Admitting Physician

The doctor responsible for admitting a patient to a hospital or other inpatient health facility.

Advance Directive (Health Care)

Written ahead of time, a health care advance directive is a written document that says how you want medical decisions to be made if you lose the ability to make decisions for yourself. Advance directives may include a Living Will, Durable Power of Attorney for health care and Durable Power of Attorney of financial matters.

The American Association of Homes and Services for the Aging (AAHSA)

AAHSA is committed to healthy, affordable and ethical aging services for America. The association represents 5,600 mission-driven, not-for-profit nursing homes, continuing care retirement communities, assisted living and senior housing facilities, and home and community-based service providers. Every day, AAHSA's members serve one million older persons across the country. AAHSA has state association partners that represent AAHSA members in most states.

Assisted Living

A special retirement community designed for older adults that need assistance with one or more Activities of Daily Living (ADLs) i.e. getting dressed, bathing, remembering to take medications, etc. This lifestyle is often referred to as "independent living with assistive services". It meets the needs of people who do not need 24 hour nursing care, yet cannot successfully live in an independent setting. Assisted living is now licensed in the state of Illinois. Assisted Living Residences typically offer a rental arrangement, with residents or their families paying the entire cost privately. Depending upon the terms of the policy, long term care insurance may pay for Assisted Living. Some states have Medicaid Waiver Programs that are designed to help lower-income seniors reside in an Assisted Living Residence. Many, but not all states, license and/or certify Assisted Living Residences.

Benefit Period

The way that Medicare measures your use of hospital and skilled nursing facility services. A benefit period begins the day you go to a hospital or skilled nursing facility. The benefit period ends when you haven't received hospital or skilled nursing care for 60 days in a row. If you go into the hospital after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods you can have. (See "Deductible" and "Skilled Nursing Facility".)

Centers For Medicare & 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 the beneficiaries in these programs are able to get high quality health care.

The Continuing Care Accreditation Commission (CCAC)

A not-for-profit organization founded in 1985, is the nation's only accrediting body for aging services continuums, including continuing care retirement communities. CCAC's accreditation program is based on the belief that accreditation promotes and maintains quality and integrity in the aging services profession. www.ccaconline.org

Continuing Care Retirement Community (CCRC)

A housing community that provides different levels of care based on what each resident needs over time. This 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.

Continuum Of Care

Another term used when referring to all the three lifestyles in a continuing care retirement community. i.e. "We have access to the full continuum of care."

Deductible (Medicare)

The amount you must pay for health care before Medicare begins to pay, either for each benefit period for Part A, or each year for Part B. These amounts can change every year. (See "Benefit Period", "Medicare Part A" and "Medicare Part B".)

Discharge Planning

A process used to decide what a patient needs for a smooth move from one level of care to another. This is done by a social worker or other health care professional. It includes moves from a hospital to a nursing home or to home care. Discharge planning may also include the services of home health agencies to help with the patient's home care.

Elder Law

The group of laws about rights and issues of the health, finances, and well-being of the elderly.

Eldercare

Public, private, formal, and informal programs and support systems, government laws, and finding ways to meet the needs of the elderly, including: housing, home care, pensions, Social Security, long-term care, health insurance, and elder law.

Eligibility/Medicare Part A

You are eligible for premium-free (no cost) "Medicare Part A (Hospital Insurance)" if:

• You are 65 or older and you are receiving, or are eligible for, retirement benefits from Social Security or the Railroad Retirement Board, or
• You are under 65 and you have received Railroad Retirement disability benefits for the prescribed time and you meet the Social Security Act disability requirements, or
• You or your spouse had Medicare-covered government employment, or
• You are under 65 and have End-Stage Renal Disease (ESRD).

If you are not eligible for premium-free "Medicare Part A", you can buy Part A by paying a monthly premium if:

• You are age 65 or older, and
• You are enrolled in Part B, and
• You are a resident of the United States, and are either a citizen or an alien lawfully admitted for permanent residence who has lived in the United States continuously during the 5 years immediately before the month in which you apply.

Eligibility/Medicare Part B

You are automatically eligible for Part B if you are eligible for premium-free Part A. You are also eligible for Part B if you are not eligible for premium-free Part A, but are age 65 or older AND a resident of the United States or a citizen or an alien lawfully admitted for permanent residence. In this case, you must have lived in the United States continuously during the 5 years immediately before the month during which you enroll in Part B.

Entrance Fee

This Term Is Sometimes Referred To As The "Buy-In" Or The "Endowment" . The entrance fee applies to the CCRC type of community and equates to buying a house. There are usually different options available for the return of the entrance fee or a portion of it, depending on which financial option the consumer chooses. These may be different in every community. It is important to understand your options and what you get for the money you invest.

Exclusions (Medicare)

Items or services that Medicare does not cover, such as most prescription drugs, long-term care, and custodial care in a nursing or private home.

Health Insurance Portability and Accountability Act (HIPPAA)

A federal law guaranteeing medical privacy rights.

Hospice

Hospice is a special way of caring for people who are terminally ill, and for their family. This care includes physical care and counseling. Hospice care is covered under "Medicare Part A (Hospital Insurance)".

Hospital Insurance Part A

The part of Medicare that pays for inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care.

Illinois Department of Public Health (IDPH)

The agency responsible for the licensure of Assisting Living and Skilled Nursing Facilities in the state of Illinois.

