Nursing Home Abuse Glossary

P

Part A (Medicare). See Medicare Part A.

Part B (Medicare). See Medicare Part B.

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. Plans of care must include measurable objectives and schedules to meet each resident's medical, nursing, mental, and psychosocial needs as identified in the a comprehensive assessment. The comprehensive assessment must be completed within 14 days of admission. The plan of care must then be developed within 7 days after completion of the assessment. The plan of care must also detail the services to be provided. It must be periodically reviewed and revised by a team of qualified persons after each comprehensive assessment.

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.

Pressure Sore. See bedsore.

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. Oftentimes, Medicare managed care plans require a participant to see their PCP before seeing any other health-care provider.

Privileged Communication. Statement protected from forced disclosure in court because the statement was made within a "protected" relationship such as attorney/client. See attorney-client privilege.

Procedural Law. Generally, the body of law establishing the method or procedure of enforcing rights or obtaining redress for invasion of rights. Compare with substantive law which establishes 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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