Glossary of Senior Living Acronyms and Selected Terms
- 1 October 2020
- book chapter
- Published by Springer Publishing Company
Abstract
Focus Previous Next Glossary of Senior Living Acronyms and Selected Terms Add to Favorites Download PDF Permissions Share Close Share this chapter Copy link Share via email Share via: Close table of contents chapter information Contents Search Search Copyright Dedication Foreword Preface Acknowledgments Introduction SECTION I: The Postacute Segment of Healthcare and Human Services CHAPTER 1: The Senior Living Field: Background, History, and Its Current and Future State CHAPTER 2: Customer Care, Supports, and Services SECTION II: Operations CHAPTER 3: Human Resources CHAPTER 4: Financial Management in Senior Care CHAPTER 5: Environment SECTION III: Leadership and Management CHAPTER 6: Providing a Context for Leadership CHAPTER 7: Strategic Thinking and Innovation: Positioning for the Future CHAPTER 8: Marketing and Public Relations for Senior Living Organizations CHAPTER 9: Critical Thinking and Operational Practice for the Health Services Leader: Pulling It Together CHAPTER 10: People: Human Resources and Relationships CHAPTER 11: Customer Service: How Are We Different? CHAPTER 12: Personal Development: Investing in Yourself CHAPTER 13: Conclusion Afterword: COVID-19 and Senior Care and Services Glossary of Senior Living Acronyms and Selected Terms DOI: 10.1891/9780826177339.ap02 One constant challenge in senior living leadership is keeping up with the seemingly ever-evolving list of relevant acronyms, abbreviations, and terms of art—the “jargon” frequently used across the senior living continuum. The following compilation includes many of the most commonly used ones, most of which appear in this text at some point. Some might be rather unfamiliar or surface only periodically. Acronyms and abbreviations may have more than one meaning—inside the profession and externally; only the definitions applying to senior living leadership are included here. This glossary is not an exhaustive list of the terms encountered in aging services and long-term care administration, but it can serve as a handy desk reference for the health services executive in deciphering the “alphabet soup” of senior living terminology. Glossary A AA Alzheimer’s Association: Nonprofit NGO with the mission “to eliminate Alzheimer’s disease and all other dementia through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health.” https://www.alz.org AAA Area Agency on Aging: Designated planning and service areas to provide specific programming funded by the state and Administration on Aging to meet the needs of older adults and disabled persons, as well as evaluate program effectiveness. (See also N4A.) AADNS American Association of Directors of Nursing Services: Nonprofit professional society advocating for and addressing the interests of its member senior living directors of nursing departments. https://www.aadns-ltc.org AAH American Association of Homecare: Nonprofit trade association advocating for and addressing the interests of its member home healthcare provider organizations. https://www.aahomecare.org AAIDD American Association on Intellectual and Developmental Disabilities: Nonprofit NGO with the mission of promoting “progressive policies, sound research, effective practices, and universal human rights for people with intellectual and developmental disabilities. https://www.aaidd.org/ AALTCI American Association for Long-Term Care Insurance: Nonprofit professional association advocating for and addressing the interests of its member providers of long-term care insurance and life planning solutions. https://www.aaltci.org AAO American Association of Ophthalmology: Nonprofit professional society advocating for and addressing the interests of its member ophthalmologists, with the mission “to protect sight and empower lives by serving as an advocate for patients and the public, leading ophthalmic education, and advancing the profession of ophthalmology.” https://www.aao.org AAPC American Academy of Professional Coders: Nonprofit professional society advocating for and addressing the interests of its members, with the mission of providing “education and professional certification to physician-based medical coders and to elevate the standards of medical coding by providing training, certification, networking, and job opportunities.” https://www.aapc.com AARP American Association of Retired Persons: Nonprofit, nonpartisan membership organization for people age 50 years and over advocating for and addressing the interests of its members, with the mission “to empower people to choose how they live as they age.” The organization is dedicated to enhancing quality of life for all seniors. https://www.aarp.org AASA Aging and Adult Services Administration: The principal agency of the U.S. Department of Health and Human Services designated to carry out the provisions of the Older Americans Act of 1965. (See also OAA.) https://acl.gov/about-acl/administration-aging AAUAP American Association of University Affiliated Programs for Persons with Developmental Disabilities: Nonprofit trade association advocating for and addressing the interests of its member university-affiliated programs (UAPs), with a shared vision that foresees a nation in which all Americans, including Americans with disabilities, participate fully in their communities. (See also UAP.) http://aauap.org ABA American Barbers Association: Nonprofit professional society advocating for and addressing the interests of its member barbers, with the mission of giving its members the resources they need to be a “cut above the rest.” https://americanbarber.org or American Board of Audiology: Nonprofit professional society advocating for and addressing the interests of its member audiologists, with the mission of creating, administering, and promoting “rigorous credentialing programs that elevate professional practice and advance patient care.” https://www.boardofaudiology.org or Board Certified in Audiology: Credential awarded by the American Board of Audiology for demonstrating advanced proficiency in relevant knowledge and skills for serving as an audiologist. (See also CCC-A.) ABI Waiver Acquired Brain Injury Waiver Program/Services: Federal Medicaid waiver that permits approved states to provide rehabilitative home- and community-based services to individuals with brain injuries as an alternative to nursing home facility services and to support individuals’ efforts to return to a community setting with existing resources. ABN Advance Beneficiary Notice (of Noncoverage)—Medicare Form CMS-R-131: Issued by Medicare-certified providers to Original Medicare (fee for service—FFS) beneficiaries in situations where Medicare payment is expected to be denied in order to transfer potential financial liability to the Medicare beneficiary in certain instances. https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN ACA Affordable Care Act: Shortened name for the Patient Protection and Affordable Care Act of 2010; comprehensive healthcare reform law and its amendments addressing health insurance coverage, healthcare costs, and preventive care. (See also PPACA.) ACHCA American College of Health Care Administrators: Nonprofit professional society advocating for and addressing the interests of its members and dedicated to administrative leadership and excellence in postacute care and aging services across the spectrum of healthcare services. https://achca.memberclicks.net ACHE American College of Health Care Executives: Nonprofit professional society advocating for and addressing the interests of its members—people who lead hospitals, healthcare systems, and other healthcare organizations—with the mission of advancing “healthcare management excellence.” https://www.ache.org ACL Administration for Community Living: Federal agency in the U.S. Department of Health and Human Services that combines the interests of the Administration on Aging and other agencies representing the needs of individuals with both intellectual and physical disabilities. ACO Accountable care organization: Group of doctors, hospitals, and other healthcare providers who voluntarily affiliate to deliver coordinated high-quality care to Medicare patients, aiming to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When successful in both delivering high-quality care and cost containment, the ACO can share in the savings it achieves. https://innovation.cms.gov ACP Advance care planning: Process that supports a person’s understanding of—and expressly sharing—their personal values, life goals, and preferences regarding future medical care, with the goal of ensuring that they receive medical care that is consistent with those values, goals, and preferences. AD Advance directive: Legal document that takes effect if one cannot make decisions due to illness or incapacity, such as a living will (instructions on which measures can be used to prolong life) or medical power of attorney (appointment of a surrogate decision-maker for medical questions). or Alzheimer’s disease (also DAT—dementia of the Alzheimer’s type): A degenerative and progressive brain disease with varying combinations of symptoms, from memory loss, confusion, and cognitive decline to irritability, paranoia, and behavior changes. ADA American Dental Association: Nonprofit professional society advocating for and addressing the interests of its member dentists, with the mission of “promoting good dental health.” https://www.ada.org or Americans with Disabilities Act: Federal civil rights law that prohibits discrimination against individuals with disabilities, guaranteeing them equity in public accommodations, employment, transportation, state and local government services, and telecommunications. ADC Average daily census: Average number of service recipients (residents, patients, participants, clients or customers) per day over a specific period (week, month, quarter of year). or Adult day care: Services provided during the day at a community-based center with programs that are designed to meet the needs of functionally and/or cognitively impaired adults through an individual plan of care. The structured programs provide a variety of social and support services in a protective setting during any part of a day, but less than 24-hour care. Many adult day service programs include health-related services. (See also ADHC.) ADEA Age Discrimination in Employment Act: Federal law that protects certain applicants and employees 40-and-older from discrimination on the basis of age in hiring, promotion, discharge, compensation, or terms, conditions, or privileges of employment. ADHC Adult Day Health Care: An adult day care program that is also licensed to provide continuous supervision of a participant’s medical and health needs, such as administering medications and providing therapeutic services. (See also ADC.) ADL Activities of daily living: Blended metric for determining whether a person requires assistance in performing common functions: bathing, dressing, eating, continence and toileting, transferring; maintaining personal hygiene or walking (ambulating) might also be included to evaluate self-care and mobility. ADON Assistant Director of Nursing: Chief lieutenant in nursing administration; duties vary by scope and size of the organization. ADR Alternative dispute resolution: Any method of resolving disputes without litigation. Arbitration and mediation are two major forms of ADR. ADRD Alzheimer’s disease or related disorder: The National Institute on Aging (NIA) includes in this group of dementias Alzheimer’s disease, frontotemporal degeneration (FTD), Lewy body dementia (LBD), vascular contributions to cognitive impairment and dementia (VCID), and mixed etiology dementias (MED). Advancing states Nonprofit association advocating for and addressing the interests of its member state agencies on aging and disabilities, with the mission of designing, improving, and sustaining state systems delivering long-term services and supports for older adults, people with disabilities, and their caregivers. www.advancingstates.org AE Adaptive environment: Home modifications and provision of assistive technologies that support independent living among older adults, such as adaptations to the physical environment, such as eliminating slip and trip hazards, installing grab bars or railings. AFC Adult foster care: System in which adults are placed into group or private homes with caregivers. Adult foster care is typically arranged through governmental or private agencies, but it may be arranged by relatives who are unable to care for the adult in question. Aging in place Providing a familiar, stable, and supportive environment where an elder can receive needed services as their care needs evolve. AHA American Hospital Association: Nonprofit trade association advocating for and addressing the interests of its member hospitals and health systems, with the mission of advancing “the health of individuals and communities; AHA leads, represents, and serves hospitals, health systems, and other related organizations that are accountable to the community and committed to health improvement.” https://www.aha.org AHCA American Health Care Association: Nonprofit trade association advocating for and addressing the interests of its member senior living provider organizations—the nation’s largest association of long-term and postacute care providers—with the mission of “improving lives by delivering solutions for quality care” (affiliated with NCAL). https://www.ahcancal.org AHIMA American Health Information Management Association: Nonprofit professional society advocating for and addressing the interests of its members, with the mission of “transforming healthcare by leading HIM, informatics, and information governance.” www.ahima.org AHIP America’s Health Insurance Plans: Nonprofit trade association “whose members provide coverage and health related services that improve and protect the health and financial security of consumers, families, businesses, communities, and the nation.” https://www.ahip.org AHRQ Agency for Healthcare Research and Quality (previously the Agency for Health Care Policy and Research): Federal agency with the mission of producing evidence to make healthcare safer, higher quality, more accessible, equitable, affordable, understood, and used. https://www.ahrq.gov AIDS Acquired immunodeficiency syndrome (also stage 3 HIV): Condition when the HIV (human immunodeficiency virus) has caused serious damage to one’s immune system, making one more vulnerable to contracting infections. (See also HIV.) AIT Administrator-in-training: A person serving an internship with a qualified preceptor/mentor in order to meet the experiential requirements of a state professional licensing board to practice as a licensed senior living administrator; requirements and applicable service lines vary by state. AL Assisted living: Type of housing facility for older or disabled adults who may require assistance with their activities of daily living; licensure requirements vary by state. (See also ACLF.) Related terms: AL/RC: Assisted living/residential care facility ALC: Assisted living community ALF: Assisted living facility ALR-RC: Assisted living residence–residential care ALR-SRHC: Assisted living residence–supported residential healthcare RC/AL: Residential care/assisted living ALS Amyotrophic lateral sclerosis: Progressive nervous system disease that affects nerve cells in the brain and spinal cord, causing loss of muscle control; sometimes called “Lou Gehrig’s disease” after famous professional baseball player with this diagnosis. AMA American Medical Association: Nonprofit professional society advocating for and addressing the interests of its member physicians, with the mission to promote the art and science of medicine and the betterment of public health. https://www.ama-assn.org AMDA American Medical Directors Association (now the Society for Post-Acute and Long-Term Care Medicine or SPALTCM) ANA American Nurses Association: Nonprofit professional society advocating for and addressing the interests of its member professional nurses, with the mission of leading the profession to shape the future of nursing and healthcare. https://www.nursingworld.org/ana ANFP Association of Nutrition and Foodservice Professionals: Nonprofit professional society dedicated to the practice of providing optimum nutritional care through foodservice management. https://www.anfponline.org AOA Administration on Aging: Federal agency under the Department of Health and Human Services designated to carry out the provisions of the Older Americans Act. https://acl.gov/about-acl/administration-aging APC Association of Professional Chaplains: Nonprofit professional society advocating for and addressing the interests of its member healthcare chaplains, with the mission of promoting “quality chaplaincy care through advocacy, education, professional standards, and service to its members.” www.professionalchaplains.org APHA American Public Health Association: Nonprofit trade association advocating for and addressing the interests of its member public health agencies and professionals, with the mission to “improve the health of the public and achieve equity in health status.” https://apha.org APMA American Podiatric Medicine Association: Nonprofit professional society advocating for and addressing the interests of its member podiatrists, with the mission of https://www.apma.org APS Adult Protective Services: Social services provided by state and/or local governments serving older adults and adults with disabilities who are in need of assistance; investigates cases of abuse, neglect, or exploitation. (See also NAPSA.) APTA American Physical Therapy Association: Nonprofit professional society with the mission of “building a community that advances the profession of physical therapy to improve the health of society.” www.apta.org Arbitration Alternative dispute resolution (ADR) method in which one or more persons review a dispute and render a binding decision. Arc “The Arc” (formerly the Association for Retarded Citizens): Largest national