This glossary is available to give you general information about words and terms associated with aging, disability or long-term care. Many sources have been used to compile this list. To find a term, select the first letter of the word/term you are seeking.
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Accessibility
As required by the
Americans with Disabilities Act, removal of barriers that would hinder a person
with a disability from entering, functioning, and working within a facility.
Required restructuring of the facility cannot cause undue hardship for the
employer.
Accreditation
A process whereby a
program of study or an institution is recognized by an external body as meeting
certain predetermined standards. For facilities, accreditation standards are
usually defined in terms of physical plant, governing body, administration, and
medical and other staff. Accreditation is often carried out by organizations
created for the purpose of assuring the public of the quality of the accredited
institution or program. The state or federal governments can recognize
accreditation in lieu of, or as the basis for licensure or other mandatory
approvals. Public or private payment programs often require accreditation as a
condition of payment for covered services. Accreditation may either be
permanent or may be given for a specified period of time.
Activities of Daily Living (ADLs)
Basic
personal activities which include bathing, eating, dressing, mobility,
transferring from bed to chair, and using the toilet. ADLs are used to measure
how dependent a person may be on requiring assistance in performing any or all
of these activities. (Information about activities of daily living can be located on our
Site Index.)
Acute Care
Care that is generally provided
for a short period of time to treat a certain illness or condition. This type
of care can include short-term hospital stays, doctor's visits, surgery, and
X-rays.
Acute Illness
Illness that is usually
short-term and that often comes on quickly.
Adult Care Home
(Also called board
and care home or group home.) Residence which offers
housing and personal care services for 3 to 16 residents. Services (such as
meals, supervision, and transportation) are usually provided by the owner or
manager. May be single family home. (Licensed as adult family home or
adult group home.)
Adult Day Care
A daytime community-based
program for functionally impaired adults that provides a variety of health,
social, and related support services in a protective setting.
Age Discrimination in Employment Act
(ADEA)
A 1967 federal law that prohibits employers with 20 or more
employees from discriminating on the basis of age in hiring, job retention,
compensation, and benefits. ADEA also sets requirements for the duration of
employer-provided disability benefits.
Alzheimer's Disease
A progressive,
irreversible disease characterized by degeneration of the brain cells and serve
loss of memory, causing the individual to become dysfunctional and dependent
upon others for basic living needs.
Ambulatory Care
All types of health
services which are provided on an outpatient basis, in contrast to services
provided in the home or to persons who are inpatients. While many inpatients
may be ambulatory, the term ambulatory care usually implies that the patient
must travel to a location to receive services which do not require an overnight
stay.
Area Agency on Aging (AAA)
A local (city or
county) agency, funded under the federal Older Americans Act, that plans and
coordinates various social and health service programs for persons 60 years of
age or more. The network of AAA offices consists of more than 600 approved
agencies.
Assisted Living
Residences that provide
a "home with services" and that emphasize residents' privacy and choice.
Residents typically have private locking rooms (only shared by choice) and
bathrooms. Personal care services are available on a 24-hour-a-day basis.
(Licensed as residential care facilities or as rest homes.)
(Information about assisted living can
be located on our Site Index.)
Assistive Devices
Tools that enable
individuals with disabilities to perform essential job functions, e.g.,
telephone headsets, adapted computer keyboards, enhanced computer monitors.
(Information about assistive
device/technology can be located on our Site Index.)
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Board and Care Home
(Also called
adult care home or group home.) Residence which
offers housing and personal care services for 3 to 16 residents. Services (such
as meals, supervision, and transportation) are usually provided by the owner or
manager. May be single family home. (Licensed as adult family home or
adult group home.)
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Capitation
A method of payment for
health services in which the provider is paid a fixed amount for each patient
without regard to the actual number or nature of services provided. Capitation
payments are charactistic of health maintenance organizations (HMOs). Also, a
method of public support of health professional schools in which eligible
schools receive a fixed grant for each student enrolled.
Care Plan
(Also called service
plan or treatment plan.) Written document which outlines
the types and frequency of the long-term care services that a consumer
receives. It may include treatment goals for him or her for a specified time
period.
Caregiver
Person who provides support
and assistance with various activities to a family member, friend, or neighbor.
May provide emotional or financial support, as well as hands-on help with
different tasks. Caregiving may also be done from long distance.
(Information about caregiver/caregiving can be located on our
Site Index.)
Care/Case Management
Offers a single point
of entry to the aging services network. Care/case management assess clients'
needs, create service plans, and coordinate and monitor services; they may
operate privately or may be employed by social service agencies or public
programs. Typically case managers are nurses or social workers. (Information
about care/case management can be located on
our Site Index.)
Case Mix
A method by which a health care
provider measures the service needs of the patient population, and may be based
on age, medical diagnosis, severity of illness, or length of stay. A nursing
home or hospital's actual case mix influences cost and scope of the services
provided by the facility to the patient, and case mix reimbursement systems
adjust payment rates accordingly.
Certificate of Need (CON)
A certificate
issued by a government body to a health care provider who is proposing to
construct, modify, or expand facilities, or to offer new or different types of
health services. CON is intended to prevent duplication of services and
overbedding. The certificate signifies that the change has been approved.