Instrumental Activities of Daily Living (IADL's)

More complex activities needed for daily living, such as shopping, bill paying, cooking, meal preparation, medication management, telephone use, housekeeping and use of transportation.

Life Services Network (LSN)

The Illinois state association that represents AAHSA at the state level.

Lifecare

A term used when referring to a continuing care retirement community that financially underwrites a portion of the cost of a person’s long term care needs.

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 is custodial care. Medicare does not pay for this type of care.

Long-Term Care Insurance

This is an insurance policy designed to help off set the costs for assisted living and/or skilled nursing care. It is NOT health insurance. A private insurance policy to help pay for some long-term medical and non-medical care, like help with activities of daily living. Because Medicare generally does not pay for long-term care, this type of insurance policy may help provide coverage for long-term care that you may need in the future. Some long-term care insurance policies offer tax benefits; these are called "Tax-Qualified Policies."

Medicaid

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.

Medical Insurance (Part B)

The part of Medicare that covers doctors' services and outpatient hospital care. It also covers other medical services that Part A does not cover, like physical and occupational therapy. (See Medicare Part B (Medical Insurance).)

Medicare

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).

Medicare Part A (Hospital Insurance)

Hospital insurance that pays for inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care. (See Hospital Insurance Part A.)

Medicare Part B (Medical Insurance)

Medicare medical insurance that helps pay for doctors' services, outpatient hospital care, durable medical equipment, and some medical services that are not covered by Part A. (See Medical Insurance.)

Mini Mental State Examination (MMSE)

A standardized assessment used to evaluated the mental status of older adults.

Monthly Service Fee

This term equates to what it costs to live in your home. It will bundle together a wide variety of services, which may differ slightly in each community, but usually include property taxes, maintenance, utilities, dining services, housekeeping, security, activities, transportation etc. The monthly services will be very similar in the rental community and CCRC, except long term care services will be included in this monthly fee for the type A and B contracts used in a CCRC.  (See Residency Agreement.)

Physical Therapy

Treatment of injury and disease by mechanical means, as heat, light, exercise, and massage.

Physician's Assessment Certification

A certification that requires an incoming resident to go through their own personal Physician's evaluation deeming them appropriate for assisted living.

Ratios

This refers to the number of units for independent living within a CCRC and how that number compares to the total number of units in the continuum of care. Example: 500 apartments for independent living, 25 units for assisted living, 50 units for skilled nursing care would NOT be favorable ratios. (500/75) Your concern as a consumer is that a CCRC has sufficient space available to handle the aging in place process with enough available units in the continuum of care.

Residency Agreement

The primary legal document signed by the resident(s) when moving into a Continuing Care Retirement Community. There are 3 types of contracts most frequently used in a CCRC.

Type A Contract - Often referred to as a "full lifecare" contract, this type of contract provides maximum risk protection. It is a form of long term care insurance where the resident receives life long care for about the same cost as their current monthly service fee in their independent unit throughout the entire continuum of care. In some CCRC communities, this type of contract may also include a charitable care clause. A medical approval is required. Much like an insurance company, the CCRC is assessing a risk (the applicant’s health and financial resources) and determining if they will underwrite the cost of their long-term care for the rest of their lives.

Type B Contract - Often referred to as a "modified lifecare" contract, this type of contact provides the resident with a certain number of days of care throughout the continuum of care…usually 30, 60, 90 or 180 days. After the specified number of days has been utilized, the resident pays the private pay rates for assisted living and skilled nursing care usually receiving a 10% discount. Because the CCRC is not absorbing as much financial risk to pay for long term care costs, the consumer will usually see lower entrance fees and lower monthly fees for the B contract as compared to the A contract.

Type C Contract - Often referred to as a "fee for service" contract, this type of contract provides the resident with all the advantages of the CCRC lifestyle, but does not include any financial underwriting when people access the continuum of care. It is essentially a "pay as you go….if and when you need the higher levels of care". Usually this type of contract will provide the lowest possible entrance fee and monthly fees available in the CCRC options because there is no financial risk on the part of the community.

Respite Care

Temporary or periodic care provided in a nursing home, assisted living residence, or other type of long-term care program so that the usual caregiver can rest or take some time off.

Service Plan

A written plan developed and mutually agreed upon by the community / resident / family based on the physician's assessment and evaluation for resident coming into an assisted living community.

Skilled Care

A type of health care given when you need skilled nursing or rehabilitation staff to manage, observe, and evaluate your care.

Skilled Nursing Care

A level of care that must be given or supervised by Registered Nurses. All of your needs are taken care of with this type of service. Examples of skilled nursing care are: getting intravenous injections, tube feeding, oxygen to help you breathe, and changing sterile dressings on a wound. Any service that could be safely done by an average non-medical person (or one's self) without the supervision of a Registered Nurse is not considered skilled care.

Skilled Nursing Facility (SNF)

A nursing facility with the staff and equipment to give skilled nursing care and/or skilled rehabilitation services and other related health services. Often referred to as a nursing home, this type of community is designed to provide the highest level of care for individuals requiring a registered nurse and care 24 hours a day. Some, but not all, skilled nursing facilities are certified for Medicare and Medicaid. In Illinois skilled nursing facilities are licensed and regulated by the Illinois Department of Public Health.