Activities of Daily Living (ADL)
Physical functions that an independent person performs each day, including bathing, dressing, eating, using the restroom, walking or wheeling, and
transferring into and out of bed.
A sudden and sometimes severe condition.
An appliance or gadget which assists users in the operation of self-care, work or leisure activities.
A written statement of an individual's preferences and directions regarding healthcare. 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.
A progressive and irreversible organic disease, typically occurring in the elderly and characterized by degeneration of the brain cells,
leading to dementia, of which Alzheimer's is the single most common cause. Progresses from forgetfulness to severe memory loss and
disorientation, lack of concentration, loss of ability to calculate numbers and finally to increased severity of all symptoms and
significant personality changes.
The loss of ability to express oneself and/or understand language.
Inability to carry out a complex or skilled movement due to deficiencies in cognition.
Determination of a resident's care needs, based on a formal, structured evaluation of the resident's physical and psychological condition and ability to perform activities of daily living.
Senior housing that provides individual apartments, which may or may not have a kitchenette. Facilities offer 24-hour on-site staff, congregate
dining, and activity programs. Limited nursing services may be provided for an additional fee.
Healthcare professionals specializing in the measurement of hearing and the correction of hearing impairment or hearing loss.
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See pressure ulcers.
To be bedridden.
Any individual who takes care of an elderly person or someone with physical or mental limitations.
A system in which one individual helps the insured person and his or her family determine and coordinate necessary healthcare services and the
best setting for those services.
Certificate of Medical Necessity
A document completed and signed by a physician to certify a resident's need for certain types of durable medicalequipment (i.e., wheelchairs, walkers).
Certified Nursing Assistant (CNA)
The CNA provides personal care to residents such as bathing, dressing, changing linens, transporting and other essential activities. CNAs are trained, tested, certified and work under the supervision of an RN or LPN.
A lasting, lingering or prolonged illness or symptom.
A disease which is permanent, or leaves residual disability, or is caused by non-reversible pathological alteration.
Chronic Obstructive Pulmonary Disease (COPD)
A group of chronic respiratory disorders characterized by the restricted flow of air into and out of the lungs. The most common example is
The process of knowing and of being aware of thoughts. The ability to reason and understand.
A diminished mental capacity, such as difficulty with short-term memory.
Multiple disease processes.
Nonmedical services that are provided in the resident's home. Examples include, but are not limited to: helping the senior with everyday activities, making meals, grooming and ensuring safety. No medical care is provided.
Congestive Heart Failure (CHF)
A common type of heart disease characterized by inadequate pumping action of the heart.
Person appointed by the court to act as the legal representative of a person who is mentally or physically incapable of managing his or her affairs.
Board, room and other personal assistance services (including assistance with activities of daily living, taking medicine and similar personal needs) that may not include a skilled nursing care component.
Refers to a cerebrovascular accident or stroke in which an area of the brain is damaged due to a sudden interruption of blood supply.
See pressure ulcers.
Progressive mental disorder that affects memory, judgment and cognitive powers. One type of dementia is Alzheimer's disease.
Developmental Disability (DD)
Refers to a serious and chronic disability, which is attributable to a mental or physical impairment or combination of mental and physical
impairments. Those affected have limitations in three or more of the following areas: self-care, receptive and expressive language, learning, mobility, self-direction, capacity of independent living, economic self-sufficiency. Those who have a developmental disability often require long-term treatment and care-planning.
Diagnostic Related Groups (DRGs)
DRGs are used to determine the amount that Medicare reimburses hospitals for in-patient services. The hospital is reimbursed a fixed amount based on the DRG code for the patient.
A social worker or nurse who assists patients and their families with healthcare arrangements following a hospital stay.
Separate units in a nursing facility where beds are available only for people whose care is paid for by a specificpayment source, such as Medicare.
Durable Power of Attorney for Health Care (DPAHC)
A legal document in which a competent person gives another person (called an attorney-in-fact) the power to make healthcare 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
A swallowing disorder often depicted by difficulty in oral preparation for swallowing. The person has difficulty moving material from the mouth to stomach.
A collection of fluid in the tissues which causes swelling.
Emergency Response Systems
Electronic monitors on a person or in a home that provide automatic response to medical or other emergencies.
End-Stage Renal Disease (ESRD)
Medical condition in which a person's kidneys no longer function, requiring the individual to receive dialysis or a kidney transplant to sustain his or her life.