Chore Services
Help with chores such as
home repairs, yard work, and heavy housecleaning.
Chronic Care
Care and treatment given to
individuals whose health problems are of a long-term and continuing nature.
Rehabilitation facilities, nursing homes, and mental hospitals may be
considered chronic care facilities. (Information about
chronic care/illness can be located on our
Site Index.)
Chronic Illness
Long-term or permanent
illness (e.g., diabetes, arthritis) which often results in some type of
disability and which may require a person to seek help with various activities.
(Information about chronic care/illness
can be located on our Site Index.)
Civilian Health and Medical Program of the
Uniformed Services (CHAMPUS)
A Department of Defense program
supporting private sector care for military dependents.
Co-Insurance
(Also called
co-payment.) The specified portion (dollar amount or percentage)
that Medicare, health insurance, or a service program may require a person to
pay toward his or her medical bills or services.
Co-Payment
(Also called
co-insurance.) The specified portion (dollar amount or
percentage) that Medicare, health insurance, or a service program may require a
person to pay toward his or her medical bills or services.
Cognitive Impairment
Deterioration or
loss of intellectual capacity which requires continual supervision to protect
the insured or others, as measured by clinical evidence and standardized tests
that reliably measure impairment in the area of (1) short or long-term memory,
(2) orientation as to person, place and time, or (3) deductive or abstract
reasoning. Such loss in intellectual capacity can result from Alzheimer's
disease or similar forms of senility or Irreversible Dementia. (Information
about cognitive impairment can be located
on our Site Index.)
Community Health Center
(Also called
neighborhood health center.) An ambulatory health care program
usually serving a catchment area which has scarce or nonexistent health
services or a population with special health needs. These centers attempt to
coordinate federal, state, and local resources in a single organization capable
of delivering both health and related social services to a defined population.
While such a center may not directly provide all types of health care, it
usually takes responsibility to arrange all medical services needed by its
patient population.
Community-Based Services
services
designed to help older people remain independent and in their own homes; can
include senior centers, transportation, delivered meals or congregate meals
site, visiting nurses or home health aides, adult day care, and homemaker
services. (Information about community
based care/services can be located on our Site Index.)
Conditions of Participation (COP)
Standards
a facility or supplier of services, desiring to participate in the Medicare or
Medicaid program, is required to meet. These conditions include meeting a
statutory definition of the particular institution or facility, conforming with
state and local laws and having an acceptable utilization review plan. Surveys
to determine whether facilities meet conditions of participation are made by
the appropriate state health agency.
Congregate Housing
Individual
apartments in which residents may receive some services, such as a daily meal
with other tenants. (Other services may be included as well.) Buildings usually
have some common areas such as a dining room and lounge as well as additional
safety measures such as emergency call buttons. May be rent-subsidized (known
as Section 8 housing).
Continuing Care Retirement Community
(CCRC)
communities which offer multiple levels of care (independent
living, assisted living, skilled nursing care) housed in different areas of the
same community or campus and which give residents the opportunity to remain in
the same community if their needs change. Provide residential services (meals,
housekeeping, laundry), social and recreational services, health care services,
personal care, and nursing care. Require payment of a monthly fee and possibly
a large lump-sum entrance fee. (Licensed as nursing homes/residential care
facilities or as homes for the aging.)
Continuum of Care
The entire spectrum
of specialized health, rehabilitative, and residential services available to
the frail and chronically ill. The services focus on the social, residential,
rehabilitative and supportive needs of individuals as well as needs that are
essentially medical in nature.
Cost Containment
A set of steps to control
or reduce inefficiencies in the consumption, allocation, or production of
health care services which contribute to higher than necessary costs.
Inefficiencies in consumption can occur when health services are
inappropriately utilized; inefficiencies in allocation exist when health
services could be delivered in less costly settings without loss of quality;
and inefficiencies in production exist when the cost of producing health
services could be reduced by using a different combination of resources.
Cost of Living Adjustment (COLA)
increase
to a monthly long-term disability benefit, usually after the first year of
payments. May be a flat percentage (e.g., 3%) or tied to changes in inflation.
In some states, workers' compensation income replacement benefits also include
annual COLAs.
Custodial Care
Care that does not
require specialized training or services. (See also personal care.)
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Deinstitutionalization
Policy which
calls for the provision of supportive care and treatment for medically and
socially dependent individuals in the community rather than in an institutional
setting.
Dementia
Term which describes a group
of diseases (including Alzheimer's Disease) which are characterized by memory
loss and other declines in mental functioning. (Information about
dementia can be located on our Site
Index.)
Developmental Disability (DD)
A disability
which originates before age 18, can be expected to continue indefinitely, and
constitutes a substantial handicap to the disabled's ability to function
normally. (Information about developmental disability can be located
on our Site Index.)
Diagnosis-Related Group (DRG)
A
classification system which uses diagnosis information to establish hospital
payments under Medicare. This system groups patient needs into 467 categories,
based upon the coding system of the International Classification of Disease,
Ninth Revision-Clinical Modification (ICD-9-CM).
Diagnostic and Statistical Manual of Mental Disorders
(DSM)
A tool used by the medical and psychological communities to
identify and classify behavioral, cognitive, and emotional problems according
to a standard numerical coding system of mental disorders.
