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
Activities of Daily Living
Everyday activities such as bathing, grooming, eating, toileting,
(Americans with Disabilities Act):
passed by Congress in 1980, establishing a clear and comprehensive prohibition
of discrimination on the basis of disability.
Generally, a licensed professional who manages the day-to-day
operation of a care facility such as a nursing home or assisted living facility.
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.
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.
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. Click here to learn more.
Describes ability to
ambulate, walk around, not bedridden or hospitalized.
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.
Services 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.
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
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.
See Nursing Home.
cognitive, or medical disorder that affects memory, judgment, and cognitive
Developmental Disability (DD):
Affliction characterized by chronic physical and mental
disabilities, which may include: cerebral palsy, retardation, thyroid problems,
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 care.
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.
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
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 (Senior Apartment).
Instrumental Activities of Daily Living (IADLs):
Day-to-day tasks such as
preparing meals, shopping, managing money, taking medication, and
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
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
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.
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 care agencies.
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
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).
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
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 itself.
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.
Inability to ambulate, walk
around, and usually bedridden or hospitalized.
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
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.
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 Nurse.
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. Click here to
Process to help individuals relearn activities of daily living,
generally administered by a licensed therapist.
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.
Therapeutic care for persons requiring intensive physical,
occupational, or speech therapy.
See Assisted Living.
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.
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 provided.
Skilled Nursing Facility (SNF):
A Medicare-certified nursing home, with
increased emphasis on rehabilitative therapies. See also Nursing Home.
long term care setting, social workers assesses a resident's psychosocial
progress and helps the resident to maintain a healthy outlook on life. A social
worker provides counseling to residents and families, and are important during a
resident's initial period of adjustment to the long term care setting.
Services for persons requiring care that may
include intravenous therapy, intensive rehabilitation, wound care, or other
needs. May be provided for in a nursing home or hospital
Supplemental Security Income (SSI):
SSI is a monthly cash
payment from the federal government for eligible individuals in financial need
who are aged 65 or older or persons who are blind or have a disability
(including children). Typically, a person eligible for SSI payments has no or
little income, total assets of less than a few thousand dollars (within certain
limits set out in regulations, not including a home used for self support,
automobile, values of household goods, personal effects, and life insurance),
has U.S. citizenship or qualified alien status, and US residency.
certain circumstances, the SSI payment may be used towards some housing and care
needs of the individual. The SSI program is run by the Social Security
Administration (www.ssa.gov), but SSI is not the same as Social
Security. Money for SSI payments comes from the general fund of the
US Treasury, and some states add money to the
Housing Net, 2000