community-based organization advocating for and with people with intellectual and developmental disabilities (I/DD) and their families, with the mission of promoting and protecting “the human rights of people with intellectual and developmental disabilities and actively support(ing) their full inclusion and participation in the community throughout their lifetimes.” https://thearc.org ARNP Advanced registered nurse practitioner: Credential earned by an RN who completes further clinical training reflecting their advanced proficiency in the profession. ASA American Society on Aging: Nonprofit membership organization advocating for and addressing the interests of its members, with the shared goal “to support the commitment and enhance the knowledge and skills of those who seek to improve the quality of life of older adults and their families.” https://www.asaging.org ASCP American Society of Consultant Pharmacists: Nonprofit professional society advocating for and addressing the interests of its member consulting pharmacists who focus on the unique medication needs of older adults, with the mission “to promote healthy aging by empowering pharmacists with education, resources, and innovative opportunities.” https://www.ascp.com Asepsis The absence of pathogens (harmful microbes); clean and sanitary. ASHA American Speech-Language-Hearing Association: Nonprofit professional society advocating for and addressing the interests of its member speech, language, and hearing therapists, with the mission of “empowering and supporting audiologists, speech-language pathologists, and speech, language, and hearing scientists through advancing science, setting standards, fostering excellence in professional practice, and advocating for members and those they serve.” https://www.asha.org ASL American sign language: Form of sign language developed in the United States and used also in English-speaking parts of Canada. Assault Intentionally giving another person reasonable concern about an imminent harmful or offensive contact. AUPHA Association of University Programs in Health Administration: Nonprofit association advocating for and addressing the interests of its member undergraduate academic programs in health services administration, with the mission of fostering “excellence and innovation in health management and policy education, and scholarship.” https://www.aupha.org/about/visionmissionvalues Autonomy Ethical concept focused on the importance of a person’s independence, freedom of choice, and self-determination. AWP Average wholesale price: The average value at which wholesalers sell prescriptions drugs to pharmacies and other customers, and it is the generally accepted standard measure for calculating the cost of a medication. B Bargaining unit Distinct group of employees whose job responsibilities and/or pay level might justify classifying them together for the purpose of unionization or collective bargaining. Battery Intentionally causing harmful or offensive contact with another person without their consent. BBA Balanced Budget Act of 1997: Established a Medicare prospective payment system for skilled nursing facility services. BCBS Blue Cross and Blue Shield: Federation of 36 insurance companies providing hospital (Blue Cross) and medical (Blue Shield) insurance products and services in both the group and individual markets. BCC Board-certified chaplain: Credential awarded by the Association of Professional Chaplains for demonstrating advanced proficiency in relevant knowledge and skills for serving as a healthcare chaplain. (See also APC.) BENHA Board of Examiners for Nursing Home Administrators: State government agency overseeing the professional licensing of long-term care administrators. Best FriendsTM Best FriendsTM approach to Alzheimer’s and dementia care: Program model pioneered by David Troxel and Virginia Bell that recasts the caregiver-recipient relationship from staff-patient to “best friends.” http://bestfriendsapproach.com BHO Behavioral healthcare organization: Provider focused on coordinating preventive and treatment services concerning behavioral factors in chronic illness care, non–disease-related physical symptoms, and health behaviors. BHP Behavioral health plan: Insurance program covering behavioral health conditions and interventions. BIW Brain injury waiver: Federal waiver permitting a state Medicaid program to provide home- or community-based services to persons with a brain injury. BLS Bureau of Labor Statistics: The U.S. Department of Labor bureau that tracks economic indicators (such as the Consumer Price Index) and employment data (such as the unemployment rate, pay and benefits, workplace safety performance and productivity). https://www.bls.gov Board and care home Congregate housing that provides basic shelter, food, nonmedical personal assistance, and safety monitoring. BRFSS Behavioral risk factor surveillance system: Collaborative project among all of the states and participating U.S. territories with the Centers for Disease Control and Prevention (CDC) to collect uniform data on adults’ health-related risk behaviors, chronic health conditions use of preventive services. Bundled payment Combined payment (per the Affordable Care Act) for services that Medicare reimburses separately in a fee-for-service model to each provider for the services it renders. C CADE Commission on Accreditation for Dietetics Education: Governs curriculum and related standards for academic programs preparing dietitians. CAH Critical Access Hospital: Centers for Medicare & Medicaid-designated primary healthcare hospital that provides limited outpatient and inpatient hospital services to people in rural areas. CAHME Commission on Accreditation of Healthcare Management Education: Private nonprofit NGO that offers objective assessment of graduate academic programs in health services management through its accreditation programs. CARF Commission on Accreditation for Rehabilitation Facilities: Independent, nonprofit organization focused on advancing the quality of services delivered by rehabilitation providers through its program accreditation programs. Case mix Acuity-based classification system to depict the care need profile of a patient population. CASPER Certification and Survey Provider Enhanced Reporting (formerly OSCAR): Centers for Medicare & Medicaid’s operational data resource for monitoring the status of a provider’s short- and long-term quality measure rates and the effectiveness of applied improvement strategies. CAST Center for Aging Services Technologies: LeadingAge’s initiative to unleash the potential of technology for innovative development across the continuum of healthcare, housing, and services for the aging. https://www.leadingage.org/leadingage-cast-mission-and-vision CBO Community-based organization: Noninstitutional provider of senior living services. or Congressional budget office: Federal agency charged with producing independent, impartial, and nonpartisan analyses of budgetary and economic issues to inform the Congressional budget process; does not make policy recommendations. https://www.cbo.gov CCC-A Certificate of Clinical Competence in Audiology: Credential awarded by the American Speech and Hearing Association for demonstrating advanced proficiency in relevant knowledge and skills for serving as an audiologist. (See also ABA.) CCC-SLP Certificate of Clinical Competence in Speech-Language Pathology: Credential awarded by the American Speech and Hearing Association for demonstrating advanced proficiency in relevant knowledge and skills for serving as an speech-language pathologist. CCGP Commission on Certification of Geriatric Pharmacy: Coalition of 11 professional organizations focused on creating uniform standards for pharmacy credentials and certifications. CCO Chief clinical officer: Lead executive staff member overseeing all clinical aspects of a provider organization’s operations especially QAPI and quality of life. (See CMO.) CCRC Continuing care retirement community: Senior living option with multiple levels of care co-located, from independent and assisted living to memory care, skilled nursing, and rehab care, as well as home health services, to accommodate changing needs. (See also life plan community.) CDBG Community Development Block Grant: The U.S. Department of Housing and Urban Development program that funds local community development activities that provide affordable housing, antipoverty programs, and infrastructure development. CDC Centers for Disease Control and Prevention: Federal agency under the Department of Health and Human Services, with the main goal of protecting public health and safety through the control and prevention of disease, injury, and disability. CDM Certified dietary manager: Credential awarded by the Association of Nutrition and Food Service Professionals for demonstrating basic proficiency in relevant knowledge and skills for serving as a dietary/dining services manager. CDO Consumer-directed options: Medicaid waiver that offers eligible beneficiaries more choices about how and when nonmedical services are provided and by whom. (Varies by state.) CE/CEU Continuing education professional learning experiences designed to augment knowledge and skills of healthcare professionals after completing their initial academic preparation; required for relicensure and/or specialty certification in most health professions. (Varies by state and discipline.) CEO Chief executive officer: Lead executive staff member overseeing all management and leadership aspects of a provider organization’s operations, especially strategic planning, social impact, governing board relations, and resource development. CFO Chief financial officer: Lead executive staff member overseeing all financial management aspects of a provider organization’s operations, especially budgeting, financial performance, and resource management. CFR Code of Federal Regulations: The codification of the general and permanent rules published in the Federal Register by the federal government’s departments and agencies. CHAMPUS Civilian Health and Medical Program of the Uniformed Services: Supplemental program to the Uniformed Services Direct Medical Care System (USDMCS); similar to private insurance programs; designed to provide financial assistance to CHAMPUS beneficiaries for certain prescribed medical care obtained from civilian sources. CHAMPVA Civilian Health and Medical Program of the Department of Veterans Affairs: Comprehensive healthcare program in which the VA shares the cost of covered healthcare services and supplies with eligible beneficiaries. https://www.va.gov/ CHC Community health center: Community-based health provider organization that delivers comprehensive, culturally competent, high-quality primary healthcare services to the nation’s most vulnerable individuals and families, including people experiencing homelessness, agricultural workers, residents of public housing, and the nation’s veterans. CHF Congestive heart failure: Condition in which the heart muscle is weakened and cannot pump normally, triggering fluid retention, particularly in the lungs, legs, and abdomen; major causes include coronary heart disease (most common), hypertension, idiopathic cardiomyopathy, and other heart diseases. CHRO Chief human resources officer: Lead executive staff member overseeing all personnel and human resources management aspects of a provider organization’s operations. CIL Center for Independent Living: Private non-governmental organization that is consumer-controlled, community-based, cross-disability, and nonresidential, designed and operated within a local community by individuals with disabilities, and provides an array of independent living services. or Centers for Independent Living: Federal agency under the Administration for Community Living, U.S. Department of Health and Human Services; focused on supporting community living and independence for people with disabilities. https://acl.gov/programs/aging-and-disability-networks/centers-independent-living CIO Chief information officer: Lead executive staff member overseeing all technology, information, and communication aspects of a provider organization’s operations, especially protected health information (PHI), cybersecurity, infrastructure, and redundancy. (See also CTO.) CMA or CMT Certified medication aide/technician: Nursing assistant with additional pharmacology training in fundamental pharmacology and relevant observation protocols. (Not all states.) CMD Certified medical director: Credential awarded by the Society for Post-Acute and Long-Term Care Medicine (formerly American Medical Directors Association) for demonstrating advanced proficiency in relevant knowledge and skills for serving as medical director in the senior living field. CME Continuing medical education: Professional learning experiences designed to augment knowledge and skills of physicians after completing their initial academic preparation; required for relicensure and/or specialty certification. (Varies by state and speciality.) CMHC Community Mental Health Center: Publicly funded, not-for-profit center that contracts with the government (federal, state, and/or local) to provide mental healthcare through inpatient, outpatient, day treatment, and emergency services. CMO Care Management Organization: NGO (for-profit or not-for-profit) that develops, coordinates, and monitors individualized service plans, typically for Medicaid beneficiaries. (See also MCO.) or Chief medical officer: Lead executive staff member overseeing all clinical aspects of a provider organization’s medical operations, especially quality assurance and performance improvement (QAPI) and quality of life. (See also CCO.) CMP Civil monetary penalty: Fine levied by Centers for Medicare & Medicaid Services in response to a Medicare/Medicaid-certified provider’s severe or consistent noncompliance with the regulations governing program participation. CMR Computerized medical record: Automated record of patient treatment information. (See also EHR or EMR.) CMS Centers for Medicare & Medicaid Services (formerly HCFA): Federal agency under the Department of Health and Human Services charged with overseeing program operations of Medicare and Medicaid. www.cms.gov CNA/SRNA Certified nursing assistant/aide or state-registered nursing assistant/aide: Provide direct or care services to residents/patients/clients/participants under the supervision of licensed nursing staff. COB Coordination of benefits: Centers for Medicare & Medicaid Services program that allows plans that provide health and/or prescription coverage for a Medicare beneficiary to determine their respective payment responsibilities. COBRA Consolidated Omnibus Budget Reconciliation Act of 1985: Federal law that affords qualified workers and their families who lose their health benefits the right to continue group health benefits provided by their group health plan for limited period under certain circumstances (i.e., voluntary or involuntary job loss, reduction in hours worked, transition between jobs, death, divorce, and other life events). COLA Cost of living adjustment: Periodic modification to wage rates or retirement payments to reflect inflation, generally based on the Consumer Price Index or some similar measure. CON Certificate of Need: Authorization from state health planning for a provider to make a significant capital investment for initiating or expanding a covered service. (Varies by state.) Conditions of Participation (Now Requirements of Participation): Centers for Medicare & Medicaid Services rules governing provider qualification for certification by Medicare and Medicaid. Controlled Substance Drug that is governed by the Controlled Substances Act, which categorizes drugs into five classifications (“schedules”) based on their potential for abuse, status in international treaties, and any medical benefits they may provide; includes hallucinogens, narcotics, depressants, and stimulants. COO Chief operating officer: Lead executive staff member overseeing and coordinating all aspects of a provider organization’s daily operations, especially regulatory compliance, quality assurance and performance improvement, resource optimization, and quality of life. (See also CCO.) Cost report Financial report filed by providers that informs Medicare and Medicaid reimbursement. COTA Certified occupational therapist assistant: Works under the direct supervision of an occupational therapist by performing specified treatments, documenting therapeutic interventions, and providing feedback on a patient’s progress. CPC Certified professional coder: Credential awarded by the American Academy of Professional Coders verifying basic proficiency in medical records coding. (Related: RHIT.) CPE Clinical pastoral education: Postgraduate academic program teaching pastoral care techniques and approaches to clergy and others; primary method of training healthcare chaplains and spiritual care providers in the United States, Canada, Australia, and New Zealand. CPOE Computerized/computer-based physician/provider order entry: Application that allows healthcare providers to directly enter medical orders electronically in EMR systems in a variety of care settings, replacing the more traditional order methods of paper, verbal, telephone, and fax. (See also CPOM.) CPT Current procedural terminology: Medical code set maintained by the American Medical Association (AMA) designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes; similar to ICD-10 coding, but identifies services rendered rather than diagnoses; revised each October. CPTAS Certified physical therapist aide specialist: Credential awarded by the National Career Certification Board for demonstrating basic proficiency in relevant knowledge and skills for serving as a PTA. CQI Continuous quality improvement: See QAPI. CTO Chief technology officer: Lead executive staff member overseeing all technology, information, and communication aspects of a provider organization’s operations, especially PHI, cybersecurity, infrastructure, and redundancy. (See also CIO.) Cultural competence Ability of a senior living provider organization