Glossary of Terms
Accreditation A seal of approval given by a governing body to
a housing and/or service provider. To become accredited, the community
or provider must meet specific requirements set by the accreditation
entity and is then generally required to undergo a thorough review
process by a team of evaluators to ensure certain standards of
quality. The accrediting organizations are not government agencies
or regulatory bodies. Examples of some accreditation bodies for
the senior housing and care industry include CCAC (Continuing
Care Accreditation Commission), CARF (Commission on Accreditation
of Rehabilitation Facilities) and JCAHO (Joint Commission on Accreditation
of Healthcare Organizations).
Activities of Daily Living (ADLs): Everyday activities such as
bathing, grooming, eating, toileting, and dressing.
ADA (Americans with Disabilities Act): Law passed by Congress
in 1980, establishing a clear and comprehensive prohibition of
discrimination on the basis of disability.
Administrator: Generally, a licensed professional who manages
the day-to-day operation of a care facility such as a nursing home
or assisted living facility.
Adult Day Care: Daily structured programs in a community setting
with activities and health-related and rehabilitation services to
elderly who are physically or emotionally disabled and need a protective
environment. This care is provided for during the day, the individual
returning home for the evening.
Aging in Place: Concept which advocates allowing a resident to
choose to remain in his/her living environment despite the physical
and or mental decline that may occur with the aging process of aging.
Alzheimer's: Degenerative age-related disease that impairs an
individual's cognitive ability. Symptoms may include forgetfulness,
wandering, and inability to recognize others. The disease is caused
by neuron dysfunction and death in specific brain regions responsible
for cognitive functions. Both genetic and environmental factors
likely play a role in the development of Alzheimer's.
Ambulatory: Describes ability to ambulate, walk around, not bedridden
Assisted Living: In general, state-licensed program offered at
a residential community with services that include meals, laundry,
housekeeping, medication reminders, and assistance with Activities
of Daily Living (ADLs) and Instrumental Activities of Daily Living
(IADLs). The exact definition will vary from state to state, and
a few states do not license assisted living facilities. Generally
regarded as one to two steps below skilled nursing in level of care.
Approximately 90 percent of the country's assisted living services
are paid for with private funds, although some states have adopted
Medicaid waiver programs. Might also be referred to as Personal
Care, Board and Care, Residential Care, Boarding Home, etc., although
some states differentiate between their definition of "Assisted
Living" and these other terms (e.g., Washington state recognizes
and licenses "Assisted Living" facilities as well as "Boarding
Homes"; Although licensed by the State of Washington, a Boarding
Home does not meet the higher physical plant and service requirements
necessary to be considered an Assisted Living facility) .
Charge Nurse: An RN or LPN who is responsible for the supervision
of a unit within a nursing facility. The charge nurse schedules
and supervises nursing staff and provides care to facility residents.
Congregate Housing: See Independent Living (may be also referred
to as Supportive Housing).
Continuing Care Retirement Community (CCRC): Housing planned
and operated to provide a continuum of accommodations and services
for seniors including, but not limited to, independent living, congregate
housing, assisted living, and skilled nursing care. A CCRC resident
contract often involves either an entry fee or buy-in fee in addition
to the monthly service charges, which may change according to the
medical services required. Entry fees may be partially or fully
refundable. The fee is used primarily as a method of privately financing
the development of the project and for payment for future healthcare.
CCRCs are typically licensed by the state. See also Life Care Community.
Continuum of Care: Full spectrum of care available at Continuing
Care Retirement Communities which may include Independent Living,
Assisted Living, Nursing Care, Home Health, Home Care, and Home
and Community Based Services.
Convalescent Home: See Nursing Home.
Dementia: Progressive neurological, cognitive, or medical disorder
that affects memory, judgment, and cognitive powers.
Developmental Disability (DD): Affliction characterized by chronic
physical and mental disabilities, which may include: cerebral palsy,
retardation, thyroid problems, seizures, quadriplegia.
Director of Nursing (DON): A DON oversees all nursing staff in
a nursing home, and is responsible for formulating nursing policies
and monitoring the quality of care delivered, as well as the facility's
compliance with federal and state regulations pertaining to nursing
HMO: A Health Maintenance Organization (HMO) is an organized
system for providing comprehensive health care in a specific geographic
area to a voluntarily enrolled group of members.
Home Health Care: Provision of medical and nursing services in
the individual's home by a licensed provider.
Hospice Care: Care and comfort measures provided to those with
a terminal illness and their families- it can include medical, counseling,
and social services. Most hospice care is furnished in-home, while
specialized hospices or hospitals also provide this service.
Independent Living: Multi-unit senior housing development that
may provide supportive services such as meals, housekeeping, social
activities, and transportation (Congregate Housing, Supportive Housing,
Retirement Community). Independent Living typically encourages socialization
by provision of meals in a central dining area and scheduled social
programs. May also be used to describe housing with few or no services
Instrumental Activities of Daily Living (IADLs): Day-to-day tasks
such as preparing meals, shopping, managing money, taking medication,
Kitchenette: Each facility may have its own definition of a kitchenette,
but generally one includes a sink, cabinet space, and a mini-refrigerator,
maybe a microwave. In contrast, a full kitchen would usually have
a burner unit, sink, cabinets, full-size refrigerator, and possibly
a microwave or stove.
