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Glossary of Terms

Glossary of Terms

While researching the senior living industry, you’ll come across unfamiliar or confusing terminology. We hope you’ll find this Glossary of Terms helpful.

Activities of Daily Living (ADL) – Physical functions that an individual performs each day, including bathing, dressing, eating, toileting, walking or wheeling, and transferring into and out of bed.

Advanced Directives – A written statement of an individual’s preferences and directions regarding health care. Advanced directives protect a person’s rights even if he or she becomes mentally or physically unable to choose or communicate his or her wishes. Examples include Living Wills and Medical and Durable Powers of Attorney.

Assessment – Determination of a resident’s care needs, based upon a formal structured evaluation of the resident’s physical and psychological condition and ability to perform activities of daily living.

Assistive Device – Physical aid such as a cane, walker, wheelchair, or hearing aid.

Assisted Living Facility (ALF) – Assisted living communities provide moderate care and assistance with daily activities, aimed at maximizing resident independence. Typical support may include meal preparation, medication management, transportation, assistance with getting dressed, and help using the restroom. Assisted Living may not be appropriate for those with severe cognitive issues, behavioral issues, limited mobility (bed bound), or for those who require ongoing nursing care.

Benefit Period – Starts the day the subscriber is admitted to a hospital or SNF and ends when the subscriber has not received hospital inpatient or SNF care for 60 consecutive days.

Centers for Medicare and Medicaid Services (CMS) – CMS is an element of the Department of Health and Human Services, which finances and administers the Medicare and Medicaid programs. Among other responsibilities, CMS establishes standards for the operation of nursing facilities that receive funds under the Medicare and Medicaid programs.

Continuing Care Retirement Communities (CCRC) – A unique senior community with varying levels of care, often encompassing Independent LivingAssisted Living, and Skilled Nursing services on a single campus. As an older adult’s health and care needs change, they may transition from one level of care to another, allowing them to “age in place.” Also known as Life Plan Communities.

Deductible – The amount the subscriber must pay (1) for each benefit period for Part A and/or (2) each year for Part B before Medicare begins to pay.

Dementia – The loss of intellectual functions (thinking, remembering, reasoning) of sufficient severity to interfere with a person’s daily functioning. Rather than a single disease or condition, dementia is actually a variety of symptoms that may accompany certain diseases or conditions, including memory loss and impaired cognition. Symptoms may also include changes in personality, mood, and behavior. Dementia is irreversible when caused by disease or injury, but may be reversible when caused by drugs, alcohol, depression, or imbalances of hormones or vitamins. Examples include Alzheimer’s and Louis Body Dementia.

Durable Power of Attorney – A legal document in which a competent person gives another person (called an attorney-in-fact) the power to make health care decisions for him or her if unable to make those decisions. A DPA can include guidelines for the attorney-in-fact to follow in making decisions on behalf of the incompetent person.

Healthcare Power of Attorney – The appointment of a healthcare agent to make decisions when the principal becomes unable to make or communicate decisions.

HIPPA – The Health Insurance Portability and Accountability Act (HIPAA) requires that all covered entities (most nursing facilities meet the definition of covered entity) provide a notice to patients detailing the ways in which the covered entity will use or disclose the patient’s protected healthcare information (PHI). PHI is defined as individually identifiable health information that relates to the past, present, or future physical or mental health of, or the provision of healthcare to, a patient or resident.

Home Health Care – Provision of medical and nursing services in the individual’s home by a licensed provider. Medicare can cover this care if it meets certain guidelines regarding a recent hospital stay.

Hospice – Hospice care is provided to enhance the life of the dying person. The program provides supportive services to terminally ill patients and their families in the form of physical, social, and spiritual care. In a nursing facility hospice does not pay for room and board.

Hospital Lifetime Reserve Days – Each Subscriber has 60 hospital lifetime reserve days. These days are not renewable and therefore, may be used only once.

Independent Living Community – For residents residing in Independent Living, services are aimed at minimizing seniors’ daily responsibilities, not assisting with activities of daily living (ADLs). Landscaping, laundry and housekeeping services, on-site dining facilities, security surveillance, and a variety of activities and events are the typical offerings in IL settings. However, they do not have full-time staff dedicated to providing custodial or medical care. (

Life Plan Plan Communities – See Continuing Care Retirement Communities.

