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Related Guides on this Topic

You may also want to see these guides on related topics: Aging, Informal Caregiving, Home Health, Hospice and Palliative Care

Introduction

Most seniors want to age successfully and safely in their own home. For reasons of comfort, security and peace of mind, staying at home, even when help is needed such as using the services of home health care, is often a senior's first choice. When staying at home is not an option, there are alternatives such as independent apartments, adult homes for temporary or long-term residence, assisted living, retirement communities, and nursing homes. Long-Term Care provides the quality of care and quality of life needed while being in a safe and secure environment.

Frequently Asked Questions

Tools

AARP Policy & Research: Topics in Long-Term Care
Database
Provides long-term care information, research results and policy insights about access to health care, finances, benefits, services, Medicare, insurance, and more.
Sponsoring organization: AARP

Aging and Disability Resource Centers
Web site
Developed to assist states in their efforts to create a single, coordinated system of information and access for all persons seeking long term support to minimize confusion, enhance individual choice, and support informed decision-making.
Sponsoring organization: Administration on Aging

Caregiver.com
Web site
Provides information, support and guidance for family and professional caregivers. Includes topic specific newsletters, online discussion lists, back issue articles of Today's Caregiver magazine, chat rooms and an online store.
Sponsoring organization: Caregiver.com Inc.

Caregiving Across the States: A State-by-State Resource
Web site
Offers information on publicly-funded caregiver support programs in each of the 50 states and the District of Columbia.
Sponsoring organization: Family Caregiver Alliance

Cash & Counseling
Web site
Provides a flexible monthly allowance to recipients of Medicaid personal care services or home and community based services, which allows them to direct and manage their own personal assistance services and address their own specific needs.
Sponsoring organization: Robert Wood Johnson Foundation

Commonwealth Fund ChartCart
Web site
Offers access to charts on various health care themes developed by The Commonwealth Fund.
Sponsoring organization: Commonwealth Fund

Eldercare Locator: Community Assistance for Seniors
Database
Connects older Americans and their caregivers with sources of information on senior services. Links those who need assistance with state and local area agencies on aging and community-based organizations that serve older adults and their caregivers.
Sponsoring organization: Administration on Aging

Federal Long Term Care Insurance Program
Database
Created by the Federal Long-Term Care Security Act. The only Congressionally authorized long-term care insurance program for current and retired Federal government employees and their families. Provides information on long-term care insurance including resource library, glossary, phone numbers, FAQs, application forms and more.
Sponsoring organization: U.S. Office of Personnel Management

Five Wishes
Print publication
Helps people express how they want to be treated if they are seriously ill and unable to speak for themselves. Covers a range of a person's needs: medical, personal, emotional and spiritual. See website for ordering information.
Sponsoring organization: Robert Wood Johnson Foundation

Health Information Technology Toolkit for Nursing Homes
Web site
Designed for use in implementing Health Information Technology or Electronic Health Record system in a nursing home and to evaluate system effectiveness.
Sponsoring organization: Stratis Health

Health Policy Center: Disability and Long Term Care
Web site
Presents research, publications, and statistics on issues in long term care, including trends; delivery system innovations; and costs.
Sponsoring organization: Urban Institute

Home & Community Based Services
Web site
Assists states in improving the overall quality of services provided to Medicaid recipients, provides states with assessment and improvement systems, and helps develop effective methods to utilize implementation and improvement strategies. Allows states to request and provide homemaker/home health aide services, personal care services, adult day health, case management, and respite care.
Sponsoring organization: Centers for Medicare and Medicaid Services

Home Health Compare
Web site
Provides detailed information about Medicare-certified home health agencies in your area.
Sponsoring organization: Centers for Medicare and Medicaid Services

Long Term Care Hospital PPS
Database
Discusses the implementation of a per diem prospective payment system (PPS) for skilled nursing facilities (SNFs) covering all costs (routine, ancillary and capital) related to the services furnished to beneficiaries under Part A of the Medicare program.
Sponsoring organization: Centers for Medicare and Medicaid Services

Long-Term Care
Web site
Provides information on research activities, conferences, meetings and more.
Sponsoring organization: Agency for Healthcare Research and Quality

LTCFocus.org
Research instrument
A project of the Brown University Center for Gerontology and Healthcare Research that provides data on nursing home care in the United States. Includes national and state-level data on the health status of nursing home residents, characteristics of care facilities, and state and local policies.