to design and deliver services in alignment with the cultural needs and preferences of its customers. Culture change Senior living’s movement toward person-centered care, where the elder’s values, preferences, practices, and personhood are all considered in the planning and delivery of care; emphasis on individual choice, purposeful living, self-determination, and respect. Custodial care Nonmedical services, including assistance with performing activities of daily living (ADLs), but not nursing or rehabilitative treatments. CVA Cerebral vascular (or cerebrovascular) accident: Stroke; when blood flow to a part of the brain is suddenly stopped, either by a blockage or the rupture of a blood vessel, and preventing oxygen from reaching it. D DAT Dementia—Alzheimer’s type: A degenerative and progressive brain disease with varying combinations of symptoms, from memory loss, confusion, and cognitive decline to irritability, paranoia, and behavior changes. (See also AD—Alzheimer’s disease.) DCF Domiciliary care facility: Designation in some states or insurance policies describing a board-and-care home. DD Developmental disability (or developmentally disabled): A chronic condition due to a mental or physical impairment that emerges before adulthood and typically limits a person’s ability to learn, communicate, or live independently. DDA Developmental Disabilities Administration: State agency that assists individuals with developmental disabilities and their families to obtain services and support based on individual preference, capabilities, and needs. (Varies by state.) DDS Doctor of Dental Surgery: Professional degree awarded by accredited academic programs in dentistry for completing the required course of study; dentists diagnose and treat conditions affecting teeth, gums, and the oral cavity. (See also DMD.) Decision support system Information technology that provides analytical tools to support effective decision-making, especially for clinical applications, purchasing, and strategic planning. de minimus Doctrine Legal concept holding that a very small amount of either time or money is so insignificant that it makes accounting for it unreasonable or impractical. DHHS U.S. Department of Health and Human Services: Federal cabinet-level agency with the mission of enhancing and protecting the health and well-being of all Americans by providing for effective health and human services and fostering advances in medicine, public health, and social services. The ACL, CDC, CMS, HRSA, and NIH operate as agencies under the DHHS. (See also HHS.) https://www.hhs.gov DHS Department of Health Services: State agency responsible for overseeing and coordinating health programs, as well as targeted social programs. Also known as DHFS: Department of Health and Family Services DHMH: Department of Health and Mental Hygiene DHSS: Department of Health and Senior (or Social) Services DOH: Department of Health or U.S. Department of Homeland Security: Cabinet-level federal agency charged with overseeing the nation’s efforts concerning anti-terrorism, border security, immigration and customs, cybersecurity, and disaster prevention and management. https://www.dhs.gov DI Disability insurance: Type of insurance that provides continuing income if a covered worker is unable to fulfill their job duties due to an acquired disability. DMAIC Define–measure–analyze–improve–control: Refers to a data-driven improvement cycle used for optimizing and stabilizing an organization’s operating processes. Pronounced “də-MAY-ick,” it is an integral part of the Six Sigma initiative. DMD Doctor of Medical Dentistry: Professional degree awarded by accredited academic programs in dentistry for completing the required course of study; dentists diagnose and treat conditions affecting teeth, gums, and the oral cavity. (See also DDS.) DME Durable medical equipment: Equipment that provides therapeutic benefits to a person in need because of a medical condition, illness, or injury (typically not useful otherwise) and designed to endure repeated use; examples include a wheelchair, walker, or crutches. DNP Doctor of Nursing Practice: Terminal clinical graduate degree in the profession of nursing. DNR Do not resuscitate: Medical order written by a physician instructing all members of the healthcare team not to initiate cardiopulmonary resuscitation (CPR) if a patient’s heartbeat or breathing stops; typically established as an “advance directive” to reflect the patient’s preferences. DNS Director of Nursing Services: Administrative leader of a senior living provider’s nursing department. (See also DON.) DNS-CT Director of Nursing Services—Certified: Credential awarded by the American Association of Directors of Nursing for demonstrating advanced proficiency in managing a senior living nursing department. DO Doctor of Osteopathy (Physician): Professional degree awarded by accredited academic programs in osteopathic medicine for completing the required course of study; physicians diagnose and treat conditions of the whole body (or specialize in one aspect or body system), and educate patients on medical conditions and preventive care; all states recognize DOs as physicians and license them accordingly. DoE U.S. Department of Education: Cabinet-level federal agency with the mission “to promote student achievement and preparation for global competitiveness by fostering educational excellence and ensuring equal access.” (See also DOE.) https://www.ed.gov DOJ U.S. Department of Justice (also Justice Department): Federal agency charged with enforcing national civil and criminal laws, particularly those relating to antitrust, civil justice, civil rights, the environmental protection, and taxes. https://www.justice.gov DOL U.S. Department of Labor (also Labor Department): Federal agency administers federal labor laws to protect and guarantee workers’ rights to fair, safe, and healthy working conditions, including minimum hourly wages and overtime pay, protection against employment discrimination and provision of unemployment insurance. https://www.dol.gov DON Director of Nursing: Administrative leader of a senior living provider’s nursing department. (See also DNS.) DP Doctor of Pharmacy: Professional degree awarded by accredited academic programs in pharmacy for completing the required course of study. (See also PharmD.) DPAHC Durable Power of Attorney for Health Care: Document that designates someone as a person’s agent or proxy to make healthcare decisions if the patient is no longer able to make them. DPH Department of Public Health: State agency responsible for overseeing and administering programs and services aimed at protecting and fostering public health. DPM Doctor of Podiatric Medicine: Professional degree awarded by accredited academic programs in podiatric medicine for completing the required course of study; podiatrists diagnose and treat conditions affecting the foot, ankle, and related structures of the leg. DPOA Durable power of attorney: Formal written designation of someone to act as one’s agent of proxy in managing legal or financial transactions; “durable” means that if the principal becomes incapacitated, the form would remain valid and in effect. DPOC Directed plan of correction: When a Medicare/Medicaid-certified senior living provider receives notice from the Centers for Medicare & Medicaid Services (CMS) that an inspection has identified an Immediate Jeopardy (IJ) situation (alleging that the provider’s noncompliance with one or more of the requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a patient), the CMS may direct the provider to take specific corrective action to achieve specific outcomes within prescribed time frames. DPT Doctor of Physical Therapy: Professional degree awarded by accredited academic programs in physical therapy for completing the required course of study; physical therapists treat and guide people to restore movement, relieve pain, improve strength, and/or prevent disability. DRG Diagnosis-related group: Cost classification method included in the prospective payment system used by Medicare and other insurers to determine reimbursement rates based on a hospital’s mix of diagnoses and related treatments. DSH Disproportionate share hospital: Acute care provider that received payments statutorily required payments intended to offset its uncompensated care costs to improve access for Medicaid and uninsured patients, as well as preserve its financial stability as a safety-net hospital. DSM-5 Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition): The standard reference used by healthcare providers to diagnose mental and behavioral conditions, published by the American Psychiatric Association. E EAP Employee assistance plan (or program): Plan or program that provides employees with short-term counseling, referrals to specialized professionals or organizations, and follow-up services to address significant life challenges they may face. EBM Evidence-based medicine: Judicious and reasonable application of the most current scientific research evidence in making decisions about the care of individual patients. ECF Extended care facility: Medical institution that provides prolonged care; popularly used in the early days of Medicare, but replaced in federal and most state regulations by other terms, such as intermediate care facility, nursing facility, or skilled nursing facility. ED Emergency department: Hospital department responsible for the provision of medical and surgical care to patients arriving at the hospital in need of immediate care. (See also ER.) EEOC U.S. Equal Employment Opportunity Commission: Agency responsible for enforcing federal laws regarding discrimination or harassment against a job applicant or an employee because of the person’s race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability, or genetic information. https://www.eeoc.gov e-HIE Electronic health information exchange: Health information exchange network for securely sharing clinical information over the Internet nationwide; spans all 50 states. (See also HIE.) EHR Electronic health record: Automated record of patient treatment information. (See also CHR EMR.) EJCC Elder Justice Coordinating Council: Federal entity under the Administration for Community Living charged with identifying and proposing solutions to the problems surrounding elder abuse, neglect, and financial exploitation. Elimination period Initial waiting period after admission to qualify for insurance benefits to become active; typically 20–60 days. Employment-at-will Doctrine that holds an employer can terminate an employee at any time for any reason (except an illegal one) without incurring legal liability, and an employee can leave a job at any time for any reason with no adverse legal consequences. EMR Electronic medical record: Automated record of patient treatment information. (See also CHR or EHR.) EMS Emergency medical services: Network of services providing aid and medical assistance from primary response to definitive care, involving personnel trained in the rescue, stabilization, transportation, and advanced treatment of traumatic medical emergencies. ENP Elderly Nutrition Program: (See NPE—Nutrition Program for the Elderly) ER Emergency room: Hospital department responsible for the provision of medical and surgical care to patients arriving at the hospital in need of immediate care. (See also ED.) ERISA Employee Retirement and Income Security Act of 1974: Federal law that protects Americans’ retirement assets by implementing rules that qualified plans must follow to ensure that plan fiduciaries properly manage plan assets. ESRD End-stage renal (kidney) disease: When gradual loss of kidney function reaches an advanced state, rendering one’s kidneys ineffective. F FADE Focus–analyze–develop–execute: Quality improvement approach aimed at either strengthening process safety or consumer experience or evaluating changes in efficiency or workflow. FCA False Claims Act of 1863: Federal law prohibiting knowingly presenting a false or fraudulent claim to the U.S. government for payment; “knowingly” means either having actual knowledge that information is false or acting with reckless disregard of the truth. FDA U.S. Food and Drug Administration: Federal agency responsible for reviewing, approving, and regulating medical products, including pharmaceutical drugs and medical devices and regulating various other products, including food, cosmetics, veterinary drugs, radiation-emitting products, biological products, and tobacco. https://www.fda.gov FDAMA Food and Drug Administration Modernization Act of 1997: Federal law that increased patient access to experimental drugs and medical devices, accelerated the review of promising new medications and provided for an expanded database on clinical trials. Federal Register The daily journal of the federal government; published every business day by the National Archives and Records Administration (NARA)’s Office of the Federal Register (OFR); includes federal agency regulations (proposed rules and notices of interest to the public), executive orders, proclamations, and other presidential documents. FEHBP Federal Employees Health Benefits Program: System through which health insurance benefits are provided to civilian government employees of the U.S. government and their families. FEMA U.S. Federal Emergency Management Agency: Federal agency with the purpose of coordinating aid and responding to disasters around the nation when local resources are insufficient. https://www.fema.gov FFS Fee-for-service: Health insurance payment system in which a provider is paid a fee for each particular service rendered. FHA Fair Housing Act of 1968 (and amendments): Federal law that prohibits discrimination on the basis of disability in all types of housing transactions; disability means mental or physical impairments that substantially limit one or more major life activities, such as blindness, impaired hearing or mobility, HIV infection, intellectual or developmental disability, alcoholism, drug addiction, chronic fatigue, learning disability, head injury, or mental illness. or U.S. Federal Housing Administration: Federal agency in the Department of Housing and Urban Development (HUD) that sets standards for construction and underwriting and insures loans made by banks and other private lenders for home building; its central goals are to improve housing standards and conditions, provide an adequate home financing system through insurance of mortgage loans, and stabilize the mortgage market. https://www.hud.gov/federal_housing_administration FI Fiscal intermediary: An entity that has a contract with the Centers for Medicare & Medicaid Services to determine and to pay Medicare Part A and some Part B bills submitted by certified providers and to perform other related functions. FICA Federal Insurance Contributions Act of 1935 (and amendments): Federal law establishing payroll taxes to fund the Social Security and Medicare programs; composed of the old-age, survivors and disability insurance taxes (Social Security) and the hospital insurance tax (Medicare); different rates apply and are calculated as a percentage of the employee’s wages. FIFO First-in-first-out: Asset management and valuation method in which assets produced or acquired first are sold, used, or disposed of first; applicable to accounting and inventory control. Fixed Cost Operating expense that does not fluctuate with census (i.e., property tax or mortgage). FLSA Fair Labor Standards Act of 1938 (and amendments): Federal law that establishes minimum wage, overtime pay, recordkeeping, and youth employment standards. FMAP Federal Medical Assistance Percentage: Metric used in determining the amount of federal matching funds to distribute to each state for its expenditures on assistance payments for certain social services and Medicaid program. FMEA Failure mode and effects analysis: Proactive and systematic method for evaluating a process, identifying how it might fail, and assessing the relative impact of the failure(s), in order to flesh out which part(s) of the process to consider changing. FMLA Family and Medical Leave Act of 1993 (and amendments): Federal law that requires covered employers to provide employees with job-protected and unpaid leave for qualified medical and family events. FPL Federal poverty level: Measure of income issued every year by the Department of Health and Human Services used to determine eligibility for certain programs and benefits, from marketplace health insurance to Medicaid and Children’s Health Insurance Program (CHIP) coverage. https://www.healthcare.gov FSBPT Federation of State Boards of Physical Therapy: Nonprofit professional association of state boards of physical therapy advocating for and addressing the interests of its member professional licensing boards, with the mission of protecting the public by providing service and leadership that promote safe and competent physical therapy practice. https://www.fsbpt.org FSES Fire safety evaluation system: Measuring system for ensuring compliance of a provider’s blend of safeguards with the standards set forth in NFPA 101—Life Safety Code. FTD Frontotemporal degeneration: Clinical syndrome associated with shrinking of the frontal and temporal anterior lobes of the brain; the National Institute of Neurological Disorders and Stroke (NINDS) groups together Pick’s disease, primary progressive aphasia, and semantic dementia as FTD. (See also ADRD.) FTE Full-time equivalent (or employee): Measure that reflects the number of full-time employees an organization would have during a given period. Example: If 100 employee hours are recorded for the week and assuming a full-time employee works 40 hours per week, the full-time equivalent calculation is 100 hours/40 hours = 2.5 FTEs. (Also known as work-time equivalent or WTE.) FUTA Federal Unemployment Tax Act of 1939 (and amendments): Federal law that allows the government to collect a tax on businesses with employees for the purpose distributing funds to state unemployment agencies to provide unemployment benefits to qualified citizens. G GA General assistance (also general relief): Term