Direct Cost
A cost which is identifiable
directly with a particular activity, service, or product of the program
experiencing the costs. These costs do not include the allocation of costs to a
cost center which are not specifically attributable to that cost center.
Disability
The limitation of normal
physical, mental, social activity of an individual. There are varying types
(functional, occupational, learning), degrees (partial, total), and durations
(temporary, permanent) of disability. Benefits are often available only for
specific disabilities, such as total and permanent (the requirement for Social
Security and Medicare). (Information about
disability can be located on our Site
Index.)
Discharge
A formal termination of
inpatient care.
Durable Medical Equipment (DME)
(Also called
home medical equipment.) Equipment such as hospital beds,
wheelchairs, and prosthetics used at home. May be covered by Medicaid and in
part by Medicare or private insurance.
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Early and Periodic Screening, Diagnosis, and
Treatment Program (EPSDT)
A program mandated by law as part of the
Medicaid program. The law requires that all states have in effect a program for
eligible children under age 21 to ascretain their physical or mental defects
and to provide such health care treatments and other measures to correct or
ameliorate defects and chronic conditions discovered. The state programs also
have active outreach components to inform eligible persons of the benefits
available to them, to provide screening, and if necessary, to assist in
obtaining appropriate treatment.
Emergency Medical Services (EMS)
Services
utilized in responding to the perceived individual need for immediate treatment
for medical, physiological, or psychological illness or injury.
Employee Retirement Income Security Act
(ERISA)
A federal act, passed in 1974, that established new
standards and reporting/disclosure requirements for employer-funded pension and
health benefit programs.
Epidemiology
The study of the
patterns of determinants and antecedents of disease in human populations. It
utilizes biology, clinical medicine, and statistics in an effort to understand
the etiology (causes) of illness and/or disease. The ultimate goal of the
epidemiologist is not merely to identify underlying causes of a disease but to
apply findings to disease prevention and health promotion.
Escort Services
(Also called
transportation services.) Provides transportation for older
adults to services and appointments. May use bus, taxi, volunteer drivers, or
van services that can accommodate wheelchairs and persons with other special
needs.
Estate Recovery
By law states are
required to recover funds from certain deceased Medicaid recipients' estates up
to the amount spent by the state for all Medicaid services (e.g., nursing
facility, home and community-based services, hospital, and prescription
costs).
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Family and Medical Leave Act (FMLA)
A 1993
federal law requiring employers with more than 50 employees to provide eligible
workers up to 12 weeks of unpaid leave for birth, adoptions, foster care
placement, and illnesses of employees and their families.
Fee Schedule
A list of physician services
in which each entry is associated with a specific monetary amount that
represents the approved payment level for a given insurance plan.
Fee-for-Service
The way traditional Medicare
and health insurance work. Medical providers bill for whatever service they
provide. Medicare and/or traditional insurance pay their share, and the patient
pays the balance through co-payments and deductibles.
For-Profit
Organization or company in which
profits are distributed to shareholders or private owners.
Functionally Disabled
A person with
a physical or mental impairment that limits the individual's capacity for
independent living.
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Geriatrician
Physician who is
certified in the care of older people.
Geriatrics
Medical specialty focusing
on treatment of health problems of the elderly. (Information about
geriatrics/gerontology can be located on
our Site Index.)
Gerontology
Study of the biological,
psychological and social processes of aging. (Information about
geriatrics/gerontology can be located on
our Site Index.)
Group Home
(Also called adult care
home or board and care home.) Residence which offers
housing and personal care services for 3 to 16 residents. Services (such as
meals, supervision, and transportation) are usually provided by the owner or
manager. May be single family home. (Licensed as adult family home or
adult group home.)
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Handicapped
As defined by Section
504 of the Rehabilitation Act of 1973, any person who has a physical or mental
impairment which substantially limits one or more major life activity, has a
record of such impairment, or is regarded as having such an impairment.
Health
The state of complete physical,
mental, and social well-being and not merely the absence of disease or
infirmity. It is recognized, however, that health has many dimensions
(anatomical, physiological, and mental) and is largely culturally defined. The
relative importance of various disabilities will differ depending upon the
cultural milieu and the role of the affected individual in that culture. Most
attempts at measurement have been assessed in terms or morbidity and mortality.
(Information about health can be located
on our Site Index.)
Health Insurance
financial protection
against the medical care costs arising from disease or accidental bodily
injury. Such insurance usually covers all or part of the medical costs of
treating the disease or injury. Insurance may be obtained on either an
individual or a group basis.
Health Insurance Portability and Accountability Act
(HIPAA)
federal health insurance legislation passed in 1996, which
sets standards for access, portability, and renewability that apply to group
coverage--both fully insured and self-funded--as well as to individual
coverage. HIPAA allows under specified conditions, for long-term care insurance
policies to be qualified for certain tax benefits under Section 7702(b) of the
Internal Revenue Code.
Health Maintenance Organization
(HMO)
Managed care organization that offers a range of health
services to its members for a set rate, but which requires its members to use
health care professionals who are part of its network of providers. (See also
Medicare HMOs.)
