Residential Care & Assisted Living Bed Availability Report

Activities of Daily Living (ADL's)
Essential and basic requirements for self-care, including bathing, dressing, toileting, transfer, continence, and feeding.

Advanced Directive
A written document stating how you want medical decisions made for you if you lose the ability to make decisions for yourself. The two most common advance directives are living wills and durable powers of attorney for health care.

Adult Day Care
Community based day programs designed for adults with physical disabilities or cognitive impairment who may need assistance with their activities of daily living, supervision, or increased socialization. These programs are structured to provide health, social, and other related support services.

Alzheimer's Disease
A progressive, degenerative, and neurological illness characterized by chemical and structural changes in the brain. It is the most common type of dementia.

Apraxia
One of the symptoms of Alzheimer's disease - inability to carry out motor tasks, despite the fact that the motor system is intact. The person may possess all the faculties necessary to pick up a fork, for example, but he is unable to do so.

Area Agency on Aging
A regional, government-supported agency that acts as a clearinghouse for services and programs for the elderly.

Assignment
A process in which a Medicare beneficiary agrees to have Medicare's share of the cost of a service paid directly to a doctor or other provider, and the provider agrees to accept the Medicare-approved charge as payment in full. For most services, Medicare pays 80 percent of the cost, and the beneficiary pays 20 percent.

Assisted Living Facility
A facility that provides 24 hour care to residents who are able to care for themselves, but who may need reminders to take medications or minimal assistance with personal grooming. The facility offers shelter, board, and protective oversight.

Benefit Period
A method for measuring a beneficiary's use of services covered by Medicare. A benefit period begins the day the beneficiary is hospitalized or enters a skilled nursing facility. It ends after the beneficiary has been out of the hospital or facility for a period of 60 consecutive days. If the beneficiary requires additional facility care after the 60-day period, a new benefit period begins.

Care Management, Case Management
The process of assessing a person's need for services (physical, psychological, or other), arranging for them, and monitoring their delivery. Private, professional care managers can be hired to oversee the care of an elderly relative who lives far away.

Care Plan
A carefully thought-out program of services to help meet the needs of a person requiring assistance.

Carrier
A private organization, usually an insurance company, that has a contract with the Health Care Financing Administration to process claims under Part B (doctor insurance) of Medicare.

Catastrophic illness
Any unusually expensive or lengthy illness that greatly exceeds an individual's ability to pay.

Certified Nursing Assistants/Home Health Aides
Home health care workers who provide all that companions and homemakers do as well as personal care help such as bathing, dressing, bandage changes, help with medications, and management of incontinence. They are usually trained and certified through exams and work under the supervision of a registered nurse.

Companion/Homemaker Services
A home care worker who provides socialization, companionship, and accompaniment on walks, errands, and appointments. Homemakers provide all that companions do as well as light housekeeping, laundry, grocery shopping, meal preparation, and running errands.

Continuing Care Retirement Community (CCRC)
A living environment that provides housing for older adults who desire the continuum of services under one umbrella agency. CCRC's offer independent living, assisted living, and skilled nursing care on the same campus or at a nearby location.

Co-payment
The portion of the cost of care an insured person is required to pay, while the person's insurance plan usually, but not always, pays for the majority of the cost.

Custodial Care
A level of nonmedical care for people who do not require the constant services of nurses or aides; also called sheltered care. It is designed for people who are capable of independent living but who may require some assistance with personal care and homemaking services.

Custodial care facility
A facility that provides medical or nonmedical services (for example, assistance in the activities of daily living) that do not seek to cure, are provided during periods when the medical condition of the patient is not changing or do not require continued administration by medical personnel.

CVA (cardiovascular accident)
Stroke

Deductible
The amount that an insured person must pay before an insurance plan pays for any portion of the cost of health care.

Dementia
A progressive mental disorder that may be a disease in itself or a consequence of other conditions, such as stroke. Dementia results in increased difficulty remembering and performing everyday tasks. Alzheimer's disease is one of the many kinds of dementia.

Durable medical equipment
Medical equipment that is intended to be used repeatedly, usually by the patient or a caregiver, rather than being used once or a few times and discarded. Examples include wheelchairs, hospital beds, oxygen tanks, and walkers.

Durable General Power of Attorney
A delegation of power to another to make legal or financial decisions.

Durable Power of Attorney for Health Care
A delegation of power to another to make medical decisions. It should be used as a companion document with a living will.

