Glossary

AAA to CPRA

A

AAA - Area Agency on Aging: www.c4a.info

AARP - American Association of Retired Persons: www.aarp.org

ACHE - American College of Healthcare Executives: www.ache.org

ADA - Americans with Disabilities Act: www.ada.gov

ADL - Activities of Daily Living

AHCA - American Healthcare Association: www.ahcancal.org

AHMANNH - Affordable Housing Management Association of Northern California, Nevada and Hawaii: ahma-nch.org

AJAS - Association of Jewish Aging Services: www.ajas.org

AL - Assisted Living

ALFA - Assisted Living Federation of America: www.alfa.org

ALQI - Assisted Living Quality Assurance

ALWPP - Assisted Living Waiver Pilot Project

AMDA - American Medical Directors' Association: www.amda.com

AoA - The Administration on Aging (the federal agency that administers the OAA - Older Americans Act)

ASA - American Society on Aging: www.asaging.org

Acute Care - Medical Services for life-threatening injury or serious illness requiring a hospital stay.

Adult Day Care - Social and recreational programs. Frequently provides transportation and a meal. Focus is on maintaining elder's independence.

Adult Day Health Care - A licensed community-based day care program providing a variety of health, therapeutic, and social services designed to serve the specialized needs of those at risk of being placed in a nursing home.

Advanced Directives - Statement of an individual's instruction's for treatment in the event of the need for a life-sustaining treatment.

Aging in Place - The gradual aging of an entire defined population (ie: within a facility or within a country) and the associated increase in service needed as a result of that aging.

Alzheimer's Association - A statewide and national organization committed to education, research and support of individuals with Alzheimer's disease.

Approved Vendor - LeadingAge California's Approved Vendors have been selected by the Group Services Board because they bring value to members through enhanced services or special pricing. Each vendor has been thoroughly evaluated on company stability, quality of product or service offered, ability to serve members throughout the state, and board appeal.

B

BBA - Balanced Budget Act

Board and Care Facility - Provides food, shelter, supervision and some help with ADLs for six or fewer seniors. See RCFE for further description.

BOE - Board of Equalization: www.boe.ca.gov

Boren Amendment - OBRA 1980 required that Medicaid nursing home ratios be reasonable and adequate to meet the costs of well-run nursing homes to provide quality care. (Replaced by BBA 1997).

C

CAADS - California Association of Adult Day Services: www.caads.org

CAHF - California Association of Health Facilities: www.cahf.org

CAHSAH - California Association of Health Services at Home, a state association of home health agencies

CALA - California Assisted Living Association: caassistedliving.org

CALCRA - California Continuing Care Residents Association

Cal-Mortgage - Cal-Mortgage is a Division of the Office of Statewide Health Planning and Development (OSHPD). Cal-Mortgage administers the California Health Facility Construction Loan Insurance Program (Program). oshpd.ca.gov/calmort

CANHR - California Advocates for Nursing Home Reform: www.canhr.org

CAPP - Californians Allied for Patient Protection: www.micra.org

CARF-CCAC - Commission on Accreditation of Rehabilitation Facilities; Continuing Care Accreditation Commission which accredits communities meeting strict criteria in the areas of finance, governance and administration, resident life and health care. The only accreditation program for CCRCs.

CARA - California Alliance for Retired Americans: www.californiaalliance.org

CASP - Certified Aging Services Professional. Formerly Retirement Housing Professional

CAST - Center for Aging Services Technology: www.leadingage.org/cast

CBO - Community Based Organization

CBO - Congressional Budget Office: www.cbo.gov

CCCB - Continuing Care Contracts Branch - an office within the Department of Social Services with oversight of continuing care contracts. www.calccrc.ca.gov

CCCC - California Coalition for Compassionate Care

CCCC - California Culture Change Coalition

CCLD - Community Care Licensing Division: www.ccld.ca.gov

CCRC - Continuing Care Retirement Community, licensed by the Department of Social Services, to contract for the provision of care for more than one year. Generally includes three levels of care: independent, assisted living, and nursing care. CCRCs require that an entrance fee be paid by the applicant upon admission. Life care facilities, a subset of CCRCs, provide all levels of care, including acute care and physicians services for the duration of the person's life.

