Helpful Resources for Seniors

Activities of Daily Living (ADLs, ADL)

An individual’s daily habits such as bathing, dressing and eating. ADLs are often used as an assessment tool to determine an individual’s ability to function at home, or in a less restricted environment of care.

Advance Directive

A legal document outlining medical decisions to be made for a person should he or she not be fully capable of deciding for themselves due to the nature of his or her injury or illness. These directives can include Living Wills or Durable Power of Attorney.

Acute Care

A pattern of health care in which a patient is treated for an acute (immediate and severe) episode of illness, for the subsequent treatment of injuries related to an accident or other trauma, or during recovery from surgery. Specialized personnel using complex and sophisticated technical equipment and materials usually give acute care in a hospital. Unlike chronic care, acute care is often necessary for only a short time.

Assisted Living

Broad range of residential care services, but does not include nursing services. Normally lower in cost than nursing homes.

CCRC (Continuing Care Retirement Community)

A campus or community that provides multiple levels of care to residents based on their needs, including independent living, assisted living or skilled nursing care. Residents can move from one level to another based on their needs without having to travel far.

Caregiver

A person who is providing care for someone recovering from an illness, injury or disease.

Case Manager

A nurse, doctor, or social worker who works with patients, providers and insurers to coordinate all services deemed necessary to provide the patient with a plan of medically necessary and appropriate health care.

Census (Occupancy Rate)

A measure of inpatient health facility use, determined by dividing available bed days by patient days. It measures the average percentage of a hospital’s beds occupied and may be institution-wide or specific for one department or service.

Centers for Medicare and Medicaid Services (CMS)

The Centers for Medicare & Medicaid Services (CMS) is a Federal agency within the U.S. Department of Health and Human Services. Programs for which CMS is responsible include Medicare, Medicaid, State Children’s Health Insurance Program (SCHIP), HIPAA and CLIA. Formerly was HCFA. Centers for Medicare & Medicaid Services has historically maintained the UB-92 institutional EMC format specifications, the professional EMC NSF specifications, and specifications for various certifications and authorizations used by the Medicare and Medicaid programs. CMS is responsible for oversight of HIPAA administrative simplification transaction and code sets, health identifiers, and security standards. CMS also maintains the HCPCS medical code set and the Medicare Remittance Advice Remark Codes administrative code set.

Discharge Planning

Required by Medicare and JCAHO for all hospital patients. A procedure where aftercare services are determined for after discharge from the inpatient facility.

Durable Power of Attorney

A legal document that designates a specific individual to act on a person’s behalf should they become disabled or incapacitated.

Entitlements

Various federal and state government programs that provide financial benefits or services to people who meet specific eligible conditions. Entitlement programs include Social Security, Medicare, Medicaid, and more.

Grooming

Washing hair and shaving as needed.

HMO (Health Maintenance Organization)

A type of care plan where a person receives health benefits from a specific network of doctors, hospitals, and other health care providers who receive compensation from a specific insurance company or entitlements program.

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

A Federal law that allows persons to qualify immediately for comparable health insurance coverage when they change their employment relationships. …

Hospice Care

An array of services that provides care for terminally ill patients. Hospice Care also provides support and counseling for families as well. Also see Palliative Care.

Independent Living

A facility for seniors who are healthy, mobile and capable of living on their own. Independent Living Facilities may also offer some level of care should residents need it.

Inpatient Care

Health care provided to an individual in a hospital or other institutional setting.

Length of Stay (LOS)

The duration of an episode of care for a covered person. The number of days an individual stays in a hospital or inpatient facility. May also be reviewed as Average Length of Stay (ALOS).

Long-term Care (LTC)

A set of health care, personal care and social services required by persons who have lost, or never acquired, some degree of functional capacity …

Long-term Care Insurance

Insurance designed to pay for some or all of the costs of long term care.

Managed Care

Systems and techniques used to control the use of health care services …

Medicaid (Title XIX)

A joint federal and state program that helps with medical costs for some people with low incomes and limited resources …

Medicare (Title XVIII)

A federal program for the elderly and disabled, regardless of financial status …

Medicare Part A

The Medicare component that provides basic hospital insurance …

Medicare Part B

The Medicare component that provides benefits to cover the costs of physicians’ professional services …

Medicare Part D

A program to aid with the costs of prescription drug expenses for Medicare beneficiaries.

Medicare Prescription Drug Plan (PDP or MPDP)

A stand-alone drug plan, offered by insurers and other private companies …

Medigap

A Medicare supplement insurance policy sold by private insurance companies to cover areas that are not covered by typical Medicare plans.

Nutritional Management

A care service designed to assist patients with a balanced diet.

Occupational Therapy

Treatment given to help with resuming everyday activities such as bathing, preparing meals and housekeeping following an injury or illness.

Outpatient Care

Care given to a person who is not bedridden; also called ambulatory care …

Oral Hygiene

Brushing teeth or taking care of dentures.

Pain Management

A care service designed to assist patients with the prevention and treatment of pain.

Palliative Care

An array of services that provides care for terminally ill patients. Palliative Care also provides support and counseling for families as well. Also see Hospice Care.

Physical Therapy

Treatment of injury and disease via exercise, massage and other physical activities.

Post-Acute Care

Medical care specifically designed to help a patient recover after a hospital stay.

Public Aid

An entitlements program where the government provides financial benefits to the poor, elderly, or disabled.

Referral

The process of sending a patient from one practitioner to another for health care services …

Rehabilitation

Rehabilitative services are normally ordered by a doctor to help a patient recover from an illness or injury …

Respite Care

A care service designed to give the everyday caregiver a rest or break …

Restorative Nursing

A nursing program designed to assist persons who have a debilitating illness or injury …

Secondary Coverage

Health plan that pays costs not covered by primary coverage under coordination of benefits rules …

Skilled Care

A type of health care given when a patient needs skilled nursing or rehabilitation staff to manage, observe, and evaluate care …

Skilled Nursing Care

A level of care that includes services that can only be performed safely and correctly by a licensed nurse …

Skilled Nursing Facility (SNF)

A licensed institution, as defined by Medicare, which is primarily engaged in the provision of skilled nursing care …

Speech Therapy

Treatment to regain and strengthen speech skills typically following a stroke or other neurological injuries.

Sub-Acute Care

An inpatient care service for those recovering from an illness, injury, or disease who do not need to be treated for immediate or acute conditions.

Toileting

Maintaining control of bowels and bladder or independently managing incontinence issues.

Transferring

Walking from place to place as necessary, or at the very least, being capable of transferring from the bed to the walker or the wheelchair and back.

Transitional Care

A care service designed to provide health care to a patient during a transition from one healthcare setting to another, typically at a hospital, skilled nursing facility or the patient’s home.

TriCare

A health care program for active duty and/or retired uniformed service members, as well as their families.