National Clearinghouse for Long-Term Care Information
Web site
Provides information and resources to help plan for future long-term care needs. Intended as an information and planning resource for individuals who don't yet require long-term care, but it includes information on services and financing options that can be helpful to all individuals.
Sponsoring organization: U.S. Department of Health and Human Services

National Clearinghouse on the Direct Line Workforce
Web site
Consists of a national on-line library for people in search of solutions to the direct-care staffing crisis in long-term care. Includes government and research reports, news, issue briefs, fact sheets, and other information on topics such as recruitment, career advancement supervision, workplace culture, and caregiving practices.
Sponsoring organization: Paraprofessional Healthcare Institute

National Family Caregiver Support Program (NFCSP)
Web site
Provides families, caregivers, and health care professionals with information on where support and assistance can be sought and on providing services to caregivers.
Sponsoring organization: Administration on Aging

National Long Term Care Ombudsman Resource Center
Web site
Provides support, technical assistance, and training to the 53 State Long Term Care Ombudsman Programs and their statewide networks of almost 600 regional programs. Works to enhances the skills, knowledge and management capacity of the State programs to enable them to handle residents' complaints and represent resident interests.
Sponsoring organization: Administration on Aging

National Respite Locator Service
Database
Helps parents, professionals, and caregivers locate respite services. Search for respite care providers by state, age and condition.
Sponsoring organization: ARCH National Respite Network

Nursing Home Compare
Database
Provides detailed information about the past performance of every Medicare and Medicaid certified nursing home in the country.
Sponsoring organization: Centers for Medicare and Medicaid Services

Nursing Home Quality Improvement Initiative
Web site
Contains the eight Quality Measures that CMS and HHS identified regarding residents in nursing homes, designed for the public to see.
Sponsoring organization: American Medical Director's Association

Own Your Future: Long-Term Care Pilot Awareness Program
Web site
Designed to increase consumer awareness about the need to plan ahead for long-term care. Consists of three phases and is a partnership between the federal government and the states. Includes success stories of campaigns have been launched in eight states that provide tools and information to help individuals make the best choices for their potential long-term care needs.
Sponsoring organization: Administration on Aging

Preparedness Resources for Healthcare Facilities
Web site
Serves as an online resource center designed to help hospitals and health care facilities improve preparedness for disasters and large-scale emergencies.
Sponsoring organization: Centers for Disease Control and Prevention

Program of All-Inclusive Care for the Elderly (PACE)
Web site
Developed to address the needs of long-term care clients, providers, and payers. Permits loved ones to continue living at home while receiving services rather than being institutionalized.
Sponsoring organization: Centers for Medicare and Medicaid Services

Rural Health Research: Long Term Care
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of long term care, produced by the Office of Rural Health Policy's funded rural health research centers.
Sponsoring organization: Rural Health Research Gateway

Rural PACE Technical Assistance Program
Web site
Provides technical assistance to organizations interested in developing a PACE (Program of All-Inclusive Care for the Elderly) program to serve a rural area. Includes information on the Community Options for Rural Elders (CORE) Act.
Sponsoring organization: National PACE Association

Selected Long-Term Care Statistics: What is Long-Term Care?
Web site
Discusses what long-term care is and who needs it. Provides statistics, who provides long-term care and where, and estimated expenditures.
Sponsoring organization: Family Caregiver Alliance

Technology for Long-Term Care
Database
Contains information on hundreds of technology products to improve quality of life and care for people in long-term care settings such as nursing homes, assisted living, boarding care, and adult day care programs.
Sponsoring organization: U.S. Department of Health and Human Services

Funding

Alzheimer's Foundation of America Grants
Grants to its nonprofit member organizations to develop or enhance educational and support services.

