This is a decorative element. It displays words and images about NCHCFA. You are seeing this image because you do not have Macromedia's Flash Player installed on your system.

Terms to Know About Long-Term Care

Talking about long-term care includes a lot of phrases you may not be familiar with. Here are some of the most common terms used by government agencies and medical facilities.



ACTIVITIES OF DAILY LIVING (ADL)

A term used to describe basic self-care tasks that are a part of most people's regular day, such as bathing, dressing, grooming, moving around the house, and eating. ADLs are widely used to assess individual functioning status.


ADULT CARE HOMES

An assisted living residence in which the housing management provides 24-hour scheduled and unscheduled personal care services to two or more residents, either directly or, for scheduled needs, through formal written agreement with licensed home care or hospice agencies. Some licensed adult care homes provide supervision to persons with cognitive impairments whose decisions, if made independently, may jeopardize the safety or well-being of themselves or others and therefore require supervision. Medication in an adult care home may be administered by designated, trained staff. Adult care homes that provide care to two to six unrelated residents are commonly called family care homes. Adult care homes and family care homes are subject to licensure by the Division of Facility Services.


ADULT DAY CARE

The provision of group care and supervision of adults (who may be physically or mentally disabled) in a place other than their usual residence on a less than 24 hour basis. Services are designed to support the adult's personal independence, as well as their physical, social, and emotional well-being. Adult day care programs are subject to certification by the Division of Aging and Adult Services.


ADULT DAY HEALTH CARE

A community-based day care program that provides health, social and recreational care, along with rehabilitative services. Staffing is by trained professionals and paraprofessionals and is under the supervision of a registered nurse. The program is ideal for the elderly or physically impaired adult who needs assistance in a protective setting during the day. Adult day health programs are subject to certification by the Division of Aging and Adult Services.


ADULT PLACEMENT SERVICES

County agency that helps aging or disabled adults find appropriate living and healthcare arrangements when their health, safety, and well-being can no longer be maintained at home. Placement arrangements are made in adult care homes, nursing homes, other substitute homes, residential health care settings, or institutions. Adults and their families receive help to complete medical evaluations and financial applications, and locate and move to new settings. They also may receive counseling to help them adjust to the change.

Adult placement services also help elderly and disabled adults in the following situations:

  • Those unable to maintain themselves in their own homes independently or with available community or family supports.
  • Those living in substitute homes, residential health care facilities, or institutions and need assistance in relocating due to changes in level of care needed.
  • Those who need assistance in returning to more independent living arrangements.
  • Those who need assistance in adjusting to or maintaining their placements due to individual or family problems or a lack of resources.

All 100 county departments of social services provide adult placement services.


AREA AGENCY ON AGING

Area Agencies on Aging (AAA) plan, coordinate, and advocate for the development of a comprehensive service delivery system to meet the needs of older people in a specific geographic area.


ASSISTED LIVING

Any group housing and services program for two or more unrelated adults, that makes available, at a minimum, one meal a day and housekeeping services and provides personal care services directly or through a formal written agreement with one or more licensed home care or hospice agencies. The Department may allow nursing service exceptions on a case-by-case basis. Settings in which services are delivered may include self-contained apartment units or single or shared room units with private or area baths. Assisted living residences are to be distinguished from nursing homes subject to provisions of G.S. 131E-102.


COMBINATION FACILITY

A facility licensed under G.S. 131E-102 providing intermediate care and/or skilled nursing care and adult home care.


CONTINUING CARE RETIREMENT COMMUNITY (CCRC)

A facility that offers a continuum of care - from independent living, assisted-living, or rest home care, to nursing home care. Individuals are offered an independent living lifestyle with the security of knowing supportive and health care services are available if needed.


COUNCIL ON AGING (COA)

A private, nonprofit organization or public agency that serves as a county focal point on aging and traditionally provides supportive services to older adults (located in some, but not all counties). Sometimes they serve as advisory boards to the county board of commissioners. Department on Aging is the term typically used when it is a public agency.


FAMILY CARE HOME

An adult care home having two to six residents. The structure of a family care home may be no more than two stories high and none of the aged or physically disabled persons being served there may be housed in the upper story without provision for two direct exterior ground-level accesses to the upper story. It is licensed by the N.C. Division of Health Service Regulations.