Home and Community-Based Waivers
Section
2176 of the Omnibus Reconciliation Act permits states to offer, under a waiver,
a wide array of home and community-based services that an individual may need
to avoid institutionalization. Regulations to implement the act list the
following services as community and home-based services which may be offered
under the waiver program: case management, homemaker, home health aide,
personal care, adult day health care, habilitation, respite care and other
services.
Home Health Agency (HHA)
A public or private
organization that provides home health services supervised by a licensed health
professional in the patient's home either directly or through arrangements with
other organizations.
Home Health Aide
A person who, under the
supervision of a home health or social service agency, assists elderly, ill or
disabled person with household chores, bathing, personal care, and other daily
living needs. Social service agency personnel are sometimes called personal
care aides.
Home Health Care
Includes a wide range of
health-related services such as assistance with medications, wound care,
intravenous (IV) therapy, and help with basic needs such as bathing, dressing,
mobility, etc., which are delivered at a person's home.
Home Medical Equipment
(Also called
durable medical equipment.) Equipment such as hospital beds,
wheelchairs, and prosthetics used at home. May be covered by Medicaid and in
part by Medicare or private insurance.
Homebound
One of the requirements to
qualify for Medicare home health care. Means that someone is generally unable
to leave the house, and if they do leave home, it is only for a short time
(e.g., for a medical appointment) and requires much effort.
Homemaker Services
In-home help with
meal preparation, shopping, light housekeeping, money management, personal
hygiene and grooming, and laundry.
Hospice
A program which provides
palliative and supportive care for terminally ill patients and their families,
either directly or on a consulting basis with the patient's physician or
another community agency. The whole family is considered the unit of care, and
care extends through their period of mourning. (Information about
hospice can be located on our Site
Index.)
Hospice Care
Services for the
terminally ill provided in the home, a hospital, or a long-term care facility.
Includes home health services, volunteer support, grief counseling, and pain
management.
Hospital
An institution whose primary
function is to provide inpatient diagnostic and therapeutic services for a
variety of medical conditions, both surgical and nonsurgical.
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Impairment
Any loss or abnormality of
psychological, physiological, or anatomical function.
Independent Living Facility
Rental
units in which services are not included as part of the rent, although services
may be available on site and may be purchased by residents for an additional
fee.
Indigent Care
Health services provided
to the poor or those unable to pay. Since many indigent patients are not
eligible for federal or state programs, the costs which are covered by Medicaid
are generally recorded separately from indigent care costs.
Indirect Cost
Cost which cannot be
identified directly with a particular activity, service or product of the
program experiencing the cost. Indirect costs are usually apportioned among the
program's services in proportion to each service's share of direct costs.
Inpatient
A person who has been
admitted at least overnight to a hospital or other health facility (which is
therefore responsible for his or her room and board) for the purpose of
receiving diagnostic treatment or other health services.
Institutional Health
Services
Health services delivered on an inpatient basis in
hospitals, nursing homes, or other inpatient institutions. The term may also
refer to services delivered on an outpatient basis by departments or other
organizational units of, or sponsored by, such institutions.
Instrumental Activities of Daily Living
(IADLs)
Household/independent living tasks which include using the
telephone, taking medications, money management, housework, meal preparation,
laundry, and grocery shopping.
Intermediate Care
Occasional
nursing and rehabilitative care ordered by a doctor and performed or supervised
by skilled medical personnel.
Intermediate Care Facility (ICF)
A nursing
home, recognized under the Medicaid program, which provides health-related care
and services to individuals who do not require acute or skilled nursing care,
but who, because of their mental or physical condition, require care and
services above the level of room and board available only through facility
placement. Specific requirements for ICF's vary by state. Institutions for care
of the mentally retarded or people with related conditions (ICF/MR) are also
included. The distinction between "health-related care and services" and "room
and board" is important since ICF's are subject to different regulations and
coverage requirements than institutions which do not provide health-related
care and services.
Intermediate Care Facility for the Mentally Retarded
(ICF/MR)
An ICF which cares specifically for the mentally
retarded.
International Classification of Diseases, ninth
edition (Clinical Modification) (ICD-9-CM)
A list of diagnoses and
identifying codes used by physicians and other health care providers. The
coding and terminology provide a uniform language that permits consistent
communication on claim forms.
International Classification of Functioning,
Disability and Health (ICF)
An internationally standardized list of
identifying codes and definitions of human functioning and disabilities
organized by body functions and structures, domains of activities and
participation, and environmental factors. The coding and terminology provide a
uniform language that permits consistent communication on claim forms.
Inventory
A detailed description of
quantities and locations of different kinds of facilities, major equipment, and
personnel which are available in a geographic area and the amount, type, and
distribution of services these resources can support.
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Level of Care (LOC)
Amount of assistance
required by consumers which may determine their eligibility for programs and
services. Levels include: protective, intermediate, and skilled.
License/Licensure
A permission granted
to an individual or organization by a competent authority, usually public, to a
engage lawfully in a practice, occupation, or activity.
Long-Term Care (LTC)
Range of medical and/or
social services designed to help people who have disabilities or chronic care
needs. Services may be short- or long-term and may be provided in a person's
home, in the community, or in residential facilities (e.g., nursing homes or
assisted living facilities). (Information about long-term care can be located on our Site
Index.)
