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Longer term care minimum data set

Core set of screening and assessment elements of the Resident Assessment Instrument (RAI). This assessment system provides a comprehensive, accurate, standardized, reproducible assessment of each long-term care facility resident’s functional capabilities and helps staff to identify health problems. This assessment is performed on every resident in a Medicare and/or Medicaid-certified long-term care facility including private pay.

Looping

The automated diagnosis-related group (DRG) grouper process (computer software program that assigns DRGs) that searches all listed diagnoses for the presence of any comorbid condition or complication or searching all procedures for operating room procedures or other specific procedures.

Loss

UK: (1) event giving rise to a claim, (2) financial disadvantage incurred by the insured as a result of an adverse contingency; (3) cost of settlement of a claim (4) in the term underwriting loss, an excess of amounts payable over amounts receivable (in the usual accounting sense) referable to underwriting.
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US: (1) The basis of a claim for damages under the terms of a policy. (2) Loss of assets resulting from a pure risk. Broadly categorized, the types of losses of concern to risk managers include personnel loss, property loss, time element loss, and legal liability loss.
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MEDICAL,USA: 1. Reason for an insurance claim for recovery of indemnity or payment for damages. 2. Any reduction of the quantity, quality, or value of a property.
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UK: A claim under a policy. The financial loss caused to the insured by the occurrence of the event insured against. Certain ‘loss’ definitions such as constructive total loss are contained in the Marine Insurance Act 1906.
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A general term used to refer to the amount of a claim filed by the insured. This term can also mean the amount the insured’s property value decreased as a result of a loss. This term can also refer to the amount an insurer has paid on behalf of an insured.
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An unintentional decline or disappearance in value arising from an event.
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An unplanned decrease in a property (or other) value which can be measured in rupee terms. As regards insurance the term generally refer to (i) The amount of reduction in the value of an insured’s property caused by an insured peril. (ii) The amount sought through an insurance claim. (iii) The amount paid on behalf of an insured under an insurance contract. (02) What the Policyholder may suffer an what insurance is designed to cover.
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US: The happening of the event for which insurance pays.

Loss (or Claim) Reserve

(i) Reserve representing an Insurer’[s estimate of amounts payable for insured losses which have already occurred (including) losses which have occurred but not yet been reported to the Insurer). Loss reserves may be established through estimates for individual cases, as well as through various averaging and formula methods. (ii) Similar reserve established by an organization retaining its own losses.Reserve for Incurred But Not Reported Losses (or Claims) : Loss reserves established by an Insurer because it knows from past experience that, although it has not yet been informed of them, some events have already occurred that will give rise to insured losses or claims.Unearned Premium Reserve : Reserve, for the total of the unearned premiums on policies an Insurer has in force, representing the Insurer’s obligation to return unearned premiums on request, and enabling the Insurer to purchase portfolio Reinsurance, if needed.Res Ipsa Loquitur : Literally translated this expression means “facts speak for themselves.” Under this doctrine, an individual is presumed to be negligent if the circumstances of injury are under his complete and exclusive control and it can be shown that the injury or damage could only have occurred if the individual were negligent.