Licensed Practical Nurse (LPN): LPNs are trained to administer
technical nursing procedures as well as provide a range of health
care services, such as administration of medication and changing
of dressings. One year of post high school education and passage
of a state licensing exam is required.
Life Care Community: A Continuing Care Retirement Community (CCRC)
which offers an insurance type contract and provides all levels
of care. It often includes payment for acute care and physician's
visits. Little or no change is made in the monthly fee, regardless
of the level of medical care required by the resident, except for
cost of living increases.
Long-Term Care: Provision of services to persons of any age who
are afflicted with chronic health impairments.
Long-term Care Insurance: Privately issued insurance policy which
covers the cost of nursing home care, assisted living, and home
health care. Premiums are based on age, health, length of deductible
period, amount paid, and duration of benefits. Currently pays only
two percent of national nursing home costs.
Managed Care: There is currently no standard definition of managed
care, but it can best be described as a combination of insurance
and a health care delivery system. The basic goal of managed care
is to coordinate all health care services received to maximize benefits
and minimize costs. Managed care plans use their own network of
health care providers and a system of prior approval from a primary
care doctor in order to achieve this goal. Providers include: specialists,
hospitals, skilled nursing facilities, therapists, and home health
Medicaid: A jointly funded medical financial Federal-State health
insurance assistance program, offering benefits to individuals with
limited financial resources, the disabled, and the elderly. There
are income eligibility criteria which must be met to qualify for
Medicaid. Medicaid accounts for about 52 percent of the nation's
care costs, and is the source of payment for almost 70 percent of
residents in nursing homes. The person must have exhausted nearly
all assets and be in a nursing facility that participates in this
program. Medicaid can reimburse Nursing Facilities for the long-term
care of qualifying seniors, and in some states, Medicaid pays for
Assisted Living care through Medicaid waivers.
Medicare: Nationwide medical insurance program administered by
the Social Security Administration for individuals 65 and over and
certain disabled people, regardless of income. Provides for hospital
and nursing facility care (Part A) and physician services, therapies,
and home health care (Part B).
Medical Director: A staff medical director assumes overall responsibility
for the formulation and implementation of all policies related to
medical care. The medical director also coordinates with an individual's
personal physician to ensure that the facility delivers the care
that is prescribed. In some instances, the medical director may
be a resident's primary physician.
Medications Management / Medication Administration: Formalized
procedure with a written set of rules for the management of self-administered
medicine, as in an assisted living setting. A program may include
management of the timing and dosage for residents, and could include
coordination with a resident's personal physician. The resident
must take the medication him or herself. For instance, the facility
can remind the resident that she needs to give herself the medicine
injection, but the facility cannot perform the actual injection
Medigap Insurance: Private health insurance policies that supplement
Medicare coverage, covering health care costs above those covered
by Medicare Part A or Part B. Does not provide benefits for long
term care, covering primarily hospital and doctor bills.
Non-Ambulatory: Inability to ambulate, walk around, and usually
bedridden or hospitalized.
Not-for-Profit: Status of ownership and/or operation characterized
by government by community-based boards of trustees who are all
volunteers. Board members donate their time and talents to ensure
that a not-for-profit organization's approach to caring for older
people responds to local needs. Not-for-profit homes and services
turn any surplus income back into improving or expanding services
for their clients or residents. Many not-for-profit organizations
are often associated with religious denominations and fraternal
groups. Not-for-profits may also interact with Congress and federal
agencies to further causes that serve the elderly.
Nurse Assistant: A Nurse Assistant provides the most personal
care to residents, including bathing, dressing, and toileting. Must
be trained, tested, and certified to provide care in nursing facilities
that participate in the Medicare and Medicaid programs. Nurse assistants
work under the supervision of an Registered Nurse or Licensed Practical
Nursing Home: Facility licensed by the state that provides 24-hour
nursing care, room and board, and activities for convalescent residents
and those with chronic and/or long-term care illnesses. One step
below hospital acute care. Regular medical supervision and rehabilitation
therapy are mandated to be available, and nursing homes are eligible
to participate in the Medicaid program. May be referred to as Nursing
Facility or Convalescent Home. See also Skilled Nursing Facility.
Occupational Therapy: Process to help individuals relearn activities
of daily living, generally administered by a licensed therapist.
Physical Therapy: Process that includes individualized programs
of exercise to improve physical mobility, often administered following
a stroke, fall, or accident. Physical therapists plan and administer
prescribed physical therapy treatment programs for residents to
help restore their function and strength.
Registered Nurse (RN): Graduate trained nurse who has both passed
a state board examination and is licensed by a state agency to practice
nursing. The RN plans for resident care by assessing resident needs,
developing and monitoring care plans in conjunction with physicians,
as well as executing highly technical, skilled nursing treatments.
A minimum of two years of college is required in addition to passage
of the state exams.
Rehabilitation: Therapeutic care for persons requiring intensive
physical, occupational, or speech therapy.
Residential Care: See Assisted Living.
Respite Care: Temporary relief from duties for caregivers, ranging
from several hours to days. May be provided in-home or in a residential
care setting such as an assisted living facility or nursing home.
Senior Apartment: Age-restricted multiunit housing with self-contained
living units for older adults who are able to care for themselves.
Usually no additional services such as meals or transportation are
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