Long-Term Care Insurance
Insurance policies
which pay for long-term care services (such as nursing home and home care) that
Medicare and Medigap policies do not cover. Policies vary in terms of what they
will cover, and may be expensive. Coverage may be denied based on health status
or age. (Information about long-term care
insurance can be located on our Site Index.)
Long-Term Care Ombudsman
An individual
designated by a state or a substate unit responsible for investigating and
resolving complaints made by or for older people in long-term care facilities.
Also responsible for monitoring federal and state policies that relate to
long-term care facilities, for providing information to the public about the
problems of older people in facilities, and for training volunteers to help in
the ombudsman program. The long-term care ombudsman program is authorized by
Title III of the Older Americans Act.
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Managed Care
Method of organizing and
financing health care services which emphasizes cost-effectiveness and
coordination of care. Managed care organizations (including HMOs, PPOs, and
PSOs) receive a fixed amount of money per client/member per month (called a
capitation), no matter how much care a member needs during that month.
(Information about managed care can be
located on our Site Index.)
Medicaid (Title XIX)
Federal and
state-funded program of medical assistance to low-income individuals of all
ages. There are income eligibility requirements for Medicaid. (Information
about Medicaid can be located on our Site
Index.)
Medical Necessity
Services or supplies
which are appropriate and consistent with the diagnosis in accord with accepted
standards of community practice and are not considered experimental. They also
can not be omitted without adversely affecting the individual's condition or
the quality of medical care.
Medically Indigent
People who cannot
afford needed health care because of insufficient income and/or lack of
adequate health insurance.
Medicare (Title XVIII)
Federal health
insurance program for persons age 65 and over (and certain disabled persons
under age 65). Consists of 2 parts: Part A (hospital insurance) and Part B
(optional medical insurance which covers physicians' services and outpatient
care in part and which requires beneficiaries to pay a monthly premium).
(Information about Medicare can be
located on our Site Index.)
Medicare HMOs
Under Medicare HMOs
(health maintenance organizations), members pay their regular monthly premiums
to Medicare, and Medicare pays the HMO a fixed sum of money each month to
provide Medicare benefits (e.g., hospitalization, doctor's visits, and more).
Medicare HMOs may provide extra benefits over and above regular Medicare
benefits (such as prescription drug coverage, eyeglasses, and more). Members do
not pay Medicare deductibles and co-payments; however, the HMO may require them
to pay an additional monthly premium and co-payments for some services. If
members use providers outside the HMO's network, they pay the entire bill
themselves unless the plan has a point of service option.
Medicare Supplement Insurance
(MedSupp)
(Also called Medigap.) Insurance supplement
to Medicare that is designed to fill in the "gaps" left by Medicare (such as
co-payments). May pay for some limited long-term care expenses, depending on
the benefits package purchased.
Medigap
(Also called Medicare
supplement insurance. Insurance supplement to Medicare that is designed
to fill in the "gaps" left by Medicare (such as co-payments). May pay for some
limited long-term care expenses, depending on the benefits package
purchased.
Mental Health
The capacity in an
individual to function effectively in society. Mental health is a concept
influenced by biological, environmental, emotional, and cultural factors and is
highly variable in definition, depending on time and place. It is often defined
in practice as the absence of any identifiable or significant mental disorder
and sometimes improperly used as a synonym for mental illness.
Mental Health Services
Variety of
services provided to people of all ages, including counseling, psychotherapy,
psychiatric services, crisis intervention, and support groups. Issues addressed
include depression, grief, anxiety, stress, as well as severe mental
illnesses.
Mental Illness/Impairment
A deficiency
in the ability to think, perceive, reason, or remember, resulting in loss of
the ability to take care of one's daily living needs. (Information about
mental disability/illness can be located on
our Site Index.)
Morbidity
The extent of illness,
injury, or disability in a defined population. It is usually expressed in
general or specific rates of incidence or prevalence.
Mortality
Death. Used to describe the
relation of deaths to the population in which they occur. (Information about
mortality can be located on our Site
Index.)
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Neighborhood Health Center
(Also
called community health center.) An ambulatory health care
program usually serving a catchment area which has scarce or nonexistent health
services or a population with special health needs. These centers attempt to
coordinate federal, state, and local resources in a single organization capable
of delivering both health and related social services to a defined population.
While such a center may not directly provide all types of health care, it
usually takes responsibility to arrange all medical services needed by its
patient population.
Nonprofit/Not-For-Profit
An
organization that reinvests all profits back into that organization.
Nurse
An individual trained to care for
the sick, aged, or injured. Can be defined as a professional qualified by
education and authorized by law to practice nursing.
Nurse Practitioner (NP)
A registered nurse
working in an expanded nursing role, usually with a focus on meeting primary
health care needs. NPs conduct physical examinations, interpret laboratory
results, select plans of treatment, identify medication requirements, and
perform certain medical management activities for selected health conditions.
Some NPs specialize in geriatric care.
Nursing Home
Facility licensed by the
state to offer residents personal care as well as skilled nursing care on a 24
hour a day basis. Provides nursing care, personal care, room and board,
supervision, medication, therapies and rehabilitation. Rooms are often shared,
and communal dining is common. (Licensed as nursing homes, county
homes, or nursing homes/residential care facilities.)
