Senior Housing – Glossary of Terms

The terms below can help you learn about commonly used terms and the different senior housing and care choices available.

Accreditation: A seal of approval given by an autonomous governing body to a community 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 independent, not government agencies or regulatory bodies. Some examples of accreditation bodies for the senior housing and care industry include CARF (Commission on Accreditation of Rehabilitation Facilities), CCAC (Continuing Care Accreditation Commission), and JCAHO (Joint Commission on Accreditation of Healthcare Organizations).

Activities of Daily Living (ADLs): Bathing, eating, grooming, dressing, toileting and other day-to-day activities.

ADA (Americans with Disabilities Act): Passed by Congress in 1980, this law establishes a clear and comprehensive prohibition of discrimination on the basis of disability.

Administrator: In most cases, a licensed professional who undertakes the duty of managing the day-to-day operations of a care facility such as a nursing home or assisted living facility.

Adult Day Care: Structured programs with stimulating social activities and health-related and rehabilitation services for the elderly who are physically or emotionally disabled and need a protective environment. The participant is usually brought to the care facility in the morning and leaves in the evening.

Advantage List: List of health service providers that agree to give particular insurance company policyholders a preset discount.

Aging in Place: A concept that advocates allowing a resident to choose to remain in his/her living environment regardless of the physical and or mental decline that may occur with the aging process of aging.

Alzheimer’s Care Center: A treatment center that specializes in providing care for those with Alzheimer’s disease with more of the care geared towards supervision of the patient in a safe and controlled environment.

Alzheimer’s: A progressive, neurodegenerative disease characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning. Alzheimer’s disease is the most common cause of dementia.

Ambulatory: The ability to walk freely & independently, not bedridden or hospitalized.

Assessment: An evaluation, usually performed by a physician, of a person’s mental, e

Assisted Living: a special combination of housing, personalized supportive services and health care designed to meet the needs — both scheduled and unscheduled — of those who need help with activities of daily living. Services provided in Assisted Living residences usually include:

• Three meals a day served in a common dining area
• Housekeeping services
• Transportation
• Assistance with eating, bathing, dressing, toileting and walking
• Access to health and medical services
• 24-hour security and staff availability
• Emergency call systems for each resident’s unit
• Health promotion and exercise programs
• Medication management
• Personal laundry services
• Social and recreational activities

Caregiver: The primary person in charge of caring for an individual with Alzheimer’s disease, usually a family member or a designated health care professional.

Case Management: A term used to describe formal services planned by care professionals.

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 the nursing staff and provides care to facility residents.

Comprehensive Outpatient Rehabilitation Facility (CORF): A facility that mainly provides rehabilitation services after an illness or injury, and provides a variety of services including physician’s services, physical therapy, social or psychological services, and outpatient rehabilitation.

Congregate Housing: Is similar to independent living except that it usually provides convenience or supportive services like meals, housekeeping, and transportation in addition to rental housing.

Continuing Care Retirement Community (CCRC): Is a community that offers several levels of assistance, including independent living, assisted living and nursing home care. It is different from other housing and care facilities for seniors because it usually provides a written agreement or long-term contract between the resident (frequently lasting the term of the resident’s lifetime) and the community which offers a continuum of housing, services and health care system, commonly all on one campus or site.

Continuum of Care: Care services available to assist individuals throughout the course of a disease. This may include Independent Living, Assisted Living, Nursing Care, Home Health, Home Care, and Home and Community Based Services.

Convalescent Home: See Nursing Home.

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.

Financial Counseling Programs: Help seniors with managing their finances, bills, and completing Medicaid, Medicare or insurance forms.

HIPAA (The Health Insurance Portability and Accountability Act of 1996): This act became a law on January 1, 1997. The act states the requirements that a long term care policy must follow in order that the premiums paid may be deducted as medical expenses and benefits not paid be considered as taxable income.

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: A special way of caring for people who are terminally ill. Hospice care involves a team-oriented approach that addresses the medical, physical, social, emotional and spiritual needs of the patient. Hospice also provides support to the patient’s family or caregiver as well. Hospice care is covered under Medicare Part A (Hospital Insurance).

Inpatient Care: Health care that you get when you are admitted to a hospital or skilled nursing facility.

Independent Living: Is a residential living setting for elderly or senior adults that may or may not provide hospitality or supportive services. Under this living arrangement, the senior adult leads an independent lifestyle that requires minimal or no extra assistance. Generally referred to as elderly housing in the government-subsidized environment, independent living also includes rental assisted or market rate apartments or cottages where residents usually have complete choice in whether to participate in a facility’s services or programs. See Senior Apartments.

Instrumental Activities of Daily Living (IADLs): Secondary level of activities (different from ADLs, such as eating, dressing, and bathing) important to daily living, such as cooking, writing, and driving.