Life Plan at Home Programs – Life Plan At Home programs offer the same kinds of services provided to senior living community residents along with the financial protection that is a part of a long-term care insurance policy, but to older adults that live in their homes. Each program member pays a one-time membership fee and a monthly fee covering a service package that provides a range of wellness services when members are independent and then provides direct care services when a member experiences a change in health or functional ability. Members are entitled to lifetime services, without a maximumupper limit. Most programs do outline adaily coverage cap, however. Also, known as Continuing Care at Home.

Living Will – A written document stating, in advance, an individual’s wishes concerning the use of life-saving devices and procedures in the event of terminal illness or injury, should the individual no longer be competent.

Long-Term Care (LTC) – The broad spectrum of medical and support services provided to persons who have lost some or all their capacity to function without assistance, due to illness or injury.

Managed Care – A partnership between an insurance provider and a health care system. Put in place to coordinate all care services received to maximize benefits and minimize costs. Managed care plans use their own network of health care providers and require approvals prior to receiving services.

Occupational Therapy – Therapeutic use of work, self-care, and play activities to increase independent function, enhance development, and prevent disability; may include an adaptation of task or environment to achieve maximum independence and to enhance quality of life.

Ombudsman – Often a volunteer representative who handles complaints of residents and families and works to resolve any problems or differences with the facility staff by defining concerns, explaining rights, and identifying choices. An ombudsman can help resolve the problem in most cases; however, complaints involving serious abuse or neglect are referred to the appropriate agency. In all situations, confidentiality is maintained, and no information is released without the permission of the resident or legal guardian. In addition, an ombudsman is a good source of information about selecting a long-term care facility, eligibility criteria, and other services for the elderly, and resident rights.

Palliative Care – Any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than striving to halt, delay, or reverse the progression of the disease itself or to provide a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex, and/or terminal illnesses.

Pre-Admission Screening and Annual Resident Review (PASARR) – A process for determining whether a person being considered for admission has any mental illness or mental retardation. Federal law requires nursing homes that participate in Medicare or Medicaid to screen all patients. If an initial evaluation reveals mental illness or mental retardation, a more in-depth evaluation is performed to determine whether the patient needs special services that cannot be provided in a nursing home. Patients whose mental conditions change during their stay in the facility will be retested.

Private Pay Patients – Patients who pay for their own care or whose care is paid for by their family or another private third party, such as an insurance company. The term is used to distinguish patients from those whose care is paid for by government programs (Medicaid, Medicare, and Veterans Administration).

Physical Therapy – Treatment of disease or injury by physical and mechanical means. Physical therapists plan and administer prescribed physical therapy treatments for patients to help restore their function and strength.

Power of Attorney – A legal document allowing one person to act in a legal manner on another’s behalf pursuant to financial or real-estate transactions.

Pre-Admission Screening – An assessment of a person’s functional, social, medical, and nursing needs to determine if the person should be admitted to a nursing facility.

Rehabilitation – Therapeutic care for individuals requiring intensive physical, occupational, or speech therapy, provided to restore them to a former capacity.

Resident Assessment – A standardized tool that enables nursing homes to determine a patient’s abilities, what assistance the patient needs, and ways to help the patient improve or regain abilities. Patient assessment forms are completed using information gathered from medical records, discussions with the patient and family members, and direct observation.

Resident Care Plan – A written plan of care for nursing facility residents developed by an interdisciplinary team with specific, measurable objectives and time tables for service to be provided to meet a resident’s medical, nursing, mental, and psychosocial needs.

Respite Care – Scheduled short-term nursing facility care provided on a temporary basis to an individual who needs this level of care but who is normally cared for in the community. The goal of scheduled short-term care is to provide relief for caregivers while providing nursing facility care for the individual.

Skilled Nursing Care – Level of care that includes services that can only be performed safely and correctly by a licensed nurse (either a registered nurse (RN) or a licensed practical nurse (LVN).

Skilled Nursing Facility (SNF) – Generally speaking, a skilled nursing facility is a clinical provider of 24-hour licensed nursing. A SNF is primarily engaged in providing services for residents who require medical or nursing care and/or therapy services for the rehabilitation of injured, disabled, or sick persons.

Survey – A detailed, unannounced inspection of each licensed nursing home conducted at least once a year by the Quality Assurance division of the nursing home’s state Department of Aging and Disabiity.

Transfer – To move a resident from one place to another – from the bed to a wheelchair, or from assisted living to skilled care.

Glossary of Terms originally published on