(Information about nursing facility/home
can be located on our Site Index.)
Nursing Home Care
Full-time care
delivered in a facility designed for recovery from a hospital, treatment, or
assistance with common daily activities.
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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.
Occupational Health Services
Health
services concerned with the physical, mental, and social well-being of an
individual in relation to his or her working environment and with the
adjustment of individuals to their work. The term applies to more than the
safety of the workplace and includes health and job satisfaction.
Occupational Therapy (OT)
Designed to help
patients improve their independence with activities of daily living through
rehabilitation, exercises, and the use of assistive devices. May be covered in
part by Medicare.
Older Americans Act (OAA)
Federal
legislation that specifically addresses the needs of older adults in the United
States. Provides some funding for aging services (such as home-delivered meals,
congregate meals, senior center, employment programs). Creates the structure of
federal, state, and local agencies that oversee aging services programs. (See
also Title III services.)
Ombudsman
A representative of a public
agency or a private nonprofit organization who investigates and resolves
complaints made by or on behalf of older individuals who are residents of
long-term care facilities.
Omnibus Budget Reconciliation Act (OBRA) of
1993
Federal legislation that limits the amount of compensation that
can be paid to employees covered by long-term disability plans funded through
voluntary employees' beneficiary association trusts. Any such plan with
participants earning more than $150,000 could lose its tax-exempt status.
Outpatient
A patient who is receiving
ambulatory care at a hospital or other facility without being admitted to the
facility. Usually, it does not mean people receiving services from a
physician's office or other program which also does not provide inpatient
care.
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Peer Review
Generally, the evaluation by
practicing physicians or other professionals of the effectiveness and
efficiency of services ordered or performed by other members of the profession
(peers).
Personal Care
(Also called
custodial care.) Assistance with activities of daily living as
well as with self-administration of medications and preparing special diets.
(Information about personal assistance/care
services can be located on our Site Index.)
Physical Therapy (PT)
Designed to
restore/improve movement and strength in people whose mobility has been
impaired by injury and disease. May include exercise, massage, water therapy,
and assistive devices. May be covered in part by Medicare.
Physician Assistant (PA)
(Also known as a
physician extender.) A specially trained and licensed or
otherwise credentialed individual who performs tasks, which might otherwise be
performed by a physician, under the direction of a supervising physician.
Point of Service
A health insurance
benefits program in which subscribers can select between different delivery
systems (i.e., HMO, PPO and fee-for-service) when in need of medical services,
rather than making the selection between delivery systems at time of open
enrollment at place of employment.
Post-Acute Care (PAC)
(Also called
subacute care or transitional care.) Type of
short-term care provided by many long-term care facilities and hospitals which
may include rehabilitation services, specialized care for certain conditions
(such as stroke and diabetes) and/or post-surgical care and other services
associated with the transition between the hospital and home. Residents on
these units often have been hospitalized recently and typically have more
complicated medical needs. The goal of subacute care is to discharge residents
to their homes or to a lower level of care. (Information about
post acute care/services can be located on our
Site Index.)
Pre-Admission Certification
A
process under which admission to a health institution is reviewed in advance to
determine need and appropriateness and to authorize a length of stay consistent
with norms for the evaluation.
Pre-Existing Condition
Illnesses or
disability for which the insured was treated or advised within a stipulated
time period before making application for a life or health insurance policy. A
pre-existing condition can result in cancellation of the policy.
Preferred Provider Arrangement
(PPA)
Selective contracting with a limited number of health care
providers, often at reduced or pre-negotiated rates of payment.
Preferred Provider Organization
(PPO)
Managed care organization that operates in a similar manner to
an HMO or Medicare HMO except that this type of plan has a larger provider
network and does not require members to receive approval from their primary
care physician before seeing a specialist. It is also possible to use doctors
outside the network, although there may be a higher co-payment.
Premium
The periodic payment (e.g.,
monthly, quarterly) required to keep an insurance policy in force.
Prepayment
Usually refers to any
payment to a provider for anticipated services (such as an expectant mother
paying in advance for maternity care).
Preventive Medicine
Care which has
the aim of preventing disease or its consequences. It includes health care
programs aimed at warding off illnesses (e.g., immunizations), early detection
of disease (e.g., Pap smears), and inhibiting further deterioration of the body
(e.g., exercise or prophylactic surgery). Preventive medicine is also concerned
with general prevention measures aimed at improving the healthfulness of the
environment. (Information about prevention/preventive can be located on our
Site Index.)
Primary Care
Basic or general health
care focused on the point at which a patient ideally first seeks assistance
from the medical care system.
Probability (P value)
The likelihood
that an event will occur.
Prospective Payment
Any method of
paying hospitals or other health programs in which amounts or rates of payment
are established in advance for a defined period (usually a year).
Provider
Individual or organization
that provides health care or long-term care services (e.g., doctors, hospital,
physical therapists, home health aides, and more).
Provider Sponsored Organization
(PSO)
Managed care organization that is similar to an HMO or
Medicare HMO except that the organization is owned by the providers in that
plan and these providers share the financial risk assumed by the
organization.