FL-2 FORM

Long-Term Services prior approval form which gives a summary of the patient's medical requirements and which reflects the attending physician's recommendation for the level of care needed in an institutional setting. An approved FL-2 is required for any Medicaid recipient in a skilled nursing facility (SNF) or an intermediate care facility (ICF).


GUARDIANSHIP

The legal authority and duty given by the court to a person (guardian) for the purpose of assuming responsibility for the care and maintenance of another person (ward), who has been determined incapable of handling his/her own personal affairs. The powers and authority conferred upon a guardian depend on what type of guardianship is granted by the court.

  • Guardian of the Estate - Is responsible for collecting, preserving, and administering the property and income of the ward.
  • Guardian of the Person - Is entitled to custody of the ward and is responsible for the ward's care, comfort and maintenance. The guardian makes decisions such as where the ward will live, gives consent for medical or professional treatment of for the ward. The Guardian of the Person is responsible for the basic physical care of the ward and his/her immediate personal effects.
  • General Guardian - Performs the duties of both the Guardian of the Estate and Guardian of the Person.

INSTRUMENTAL ACTIVITIES OF DAILY LIVING (IADL)

Basic tasks that are essential to living independently, such as cooking meals, housekeeping, laundry, paying bills, shopping, and using the telephone.


INTERMEDIATE-LEVEL CARE

A level of care in a nursing facility that provides 24-hour assistance, with a minimum of eight hours of coverage daily by a licensed nurse, but no requirement for 24-hour skilled nursing services. Medicaid pays for skilled and intermediate care. Medicare pays only for skilled care.


LONG-TERM CARE INSURANCE

A type of insurance designed to pay some or all of the costs of nursing home, community, or home health care. The Seniors' Health Insurance Information Program provides useful information on this form of insurance, including a fact sheet. SHIIP and the Division of Aging and Adult Services and Adult Services have developed a Consumer Bill of Rights for Buyers of Long-Term Care Insurance.


LONG-TERM CARE OMBUDSMAN

A professional who serves as an advocate for long-term care residents of nursing homes and adult care homes. Advocacy includes educating individuals about their rights and complex rules or regulations governing the long term care system. An ombudsman can be requested to investigate concerns and serve as a mediator for conflict resolution should a resident encounter difficulty exercising rights.

Ombudsmen are available to:

  • Serve as a resource for anyone who has questions about long term care regulations;
  • Be involved in the care planning process or family meetings;
  • Provide training to staff, resident councils, or family councils;
  • Provide information and referral;
  • Provide state survey results on local facilities; and
  • Talk about any situation that may arise from being a resident, family member, or staff person of a facility.

The Long Term Care Ombudsman program is federally mandated through the Older Americans Act. There is at least one Ombudsman for each of the 17 aging regions in North Carolina.


MEDICAID(TITLE XIX of the Social Security Act)

A federal- and state-funded health care program for eligible persons. To be eligible, a person must meet income and assets limits, and be aged, blind, disabled, a member of a family with dependent children, or a pregnant woman. Some people are covered by both Medicare and Medicaid. Administered by the Division of Medical Assistance in the North Carolina Department of Health and Human Services, the program provides medical care for qualifying recipients. Applications for Medicaid are made through the County Department of Social Services.


MEDICARE

A federal health insurance program for persons aged 65 and over who are eligible for Social Security or Railroad Retirement benefits and for some people who are disabled regardless of age. There are two parts: Part A is hospital insurance which is automatic, for those eligible, and Part B covers the physician and other services. Part B is voluntary and requires a monthly premium.


NURSING HOMES

Skilled nursing and intermediate-care facilities.


QUALIFIED MEDICARE BENEFICIARY/MEDICARE-AID (QMB)

Assistance for those who do not qualify for Medicaid, but whose income is very low (pays Medicare Part B premiums and deductibles for A and B, etc.).


RETIREMENT COMMUNITY

A housing complex designed for older adults. Many of the retirement communities allow monthly rental, while others require purchase of the unit. Persons living in retirement communities are generally able to care for themselves; however, assistance from home care agencies is allowed by some communities. Activities and socialization are provided.


SKILLED NURSING FACILITY (SNF)

A nursing home that provides 24-hour nursing services for a person who has serious health care needs but does not require the intense level of care provided in a hospital. Rehabilitation services may also be provided. Many of these facilities are federally certified, which means they may participate in Medicaid or Medicare programs.

Definitions provided by the North Carolina Department of Health and Human Services. See the full glossary.