used in some states to describe social programs intended to benefit adults without dependents. GAAP Generally accepted accounting principles: Set of rules recognized by the Financial Accounting Standards Board (FASB) that encompass the details, complexities, legalities, methods, and practices of business and corporate accounting. GAO U.S. Government Accountability Office: Federal agency that monitors and audits government spending and operations and provides results directly to Congress. https://www.gao.gov GDP Gross domestic product: Total monetary value of all the finished goods and services produced within a country’s borders in a specific time period; a comprehensive scorecard of the country’s economic health. Geriatrics Branch of medicine focused on the health and wellness of older adults. Gerontology Study of aging; area of knowledge concerning the aging process and associated changes. GHP Green House® Project: Private non-governmental organization with the mission of partnering with “organizations, advocates, and communities to lead the transformation of institutional long-term and postacute care by creating viable homes that spread the Green House Project vision—demonstrating more powerful, meaningful, and satisfying lives, work, and relationships.” https://www.thegreenhouseproject.org GNP Gerontological (or geriatric) nurse practitioner: Credential earned by an RN who completes further clinical training reflecting their advanced proficiency in gerontological nursing. GP General practitioner: Physician who treats acute and chronic illnesses, as well as provides preventive care and health education, to patients of any age and gender. GPO Group purchasing organization: Entity that helps service providers realize savings and efficiencies by aggregating their purchasing volume and using that leverage to negotiate discounts with manufacturers, distributors, and other vendors. GSA Gerontological Society of America: Nonprofit membership organization addressing the interests of its members, promoting the advancement and dissemination of multi- and interdisciplinary research in aging, and supporting and advocating for aging education and training. https://www.geron.org G-Tube Gastrostomy tube: Small tube inserted through the abdomen that delivers nutrition directly to the stomach. Guardian A person who has been court-appointed to assume legal responsibility to care for another person (called a “ward”), including their personal and property interests, and to make decisions on the ward’s behalf; requires the court to determine the ward as incapable of exercising judgement in their own best interest (incompetent). H H&P History and physical: Documentation of a patient’s medical history and assessment of their current condition; typically completed at (or before) admission, and one of the first entries in the medical record. HAA Hospice Association of America: Now affiliate of the National Association of Home Care and Hospice (NAHC). HAB U.S. HIV/AIDS Bureau: Federal agency under Department of Health and Human Services established to address HIV/AIDS; over one-half of people living with HIV in the United States receive services through its “Ryan White HIV/AIDS Program” annually. https://hab.hrsa.gov HBPC Hospital-based primary care: Health professional in an acute care setting serves as the first contact and principal point of continuing care for patients within a healthcare system and coordinates other specialist care that the patient may need. HCB Home- and community-based care or services: Formal services provided in home- or community-based settings and covered by either private or public funds (senior living examples: hospice, home health, and adult day care). Related terms: HCB-D: Home- and community-based services for the developmentally disabled HCB-S: Home- and community-based services HCB-W: Home- and community-based care waiver program HCD Healthcare directive: Legal document that takes effect if one cannot make decisions due to illness or incapacity, such as a living will (instructions on which measures can be used to prolong life) or medical power of attorney (appointment of a surrogate decision-maker for medical questions). (See also AD—advance directive.) HCFA Health Care Financing Administration (now called Centers for Medicare & Medicaid Services) HCPOA Health Care Power of Attorney: Legal document that empowers another person to make decisions about one’s medical care; term refers to both the document and the specific person appointed with this legal authority. HFMA Healthcare Financial Management Association: Nonprofit professional society advocating for and addressing the interests of its members, including helping them achieve optimal performance by providing the practical tools and solutions, education, industry analyses, and strategic guidance needed to address the many challenges surrounding the U.S. healthcare. HHA Home Health Agency: Public or private organization that offers skilled nursing care and at least one other therapeutic service in the residence of the client through physicians, nurses, therapists, social workers, and homemakers. HHS U.S. Department of Health and Human Services: Federal cabinet-level agency with the mission of enhancing and protecting the health and well-being of all Americans by providing for effective health and human services and fostering advances in medicine, public health, and social services. The ACL, CDC, CMS, HRSA, and NIH operate as agencies under the DHHS. (See also DHHS.) https://www.hhs.gov HIE Health information exchange: Electronic transmission of healthcare-related data among medical facilities and providers, health information organizations (companies that facilitate the exchange of these data), and government agencies, according to national standards; with the goal of improving the speed, quality, safety, and cost of patient care. (See also e-HIE.) HIMSS Health Information Management and Systems Society: Nonprofit professional society advocating for and addressing the interests of its member health information technology professionals, with the mission of reforming the global health ecosystem through the power of information and technology. https://www.himss.org HIPAA Health Insurance Portability and Accountability Act of 1996: Federal law ensuring that individual healthcare plans are accessible, portable, and renewable and setting the standards and the methods for how health data are shared across the U.S. health system. HIT Health information technology: Design, development, creation, use, maintenance, and protection of information systems for the healthcare industry. HITECH Health Information Technology for Economic and Clinical Health Act of 2009: Federal law that creates incentives related to healthcare information technology and the use of electronic health record (EHR) systems among providers. HIV Human immunodeficiency virus: A virus that can lead to immune system deterioration in humans, eroding its capacity for working normally; can lead to the development of AIDS (stage 3 HIV). (See also AIDS.) HL-7 Health level 7: Most widely recognized standards for measuring the degree of meaningful use achieved by interfacing computer software programs come mainly from a not-for-profit organization called Health Level Seven International. www.hl7.org HMO Health maintenance organization: A network or organization that provides health insurance coverage through doctors and other providers who are under contract to the HMO, typically exchanging increased patient volume from the HMO for lower fees. HPRD Hours per resident (per) day: Total number of hours worked divided by the total number of residents/patients/clients/participants/customers. HSA Health savings account: Tax-advantaged personal savings account that enables an employee with an HSA-qualified health plan save money on many out-of-pocket medical expenses, such as co-pays for doctor visits, prescriptions, or vision and dental care. HSE Health services executive (qualification): Credential awarded by the National Association of Long-Term Care Administrator Boards (NAB) in recognition of demonstrating relevant knowledge and skills to lead senior living organizations across the postacute continuum of care. HUD U.S. Department of Housing and Urban Development: Cabinet-level federal agency with the charge of providing affordable housing and community development assistance, and to ensure that all citizens have “fair and equal” access to housing. https://www.hud.gov I I&R Information and referral: Active process of linking a person with a need or problem with a service, which will meaningfully address the need or satisfactorily solve the problem. IAA Intra-agency agreement: Written contract in which one federal agency agrees to provide to, purchase from, or exchange with another federal agency services, information, supplies, or equipment. IADL Instrumental activities of daily living: Activities or tasks performed by an individual daily that are not essential to basic self-care and independent living but add quality to the way of life, such as operating the telephone, shopping, meal preparation, or light housekeeping. ICD-10 International Classification of Diseases and Related Health Problems (10th Edition): Medical classification list of the World Health Organization (WHO) that assigns codes to diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases; standard used for justifying billable charges and care planning. ICDR Interagency Committee on Disability Research: Federal agency established to promote coordination and collaboration among federal departments and agencies conducting disability, independent living, and rehabilitation research programs, including research related to assistive technology and principles of universal design. https://icdr.acl.gov ICF Intermediate care facility: Healthcare facility for individuals who are disabled, elderly, or nonacutely ill, usually providing less intensive care than that offered at a hospital or skilled nursing facility. ICF/MR Intermediate care facility for persons with mental retardation or a developmental disability. ICFDD Healthcare facility providing residential and rehabilitation services to people with intellectual disabilities or a related condition. ICU Intensive care unit: Specialized section of a hospital that provides comprehensive, continuous care for persons who are critically ill. IDD Intellectual and developmental disabilities: According to the American Association on Intellectual and Developmental Disabilities, the latter is an umbrella term that includes not only intellectual disability but also other disabilities that are apparent during childhood. Developmental disabilities are severe chronic disabilities that can be physical, cognitive, or both. Intellectual disability refers to a person’s limited ability to learn at an expected level and function in daily life. IDEA Individuals with Disabilities Education Act: Federal law that provides rights and protections to people with disabilities and to their parents or legal guardians. IDR Informal dispute resolution: Process in which two disagreeing parties can engage to avoid legal proceedings, meeting with a third party who facilitates discussions and negotiations to arrive at a resolution. Many states maintain an IDR process for providers to contest survey findings with which they disagree. IDT Interdisciplinary team: Group of healthcare professionals representing different fields who work together to optimally plan, provide, and evaluate care for a person. ILU Independent living unit: Housing option for senior living when little or no additional services are routinely required by the tenant; examples: apartment, condominium, or continuing care retirement community (CCRC). IMPACT Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: Federal law requiring Medicare- and Medicaid-certified providers (SNFs, IRFs, and HHAs) to submit standardized patient assessment data (i.e., MDS, PAI, and OASIS-D, respectively). Interoperable Electronic medical record data that are compatible across multiple operating systems. IOM Institute of Medicine: Nonprofit non-governmental organization established in 1970 as a component of the U.S. National Academy of Sciences that works outside the framework of government to conduct and advance evidence-based research and recommendations concerning public health and science policy. IQIES Internet quality improvement and evaluation system: Centers for Medicare & Medicaid Services’s online system for SNFs, IRFs, and HHAs to submit their IMPACT data. IRB Institutional review board: Administrative body established to protect the rights and welfare of human research subjects recruited to participate in research activities conducted under the auspices of the institution, typically a university, with which it is affiliated. IRC Internal Revenue Code: Title 26 of the U.S. Code that covers all relevant rules pertaining to income, gift, estate, sales, payroll, and excise taxes. IRF Inpatient rehabilitation facility: Free-standing rehabilitation hospital or rehabilitation unit in an acute care hospital that provides an intensive rehabilitation program of at least 3 hours per day. ISN Intensive skilled nursing: High-tech and sophisticated skilled nursing care for people with complex comorbidities. I-SNP Institutional special needs plan: Insurance model that allows nursing homes to provide a higher level of care and control the disbursement of funds. ISP Individual service plan: Assessment tool for use by residential care/assisted living communities; typically focused on supporting emotional, psychosocial, and spiritual wellness and on addressing cognitive impairment and accessing appropriate community resources. IT Information technology: Use of computers, infrastructure, and processes to create, process, store, secure, and exchange all forms of electronic data. J JCAHO The Joint Commission on Accreditation of Healthcare Organizations: (Now The Joint Commission) Joint Commission Nonprofit non-governmental organization offering unbiased, objective assessment of quality achievement by inpatient care and safety through its accreditation programs for healthcare provider organizations. https://www.jointcommission.org JV Joint venture: Separate organization formed by two or more existing organizations with the intent of pursuing a common mission or business purpose. K Kickback Payment or item of value given to someone as compensation or reward for providing favorable treatment. Example: Incentivizing patient referrals by paying or providing in-kind gifts to a physician. L LANE Local area networks for excellence: Coalition of stakeholders at the state level formed for the collective purpose of supporting providers and consumers in achieving the goals of the “National Nursing Home Quality Improvement Campaign” (formerly known as “Advancing Excellence in Nursing Homes Campaign”), a national collaborative effort to transform the quality of care and quality of life for nursing home residents. (See also NNHQI.) LBD Lewy body dementia: Disease associated with abnormal deposits of α-synuclein protein in the brain, called Lewy bodies, which can lead to problems with thinking, movement, behavior, and mood. (See also ADRD.) LCSW Licensed clinical social worker: Assists care recipients with obtaining needed services, as well as provides counseling for them and their families. LDS Limited data set: Collection of identifiable patient information as defined in the Privacy Regulations issued under the Health Insurance Portability and Accountability Act (HIPAA). Leading Age Formerly the American Association of Homes and Services for the Aging (AAHSA): Nonprofit age trade association representing faith-based and mission-driven providers of senior housing, postacute, and long-term care services. https://www.leadingage.org/ LHI Leading health indicator: High-priority health issues and actions that can be taken to address them identified by Department of Health and Human Services’ Office of Disease Prevention and Health Promotion in “Healthy People 2020.” Life plan community Senior living option with multiple levels of care co-located, from independent and assisted living to memory care, skilled nursing, and rehabilitation care, as well as home health services, to accommodate changing needs. (See also CCRC.) LNHA Licensed nursing home administrator. (See NHA.) LOC Level of care: Classification term used by providers, regulators, and third-party payers to describe the type and amount of care a person requires. LOI Letter of intent: Nonbinding document detailing a planned action on the part of an organization or individual. LOS Length of stay (or service): Period of time a person remains in a healthcare facility as an inpatient (or receives home- and community-based services (HCBS). LPN Licensed practical nurse: Professional nurse who has completed a state-approved academic program and passed the NCLEX-PN(R) exam. (See also LVN.) LSC Life Safety Code, NFPA 101: Most widely adopted standards for building design safety, published by the National Fire Protection Association (NFPA) with three central goals—protection of life, protection of property, and restoration and use of a building following a fire or other emergencies, such as earthquakes, floods, blackouts, and terrorism. LSOA Longitudinal Study of Aging (I and II): Collaborative effort of the National Center for Health Statistics (NCHS) and the National Institute on Aging (NIA) to perform a prospective study of noninstitutionalized persons 70 years of age and over from 1984—1999. LTAC Long-term acute care: Treatment of persons with serious medical conditions requiring ongoing care, but no longer requiring intensive care or extensive diagnostic procedures. LTACH Long-term acute care hospital: Facilities that specialize in the treatment of persons with serious medical conditions requiring ongoing care, but no longer requiring intensive care or extensive diagnostic procedures. LTC Long-term care: Supports and services that include medical and nonmedical care provided to people who are unable to perform basic activities of daily living, whether at home or in a