There are so many great resources out there for patients and their families to take advantage of, but in most cases they do not know that these things even exist! There are working professionals whose sole purpose is to look out for the interests of the elderly, but their services are not employed nearly enough. Here are a few basic terms describing professionals and other services here to make your life easier, and could be very important for you to know.
Adult day care – supervised care for older individuals in need, generally based on a sliding
pay scale. Often provide transportation to and from the site.
Advance directive – a legal document completed by patients to direct their medical care in
the event that they are no longer able to communicate their wishes.
Ambulatory care – care given to a patient who does not require overnight hospitalization.
Ancillary – a term used to describe additional services performed related to care, such as lab work, X-ray, and anesthesia.
AAA – Area Agency on Aging; an office that coordinates various types of programs and
services, anything from Meals on Wheels to support services and educational
Assisted living – a type of housing that provides services to residents based on their
individual level of need. The range would be from independent living to
intermediate care. Typically private pay, this is an attractive but costly option.
CCRC – Continuing Care Retirement Center; campus-style housing option with full range of
options from independent housing cottages, congregate housing apartments,
assisted living facility, and intermediate care facility. Cost is based on level of
housing and care.
Congregate housing – apartment style living which provides safe and affordable housing
based on an individual’s income and medical expenses. These facilities are also
known for their government assistance program to provide supplemental income to
its residents to afford living in the facility.
Durable Power of Attorney – a document that allows competent individuals to select
another individual to make decisions for them in the event that they become
incapacitated, including health care decisions.
Hospice – care given to dying and terminally ill individuals. Emphasis of care is on pain
management and supportive services for the patient and family.
Intermediate Care Facility (ICF) – a facility providing a level of care that is less than that of a
hospital, but greater than a level of home check-ups.
Life Safety Code – standards of construction, protection, and occupancy that are necessary
to minimize danger to life from fire, smoke, fumes, and panic. Compliance with this
code is required for JCAHO and the Medicare and Medicaid programs.
Living Will – a document generated by an individual to guide providers on desired medical
care in the case that the individual is unable to articulate his or her own wishes.
Long Term Care – care given to patients with chronic illnesses, and who usually require a
length of stay for longer than 30 days.
Managed Care – health care that utilizes its cost of services and includes a payment
structure with a limited choice of healthcare providers. The goal is to have a system
that delivers value by giving people access to quality, cost effective healthcare.
Medicaid – a state administered program funded partly by the federal government
that provides healthcare services to those who meet specific income
requirements and have no insurance.
Medicare – a federally funded program that provides health insurance primarily to
individuals entitled to Social Security who are age 65 or older.
Medicare Part A – one of two parts of the Medicare program that covers inpatient
hospital services and some services furnished by other healthcare providers
such as nursing homes, home health agencies, and hospice. Part A coverage is
automatically provided for individuals entitles to Medicare.
Medicare Part B – one of two parts of the Medicare program that covers patient,
physician, and medical supplier services. Part B coverage is optional and
must be paid for separately through monthly premiums.
Ombudsman – a representative for individuals in need of healthcare, or those not
receiving proper healthcare. Act as a “middle man” between the patient and
the healthcare providers to see that all needs are met and standards are
upheld within the facility and its workers. These individuals should be called
first if you are considering hiring a lawyer. Their services are free and just as
effective as a legal aid.
Patient Self Determination Act – a federal law that requires health care facilities to
determine if new patients have a living will and/or durable power of
attorney for health care, and takes the patient’s wishes into consideration
when developing a treatment plan.
Preferred Provider Organization – an organization of physicians, hospitals, and other
healthcare providers that provide services to an enrolled group for a fixed
periodic payment. PPO’s typically allow enrollees to see providers outside
the organization for an additional cost.
Quality Assurance – a formal set of activities to review and improve the quality of
services provided. Quality assurance includes quality assessment and
corrective actions to remedy any deficiencies identified in the quality of
direct patient, administrative, and support services.
Routine Cost Limit – a cap on cost of services used in Medicaid reimbursement.
Skilled Nursing Facility – a facility either freestanding or part of a hospital that
accepts patients in need of rehabilitation and medical care that is of a lesser
intensity than that received in a hospital.
Subacute Care – a level of care designed for the individual who has had an acute
(sudden) 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 hospital. The program takes an outcome-focused
interdisciplinary approach which utilizes a professional team to deliver
complex and clinical interventions.
Transitional Care Unit – a unit designed to provide nursing care to individuals going
from the hospital unit to either the home or a nursing facility.