Commonwealth Fund Health Grants
Supports independent research on health and social issues and makes grants to improve health care practice and policy.

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Maps & Map Collections

Elderly Population
Geographic coverage: United States
Printable map that shows the percent of population who are 65 years or older. Data source: U.S. Census Bureau, Census of Population and Housing, 2000.
Sponsoring organization: Rural Assistance Center
Date: 2000

Long Term Care Hospitals
Geographic coverage: United States
Printable map that shows the location of long term care hospitals nationwide. Data source: Centers for Medicare and Medicaid Services (CMS), July 2008.
Sponsoring organization: Rural Assistance Center
Date: 2008

Skilled Nursing Facilities
Geographic coverage: United States
Printable map that shows the location of skilled nursing facilities nationwide. Data source: Centers for Medicare and Medicaid Services (CMS), July 2008.
Sponsoring organization: Rural Assistance Center
Date: 2006

Regulations, Forms & Other Useful Documents

2007 National Survey of Resident and Family Satisfaction in Nursing Facilities
Sponsoring organization: American Health Care Association
Summarizes key findings from 92,433 surveys compiled by researchers. Data were collected in 2,899 nursing facilities in 50 states and the District of Columbia.
Date: 05 / 2008

2009 Annual Quality Report: A Comprehensive Report on the Quality of Care in America’s Nursing and Rehabilitation Facilities
Sponsoring organization: American Health Care Association
Details quality improvement trends in the nation's nursing homes and rehabilitation facilities. Co-sponsored by the Alliance for Quality Nursing Home Care.
Date: 09 / 2009

Across the States 2006: Profiles of Long-Term Care and Independent Living
Author(s): Ari N. Houser, Wendy Fox-Grage, Mary Jo Gibson
Sponsoring organization: AARP
Covers many facets of long-term care and independent living in each state and the District of Columbia. Presents comparable state-level and national data for 150 indicators.
Date: 12 / 2006

Ahead of the Curve: Emerging Trends and Practices in Family Caregiver Support
Author(s): Lynn Friss Feinberg, Kari Wolkwitz, Cara Goldstein
Sponsoring organization: AARP
Highlights three emerging trends that have important implications for addressing the needs of family caregivers: caregiver assessment; consumer direction in family caregiver support services; and collaborations between the aging network and the health care system.
Date: 03 / 2006

Assessing American Indian Long-term Care Needs
Author(s): Steven P. Wallace, William F. Benson, Richard Ludtke, Leander McDonald, Margaret Moss, Yvonne Jackson
Sponsoring organization: Agency for Healthcare Research and Quality
Overviews existing information on long-term care needs of American Indian elders and resources available to help tribes identify their long-term care needs.

Assisted Living In Unlicensed Housing: The Regulatory Experience Of Four States
Author(s): Bernadette Wright,
Sponsoring organization: AARP Public Policy Institute
Examines the issues that assisted living in unlicensed housing might have for consumers, in terms of quality of care, quality of life, and access to affordable assisted living services. Describes four states’ experiences with this model and discusses the implications for state policy.
Date: 04 / 2007

Beyond Cash and Counseling: The Second Generation of Individual Budget-based Community Long Term Care Programs for the Elderly
Author(s): Brenda Spillman, Kirsten Black, Barbara Ormond
Sponsoring organization: Kaiser Family Foundation
Describes 10 operating individual budget model programs that serve older persons. Identifies four areas of program design that are of particular importance to the success of the individual budget model. Discusses how states have addressed these areas and draws key findings and implications in several areas such as level of funding, participant choice, support systems, and quality of care monitoring.
Date: 01 / 2007