congregate living setting. LTCF Long-term care facility: Residential community that provides long-term care services. LTCI Long-term care insurance: Insurance policy that provides reimbursement for services performed by a long-term care provider for a person who needs constant supervision due to having a chronic or disabling condition. LTC Partnership Joint federal state policy initiative to promote the purchase of private long-term care insurance by shielding contract holders from Medicaid spend-down requirements through innovative coverage design (not available in all states). LTD Long-term disability insurance: Private insurance coverage that, following a qualifying period (typically 3–6 months), at least partially replaces a person’s income in the event of a medical condition that stops them from working; commonly provided by employers under a group policy. LVN Licensed vocational nurse: Professional nurse who has completed a state-approved academic program and passed the NCLEX-PN(R) exam. (See also LPN.) M MA Medical assistance: Synonym for a state’s Medicaid program. or Medical assistant: Person who performs a variety of routine administrative and clinical tasks in a clinical healthcare setting, under the direction of a qualified licensed health professional. MAC Medicare administrative contractor: Private health insurer that has been awarded a geographic area or “jurisdiction” to regionally manage the policies and process medical claims for Medicare beneficiaries. MAR Medication administration record: Schedule for administering medications to a patient for a defined period of time, including dosing, timing of administration, and details about the physician’s orders. Market segmentation Process of dividing a large market into smaller units in order to more finitely describe an organization’s target market. MCO Managed care organization: Non-governmental organization (for-profit or not-for-profit) that develops, coordinates, and monitors individualized service plans, typically for Medicaid beneficiaries. (See also CMO.) MD Medical doctor (physician): Professional degree awarded by accredited academic programs in allopathic (traditional) medicine for completing the required course of study; physicians diagnose and treat conditions of the whole body (or specialize in one aspect or body system) and educate patients on medical conditions and preventive care. MDS Minimum data set: Tool for implementing standardized assessment and for facilitating care management in Medicare-certified skilled nursing facilities (SNFs) and noncritical access hospital swing beds (SBs). MED Mixed etiology dementias: In a person with mixed dementia, it may not be clear exactly how many of a person’s symptoms are due to Alzheimer’s disease or another type of dementia. (See also ADRD.) Mediation Alternative dispute resolution (ADR) method with a neutral person helping the parties find a solution to their dispute. Medicaid Title 19 of the Social Security Act; jointly funded federal state health insurance program for medically indigent citizens that is administered by each participating state; largest public pay source for senior living services. (See also Title 19.) Medically Indigent Person who does not have—and cannot afford—health insurance. Medicare Title 18 of the Social Security Act; federal healthcare entitlement and insurance program for older and certain disabled adults, as well as people with end-stage renal disease (ESRD). (See also Title 18.) MedPAC Medicare Payment Advisory Commission: Nonpartisan federal legislative agency established by the Balanced Budget Act of 1997 to provide Congress with analysis and policy advice concerning the Medicare program. http://medpac.gov MEPS Medical Expenditure Panel Survey: Set of large-scale surveys of families and individuals, their medical providers, and employers across the United States that provides the most comprehensive source of data available on the cost and use of healthcare and health insurance coverage. MFCU Medicaid Fraud Control Unit: State agency that investigates and prosecutes Medicaid provider fraud, as well as patient abuse or neglect, in healthcare facilities and board and care facilities; operates in all states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. MFP Money follows the person: Federal program designed to move elderly Medicaid recipients out of nursing homes into their own homes (or into their families’ homes); the program also includes, in some states, persons considered at risk of nursing home placement. MGMA Medical Group Management Association: Nonprofit professional society advocating for and addressing the interests of its member medical group practice managers, with the mission of empowering medical group practices, providers, and patients to create meaningful change in healthcare. https://www.mgma.com MH/SA (or MHSA) Mental health and substance abuse. (See SA/MH—Substance Abuse and Mental Health.) MHA Master’s degree in healthcare administration: Graduate degree awarded by an institution of higher education for completing an academic program in healthcare management and leadership, typically accredited by the Commission on Accreditation of Healthcare Management Education (CAHME). or Mental Health Authority: Federally recognized state agency with responsibility for overseeing public programs for the benefit of people with mental illness. MHBG (Community) Mental Health (Services) Block Grant: Federal grant awarded to states and territories by Substance Abuse and Mental Health Services Administration (SAMHSA) to improve access to community-based healthcare delivery systems for adults with serious mental illnesses and children with serious emotional disturbances. MHPA Mental Health Parity Act of 1996: Federal law that prohibits large group health plans from imposing annual or lifetime dollar limits on mental health benefits that are less favorable than those imposed on medical/surgical benefits. MHSA Master’s degree in health services administration. (See MHA—master’s degree in healthcare administration.) MIG Medicaid Infrastructure Grant: Competitive federal grant program that has provided funding to states for Medicaid infrastructure development and build supports for people with disabilities who would like to be employed. MIPPA Medicare Improvements for Patients and Providers Act of 2008: Multifaceted federal law that introduced new funding for State Health Insurance Assistance Programs (SHIPs), Area Agencies on Aging (AAAs), and Aging and Disability Resource Centers (ADRCs) to help low-income Medicare beneficiaries apply for programs that make Medicare affordable. MMA Medicare Prescription Drug Improvement and Modernization Act of 2003: Federal law that among several modifications to Medicare introduced a new voluntary prescription drug benefit program (Part D). MMIS Medicaid management information system: Integrated group of procedures and computer processing operations (subsystems) developed at the general design level to meet principal data management objectives for state Medicaid programs. MMSE Mini-Mental Status (or Folstein) Examination: Brief, structured test of mental status; the most widely used test to assess problems with memory and other cognitive functions. MOU Memorandum of understanding: A nonbinding agreement between at least two parties that outlines the responsibilities of each of the parties to the agreement. MR/DD Mental retardation and other developmental disabilities: Mental retardation is a developmental disability that first appears in children under 18 years, which is characterized by an intellectual functioning level that is well below average (as measured by standard tests for intelligence quotient) and significant limitations in performing daily living skills (adaptive functioning). (See also IDD—intellectual and developmental disabilities.) MRSA Methicillin-resistant Staphylococcus aureus: Bacterium that causes infections and is more difficult to treat than most strains of bacteria because it does not respond to many of the most commonly used antibiotics. MS Multiple sclerosis: Chronic, progressive disease involving damage to the sheaths (myelin) of nerve cells in the brain and spinal cord resulting from the immune system abnormally attacking them. MSD Musculoskeletal disorder: Injury or illness affecting the connective tissues, such as cartilage, joints, muscles, nerves, tendons, or spinal discs. MSDS Material safety data sheet: Documentation concerning potentially hazardous chemicals or components in a particular substance or product. MSW Master’s degree in social work: Graduate degree awarded by an institution of higher education for completing an academic program in social services, typically accredited by the Council on Social Work Education (CSWE). N N4A National Association of Area Agencies on Aging: Nonprofit association advocating for and addressing the interests of its member Area Agencies on Aging, with the mission of building the capacity of its members so they can help older adults and people with disabilities live with dignity and choices in their homes and communities for as long as possible. https://www.n4a.org NAAP National Association of Activities Professionals: Nonprofit professional society advocating for and addressing the interests of its member LTC activity professionals, with the mission of providing excellence in professional support services for activity professionals in the promotion of standards, ethics, competencies, education, and advocacy. https://naap.info NAB National Association of Long-Term Care Administrator Boards: Nonprofit association advocating for and supporting the interests of its member professional licensing boards governing the practice of long-term care administration. https://www.nabweb.org NACA National Advisory Council on Aging: Advises the Secretary of the Department of Health and Human Services, Director of the National Institutes of Heath, and Director of National Institute on Aging by reviewing and recommending applications for research and training concerning aging services. https://www.nia.nih.gov/about/naca NADONA/LTC National Association of Directors of Nursing Administration/Long-Term Care: Nonprofit professional society advocating for and addressing the interests of its member Directors of Nursing in long-term care settings. https://www.nadona.org NAHC National Association for Home Care and Hospice: Nonprofit trade association advocating for and addressing the interests of its member providers of home care and hospice services, with the mission of promoting, protecting, and advancing the highest quality healthcare at home. https://www.nahc.org NAHMA National Affordable Housing Management Association: Nonprofit professional society advocating for and addressing the interests of its member managers and sponsors of affordable housing for seniors and families, with the mission of supporting legislative and regulatory policy that promotes the development and preservation of decent and safe affordable housing. https://www.nahma.org NAMI National Alliance on Mental Illness: Nonprofit membership association representing the interests of its members, with the mission of providing advocacy, education, support, and public awareness so that all individuals and families affected by mental illness can build better lives. https://www.nami.org NAPSA National Adult Protective Services Association: Nonprofit association advocating for and addressing the interests of its member adult protective service agencies, with the mission of strengthening Adult Protective Services programs in order to improve the safety and quality of life of vulnerable adults who are victims of abuse, neglect, self-neglect, or financial exploitation. https://www.napsa-now.org NASUA National Association of State Units on Aging. (Now Advancing States.) NASW National Association of Social Workers: Nonprofit professional society advocating for and addressing the interests of its member social services professionals, with the mission of promoting the quality and effectiveness of social work practice in the United States through services to individuals, groups, and communities. https://www.socialworkers.org NBCOT National Board for Certification in Occupational Therapy: National standards board for the profession of occupational therapy, with the mission of serving the public interest by advancing client care and professional practice through evidence-based certification standards and the validation of knowledge essential for effective practice in occupational therapy. https://www.nbcot.org NCAL National Center for Assisted Living: Nonprofit trade association (affiliated with AHCA) representing the interests of its member assisted living and residential care communities, with the mission of leading the assisted living profession through public policy advocacy, knowledge, education, and professional development. https://www.ahcancal.org NCCAP National Certification Council for Activities Professionals: Affiliate of the National Association of Activities Professionals; governs practice standards regarding quality of life, activities, and engagement across all senior living care settings. NCCNHR National Consumer Voice for Quality Long-Term Care (formerly the National Citizen’s Coalition for Nursing Home Reform): Nonprofit consumer advocacy non-governmental organization with the mission of improving the nation’s long-term care system and quality of life for consumers of long-term care. http://nursinghomeaction.org NCCPA National Council of Certification of Physician Assistants: Standards-setting body governing professional certification for Physician’s Assistants. https://www.nccpa.net NCD National Council on Disability: Independent federal agency charged with advising the President, Congress, and other federal agencies regarding policies, programs, practices, and procedures that affect people with disabilities. https://ncd.gov NCEA National Center on Elder Abuse: Federal agency under the U.S. Administration on Aging charged with serving as a national resource center dedicated to the prevention of elder mistreatment, with the mission of improving the national response to elder abuse, neglect, and exploitation; it aims to gather, house, disseminate, and stimulate innovative, validated methods of practice, education, research, and policy. https://ncea.acl.gov NCHS National Center for Health Statistics: Federal agency under the Centers for Disease Control and Prevention (CDC) that compiles statistical information to help guide policies to improve the health of Americans. https://www.cdc.gov/nchs NCLEX-PN® National Council Licensure Examination-Practical Nurse: Exam administered by National Council of State Boards of Nursing (NCSBN) to practical nurses (PNs) to measure a person’s command of appropriate professional nursing knowledge and skills for state licensure as a practical (or vocational) nurse. NCLEX-RN® National Council Licensure Examination-Registered Nurse: Exam administered by National Council of State Boards of Nursing (NCSBN) to RNs to measure a person’s command of appropriate professional nursing knowledge and skills for state licensure as a registered nurse. NCOA National Council on the Aging: Nonprofit membership association advocating for and addressing the interests of its members, with the mission of improving the lives of older adults, especially those who are struggling. https://www.ncoa.org NCQA National Committee for Quality Assurance: Private non-governmental organization dedicated to improving healthcare quality through its evidence-based tools, such as HEDIS (Health Effectiveness Data and Information Set). https://www.ncqa.org NCSBN National Council of State Boards of Nursing: Nonprofit professional association that advocates for and represents the interests of its member state boards of nursing, including administration of the national licensing examinations for RNs and LPN/LVNs. https://www.ncsbn.org NCSL National Conference of State Legislatures: Nonprofit association representing the interests of legislatures in the states, territories, and commonwealths of the United States with the mission of advancing the effectiveness, independence, and integrity of legislatures, fostering interstate cooperation and facilitating the exchange of information among legislatures. https://www.ncsl.org NCVHS National Committee on Vital and Health Statistics: Public advisory body for the Department of Health and Human Services concerning health data, statistics, privacy, national health information policy, and the Health Insurance Portability and Accountability Act (HIPAA). https://ncvhs.hhs.gov NDC National Drug Code: Universal product identifier for human medications in the United States that assigns a unique 10-digit or 11-digit, 3-segment number, to each product approved by the FDA (manufacturer + product + commercial packet size). NDI National Death Index: National Center for Health Statistics (NCHS)’s centralized database of death record information on file in state vital statistics offices; key resource for epidemiologists and other health and medical investigators with their mortality research activities. Neglect Failure to provide nourishment, treatment, care, goods, or services necessary for the health, safety, or welfare of a person receiving care. Negligence Failure by an individual to exercise the degree of care or caution that could be reasonably expected. NF Nursing facility: Residential healthcare facility licensed by the state to provide room, board, specified nursing care, and therapies, for people with chronic conditions or who need rehabilitation services; sometimes used interchangeably with skilled nursing facility (SNF) or nursing home (NH). NFCSP National Family Caregiver Support Program: U.S. Administration on Community Living (ACL)’s assistance program that provides grants to states and territories to fund various supports that help family and informal caregivers care for older adults in their homes for as long as possible. NFPA National Fire Protection Association: Nonprofit international non-governmental organization devoted to eliminating death, injury, property, and economic loss due to fire, electrical, and natural hazards through evidence-based building standards. (See also LSC—Life Safety Code.) https://www.nfpa.org NGO Non-government organization: Citizen-based group (typically nonprofit) that functions independently of government to serve a specific social or political purpose. NH Nursing home. (See NF—nursing facility.) NHA Nursing home administrator: Executive leader of a postacute care facility providing skilled nursing care; states are federally mandated to license NHAs as health professionals (this acronym often applies to the licensure credential, as well). NHIC National Health Information Center: Federal agency under the Department of Health and Human Services’ Office of Disease Prevention and Health Promotion that supports public health education and promotion by raising awareness about National Health Observances year-round and helps connect health professionals and consumers to the organizations that can best answer their questions. https://health.gov/our-work/health-literacy/resources/national-health-information-center NHPCO National Hospice and Palliative Care Organization: Nonprofit professional association advocating for and representing the interests of its member providers and professionals who care for people affected by serious and life-limiting illness, with the mission of leading and mobilizing social change for improved care at the end of life. https://www.nhpco.org NHQI Nursing Home Quality Initiative: Centers for Medicare & Medicaid Services program that provides consumer and provider information regarding the quality of care in nursing homes. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits NHRA Nursing Home Reform Act. (See OBRA—Omnibus Budget Reconciliation Act of 1987.) NHSC National Health Services Corps: Federal program administered by the Health Resources and Services Administration (HRSA) that provides scholarships and loan repayment to healthcare professionals practicing at approved sites located in/or serving health professional shortage areas (HPSAs) throughout the United States. https://nhsc.hrsa.gov NIH National Institutes of Health: Federal agency under the Department of Health and Human Services that serves as the principal catalyst for health research in the United States through conducting and sponsoring original investigations that support its mission of seeking fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability; 27 institutes of health comprise the agency, including the following list of those most closely tied with the senior living field. https://www.nih.gov NIA National Institute on Aging: https://www.nia.nih.gov NCI National Cancer Institute: https://www.cancer.gov NEA National Eye Institute: https://www.nei.nih.gov NHLBI National Heart, Lung and Blood Institute: https://www.nhlbi.nih.gov NIAAA National Institute of Alcohol Abuse and Alcoholism: https://www.niaaa.nih.gov NIAID National Institute of Allergy and Infectious Diseases: https://www.niaid.nih.gov NIAMS National Institute of Arthritis and Musculoskeletal and Skin Diseases: https://www.niams.nih.gov NIDCD National Institute on Deafness and Other Communication Disorders: https://www.nidcd.nih.gov NIDDK National Institute of Diabetes and Digestive and Kidney Diseases: https://www.niddk.nih.gov NIDA National Institute of Drug Abuse: https://www.drugabuse.gov NIMH National Institute of Mental Health: https://www.nimh.nih.gov NINDS National Institute of Neurologic Disorders and Stroke: https://www.ninds.nih.gov NLC Nurse Licensure Compact: Agreement among over two thirds of state boards of nursing that enables nurses—RNs and LPN/LVNs—to practice in other NLC states without having to obtain additional licenses. Visit: https://www.ncsbn.org/compacts.htm NLRA National Labor Relations Act of 1935 (Wagner Act and subsequent amendments): Federal law that permits employees to organize a collective bargaining unit, typically through joining a union, without fear of retribution from their employer. NLRB National Labor Relations Board: Federal agency established by the NLRA to administer the law’s provisions, including conducting union recognition elections and investigating allegations of unfair labor practices. NNHQI National Nursing Home Quality Improvement Campaign” (formerly “Advancing Excellence in Nursing Homes Campaign”): National collaborative effort to transform the quality of care and quality of life for nursing home residents. https://theconsumervoice.org/issues/recipients/nursing-home-residents/advancing-excellence NOFA Notice of Fund Allocation: Announcement notice published each year for the Department of Housing and Urban Development’s Discretionary Funding Programs; describes types of funding available on a competitive basis and provides instructions for applying. NORC Naturally occurring retirement community: Building or neighborhood that was not originally intended as a senior living environment but has a substantial number or proportion of residents aged 60 years or older, generally because people have moved into a home when they were younger and have aged there. or National Long-Term Care Ombudsman Resource Center: Nonprofit NGO funded by the Department of Health and Human Services’ Administration for Community Living (ACL) and jointly operated by the National Consumer Voice for Quality Long-Term Care and Advancing States with the objectives of enhancing the skills, knowledge, and management capacity of state long-term care ombudsman programs. https://ltcombudsman.org NORS National Ombudsman Reporting System: Federal program of the Administration on Community Living’s Administration on Aging (AoA) that collects and analyzes complaints received and investigated by state nursing home ombudsman offices to inform policy decisions. https://acl.gov/programs/long-term-care-ombudsman/ltc-ombudsman-national-and-state-data Nosocomial Negative health condition caused by a medical or healthcare procedure. NP Nonprofit: Exempt from taxation, typically under section 501(c)(3) of the U.S. Internal Revenue Code. or Nurse practitioner: Advanced nursing professional job title; common for an NP to include MSN or DNP in their professional title in order to disclose level of educational attainment. (See also ARNP—advanced registered nurse practitioner.) NPA National PACE® Association: Nonprofit professional association advocating for and representing the interests of its member organizations operating a PACE® (Programs of All-Inclusive Care for the Elderly) with the mission of providing leadership and support for the growth, innovation, quality, and success of the PACE® model of care. https://www.npaonline.org NPE Nutrition Program for the Elderly: Federal program that provides grants to operate nutrition programs for the elderly (i.e., Meals-on-Wheels and congregate dining programs) and additional cash payments or commodity assistance for each meal served; title III of the Older Americans Act. NPI National provider identifier: Unique 10-digit identification number issued by the Centers for Medicare & Medicaid Services (CMS) to healthcare providers; replaced the unique physician identification number (UPIN) as the required identifier for Medicare services; also used by other payers. NSCSL National Senior Citizens Law Center: Nonprofit non-governmental organization with the mission of protecting the rights of low-income older adults through its advocacy and education of local advocates, programs, and litigation assistance. http://nsclcarchives.org O OAA Older Americans Act of 1965 as amended (42 U.S.C.A. § 3001 et seq.): Federal law that promotes the well-being of older individuals by providing services and programs designed to help them live independently in their homes and communities. The Act also empowers the federal government to distribute funds to the states for supportive services for individuals over the age of 60 years. OASDI Old-Age, Survivors and Disability Insurance: Official name for Social Security benefits, supported by payroll taxes to provide benefits to retirees and disabled people, as well as their spouses, children, and survivors. OASIS Outcome and Assessment Information Set: Assessment tool developed by the Centers for Medicare & Medicaid Services for conducting a comprehensive evaluation of an adult home care patient forms the basis for measuring patient outcomes and determines agency reimbursement. OBRA Omnibus Budget Reconciliation Act: Although several laws enacted in different years by Congress and signed by the president have this name followed by the year, the one that is often also referred to as the Nursing Home Reform Act advanced in 1987, and it is interpreted by 42 CFR 483. OD Doctor of Optometry: Degree awarded by accredited academic programs in optometry for completing the required course of study; optometrists diagnose and treat diseases of the eye, perform certain eye surgeries, and prescribe corrective eyeglasses or contact lenses. OIG Office of the Inspector General: Many federal and state agencies have a unit charged with combatting fraud, waste, and abuse to improve the efficiency of the agency’s programs, commonly titled the Inspector General. The largest OIG at the federal level serves the Department of Health and Human Services, and its major focus is on the Medicare and Medicaid programs; its oversight also extends to the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and the Food and Drug Administration (FDA). State-level OIG personnel typically perform inspections (surveys) of Medicare-certified provider organizations under contract with the Centers for Medicare & Medicaid Services (CMS). OIS U.S. Office of Information Services: Federal agency under the National Archives charged with reviewing compliance of all federal agencies with Freedom of Information Act (FOIA) policies, procedures, identifying, and recommending ways to improve it and resolving FOIA disputes between federal agencies and requesters. https://www.archives.gov/ogis OMB U.S. Office of Management and Budget: Federal agency evaluates, formulates, and coordinates management procedures and program objectives among federal agencies, oversees the administration of the federal budget, and advises the President concerning budget proposals and related legislative initiatives. www.whitehouse.gov/omb OOP Out-of-pocket: Personal share of expenditures for health and related services. OSCAR Online Survey Certification and Reporting: (now CASPER) OSG U.S. Office of the Surgeon General: America’s lead medical officer, whose mission is to protect, promote, and advance the health and safety the nation. https://www.hhs.gov/surgeongeneral OSHA U.S. Occupational Safety and Health Administration: Federal agency under the Department of Labor that ensures safe and healthful workplace conditions by setting and enforcing standards and providing training, outreach, education, and assistance. https://www.osha.gov OT Occupational therapy: Healthcare profession that uses purposeful activity or interventions designed to achieve functional outcomes to develop, improve, sustain, or restore the highest possible level of independence. OT/R Registered occupational therapist: Credential that signifies a person is registered by the National Board for Certification in Occupational Therapy. OTR/L Occupational therapist registered and licensed: Standard credential that signifies a person is both registered by the National Board for Certification in Occupational Therapy and licensed by at least one state. P P&A Protection and Advocacy Systems: Initiative of the U.S. Administration on Community Living, P&As work at the state level to protect individuals with disabilities by empowering them and advocating for their rights to make choices, contribute to society, and live independently. P&L Profit and loss statement: Financial statement showing performance over a specified period. P4P Pay for performance: Reimbursement model that offers financial incentives to healthcare providers for meeting certain quality and productivity performance measures. (See also value-based purchasing.) PA Physician assistant: Must work under the supervision of a licensed physician but generally has a broad spectrum of clinical practice, including authority to diagnose and prescribe medications, approve plans of care and treatment approaches, and document progress. PAC Postacute care: Chronic, rehabilitation, or palliative services received before, after, or instead of a stay in an acute care hospital, typically in a long-term care facility, at home, or through outpatient therapy. PACE Program of All-Inclusive Care for the Elderly: Care model that utilizes an adult day program as the hub of the wheel for an HCBS-oriented IDT to coordinate housing, medical, and social supports for people who meet the Medicaid eligibility requirements for nursing home care. PAH/PPH Potentially avoidable (or preventable) hospitalization: Key metric under the ACA, readmission to an acute care facility within 30 days of discharge for the same primary diagnosis; the diagnoses most commonly associated with PAH/PPH of nursing home residents include pneumonia, urinary tract infection, dehydration, pressure ulcers, cellulitis, heart failure, and chronic obstructive pulmonary disease/asthma. PAI Patient assessment instrument: Centers for Medicare & Medicaid Services’ assessment tool for use in the inpatient rehabilitation facility setting; similar to the minimum data set used in skilled nursing facilities, but geared to patients with higher acuity and/or medical complexity. Parenteral nutrition Providing nutrients directly into the bloodstream when the gastrointestinal system is not functioning normally. Parkinson’s disease Progressive central nervous system disorder characterized by gait difficulty, postural instability, rigidity, decrease in spontaneous movement, and/or tremors. Par level Minimum number of a given supply to maintain in inventory (in use and in storage). PAS Preadmission screening: Assessment prior to admission to a facility or HCBS program of care. PASARR Preadmission screening and annual resident review: Federal requirement to help ensure that no individual with serious mental illness (SMI) or intellectual and developmental disability (IDD) is inappropriately placed in an skilled nursing facility. Patient days Cumulative number of care recipients (patients/residents/clients/participants/customers) over a specified period (census per day × days). PBM Pharmacy benefit manager: Company that manages prescription drug benefits on behalf of health insurance carriers, Medicare Part D drug plans, large employers, and other payers, negotiating with drug manufacturers and pharmacies to control drug spending. PC Personal care: Nonmedical assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL). PCA Personal care aide/assistant/attendant: Unlicensed paraprofessional who provides personal care services. PCH Personal care home: Residential, congregate, senior living setting providing room, board, and personal care services; licensed in some states. PCP Primary care physician: Specialist in family medicine, internal medicine, geriatrics, or pediatrics who provides comprehensive, point-of-first-contact and continuing medical care, which may include chronic, preventive, and acute care in both inpatient and outpatient settings. PDCA Plan–do–check–act (Deming Wheel or Shewhart Cycle): Four-step management cycle that facilitates implementing change, problem-solving, and continuous process improvement. PDP Prescription drug plan: Stand-alone health plan covering prescription drugs under Medicare Part C (Advantage) or Part D. PDPM Person-driven payment model: Reimbursement system implemented by the Centers for Medicare & Medicaid Services in 2019 for skilled nursing facility care that replaced the prospective payment system (PPS) with case mix classifications based on anticipated resource needs. PDUFA Prescription Drug User Fee Act of 1992 (and amendments): Federal law that permits the U.S. Food and Drug Administration (FDA) to collect fees from drug manufacturers to fund the approval process for new drugs. PEG tube Percutaneous endoscopic gastrostomy tube: Small tube placed directly into the stomach through an incision in the abdominal wall to provide nutrition to someone unable to ingest food by mouth for an extended period. Per diem Per day (i.e., per diem reimbursement = daily revenue rate). PERS Personal emergency response system: Aging in place technology that initiates communication with an entity—commercial or private (family or neighbor)—capable of responding directly or indirectly by referral; a wide range of products from the most basic, wearable pendant with a call button to an advanced network of in-home sensors that monitor movement, activity, and/or vital signs and report data in real time to caregivers, family members, and first responders; also referred to as life alerts, medical alerts, fall monitors, electronic home monitoring, or telemonitoring. Person-centered care Philosophy of care focused on the care recipient’s emotional needs and preferences, emphasizing relationships (social model) rather than a task-centered, institution-driven approach concerned chiefly with physical health (medical model); also referred to as person-centered approach (PCA) or resident-centered care (RCC). Person-directed care Philosophy of care that embraces as its foundation person-centered care (PCC), adding the expectations that care recipients direct their own lives and that staffing and schedules are organized to reflect their preferences. PHA Public Housing Authority: Government entity authorized to administer HUD programs. (Varies by state.) PharmD Doctor of Pharmacy: Degree awarded by accredited academic programs in pharmacy for completing the required course of study. (See also DP.) PHI Protected (or personal) health information: Individually identifiable health data created, received, stored, or transmitted by HIPAA-covered entities and their business associates concerning the provision of healthcare, healthcare operations, and payment for healthcare services. PHS U.S. Public Health Service: Federal agency responsible for administering several health agencies critical to the