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Glossary of Terms

Term Definition


The gathering of information to rate or evaluate your health and needs, such as in a nursing home.

Automatic Sprinkler Systems

One way to make nursing homes safe is to install a water sprinkler system in case of fire. These systems are called “automatic sprinkler systems.”

Currently, newly constructed and recently remodeled nursing homes must have water sprinkler systems to put out fires. Federal Rules require that by 2013, all nursing homes must be fully sprinklered. “Fully sprinklered” means sprinklers are installed throughout the nursing home.

Since March 2005, Federal rules also have required that nursing homes install battery-operated smoke alarms in all patient rooms and public areas. Local building codes may also require some nursing homes to have an automatic sprinkler system.

Note: While comparing nursing homes, it’s important for you to ask the nursing home about its sprinkler system.

Centers for Medicare and Medicaid Services (CMS)

The federal agency that runs the Medicare program. In addition, CMS works with the states to run the Medicaid program. CMS works to make sure that people with Medicare and/or Medicaid are able to get high quality health care.

Certified (Certification)

State government agencies inspect health care providers, including home health agencies, hospitals, nursing homes, and dialysis facilities home health agencies, as well as other health care providers. These providers are certified if they pass inspection. Being certified is not the same as being accredited. Medicare or Medicaid only covers care by certified providers or in a certified facility or program.

Continuing Care Retirement Community (CCRC)

A housing community that offers different levels of care based on what each resident needs over time. This is sometimes called “life care” and can range from independent living in an apartment to assisted living to full-time care in a nursing home. Residents move from one setting to another based on their needs but continue to live as part of the community. Care in CCRCs is usually expensive. Generally, CCRCs require a large payment before you move in and charge monthly fees.

Date of Last Change of Ownership

Date the most recent change of ownership occurred.


Dementia refers to a group of symptoms that are caused by changes in brain function. Signs of dementia include changes in memory, personality, and behavior. Dementia makes it hard for a person to carry out normal daily activities.

Fire Safety Deficiency

A finding that a nursing home failed to meet one or more Federal fire safety requirements.

Health Deficiency

A finding that a nursing home failed to meet one or more Federal health requirements during an annual health inspection or a complaint inspection. Inspectors identify health deficiencies by observing the nursing home’s performance, practices or conditions in the facility.

Initial Date of Certification

The date that Medicare or Medicaid certified that the nursing home met all the requirements to provide nursing home care. This date may differ from the date the state licensed the agency. This date is associated with the current Medicare and/or Medicaid CMS certification number. A nursing home may request to change their CMS certification number if there is a change in owner. You should contact the agency to find out how long it has been in the Medicare and/or Medicaid program.

Long Term Care

A “variety” of services that help people with health or personal needs and activities of daily living over a period of time. Long-term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities. Most long-term care services help with activities of daily living, such as eating, bathing, dressing or moving about. Medicare doesn’t pay for such care unless it’s part of certain short-term stays following hospitalization.


A joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.


The federal health insurance program for people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure with dialysis or a transplant, sometimes called ESRD).

Multi-nursing home (chain) ownership

Multi-nursing home chains have two or more homes under one ownership or operation.

New Owner

If a nursing home’s owner changed in the last 12 months, you will see the term “new owner” where applicable. This information may be of interest to you when visiting a nursing home.

Number of Certified Beds

Some nursing homes can have a combination of Medicare, Medicaid, and/or private pay beds. Certified beds represent the number of Medicare and/or Medicaid beds. Please check with the nursing home to find out what types of beds are available.

Nursing Home

Nursing home is a term that includes both skilled nursing facilities and nursing facilities. Skilled nursing facilities (SNF) are those that participate in both Medicare and Medicaid. Nursing facilities (NF) are those that participate in Medicaid only.

Nursing homes primarily engage in providing residents skilled nursing care and related services for residents who require medical or nursing care and rehabilitation services for the rehabilitation of injured, disabled, or sick persons.

Participates in Medicaid

This nursing home participates in the Medicaid program and can care for people with Medicaid. If a nursing home doesn’t participate in the Medicaid program or no longer participates in the Medicaid program, and the resident runs out of other funds/coverage, the resident will have to move to another nursing home if he/she wants to be on Medicaid.

Participates in Medicare

This nursing home participates in the Medicare program and can care for people with Medicare who meet certain requirements for skilled care. Generally Medicare covers short stays.

Quality Indicator Survey process

The Quality Indicator Survey (QIS) process and the traditional standard survey are the two types of surveys approved by CMS to determine compliance with Medicare/Medicaid requirements. The QIS uses a structured review of the medical records and direct observations of the care of larger samples of residents to derive rates for a comprehensive set of Quality of Care Indicators (QCIs). Surveyors then investigate care areas that have been triggered for review by the QCIs. The QIS process is being pilot tested in several states.

Quality Measures

The nursing home quality measures come from resident assessment data that nursing homes routinely collect on all residents at specified intervals during their stay. These data are converted into quality measures that give you another source of information about how well nursing homes are caring for their residents' physical and clinical needs. The quality measures have four intended purposes:

  1. To give information about the care at nursing homes to help you choose a nursing home for yourself or others
  2. To give you information about the care at nursing homes where you or family members already live
  3. To get you to talk to nursing home staff about the quality of care
  4. To give data to the nursing home to help them with their quality improvement efforts

The current quality measures aren’t benchmarks, thresholds, guidelines, or standards of care. They are based on care provided to the population of residents in a facility, not to any individual resident, and aren’t appropriate for use in a lawsuit.

Resident and Family Councils

Resident and family councils can facilitate communications with staff. The law requires nursing homes to allow councils to be set up by residents and families. If a nursing home doesn’t have a resident and family council, ask the administrator why. Ask to talk with council presidents to get a sense of how the nursing home has acted on their concerns.

Special Focus Facility (SFF)

A Special Focus Facility is a nursing home with a recent history of persistent poor quality of care, as indicated by the findings of state or Federal inspection teams. Based on inspection findings for the most recent three-year period, CMS selects a group of nursing homes with the worst repeated inspections as SFFs.

Sometimes a nursing home will fix a sufficient number of problems in order to pass one inspection, only to fail the next one. Often, many of these same problems show up in inspections again and again. This is a sign that the nursing home didn’t address the underlying problems that were causing these repeated serious deficiencies.

Many SFFs respond to the recognition of their past poor performance by making concerted efforts to improve. CMS records indicate that approximately 50% of SFFs significantly improve their quality of care within the subsequent 30 months.

Total Number of Residents

The number of residents in the nursing home during the 3-week period prior to the recent inspection. This number is used in the nursing home staffing calculations. This number only captures a specific point in time.

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Page Last Updated: December 17, 2008