Public Health
The science dealing with
the protection and improvement of community health by organized community
effort.
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Quality of Care
can be defined as a
measure of the degree to which delivered health services meet established
professional standards and judgments of value to the consumer.
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Registered Nurse (RN)
A nurse who has
graduated from a formal program of nursing education and has been licensed by
an appropriate state authority. RNs are the most highly educated of nurses with
the widest scope of responsibility, including all aspects of nursing care. RNs
can be graduated from one of three educational programs: two-year associate
degree program, three-year hopsital diploma program, or four-year baccalaureate
program.
Rehabilitation
The combined and
coordinated use of medical, social, educational, and vocational measures for
training or retaining individuals disabled by disease or injury to the highest
possible level of functional ability. Several different types of rehabilitation
are distinguished: vocational, social, psychological, medical, and educational.
(Information about rehabilitation
can be located on our Site Index.)
Rehabilitation Services
Services
designed to improve/restore a person's functioning; includes physical therapy,
occupational therapy, and/or speech therapy. May be provided at home or in
long-term care facilities. May be covered in part by Medicare.
Reimbursement
The process by which
health care providers receive payment for their services. Because of the nature
of the health care environment, providers are often reimbursed by third parties
who insure and represent patients.
Residential Care
The provision of
room, board and personal care. Residential care falls between the nursing care
delivered in skilled and intermediate care facilities and the assistance
provided through social services. It can be broadly defined as the provision of
24-hour supervision of individuals who, because of old age or impairments,
necessarily need assistance with the activities of daily living.
(Information about residential care
can be located on our Site Index.)
Respiratory Therapy
The diagnostic
evaluation, management, and treatment of the care of patients with deficiences
and abnormalities in the cardiopulmonary (heart-lung) system.
Respite Care
Service in which trained
professionals or volunteers come into the home to provide short-term care (from
a few hours to a few days) for an older person to allow caregivers some time
away from their caregiving role.
Risk Management
Service in which trained
professionals or volunteers come into the home to provide short-term care (from
a few hours to a few days) for an older person to allow caregivers some time
away from their caregiving role. (Information about
risk can be located on our Site
Index.)
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Screening
The use of quick procedures
to differentiate apparently well persons who have a disease or a high risk of
disease from those who probably do not have the disease.
Secondary Care
Services provided by
medical specialists who generally do not have first contact with patients
(e.g., cardiologist, urologists, dermatologists).
Senility
The generalized
characterization of progressive decline in mental functioning as a condition of
the aging process. Within geriatric medicine, this term has limited meaning and
is often substituted for the diagnosis of senile dementia and/or senile
psychosis.
Senior Center
Provides a variety of
on-site programs for older adults including recreation, socialization,
congregate meals, and some health services. Usually a good source of
information about area programs and services.
Service Plan
(Also called care
plan or treatment plan.) Written document which outlines
the types and frequency of the long-term care services that a consumer
receives. It may include treatment goals for him or her for a specified time
period.
Severity of Illness
A risk prediction
system to correlate the "seriousness" of a disease in a particular patient with
the statistically "expected" outcome (e.g., mortality, morbidity, efficiency of
care).
Skilled Care
"Higher level" of care
(such as injections, catheterizations, and dressing changes) provided by
trained medical professionals, including nurses, doctors, and physical
therapist.
Skilled Nursing Care
Daily nursing and
rehabilitative care that can be performed only by or under the supervision of,
skilled medical personnel.
Skilled Nursing Facility (SNF)
Facility that
is certified by Medicare to provide 24-hour nursing care and rehabilitation
services in addition to other medical services. (See also nursing
home.)
Social Security Disability Insurance
(SSDI)
A system of federally provided payments to eligible workers
(and, in some cases, their families) when they are unable to continue working
because of a disability. Benefits begin with the sixth full month of disability
and continue until the individual is capable of substantial gainful
activity.
Social Services Block Grant (SSBG)
Services
(Formerly known as Title XX services.) Grants
given to states under the Social Security Act which fund limited amounts of
social services for people of all ages (including some in-home services, abuse
prevention services, and more).
Social Health Maintenance Organization
(SHMO)
A managed system of health and long-term care services geared
toward an elderly client population. Under this model, a single provider entity
assumes responsibility for a full range of acute inpatient, ambulatory,
rehabilitative, extended home health and personal care services under a fixed
budget which is determined prospectively. Elderly people who reside in the
target service area are voluntarily enrolled. Once enrolled, individuals are
obligated to receive all SHMO covered services through SHMO providers, similar
to the operation of a medical model health maintenance organization (HMO).
Special Care Units
Long-term care
facility units with services specifically for persons with Alzheimer's Disease,
dementia, head injuries, or other disorders.
Speech Therapy
Designed to help restore
speech through exercises. May be covered by Medicare.
Spend-Down
Medicaid financial eligibility
requirments are strict, and may require beneficiaries to spend down/use up
assets or income until they reach the eligibility level.
Spousal Impoverishment
Federal
regulations preserve some income and assets for the spouse of a nursing home
resident whose stay is covered by Medicaid.
Standard Error
In statistics, the
standard error is defined as the standard deviation of an estimate. That is,
multiple measurements of a given value will generally group around the mean (or
average) value in a normal distribution. The shape of this distribution is
known as the standard error.