CDA - California Department of Aging: www.aging.ca.gov

CDC - Centers for Disease Control and Prevention: www.cdc.gov

CDDIC - Care Delivery and Design Improvement Committee

CEU - Continuing Education Unit

CHA - California Hospital Association: www.calhospital.org

CHAPCA - California Hospice and Palliative Care Association: calhospice.org

CHFA - California Housing Finance Authority: www.calhfa.ca.gov

CHHSA - California Health and Human Services Agency: www.chhs.ca.gov

CMS - Centers for Medicare and Medicaid Services. Federal agency administering/overseeing Medicare, Medicaid and other federal health financing programs. www.cms.gov

CNA - Certified Nurse Aid

CRA - California Rehabilitation Association: www.carehab.org

CSL - California Senior Legislator

CTMC - California Training Medical Center

Cal-Mortgage - A state mortgage insurance program. Bonds are issued in a not-for-profit health facility's name via a government entity acting as a conduit; the state insures the loan and lends its credit rating to the insurance.

Care Coordination - Service which provides coordination for all aspects of care, including assessment, referral treatment and payment. May also be referred to as case management.

Case Management - Service which provides coordination for all aspects of care, including assessment, referral treatment and payment. May also be referred to as care coordination.

Community Care - Generic term for state-licensed facilities or agencies, using a "social" (as opposed to medical) model to provide services. Included under Community Care are child care centers, foster homes, group homes and Residential Care Facilities for the Elderly. See RCFE.

Continuing Care - Terminology for an arrangement under which a facility agrees to pay for specified future medical costs in exchange for an entrance fee and monthly maintenance fee. There are many different kids of continuing care contracts, one of which is "life care."

Continuing Care Contract - A written contract promising one or more elements of care to an elderly resident for the duration of his or her life, or for a term in excess of one year, in exchange for the payment of an entrance fee, or payment for periodic charges, or both types of payments.

Continuing Care Contracts Branch - An office within the Department of Social Services with oversight for the continuing care contract. www.calccrc.ca.gov

Continuum of Care - Ambiguous term loosely used, roughly denoting a wide range of services that will accommodate an equally wide range of capabilities among elders (or any client group).

DHHS to Gerontology

D

DHHS - U.S. Department of Health and Human Services: www.hhs.gov

DHCS - California Department of Healthcare Services. State agency that administers, among other things, Skilled Nursing Facilities. (See SNF). www.dhcs.ca.gov

DPOA - Durable Power of Attorney

DRG - Diagnosis' related groups

DSS - California Department of Social Services. State agency that administers, among other things, RCFEs. Also see abbreviated CDSS. www.cdss.ca.gov

E

EADACPA - Elder Abuse and Dependent Adult Civil Protection Act

EOL - End of Life

Ethics Committee - An advisory group within a healthcare organization formed to review and advise caregivers on difficult moral and medical decisions, ie: end of life treatment.

F

FDIC - Federal Deposit Insurance Corporation: www.fdic.gov

FSL - Facillity and Service Licensure

Family Caregiver Alliance - A statewide organization that offers education, information and support to in-home caregivers, primarly family members.

G

Geriatrics - Medical field specializing in care for the elderly.

Gerontology - Social science field studying the biological, psychological and social aspects of aging.

HHS to Medicare

H

HHS - U.S. Department of Health and Human Services: www.hhs.gov

HIPAA - Health Insurance Protection and Accountability Act

HICAP - Health Insurance Counseling and Advocacy Program: www.cahealthadvocates.org/HICAP

HMO - Health maintenance organization. A type of health insurer that offers a range of medical services for a set, prepaid fee. The choice of doctors is generally limited to those with whom the insurer has contracted (see managed care).

HUD - U.S. Department of Housing and Urban Development. Federal agency that administers housing programs, including Section 8. portal.hud.gov/hudportal/HUD

Home and Community-Based Services (HCBS) - Home and Community-Based Services, supportive services provided to individuals and caregivers that help maintain physical, social and spiritual independence in the least restrictive environment. These services may be provided in either the home or a central location.

Home Health Services (HHS) - Home based services including care by nurses, doctors, therapists and/or social workers.

Hospice - Comfort and care provided at the end stages of a terminal illness. This coordinated and compassionate model includes medical, psychological, spiritual and clerical support offered in the home or in a health facility.