Elderlaw
The specialty within law that focuses on the legal and financial needs of the elderly, including estate planning (wills, trusts, etc.), Medicare and Medicaid eligibility and advocacy, and issues of competence.

Executor, Executrix
Individual appointed before death by a person to manage the estate of the deceased person.

Fee-For-Service system
The traditional health care payment system in which providers, including physicians and hospitals, are paid after they provide services to consumers.

Geriatrics
The branch of medicine specializing in caring for elderly people.

Gerontology
The field of study that focuses on the well being of elderly people. It includes the study of the medical problems unique to the elderly and of emotional and social matters of special relevance to the elderly and their families.

Guardian
A person appointed to manage another person's financial and personal affairs when that person can no longer do so. Guardians are appointed by the courts as a result of formal legal action.

Health-care agent
A person appointed by an individual to make end-of-life decisions when that individual can no longer do so and to see to it that the dying person's wishes are carried out.

Health Maintenance Organization (HMO)
A managed care plan that combines the functions of insurer and provider of care, giving most necessary care for a prepaid fee and placing an emphasis on prevention and careful assessment of medical necessity.

Home Health Care Agency Services
A range of services to help individuals who need assistance with personal care and skilled medical care in their own homes.

Home Health Aides/Certified Nursing Assistants
Home health care workers that provide all that companions and homemakers do as well as personal care help such as bathing, dressing, bandage changes, help with medications, and management of incontinence. They are usually trained and certified through exams and work under the supervision of a registered nurse.

Hospice
A comprehensive program, which emphasizes comfort, measures rather than aggressive treatment for the dying patient and his family. Hospice care is reserved for persons who have any terminal illness and have a life expectancy of less than six months.

Incontinence
Inability to control bladder or bowel movements.

Independent Living Facility
Independent living accommodations available to older adults who wish to live in a community setting but still maintain their own living area and are able to care for their own personal needs. Some independent living options include senior apartment buildings, retirement communities, and continuing care retirement communities.

Instrumental Activities of Daily Living (IADLs)
Activities required to live independently, such as using the telephone, shopping, preparing meals, housekeeping, doing laundry, transportation, taking medicines, and handling finances.

Intermediary
A private organization, usually an insurance company, that has a contract with the Health Care Financing Administration to process claims under Part A (hospital insurance) of Medicare.

Intermediate Care Facility
An institution that provides less intensive care than skilled nursing facilities. Intermediate Care generally does not include rehabilitation services and is therefore not covered by Medicare.

Levels of Care
A term used to describe the different kinds and intensity of care available to the elderly or ill person.

Living Will
A document executed prior to or early in the course of an illness, expressing one's wishes in regard to medical treatment if one becomes unable to direct the course of it personally.

Managed Care
A system of health care delivery that links payment with the delivery of health care services with the aim of giving people access to quality, cost-effective health care.

Managed Care Plan
A type of health care plan that utilizes the principles of managed care; examples include health maintenance organizations and preferred provider organizations.

Medicaid
A federal/state insurance program, established by the Title XIX of the Social Security Act, that provides medical care to the poor. The program is administered by individual states.

Medically Needy
A term used when a person is eligible for Medicaid, not because of absolute lack of income, but because income, less accumulated medical bills, is below state income limits for the Medicaid program.

Medical Necessity
A term used when medical treatment is thought to be required by the prevailing medical consensus. What is medically necessary in one period or one area may not be so in another.

Medicare
A federal health insurance program for people 65 or older, people of any age with permanent kidney failure and certain disabled people that cover the cost of hospitalization, medical care and some related services. The Medicare program is administered by the Health Care Financing Administration.

Medicare + Choice
An expansion of the original Medicare program that includes managed care plans such as health maintenance organizations, health maintenance organizations with point-of-service options, preferred provider organizations, provider sponsored organizations, private fee-for-service plans and medical savings accounts.

Medicare Summary Notice (MSN)
A form sent to a Medicare beneficiary after a claim is paid, indicating what Medicare has paid for and why.

Medigap
An insurance policy sold as a supplement to Medicare, usually but not always having coverage of co-payments and deductibles as its main features.

Mental Status Exam
A series of questions and instructions administered by a health-care provider to determine a person's level of mental functioning.

Nutrition Site
A location, often a Senior Center or community facility, where meals are provided for seniors who qualify for the program.

Ombudsman
A person whose job it is to investigate complaints about long-term care facilities in which older people live.

Part A
The part of Medicare that covers inpatient hospital care, skilled nursing home care, home health care, hospice care and blood services; also called hospital insurance. Part A also covers the cost of pharmaceuticals administered in the hospital but does not cover the cost of outpatient prescription medications.