Any condition or expense for which a policy will not pay.
A tube which is inserted into the bladder in order to drain urine. The urine drains through a tube and is collected in a plastic pouch.
The branch of medicine that focuses on providing healthcare for the elderly and the treatment of diseases associated with the aging process.
A tube inserted surgically through an opening in the stomach. G tubes offer another means of nutritional sustenance for those individuals
unable to use their mouths.
A written legal document which allows a person to appoint another person (agent) to make healthcare decisions should he or she be unable to make or communicate decisions.
Healthcare Power of Attorney
The appointment of a healthcare agent to make decisions when the principal becomes unable to make or communicate decisions.
Health and Human Services, Department of
An executive department of the federal government that is responsible for the oversight of the Medicare and Medicaid programs.
Hospice/palliative care is provided to enhance the life of the dying person. Often provided in the home by health professionals, today there are many nursing facilities and acute care settings that also offer hospice services. Hospice care, typically offered in the last six months of
life, emphasizes comfort measures and counseling to provide social, spiritual and physical support to the dying patient and his or her
The provision of short-term inpatient services for pain control and management of symptoms related to terminal illness.
Determined by a legal proceeding. Requires that the individual is incapable of handling assets and exercising certain legal rights.
IncontinentPartially or totally unable to control bladder and/or bowel functions.
The way that liquid solutions or liquid medications are administered directly into the blood stream through an intravenous catheter inserted
in a vein in the body. Infusion therapies can include total parenteral nutrition, antibiotics or other drugs, blood, and chemotherapy.
Length of Stay
The time a patient stays in a hospital or other healthcare facility.
A legal document in which a competent person directs (in advance) that artificial life-prolonging treatment not be used if he or she has or
develops a terminal and irreversible condition and becomes incompetent to make healthcare decisions.
Long-Term Care (LTC)
The broad spectrum of medical and support services provided to persons who have lost some or all capacity to function on their own due to a
chronic illness or condition, and who are expected to need such services over a prolonged period of time. Long-term care can consist of
care in the home by family members who are assisted with voluntary or employed help, adult day healthcare, or care in assisted living or
skilled nursing facilities.
Long-Term Care Facilities
A range of institutions that provide healthcare to people who are unable to manage independently in the community. Facilities may provide
short-term rehabilitative services as well as chronic care management.
The federally supported, state-operated public assistance program that pays for healthcare services to people with low incomes, including elderly or disabled persons who qualify. Medicaid pays for long-term nursing facility care, some limited home health services, and may pay for some assisted living services, depending on the state.
Medical Records Director/Coordinator
Plans and directs the activities and personnel of the department. Coordinates the management of resident medical records and the clerical needs of the nursing department.
Medical necessity must be established (via diagnostic and/or other information presented on the claim under consideration) before the carrier or
insurer will make payment.
MedicareThe federal program providing primarily skilled medical care and medical insurance for
people aged 65 and older, some disabled persons and those with
end-stage renal disease.
Medicare Part AHospital
insurance that helps pay for inpatient hospital care, limited skilled
nursing care, hospice care, and some home healthcare. Most people get
Medicare Part A automatically when they turn 65.
Medicare Part BMedical insurance that helps pay for doctors' services, outpatient hospital care, and some other medical services that
Part A does not cover (like some home health care). Part B helps pay
for these covered services and supplies when they are medically
necessary. A monthly premium must be paid to receive Part B.
nursing home bed in a building or part of a building, which has been
determined to meet federal standards for serving Medicare patients
requiring skilled nursing care.
Nasogastric Tube (NG Tube)A
tube that passes through a patient's nose and throat and ends in the
stomach. This tube allows for direct 'tube feeding' to maintain the
nutritional status of the patient or to remove stomach acids.
facility licensed with an organized professional staff and inpatient
beds, and that provides continuous nursing and other health-related,
psychosocial, and personal services to residents who are not in an
acute phase of illness, but who primarily require continued care on an
Nurse, Licensed Practical (LPN)A
graduate of a state-approved practical nursing education program, who
has passed a state examination and been licensed to provide nursing and
personal care under the supervision of a registered nurse or physician.
An LPN administers medications and treatments and acts as a charge
nurse in nursing facilities.