health of Americans, including the Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), and National Institutes of Health (NIH). PI Principal investigator: Individual primarily responsible for the preparation, conduct, and administration of a research grant, cooperative agreement, training or public service project, contract, or other sponsored project in compliance with applicable laws, regulations, and institutional policies. or Performance improvement: Management function of continuous study and improvement of processes with the intent to better services or outcomes, and prevent or decrease the likelihood of problems, by identifying areas of opportunity and testing new approaches to correcting underlying causes of persistent/systemic problems or barriers to improvement (CMS, 2020). Pioneer network Nonprofit non-governmental organization advocating for the shared goal of senior living providers interested in moving toward a more person-centered and person-directed approach in their programs and services. https://www.pioneernetwork.net PIP Performance improvement project: Key element of quality assurance and performance improvement (QAPI); concentrating on a problem in either one area or organization-wide by systematically gathering information to clarify issues or problems and then intervening to stimulate and foster improvements. PNA Personal needs allowance: Monthly amount the state permits a Medicaid-certified senior living beneficiary to keep for noncovered personal expenses as a deduction from what they pay to the provider. (Varies by state, but the Centers for Medicare & Medicaid Services sets minimum and maximum amounts.) POA Power of attorney: Legal document designating a person as the agent (attorney-in-fact) for another (principal) to act on their behalf with either limited or broad legal authority concerning the principal’s property, finances, and/or medical care; typically used in the event of a principal’s illness, disability, incapacity, or unavailability. POC Plan of correction: Written document developed by the senior living provider that specifies how each finding of regulatory noncompliance, violation, or deficiency identified by a governmental agency inspection will be abated and how recurrence will be prevented. or Point of care: Diagnostic testing or documentation completed at or near the time and place of patient care. (See also POS—place or point of service.) or Political Action Committee: Group organized to engage in political election activities—especially fundraising or campaigning—in support of (or opposition to) a candidate based on their position concerning a social, economic, or political cause viewed as important to the group. POS Place (or point) of Service. (See POC—point of care.) PPA Preferred provider agreement (arrangement): Third-party payer contract with a group of healthcare providers willing to furnish services at discounted rates in return for increased patient volume and prompt payment. (See also PPO.) PPACA Patient Protection and Affordable Care Act of 2010 (and amendments): Comprehensive federal healthcare reform law addressing health insurance coverage, healthcare costs, and preventive care. (See also ACA.) PPD Patient per pay: Measure of daily revenues/costs for each resident/patient. PPO Preferred provider organization: Group of healthcare providers that agrees to furnish services to customers of a third-party insurer at discounted rates in return for increased patient volume and prompt payment. (See also PPA.) PPS Prospective payment system: Reimbursement method by which payment is made based on a predetermined price. PQ Partnership qualified: Long-term care insurance policies must include certain features to be eligible for inclusion in the State Long-Term Care Partnership Program, such as designation as federally tax-qualified and inflation protection. (Varies by state.) PRN Pro re nata: Latin term that means “as needed”; typically applied to medication administration or scheduling part-time employees. PRO Peer (physician) review organization: Independent quality improvement or professional review organization staffed by licensed health professionals who conduct preadmission and service reviews concerning Medicare-certified providers. ProPAC Prospective Payment Assessment Commission: Independent advisory body that recommends to Congress and the Department of Health and Human Services Secretary an appropriate percentage change in the payments made by Medicare for inpatient hospital services and adjustments to the diagnosis-related groups (DRGs) classification and weighting factors. (The Balanced Budget Act of 1997 terminated the ProPAC and reassigned its duties to the Medicare Payment Advisory Commission—MedPAC.) PRTF Psychiatric residential treatment facility: Nonhospital facility offering intensive inpatient services to persons under 21 years who have various emotional and mental health challenges. PSDA Patient Self-Determination Act of 1990 (and amendments): Federal law that requires Medicare- and Medicaid-certified healthcare providers to ask each patient about advance directives and to provide information regarding the applicable state law; does not include physicians. PSR Physical status review: Assessment tool for an interdisciplinary team (IDT) to quantify a person’s health risk, establish their health care needs, identify related training requirements for direct care staff, and determine the optimal frequency of direct health monitoring; used primarily in MR/IDD service settings. PT Physical therapist: Licensed health professional who treats people to restore movement, relieve pain, improve strength, and prevent disability through prescribed exercise, hands-on care, and patient education. or Physical therapy: Health profession dedicated to the preservation, enhancement or restoration of movement, and physical function diminished or threatened by disease, injury, or disability utilizing therapeutic exercise, physical modalities, assistive devices, and patient education. (Also called physiotherapy.) PTA Physical therapy assistant/aide: Direct caregiver who works under the supervision of a PT. Punitive damages Monetary award in excess of the actual losses claimed by a plaintiff intended to make an example of a defendant due to extraordinarily egregious conduct. Q QA Quality assurance: Management process focused on providing confidence that quality requirements and expectations are met or exceeded; specification of standards for quality of service and outcomes; ongoing, both anticipatory and retrospective in its efforts to identify how the organization is performing. QAA Quality assessment and assurance: Synonym for quality assurance adding emphasis on initial assessment of quality indicators. QAPI Quality assurance and performance improvement: Coordinated application of two mutually reinforcing aspects of a quality management system—quality assurance (QA) and performance improvement (PI). QAPI takes a systematic, comprehensive, and data-driven approach to maintaining and improving safety and quality in nursing homes while involving all nursing home caregivers in practical and creative problem-solving. QI Quality improvement. (See QAPI.) or Quality indicator: Standardized, evidence-based measures of healthcare quality that can be used to measure and track clinical performance and outcomes. QIO Quality improvement organization: One of two CMS-designated groups of health quality experts, clinicians, and consumers organized to improve the quality of care delivered to people with Medicare. BFCC-QIO—beneficiary and family-centered QIO: Helps Medicare beneficiaries exercise their right to high-quality healthcare by managing beneficiary complaints, quality of care reviews, and beneficiary appeals of a provider’s decision to discharge or discontinue services. QIN-QIO—Quality innovation network: Coordinates data-driven initiatives to increase patient safety, improve community health posthospital care, and improve clinical quality. QM Quality measures: Tools that help measure healthcare processes, outcomes, patient perceptions, and organizational structure and/or systems associated with either the ability to provide high-quality healthcare or that relate to healthcare quality goals. QMB Qualified Medicare beneficiary: Person who is enrolled in both Medicare and Medicaid and has no legal obligation to pay Medicare providers for Part A or B cost sharing (coinsurance, copays, or deductibles); many state Medicaid programs pay for some portion of this cost. QMHP Qualified mental health professional: Clinician who is trained and experienced in providing psychiatric or mental health services to persons with a psychiatric diagnosis. (Varies by state.) QRS (Hospital inpatient) Quality reporting system: Centers for Medicare & Medicaid Services quality incentive program that rewards hospitals that report designated quality measures with a higher annual update to their reimbursement rates. Quality Standard of excellence; the World Health Organization (WHO) defines quality care as the extent to which healthcare services provided to individuals and patient populations improve desired health outcomes. In order to achieve this, healthcare must be safe, effective, timely, efficient, equitable, and people-centered. Quality of life Value of the lived experience; integration of social, emotional, personal, and spiritual wellness with environmental comfort, dignity, autonomy, security, and life fulfillment for a care recipient. Qui tam relator “Whistleblower” under False Claims Act, who has knowledge of someone or an organization defrauding the government. R RAI Resident assessment instrument: Centers for Medicare & Medicaid Services assessment tool designed to collect information for care planning and for monitoring residents in long-term care settings; clinical assessment element for completing the minimum data set (MDS). RAM Random access memory: Form of computer data storage that can be retrieved randomly and swiftly; referred to as volatile memory (lost when power is discontinued). or Reverse annuity mortgage: Loan from a lending institution to someone 62 years or older, which is secured by the borrower’s home value in which they receive a lump sum, fixed monthly payments, or line of credit and makes no loan payments; becomes due when the borrower dies, moves away permanently, or sells the home; federal regulations prohibit the loan amount from exceeding the home’s value. RAP Resident assessment protocol: Documents included in CMS resident assessment instrument (RAI) that helps determine which persons are at the risk of specific functional disabilities. RBRVS Resource-based relative value scale: CMS scale of national uniform relative values for all physicians’ services reflecting the sum of relative value units representing a physician’s practice expenses net of malpractice and professional liability insurance costs. RC/AL Residential care/assisted living: Type of housing facility for older or disabled adults who may require assistance with their activities of daily living; licensure requirements vary by state. (See also AL—assisted living.) RD Registered dietitian: Trained nutrition professional who has met the educational and experiential standards set forth by the Commission on Dietetic Registration (CDR) of the Academy of Nutrition and Dietetics (AND), as well as pass the CDR’s Registration Examination for Dietitians; licensure varies by state. RDT Registered dietetic technician: Credential awarded by the Association of Nutrition and Food Service Professionals for demonstrating basic proficiency in relevant knowledge and skills for serving as a dietetic technician. Reasonable accommodation Actions to adjust a disabled employee’s workspace or restructuring job duties to focus on essential functions so that the employee can be reasonably expected to perform them. Regulation Administrative interpretation promulgated by an executive branch agency (federal, state, or local) for implementation of a statute enacted by the related legislative body. Respondeat superior Legal doctrine that holds a corporation responsible for tort law violations of its employees; also known as “vicarious liability.” RFI Request for information: Exploratory process with the purpose of collecting written information about the capabilities of prospective suppliers, service providers, or grant applicants for objective comparison. RFP Request for proposal: Solicitation of written proposals from prospective suppliers, service providers, or grant applicants on addressing an organization’s project. RHC Rural health clinic: Outpatient clinic engaged in providing primary medical care services to Medicare and Medicaid beneficiaries in underserved, rural areas. RHIT Registered health information technician: Credential awarded by the American Health Information Management Association verifying basic proficiency in medical records management. (Related: CPC.) RN Registered nurse: Credential awarded by state boards of nursing for demonstrating basic proficiency to practice as a professional nurse by completing a state-approved academic program and passing the NCLEX-RN(R) exam. ROI Return on investment: A ratio that determines the benefit of doing something. In financial terms, it is often calculated by dividing the net income by the cost of the capital or investment resources. ROM Read-only memory: Form of computer data storage that cannot be easily altered or reprogrammed; referred to as nonvolatile (contents are retained when power is discontinued). RoP Requirements of participation: (formerly conditions of participation) Centers for Medicare & Medicaid Services rules governing provider qualification for certification by Medicare and Medicaid. RPh Registered pharmacist: Credential awarded by state boards of pharmacy for demonstrating basic proficiency to practice as a pharmacist; Pharmacists prepare and dispense prescriptions, ensure medicines and doses are correct, prevent harmful drug interactions, and counsel patients on the safe and appropriate use of their medications. RPM Remote patient monitoring: Aging in place technology that facilitates observation of a care recipient’s movement and behavior in order to inform care planning or initiate an intervention or emergency response; a wide range of products from cameras, motion detectors, and pressure-sensitive mats to personal emergency response systems (PERS). RPS Representative payee system: Federal program under the Social Security Administration under which an appointed representative (or substitute) payee accepts disability or Social Security payments for someone who is not capable of managing their benefits and assists the beneficiary with money management and protection from financial abuse or victimization. RUG Resource utilization group: Cost classification CMS applies in grouping a nursing facility’s residents according to their clinical and functional status, as identified from data supplied by the facility’s minimum data set (MDS). RVU Relative value unit: Metric reflecting the dollar value of physician services, determined by applying costs assigned to each current procedural terminology (CPT) code based on the respective time, skill, training, and intensity that was necessary to perform the procedure; key component of the Centers for Medicare & Medicaid Services’ resource-based relative value scale (RBRVS) program. S SA/MH Substance abuse and mental health: Disorders such as depression and anxiety are closely linked to substance abuse, and some substance abuse can cause prolonged psychotic reactions; one does not directly cause the other; alcohol and drugs are often used to self-medicate to battle the symptoms of mental health problems. (See also MH/SA.) SAMHSA Substance Abuse and Mental Health Services Administration: Federal agency under the Department of Health and Human Services charged with improving the quality and availability of treatment and rehabilitative services for reducing illness, death, disability, and the cost to society resulting from substance abuse and mental illness. https://www.samhsa.gov Scope and severity Centers for Medicare & Medicaid Services measures of the prevalence (scope) and seriousness (severity) of the risk posed or actual harm caused by a Medicare/Medicaid-certified long-term care provider’s noncompliant practice. SCSEP Senior Community Service Employment Program: Federal part-time employment program for low-income persons aged 55 years or over authorized by the Older Americans Act and administered by the U.S. Department of Labor. Participants work at community or government agencies, receive the higher of the federal or state minimum wage, and may receive training that enables them to transition to other employment. SDP Structured day program: Individually designed services that are provided either in an outpatient, congregate setting or in the community with goal of improving or maintaining the participant’s skills and ability to live as independently as possible in the community; benefits older and/or disabled adults. (Varies by state.) SE Supported employment: State or local government programs that provide supports and services to persons with intellectual and developmental disabilities (IDD) or serious mental illness, facilitating their employment among a variety of community-integrated work environments; designed to foster regular interaction with persons without disabilities who are not paid caregivers or service providers. SEP Service entry point: Location or name of the first contact made by a person seeking health or human services; also referred to as “service portal.” SFF Special focus facility: Nursing facilities with a persistent pattern of low performance on its most three recent Centers for Medicare & Medicaid Services standard surveys and complaint surveys; subject to enhanced regulatory agency oversight until compliance is satisfactorily restored. SFY State fiscal year: Operating period for a state government; typically, July 1 through June 30 of the subsequent calendar year. SGA Southern Gerontological Association: Nonprofit professional association advocating for and representing the interests of its member