Learning the Lingo – Terms Used by Long-Term Care Professionals

Many terms are used in talking about or providing long-term care. Many of these terms vary from state to state. Some of the more common terms are defined below.

Activities of daily living – This phrase refers to activities such as eating, bathing, grooming, getting dressed and going to the bathroom.

Advance Health Care Directive – Also referred to as durable power of attorney or power of attorney for health care. This document identifies who you are allowing to make healthcare decisions for you in the event you are not able to do so for yourself. Copies should be given to your doctor and the person you appoint as your healthcare agent. A health care directive allows a person to spell out whether you want to be an organ donor or the circumstances under which you would wish life support to be discontinued – if ever.

Assessment -- The gathering of information to rate or evaluate your health and needs. An assessment should cover a person’s strengths, abilities, limitations, nutritional status and needs, health conditions, medications, special needs and preferences and concerns. An initial assessment must be done within 14 days of being admitted to a nursing home (or seven days for Medi-Cal residents. It should be updated every year after that. This information must be in writing.

Assisted living facilities – The licensing term for this type of facility is Residential Care Facility for the Elderly (RCFE). These are group living situations where individuals receive help with activities of daily living. Services may include meals, laundry, housekeeping, transportation, medication reminders, and assistance with bathing or toileting. These facilities have no requirement for nursing staff.

Board and care facilities – See assisted living facilities. Licensed as an RCFE usually in small homes in the community housing 6 residents, set up to provide these services.

Care plan – A care plan lays out how the staff will help a person in a nursing home every day. It tells which staff member will do what when for the resident. A care plan must be done within seven days of an initial assessment. It needs to be reviewed regularly to make sure it is working. When needed, it should be revised.

Certified (certification) -- State government agencies inspect health care providers. Such inspections are done of home health agencies, hospitals, nursing homes, and dialysis facilities as well as other health care providers. If the provider passes inspection, it is certified. Medicare or Medicaid only covers care provided by certified providers. Being certified is not the same as being accredited.

Continuing care retirement community (CCRC) -- A housing community that provides different levels of care based on what each resident needs over time. Sometimes this is referred to as life care. It can range from apartment-style living to assisted living to full-time nursing home care. Residents move from one setting to another based on their needs. They continue to live as part of the community. CCRCs usually require a large deposit and charge monthly fees.

Custodial care – This refers to room and board in a nursing home where help with activities of daily living is provided. Custodial care is not covered by Medicare. Medicaid (Medi-Cal) pays for most of this type of care.

Family councils – By law since 1987, the families of nursing home resident have the right to form and hold regular private meetings of a family council. These family councils allow families to influence the quality of care for residents, create good communications with the nursing home staff and to offer support to other relatives and friends of nursing home residents. A nursing home must provide a meeting space and a designated staff person to act as a liaison between the council and the nursing home.

Fire safety deficiency – If during an inspection, a nursing home fails to meet one or more federal, state, Medicare or Medicaid fire safety requirements, it is said to have a fire safety deficiency.

Health deficiency – If during an inspection, a nursing home fails to meet federal or state health laws or requirements, it is said to have a health deficiency. Inspections are done every year. They may also be triggered by a complaint. A finding of a deficiency is based on seeing the nursing home’s performance, practices or conditions.

Long-term care – This phrase refers to a package of services that help people with needs due to health or an inability to do activities of daily living over a period of time. The care can be provided at home or in settings such as nursing homes or assisted living facilities. Most long-term care is custodial care. Medicare does not pay for this type of care.

Nursing home – See Skilled nursing facility (SNF).

Resident councils – By law nursing homes are required to establish and maintain a resident council. A resident council is an independent, organized group of nursing home residents. They meet regularly to talk about concerns, offer suggestion on improving services and to plan social activities. The council gives residents a chance to influence decisions that might affect them and their day-to-day lives. A council can help create good communications with staff. If a nursing home does not have a resident and family council, ask the Administrator why. Ask to talk with the council president to get a sense of how the nursing home has acted on their concerns.

Residential care facility for the elderly (RCFE) – Sometimes these facilities are called assisted living facilities or board and care facilities. They are designed for individuals who do not require skilled nursing care, but could benefit from personal care assistance and support services. This type of facility can range from luxury private apartments to small group homes with shared rooms.

Skilled nursing facility (SNF) – Commonly called nursing homes, skilled nursing facilities offer most intense level of care on the residential care continuum. Skilled nursing facilities (SNFs) provide 24-hour nursing care to help people who are recovering from surgery or have complex medical needs or chronic medical conditions that prevent them from living independently. SNFs must be licensed by the state to meet standards of safety, staffing and care procedures. These facilities are sometimes called convalescent homes, rehabilitation centers or sanitariums.