Nurse, Registered (RN)Nurses
who have graduated from a formal program of nursing education (two-year
associate degree, three-year hospital diploma, or four-year
baccalaureate) and passed a state-administered exam. RNs have completed
more formal training than licensed practical nurses and have a wide
scope of responsibility including all aspects of nursing care.
therapists evaluate, treat and consult with individuals whose abilities
to cope with the tasks of everyday living are threatened or impaired by
physical illness or injury, psychosocial disability, or developmental
deficits. Occupational therapists work in hospitals, rehabilitation
agencies, long-term care facilities and other healthcare organizations.
Ombudsman Program is a public/government/community-supported program
that advocates for the rights of all residents in 24-hour long-term
care facilities. Volunteers visit local facilities weekly, monitor
conditions of care and try to resolve problems involving meals,
finances, medication, therapy, placements and communication with the
OutpatientA patient who receives care at a
hospital or other healthcare facility without being admitted to the
facility. Outpatient care also refers to care given in organized
programs, such as outpatient clinics.
Private Pay PatientsPatients
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
governmental programs (Medicaid, Medicare, and Veterans Administration).
services rendered by a nurse's aide, dietitian or other healthcare
professional. These services include assistance in walking, getting out
of bed, bathing, toileting, dressing, eating and preparing special
Physical TherapyServices provided by specially
trained and licensed physical therapists to relieve pain, restore
maximum function, and prevent disability or injury.
Power of AttorneyA
legal document allowing one person to act in a legal matter on
another's behalf pursuant to financial or real estate transactions.
assessment of a person's functional, social, medical, and nursing
needs, to determine if he or she should be admitted to a nursing
facility or other community-based care services available to eligible
Medicaid recipients. Screenings are conducted by trained preadmission
Preexisting ConditionsMedical conditions
that existed, were diagnosed or were under treatment before an
insurance policy was taken out. Long-term care insurance policies may
limit the benefits payable for such conditions.
breakdown of the skin, to which older, bed-ridden persons are
especially susceptible. Also referred to as pressure sores or decubitus
ulcers. For bed-ridden persons, prevention includes turning every two
hours if tolerated by the resident.
provides medical services or supplies, such as a physician, hospital,
X-ray company, home health agency, or pharmacy.
Psychotropic DrugsTerm usually applied to medications that affect a resident's mental state.
Range of Motion (ROM)The movement of a joint to the extent possible without causing pain.
Reasonable and Necessary CareThe
amount and type of health services generally accepted by the health
community as being required for the treatment of a specific disease or
A person living in a long-term care
facility. Since nursing facilities are licensed healthcare facilities,
residents are often also referred to as patients.
Resident Assistant (RA)
generally work in assisted living residences and provide direct
personal care services to residents, but they are not certified CNAs.
Depending on the state, this position is also available in some nursing
Resident Care Plan
A written plan of care for
nursing facility residents developed by an interdisciplinary team which
specifies measurable objectives and timetables for services to be
provided to meet a resident's medical, nursing, mental and psychosocial
Assists patients with breathing difficulties to reduce fatigue and increase tolerance in performing daily activities.
Dated term for organic dementia associated with old age. Now referred to as dementia and/or Alzheimer's.
Rails on a hospital-type bed that are meant to protect a patient.
Skilled Nursing Care
and rehabilitative care that can be performed only by, or under the
supervision of, licensed and skilled medical personnel.
Skilled Nursing Facility (SNF)
Provides 24-hour nursing care for chronically ill or short-term rehabilitative residents of all ages.
type of service helps individuals overcome communication conditions
such as aphasia, swallowing difficulties and voice disorders. Medicare
may cover some of the costs of speech therapy after the client meets
A level of care
designed for the individual who has had an acute event as a result of
an illness, and is in need of skilled nursing or rehabilitation, but
does not need the intensive diagnostic or invasive procedures of a
Sub-Acute Care Facilities
often in a distinct part of a nursing facility. Provide intensive
rehabilitation, complex wound care, and post-surgical recovery for
persons of all ages who no longer need the level of care found in a
Total Parenteral Nutrition (TPN)Nutrition
administered through a large vein in the body because of its high
concentration of ingredients, including vitamins and minerals. This
type of nutritional procedure is complex and expensive, and usually not
appropriate for extremely frail or elderly residents.
ventilator, also known as a respirator, is a machine that pushes air
into the lungs through a tube placed in the trachea (breathing tube).
Ventilators are used when a person cannot breathe on his or her own or
cannot breathe effectively enough to provide adequate oxygen to the
cells of the body or rid the body of carbon dioxide.
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