Part B
The part of Medicare that covers the services of doctors provided on an inpatient or outpatient basis, surgical services and supplies, clinical laboratory services, home health care, hospital outpatient services and blood services; also called doctor insurance.

Polypharmacy
The excessive and inappropriate use of medications, resulting in duplicate prescriptions and adverse drug interactions. Polypharmacy is often a result of lack of coordination among health-care providers.

Point-Of-Service (POS)
A type of managed care plan that allows the covered person to choose to receive a service from a participating or a nonparticipating provider, with different benefit levels associated with the use of participating providers.

Power of Attorney
A document that authorizes one person to act on behalf of another in legal matters such as entering into contracts, transacting business, and paying bills. A power of attorney document may be unrestricted, in which case the attorney-in-fact (or agent) is given broad powers for an unlimited period of time. Or, it may be time limited and restricted, in which case specific powers and only those powers are granted to the agent, and for only limited periods of time. A durable power of attorney survives the incompetence or incapacity of the person authorizing another to act on his or her behalf. For most elderly people, it is wise to arrange for a durable power of attorney.

Preferred Provider Organization (PPO)
A managed care plan with a large network of physicians, hospitals and other providers.

Primary Diagnosis
The chief medical reason for an encounter with a health care provider or admission to a hospital.

Private Duty Nursing
Care given by a licensed, private duty nurse who provides daily, continuous, skilled care for one individual exclusively, residing in a nursing home or in his or her own home. Medicare does not cover private duty nursing.

Probate
A legal proceeding as a result of which an estate is divided after death. The rules of probate vary widely from state to state.

Provider
A doctor or entity (home health agency, hospital) approved to give care to Medicare beneficiaries and to receive payment from Medicare.

Provider Sponsored Organization (PSO)
A managed care plan owned by doctors and hospitals. These plans contract with consumers and businesses to provide medical services. PSOs may also contract with the Health Care Financing Administration to provide services to Medicare beneficiaries.

Qualified Medicare Beneficiary (QMB)
A Medicare beneficiary who qualifies for financial assistance based upon income and resources. Federal law requires state Medicaid programs to pay Medicare costs such as deductibles, co-payments and Part B (doctor insurance) premiums for those who qualify. Information on the QMB program is available from state welfare office.

Registered Home Care Nurse
A licensed, certified, and trained nurse who provides professional skilled nursing care such as wound care, injections, IV's, assessment, and teaching to patients in their own home. Intermittent and limited skilled nursing in-home services are generally covered by Medicare if prescribed by a medical doctor and part of a care plan.

Residential Care Facility (RCF)
A long-term care facility that provides 24 hour care for persons who are able to care for themselves with minimal assistance. The facility provides shelter, board, and protective oversight. Residents must be able to self-transfer and mentally and physically negotiate a pathway to safety in the event of an emergency. Some residential care facilities offer storage and distribution or administration of medications.

Respite Care
Short-term care arrangements, sometimes available through community agencies and long-term care facilities that provide temporary relief from caregiving responsibilities.

Retirement Community
A community that provides housing for older adults who desire the opportunity to live independently in a secure and protected environment, but still have the option to participate in the services and activities offered by the retirement community.

Secondary Diagnosis
A condition that exists in addition to the one that is the chief reason for an encounter with a health care provider or admission to a hospital.

Senior Apartment Building
Housing complexes that only rent to individuals over a certain age. Residents maintain their own apartment, cook their own meals, and take care of their own personal needs. Some senior apartment buildings offer social and congregate activities to their residents.

Skilled Nursing Facility
An institution, often times referred to as a nursing home that provides twenty-four hour skilled nursing care to residents unable to care for their mental and/or physical needs. It provides skilled nursing care, personal care, meals, medication distribution and medical supervision, housekeeping, and rehabilitation services.

Specified Low-Income Medicare Beneficiary (SLMB)
A Medicare beneficiary who is not eligible for the Qualified Medicare Beneficiary program but may still be eligible for financial assistance. The SLMB program is designed for beneficiaries whose income is slightly higher than the national poverty level. The SLMB program pays the monthly Part B (doctor insurance) premiums; however, it does not cover the deductible, co-payments or services not covered by Medicare.

Supplemental Security Income
A program that provides small stipends to the elderly, blind, and disabled who for one reason or another are not eligible for other, more generous welfare programs.

Transferring
Movement back and forth from bed to chair, wheelchair, toilet, etc.

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