Housing for the Elderly - Housing arrangements vary significantly in level and services and at a minimum, provide housing for elderly persons. Many housing facilities provide services such as meals and housekeeping to maximize residents' independence. Housing facilities are not licensed by the state of California but may be monitored by the Federal Department of Housing and Urban Development (HUD) if they are subsidized through federal programs.

HSAG - Health Services Advisory Group. California's Quality Improvement Organization. www.hsag.com

I

IAHSA - International Association of Homes and Services for the Ageing: www.iahsa.net

ICF - Intermediate Care Facilities (licensed same as SNF)

IHSS - In-Home Supportive Services

IL - Independent Living

ILA - Independent Living Apartments (or arrangements)

ILU - Independent Living Units

J

JCAHO - Joint Commission on the Accreditation of Health Care Organizations: www.jointcommission.org

K

Knox-Keene Act - Knox-Keene regulates health care service plans, ie: any entity that arranges or provides healthcare services in exchange for a periodic charge. HMOs in California fall under Knox-Keene jurisdiction; the Department of Corporations has administrative responsibility. (See HMO and Managed Care)

L

LeadingAge Center for Applied Research - Formerly IFAS. The center is staffed by an interdisciplinary team trained in public policy, public health, gerontology, epidemiology, psychology, sociology, statistics, survey research, long-term care administration and business. Their expertise spans four primary areas: program evaluation, knowledge transfer, policy analysis, and epidemiology-related clinical trials and observational studies. www.leadingage.org/Research

LTC - Long-Term Care - An umbrella term used to describe the community, social and health services that the elderly and disabled rely upon to live independently outside of an acute care hospital.

Life Care Contract - A continuing care contract promising routine services at all levels of care; including acute care and physicians and surgeons' services to a resident for the duration of his or her life. In a life care contract, no change is made in the monthly fee based on level of service. A life care contract also shall include provisions to subsidize residents who become financially unable to pay their monthly fees.

Long-Term Care Insurance - Provides coverage for the cost of health care and residential care in some cases.

M

MARC - Medical Automation Research Center: www.medicalautomation.org

MDS - Minimum Data Set

MICRA - Medical Injury Compensation Reform Act of 1975 - Enacted limits on malpractice awards.

MLRC - Multi Level Retirement Community

MMSP - Multipurpose Senior Service Program

Managed Care - A system that integrates medical care and its financing with: (1) contracts with selected physicians and hospitals to furnish comprehensive services to enrollees; (2) utilization review and quality control; and (3) assumption of some financial risk by providers (see HMO).

Managed Competition - A theory of insurance reform that asks HMOs and PPOs to compete regionally, providing a standard package of benefits.

Medi-Cal - Pays health care costs for impoverished persons who are aged, blind, disabled, or from families with dependent children. Different from Medicare (nationally known as Medicaid).

Medicare - Federal program that covers health care costs for persons aged 65 and older. Part A covers institutional care and the optional Part B covers supplemental costs, primarily outpatient and physician services.


NaCCRA to QIO

N

NaCCRA - National Continuing Care Residents' Association: www.naccra.com

NADSA - National Adult Day Services Association: nadsa.org

NARFE - National Association of Retired Federal Employees

NCBA - National Caucus and Center on Black Ages

NCCNHR - National Citizens' Coalition for Nursing Home Reform

NCOA - The National Council on Aging, Inc.: www.ncoa.org

NCRA - The National Center on Rural Aging

NHAP - Nursing Home Administrator Program

NHCOA - National Hispanic Council on Aging: www.nhcoa.org

NICOA - National Indian Council on Aging: nicoa.org

NISC - The National Institute of Senior Centers: www.ncoa.org/national-institute-of-senior-centers

NORC - Naturally Occurring Retirement Community

NOWCC - National Older Worker Career Center: www.nowcc.org/home

NPHA - Non-Profit Housing Association: nonprofithousing.org

NVOILA - The National Voluntary Organizations for Independent Living for the Aging

O

OBRA '87 - Omnibus Budget Reconciliation Act revised federal criteria for nursing home survey and enforcement. East state must adhere to this federal mandate.