health and human service professionals, educators and students, re searchers, regulators, and policy makers in 13 southern states and Washington, DC, with the shared purpose of providing the bridge between research and practice by translating and applying knowledge in the field of aging. https://southerngerontologicalsociety.org SHIP State Health Insurance Assistance Programs: Federally funded programs in each state (and some territories) that provide free counseling and assistance to Medicare enrollees and their families about benefits, premiums, cost sharing, enrollment windows, and appeals. SLMB Specified Low-Income Medicaid Beneficiary Program: Federal subsidies to state Medicaid programs to pay Medicare-B premiums for low-income Medicare beneficiaries. SLP Speech-language pathologist (also speech therapist): Licensed health professional who evaluates and treats treatment of speech, language, communication, voice, and swallowing disorders and related cognitive impairments. or Speech language pathology: Health profession specializing in the evaluation and treatment of speech, language, communication, voice, and swallowing disorders and related cognitive impairments. SME Subject matter expert: Person who has specific and relevant knowledge about a skill, technology, procedure, policy, or field. SMI Serious mental illness: Mental, behavioral, or emotional disorder resulting in serious functional impairment and substantially interfering with or limiting one or more major life activities. SN Skilled nursing: Services performed most safely and effectively by or under the direct supervision of a registered nurse, such as assessment and observation, medication administration, tube feeding, and wound treatments. SNF Skilled nursing facility: Licensed inpatient healthcare facility staffed and equipped to provide skilled nursing care and related services. SNU Skilled nursing unit: Distinct part of an acute care hospital licensed to provide skilled nursing care and related services. Social Security Act Federal law passed initially in 1935 (and amendments): Federal law that established a system of social programs to aid older adults, blind persons, dependent and disabled children, and unemployed people and to advance public health; amendments added Medicare (title XVIII) and Medicaid (title XIX). SOD Statement of deficiency: Report by the state’s licensure and certification survey team describing any findings that allege a provider’s noncompliance with applicable state regulations or Centers for Medicare & Medicaid Services requirements of participation in Medicare or Medicaid. SPA State plan amendment: Contractual change to a state Medicaid plan’s policies, included programs or operational approach, which require approval by the Centers for Medicare & Medicaid Services. SPALTCM Society for Post-Acute and Long-Term Care Medicine (formerly the American Medical Directors Association): Professional society representing the interests of physicians serving as the medical director for any senior living provider, with the mission of promoting and enhancing the development of competent, compassionate, and committed medical practitioners and leaders to provide goal-centered care across all postacute and long-term care settings. https://paltc.org SPED Service Payments for Elderly and Disabled Program: State program that provides services for older or physically disabled adults and those who have difficulty completing tasks that enable them to live independently at home. (Varies by state.) Spend Down When a Medicaid applicant’s assets exceed the strict financial limits set for eligibility, they can reduce their “countable resources” to the amount required to qualify by purchasing certain allowable personal items or services. SPIA Single-premium immediate annuity: Contract between an individual and an insurance company that pays the owner (annuitant) a guaranteed income starting almost immediately; also known as an immediate payment annuity. SPO Structure–processes–outcomes: Widely recognized and applied framework for evaluating health service quality introduced by Dr. Avedis Donabedian; structure provides context for care delivery, process influences interactions between care providers and recipients, and outcomes reflect the effects of services provided on the health status of patients and populations. SSA U.S. Social Security Administration: Federal agency that administers the Social Security retirement, survivors, and disability insurance programs, as well as the Supplemental Security Income (SSI) program for the aged, blind, and disabled. SSBG Social Services Block Grant: Department of Health and Human Services program that provides support to states and territories for social services directed toward achieving economic self-sufficiency; preventing or remedying neglect, abuse, or the exploitation of children and adults; preventing or reducing inappropriate institutionalization; and securing appropriate referrals for institutional care. SSDI Social Security Disability Insurance: Federal program administered by the Social Security Administration (SSA) that pays monthly benefits to eligible citizens who are unable to work due to a significant illness or impairment that is expected to last at least a year or to result in death within a year; eligibility and benefit levels are based on a person’s accumulated Social Security credits from having worked. SSI Supplemental Security Income: Federal program administered by the Social Security Administration (SSA) that pays a monthly stipend to persons 65 or older, blind or disabled who are unable to work for at least 12 continuous months and who meet very specific income and resource limitations; unlike SSDI benefits, claimants do not have to work or earn credits to qualify for SSI benefits, and payments are funded through general tax revenues, not the Social Security Trust Fund. SSN Social Security Number: Unique numerical identifier assigned by the Social Security Administration (SSA) to U.S. citizens (and some noncitizen residents) to track their income and determine benefits; also used now for a wide range of purposes, such as to identify individuals for tax purposes, track credit record, or perform a criminal record check. SSP State supplemental payment: In most states, SSI recipients can also receive a supplementary payment from their state; some states only provide SSP to persons with a disability living in specified supportive settings, such as an adult care home or nursing home. ST Speech therapist: See SLP—speech and language therapist. or Speech therapy: See SLP—speech and language therapy. Statute Law enacted by the legislative branch of government; federal (Congress), state (Legislature), or local (city of county legislative body). Statute of limitations Period prescribed by law in which a legal action must be initiated. STD Short-term disability insurance: Private insurance coverage that at least partially replaces a person’s income for a short period (typically 3–6 months) in the event of a medical condition that stops them from working; often provided by employers as a group policy. Subrogation: Legal right held by an insurance carrier to legally pursue a third party that caused a loss to one of its insured customers in order to recover the amount of the claim it paid. Example: If a health insurance policyholder who was injured in a traffic accident receives from their carrier $10,000 for medical treatments related to the event, that company may collect up to the same amount from the at-fault party. T TANF Temporary assistance for needy families: Federal program that provides grants to states and territories to provide families in poverty with financial assistance and related support services, such as childcare assistance, job preparation, and work assistance; replaced Aide to Families with Dependent Children (AFDC). TB Tuberculosis: Bacterial, infectious disease that usually affects the respiratory system and is particularly dangerous for persons with compromised immune systems. TBI Traumatic brain injury: Brain injury caused by an external force resulting in loss of consciousness, memory loss, dizziness, and/or confusion; can lead to long-term impairments, such as motor and sensory problems, cognitive and behavioral dysfunction, and dementia. TCM Targeted case management: Direct assistance provided to person’s with behavioral health challenges, including problem resolution, advocacy, and referral to appropriate services. TCU Transitional care unit: Distinct part of a healthcare facility that provides care and services following hospitalization and before a patient is ready to return home; typically provided in rehabilitation units, long-term care hospitals, subacute or skilled nursing care facilities, or inpatient hospices. TEFRA Tax Equity and Fiscal Responsibility Act of 1982 (and amendments): Federal law that, in addition to providing significant changes to the tax code, mandated the development of a prospective payment methodology for Medicare reimbursement to hospitals. TIA Transient ischemic attack: Mild stroke that typically lasts only a few minutes; often a warning sign for a future stroke. Title 18 (XVIII) Medicare Law (18th amendment to Social Security Act): Federal healthcare entitlement and insurance program for older and certain disabled adults, as well as people with end-stage renal disease (ESRD). (See also Medicare.) Title 19 (XIX) Medicaid Law (19th amendment to Social Security Act): Jointly funded federal state health insurance program for medically indigent citizens that is administered by each participating state; largest public pay source for senior living services. (See also Medicaid.) Tort Intentional or unintentional civil wrong, not including a breach of contract, that causes injury to a person, their property, or reputation. TPN Total parenteral nutrition: Method of feeding that bypasses the gastrointestinal tract by giving a special formula through a vein when a person cannot receive nutrition by mouth. TQM Total quality management: See QAPI—quality assurance and performance improvement. TRH Transitional rehab to home: Short-term postacute stay in a health facility with the goal of a person completing rehabilitation treatment that restores enough strength and stamina for them to return home. TSP Thrift savings plan: Defined contribution retirement plan for federal employees, including members of the military and Congress, as well as civilian employees participating in the Federal Employees Retirement System or Civil Service Retirement System; works similarly to a private sector 401k retirement savings plan. TTH Transition to home: See TRH—transitional rehab to home. TTW Ticket to work: Federal program that offers Social Security beneficiaries with disabilities opportunities and supports needed to find and keep employment, increase their earnings through work, and reduce their reliance on cash benefits. TTWWIA Ticket to Work and Work Incentives Act of 1999: Federal law that provides SSI and SSDI beneficiaries work incentives and employment-related services to support their movement to financial independence. U UAP University-affiliated program: Authorized by the Developmental Disabilities Assistance and Bill of Rights Act (PL 104-183), there is a UAP in every state and U.S. territory affiliated with a major research university. http://aauap.org Unfair Labor Practice Act of an employer or union that violates an employee’s right to improve their work conditions, such as prohibiting employees to organize or join a union, retaliation toward an employee for filing a grievance, or conspiring with an employer or union to discriminate against an employee; rules are set by the National Labor Relations Board (NLRB). Unit dose system Packaging system utilized by an institutional pharmacy that individually encases each dose of a medication. Upcoding Fraudulent clinical documentation or billing codes in order to receive inflated reimbursements. UPIN Unique physician identification number: See NPI—national provider identifier. UR Utilization review: Objective, retrospective evaluation of the necessity or appropriateness, quality, effectiveness, or efficiency of medical procedures and services. USDA U.S. Department of Agriculture: Federal agency that provides leadership on food, agriculture, natural resources, and related issues; Rural development program offers grants and loans to senior living providers in underserved, rural communities. https://www.usda.gov and https://www.rd.usda.gov USERRA Uniform Services Employment and Reemployment Rights Act: Federal law that entitles a military service member to return to their civilian employment following completion of military service with the seniority, status, and pay rate that would have applied had they remained continuously working for the employer; prohibits discrimination based on present, past, or future military service. UTI Urinary tract infection: Infection of the kidney, ureter, bladder, or urethra. V VA U.S. Department of Veterans Affairs: (Previously U.S. Veterans Administration) Federal agency that administers programs benefiting veterans and their families, offering educational opportunities and rehabilitation services, as well as providing compensation payments for disabilities or death related to military service, home loan guaranties, pensions, burials, and healthcare. https://www.va.gov VAMC Veterans Affairs Medical Center: One of over 150 acute care hospitals in the Veterans Health Administration’s network of healthcare facilities. Variable cost Operating expense that fluctuates with census (i.e., food, medical supplies, and staffing). VBP Value-based purchasing/payment: Reimbursement model that offers financial incentives to healthcare providers for meeting certain quality and productivity performance measures. (See also pay-for-performance.) VCID Vascular contributions to cognitive impairment and dementia: Encompasses all types of cerebrovascular cardiovascular disease–related cognitive decline. (See also ADRD.) VHA Veterans Health Administration: Federal agency that operates America’s largest integrated healthcare system, serving military veterans and their dependents at 1,255 healthcare facilities. https://www.va.gov/health VISN Veterans Integrated Service Network: System of 19 geographic service regions of the Veterans Health Administration’s hospitals and healthcare facilities. VistA Veterans Health Information System and Technology Architecture: Electronic medical record (EMR) system designed and developed to support a high-quality medical care environment for the Veterans Health Administration (VHA). Vital Signs Clinical metrics that serve as a health status dashboard, typically pulse rate, blood pressure, and respiration rate; abnormalities warrant further investigation. VNA or VNS Visiting Nurse Association/Service: Home health agency that provides skilled nursing care and related services in a person’s home. VR Vocational rehabilitation: Therapeutic regimen that enables a person to overcome functional, psychological, developmental, cognitive, emotional, or health disabilities or impairments to gain or regain employment. W Waiver Exception to a program policy granted by a government agency to foster innovation, such as CMS approving a waiver to a state that proposes a modification to services included in or the eligibility requirements for its Medicaid program. WC Workers’ compensation: Public insurance program that pays monetary benefits to workers who are injured or become disabled in the course of their employment. WHO World Health Organization: United Nations agency charged with improving the health of the world’s people and preventing or controlling communicable diseases worldwide. https://www.who.int WIA Workforce Investment Act of 1998: Federal law that established a national employment and training program to assist eligible participants with managing their career choices through universal access to information and career-oriented services; replaced in 2014 by the Workforce Investment and Opportunity Act. WIC Special Supplemental Food Program for Women, Infants, and Children WIOA Workforce Investment and Opportunity Act of 2014: Federal law that establishes the Department of Labor programs to provide and coordinate job search, education, and training for eligible participants seeking to gain or improve their employment prospects. WtW or W2W Welfare-to-work: Public policy of encouraging or requiring unemployed people and those receiving state financial support to seek and secure employment, often providing job training or incentivizing employers through subsidies or favorable tax treatment. ADDITIONAL RESOURCES + Websites (URL links) cited in descriptions of associations and government agencies. Centers for Medicare & Medicaid Services. Retrieved from https://www.cms.gov Google Scholar Cornell University Legal Information Institute. Retrieved from https://www.law.cornell.edu/wex Google Scholar Diffen. Retrieved from https://www.diffen.com Google Scholar Invetopedia. Retrieved from https://www.investopedia.com Google Scholar Kentucky Institute on Aging. (2016). Terms and acronyms in aging services . Google Scholar Law Insider. Retrieved from https://www.lawinsider.com Google Scholar McSweeney-Feld, M. H., Molinari, C., & Oetjen, R. (Eds.) (2017). Dimensions of long-term care management: An introduction (2nd ed.). Chicago, IL: Health Administration Press. Google Scholar National Institute on Aging. Retrieved from https://www.nia.nih.gov Google Scholar National Institutes of Health. Retrieved from https://www.nih.gov Google Scholar Pratt, J. R. (2016). Long-term care: Managing across the continuum (4th ed.) Burlington, MA: Jones and Bartlett Learning. Google Scholar Singh, D. (2016). Effective management of long-term care facilities (3rd ed.). Burlington, MA: Jones and Bartlett Learning. Google Scholar University of Wisconsin – Eau Claire, Center for Health and Aging Services Excellence. (2019). Medical terminology e-handbook . Google Scholar World Health Organization. Retrieved from https://www.who.int Google Scholar Focus Previous NextKeywords
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