State Unit on Aging
Authorized by the
Older Americans Act. Each state has an office at the state level which
administers the plan for service to the aged and coordinates programs for the
aged with other state offices.
Subacute Care
(Also called
post-acute care or transitional care.) Type of
short-term care provided by many long-term care facilities and hospitals which
may include rehabilitation services, specialized care for certain conditions
(such as stroke and diabetes) and/or post-surgical care and other services
associated with the transition between the hospital and home. Residents on
these units often have been hospitalized recently and typically have more
complicated medical needs. The goal of subacute care is to discharge residents
to their homes or to a lower level of care. (Information about
subacute care can be located on our Site
Index.)
Supplemental Security Income (SSI)
A program
of support for low-income aged, blind and disabled persons, established by
Title XVI of the Social Security Act. SSI replaced state welfare programs for
the aged, blind and disabled in 1972, with a federally administered program,
paying a monthly basic benefit nationwide of $284.30 for an individual and
$426.40 for a couple in 1983. States may supplement this basic benefit amount.
(Information about Supplemental Security
Income can be located on our Site Index.)
Support Groups
Groups of people who
share a common bond (e.g., caregivers) who come together on a regular basis to
share problems and experiences. May be sponsored by social service agencies,
senior centers, religious organizations, as well as organizations such as the
Alzheimer's Association.
Survey
An investigation in which
information is systematically collected.
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Technology Assessment
A comprehensive
form of policy research that examines the technical, economic, and social
consequences of technology applications.
Title III Services
Services provided to
individuals age 60 and older which are funded under Title III of the Older
Americans Act. Include: congregate and home-delivered meals, supportive
services (e.g., transportation, information and referral, legal assistance, and
more), in-home services (e.g., homemaker services, personal care, chore
services, and more), and health promotion/disease prevention services (e.g.,
health screenings, exercise programs, and more). (See also Older Americans
Act.)
Title XIX (Medicaid)
federal and
state-funded program of medical assistance to low-income individuals of all
ages. There are income eligibility requirements for Medicaid. (Information
about Medicaid can be located on our Site
Index.)
Title XVIII (Medicare)
Federal health
insurance program for persons age 65 and over (and certain disabled persons
under age 65). Consists of 2 parts: Part A (hospital insurance) and Part B
(optional medical insurance which covers physicians' services and outpatient
care in part and which requires beneficiaries to pay a monthly premium).
(Information about Medicare can be
located on our Site Index.)
Title XX Services
(Now known as Social
Services Block Grant services.) Grants given to states under the Social
Security Act which fund limited amounts of social services for people of all
ages (including some in-home services, abuse prevention services, and
more).
Transitional Care
(Also called
subacute care or post-acute care.) Type of
short-term care provided by many long-term care facilities and hospitals which
may include rehabilitation services, specialized care for certain conditions
(such as stroke and diabetes) and/or post-surgical care and other services
associated with the transition between the hospital and home. Residents on
these units often have been hospitalized recently and typically have more
complicated medical needs. The goal of subacute care is to discharge residents
to their homes or to a lower level of care.
Transportation Services
(Also
called escort services.) Provides transportation for older adults
to services and appointments. May use bus, taxi, volunteer drivers, or van
services that can accommodate wheelchairs and persons with other special needs.
(Information about transportation
can be located on our Site Index.)
Treatment Plan
(Also called care
plan or service plan.) Written document which outlines
the types and frequency of the long-term care services that a consumer
receives. It may include treatment goals for him or her for a specified time
period.
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Uncompensated Care
Service
provided by physicians and hospitals for which no payment is received from the
patient or from third party payers.
Underinsured
People with public or
private insurance policies that do not cover all necessary medical services,
resulting in out-of-pocket expenses that exceed their ability to pay.
Undue Hardship
With respect to the
provision of accommodation for an individual with a disability under the
Americans with Disabilities Act--significant difficulty or expense, considered
in light of the employer's financial resources, facilities, workforce, and
business operations.
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Visiting Nurse Association (VNA)
A voluntary
health agency which provides nursing and other services in the home. Basic
services include health supervision, education and counseling; beside care; and
the carrying out of physicians' orders. Personnel include nurses and home
health aides who are trained for specific tasks of personal bedside care. These
agencies had their origin in the visiting or district nursing provided to sick
poor in their homes by voluntary agencies.
Vital Statistics
Statistics relating to
births (natality), deaths (mortality), marriages, health, and disease
(morbidity).
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Wellness
A dynamic state of physical,
mental, and social well-being; a way of life which equips the individual to
realize the full potential of his or her capabilities and to overcome and
compensate for weaknesses; a lifestyle which recognizes the importance of
nutrition, physical fitness, stress reduction, and self-responsibility.
Workers' Compensation
Program
State-mandated system under which employers assume the cost
of medical treatment and wage losses for employees who suffer job-related
illnesses or injuries, regardless of who is at fault. In return, employees are
generally prohibited from suing employers, even if the disabling event was due
to employer negligence. U.S. government employees, harbor workers, and railroad
workers are not covered by state workers' compensation laws, but instead by
various federally administered laws.
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Last revised: November 12, 2003
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