OCR - Office for Civil Rights: www.hhs.gov/ocr/office

OSFM - Office of the State Fire Marshal: osfm.fire.ca.gov

OSHPD - Office of Statewide Health Planning and Development. State agency which administers Cal-Mortgage Program and which oversees the building and substantial reconstruction of health facilities in the state. www.oshpd.ca.gov

OWL - Older Women's League: www.owl-national.org

OAA - Older Americans Act - Federal legislation enacted in 1965 to create a network of state and area agencies on aging.

Olmstead Decision - U.S. Supreme Court decision requiring states to place disabled persons in the least restrictive living arrangement possible.

Ombudsman - A volunteer who visits skilled nursing facilities to monitor resident satisfaction. Ombudsmen act as a liaison between residents and their families, connecting them to resources in the community. Ombudsmen work through the local Area Agency on Aging which report to the State Department of Aging.

P

PAC - Political action committee

PACE - Program of All-Inclusive Care for the Elderly: www.calpace.org

PCU - Personal Care Unit. The third "level" of care, offering more intense services than RLA but still within RCFE regulations. (See Assisted Living.)

POP - Protect Our Parents

PPO - Preferred Provider Organization. Similar to HMOs but PPOs generally offer their clients a wider choice of doctors in exchange for higher deductibles and co-payments.

PRAC - Project Rental Assistance Contract

PRO - Peer review organization

PSA - Planning and Service Area

PSN - Provider Service Network

PSO - Provider Service Organization

Q

QA - Quality Assurance

QIO - Quality improvement organization


RCFE to Vote to Recommend

R

RCFE - Residential Care Facility for the Elderly. These facilities provide living arrangements with varying levels and intensities of care and supervision, personal care, or protective supervision for residents who are over 60 years of age. RCFEs are licensed by the California Department of Social Services.

RLA - Residential Living Apartments (or Arrangements). The second "level" of living. Includes all meals, weekly housekeeping, medication assistance if needed, ongoing health screening.

RUG - Resource utilization group

RWJ - Robert Wood Johnson Foundation: www.rwjf.org

S

SCSEP - Senior Community Service Employment Program: www.doleta.gov/seniors

SEIU - Service Employees International Union: www.seiu.org

SHMO - Social HMO

SILC - State Independent Living Council: www.calsilc.org

SNF - Skilled Nursing Facility. These facilities integrate custodial care with medical nursing, psychosocial and rehabilitative services on a continuous basis. Skilled nursing facility also includes "intermediate care" (UCF) which is a level designed for residents who do not require continuous nursing care. Skilled nursing facilities are licensed by the California Department of Health Services and can be part of a larger community.

SSI/SSP - Supplemental Security Income/State Supplemental Payment

Sarbanes-Oxley Act - Federal legislation created to help protect the public by implementing regulations organizations must follow in regards to management and financial transparency.

Section 8 - Multifaceted federal housing program that includes direct rental assistance and housing subsidies.

Section 202 - Originally a program consisting of loans for the construction or rehabilitation of housing for the elderly and handicapped authorized by the Housing Act of 1959, Section 202 is still the leading HUD production program for affordable senior housing. It was coupled with Section 8 housing assistance payments to make rents affordable. Since 1990, the program has been designed exclusively for the elderly. Funding was later changed to capital advance grants for construction costs, and project rental assistance contracts (PRACs) as the rental subsidy.

Section 221(d)(3) - A HUD program to provide Federal Housing Administration (FHA)-insured financing for multifamily housing designed for the low- and moderate-income market, including affordable senior housing. Like its successor, the 236 program, it is no longer active as a production program.

Section 232 - An FHA mortgage insurance program for the construction, substantial rehabilitation, purchase or refinancing of residential care properties. Residential care properties include nursing; intermediate care; board and care; and assisted living. Section 232 is not a direct loan program, rather, insurance is provided for loans made by a HUD-approved lender.

Section 236 - A low-income housing program created in the HUD Act of 1968 as a replacement for the Section 221(d)(3) program. FHA mortgage insurance and interest rate subsidies were used to help finance these housing communities. Some were also coupled with project-based Section 8.

Subacute Care - More intense medical care than is ordinarily provided in a nursing facility, though less complex or critical than acute hospital care.

T

Title 22 - Title 22, Division 5 of the California Cost of Regulations governs health facilities; Chapter 3 governs skilled nursing facilities. Title 22, Division 6 governs Community Care Facilities; Chapter 8 governs RCFEs.

V

VTR - Vote to Recommend