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) that 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: Care given in the form of medical and support services to persons who have lost some or all of their capacity to function due to an illness or disability.

Long-term Care Insurance: The insurance which pays for a succession of care giving services for the elderly or chronically ill. This care may be provided in a facility (nursing home, mental hospital, etc.) or in the individual’s home with a nurse or aide.

Medical Director: The medical director 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. A staff medical director assumes overall responsibility for the formulation and implementation of all policies related to medical care.

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.

National Association of Insurance Commissioners (NAIC): A national organization made up of state officials who are in charge of regulating insurance. They have considerable influence and strive to promote national uniformity in insurance regulations.

Naturally Occurring Retirement Communities (NORC): They can involve low-income residents receiving a richer mix of public services through a NORC model. They might serve people of all income levels who got together to furnish cost-effective transportation services. And there are NORCs for relatively affluent households that may charge $1,000 or even more in annual dues, and support paid and volunteer staffers who provide a rich variety of support services and cultural enrichment activities. NORCs can be very effective mechanisms to identify populations of people who need government-provided services and then provide those services in cost-effective ways

Non-Ambulatory: Inability to walk independently, 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: Nurse assistants work under the supervision of a Registered Nurse or Licensed Practical Nurse. 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.

Nursing Home: Provides 24-hour skilled care for the more acute patients. Patients generally rely on assistance for most or all daily living activities (such as bathing, dressing and toileting). 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. These facilities are State Licensed. Also referred to as Nursing Facility or Convalescent Home. See also Skilled Nursing Facility.

Occupational Therapy: A creative activity prescribed for its effect in promoting recovery or rehabilitation. This is done to help individuals relearn activities of daily living and is generally administered by a licensed therapist.

Physical Therapy: The treatment of disease or injury, by physical and mechanical means (as massage, regulated exercise, water, light, heat, and electricity.) Physical therapists plan and administer prescribed physical therapy treatment programs for residents to help restore their function and strength.

Quality care: Term used to describe care and services that allow recipients to attain and maintain their highest level of mental, physical, and psychological function, in a dignified and caring way.

Real Estate: These housing options offer home ownership opportunities for adults 55 years of age and older, or sometimes 62 years and older. Some communities offer rental programs and rent-to-own options. The types of residences you may find are: Single Family Homes, Cottages and Patio Homes, Condos and Townhouses, Manufactured Homes, Gold Communities and Gated Communities.

Regional Home Health Intermediary (RHHI): A private company that contracts with Medicare to pay home health and hospice bills under Original Medicare and check on the quality of home health care.

Registered Nurse (RN): Graduate trained nurse who has both passed a state board examination and is licensed by a state agency to practice nursing. A minimum of two years of college is required in addition to passage of the state exams. 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.

Rehabilitation: Therapeutic care for persons requiring intensive physical, occupational, or speech therapy in order to restore to the patient to a former capacity.

Residential Care: See Assisted Living.

Respite Care: Services that provide people with temporary relief from tasks associated with care giving (e.g., in-home assistance, short nursing home stays, adult day care).

Senior Apartment: Age-restricted multiunit housing for older adults who are able to care for themselves. Usually no additional services such as meals or transportation are provided. Similar to Independent Living.

Senior Citizen Policies: Insurance policies for those over the age of 65. In many cases these policies are in combination with coverage provided by the government under the Medicare Program.

Skilled Care: A type of health care given when you need skilled nursing or rehabilitation staff to manage, observe, and evaluate your care.

Skilled Nursing Care: A level of care that includes services that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse).

Skilled Nursing Facility (SNF): A nursing facility with the staff and equipment to give skilled nursing care and/or skilled rehabilitation services and other related health services.

Skilled Nursing Facility Care: This is a level of care that requires the daily involvement of skilled nursing or rehabilitation staff and that, as a practical matter, can’t be provided on an outpatient basis. Examples of skilled nursing facility care include intravenous injections and physical therapy. The need for custodial care (for example, assistance with activities of daily living, like bathing and dressing) cannot, in itself, qualify you for Medicare coverage in a skilled nursing facility. However, if you qualify for coverage based on your need for skilled nursing or rehabilitation, Medicare will cover all of your care needs in the facility, including assistance with activities of daily living.

Special Needs Plan: A special type of plan that provides more focused health care for specific groups of people, such as those who have both Medicare and Medicaid, who reside in a nursing home, or who have certain chronic medical conditions.

Subsidized Senior Housing: A type of program, available through the Federal Department of Housing and Urban Development and some States, to help people with low or moderate incomes pay for housing.

Support Group: Facilitated gathering of caregivers, family, friends, or others affected by a disease or condition for the purpose of discussing issues related to the disease.