later cases involving a
similar question of law.
Premium: Monthly payment for
health-care coverage to Medicare, an insurance company, or a health-care
plan.
Preponderance of the Evidence: The
amount of evidence needed for a plaintiff to win in a civil action. A
preponderance of the evidence is the greater weight of the evidence or
the more convincing evidence in comparison to the evidence offered in
opposition. A plaintiff can win by a preponderance of the evidence even
if plaintiff's evidence merely tips the scales in plaintiff's favor.
Primary Care Physician (PCP): A
doctor trained to give basic health care. A PCP is the first doctor seen
for a specific health problem. The PCP then coordinates with other
health-care professionals for future care and/or preventative health
care.
Privileged Communication:
Statement protected from forced disclosure in court because the
statement was made within a "protected" relationship such as
attorney/client.
Procedural Law: Generally, the
body of law establishing the method or procedure of enforcing rights or
obtaining redress for invasion of rights.
Provider: A doctor or other
health-care professional or a hospital or other health care facility
that provides health-care services.
Proximate Cause: The proximate
cause of an injury is the primary or moving cause that produces the
injury and without which the accident could not have happened, if the
injury is one which might be reasonably anticipated or foreseen as a
natural consequence of the wrongful act.
Psychoactive Drug: A medication
that alters the mental process.
Punitive Damages or Exemplary Damages:
Compensation greater than is necessary to pay a plaintiff for a loss.
These damages are awarded because the loss was aggravated by violence,
oppression, malice, fraud or wanton and wicked conduct on the part of
the defendant. Such damages are intended to punish the defendant for his
evil behavior or make an example of him or her.
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