CMS Manual System: Revisions to Appendix PP, “Guidance to Surveyors of Long Term Care Facilities”
Sponsoring organization: Centers for Medicare and Medicaid Services
Provides the revised version of the long term care section of the CMS Manual, rule changes display in red text.
Date: 06 / 2009

Costs of Long-Term Care: Public Perceptions Versus Reality in 2006
Sponsoring organization: AARP
Reports on a survey that looked at the extent to which Americans age 45-plus are aware of the costs and funding sources of a variety of long-term care options including: nursing homes, assisted living residences, and in-home care provided by skilled nurses and aides.
Date: 12 / 2006

Critical Access Hospitals: Does Inclusion of Long-Term Care Affect Profitability?
Author(s): Don Holley, Helen Stroebel
Sponsoring organization: Idaho State Office of Rural Health and Primary Care
Compares whether or not Critical Access Hospitals (CAHs) with Long-Term Care (LTC) units different from those CAHs that do not have LTC units.
Date: 11 / 2005

Developing a Better Long-Term Care Policy: A Vision and Strategy for America's Future
Author(s): Sheila P. Burke, Judith Feder, Paul N. Van de Water
Sponsoring organization: Robert Wood Johnson Foundation
Provides national spending data on formal long-term care, discusses the burden on unpaid caregivers, demographic challenges, and federal financing.
Date: 11 / 2005

Estimates of the Risk of Long Term Care: Assisted Living and Nursing Home Facilities
Author(s): Timothy A. Waidmann, Seema Thomas
Sponsoring organization: U.S. Department of Health and Human Services
Examines the characteristics of people entering assisted living and nursing home facilities. Includes statistics specific to rural areas.
Date: 07 / 2003

Expanding Rural Elder Care Options: Models That Work
Author(s): Peter Fitzgerald, Andy Coburn, Sharon K. Dwyer
Sponsoring organization: National PACE Association
Relays proceedings from the 2008 Rural Long Term Care Access and Options Workshop, which discussed model options for home, community, and facility-based care by care coordination systems that enhance autonomy and quality of life for rural elders.
Date: 06 / 2009

How Do the Residents in Assisted Living and Nursing Homes Compare?
Sponsoring organization: Center for Excellence in Assisted Living
Presents data from the 2004 National Nursing Home Survey and from an industry-sponsored survey that show important ways in which these two types of services are converging and ways in which they are still quite different.
Date: 11 / 2007

Long-Term Care in America: An Introduction
Author(s): Anne Tumlinson, Scott Woods
Sponsoring organization: National Commission for Quality Long-Term Care
Provides an overview of the current long-term care system by describing long-term care, the population that needs it, and how the care is provided and paid for. Introduces the key challenges facing the current system as the demand for long-term care changes and continues to grow.
Date: 01 / 2007

Long-Term Care: Consumers, Providers, Payers, and Programs
Author(s): Carol O'Shaughnessy, Julie Stone, Thomas Gabe, Laura B. Shrestha
Sponsoring organization: Congressional Research Service
Discusses selected characteristics of long-term care consumers and providers and describes payers and selected programs that finance long-term care services.
Date: 03 / 2007

Long-Term Care: Understanding Medicaid's Role for the Elderly and Disabled
Author(s): Ellen O'Brien
Sponsoring organization: Kaiser Family Foundation
Provides a review of how Medicaid works for people with long-term care needs and describes the fiscal challenges that states currently face and that Medicaid may face in the future as the population ages.
Date: 11 / 2005

Making Quality Assisted Living an Affordable Community-Based Care Option Identifying Roles, Risks and Recommendations for Medicaid and Other Public Subsidies
Author(s): Paula Carder, Bernadette Wright, Robert Jenkens
Sponsoring organization: Center for Excellence in Assisted Living
Presents summary proceedings and results of panel and participant discussions on affordable assisted living.
Date: 2005

Measuring Long-Term Care Work: A Guide to Selected Instruments to Examine Direct Care Worker Experiences and Outcomes
Author(s): Kristen M. Kiefer
Sponsoring organization: U.S. Department of Health and Human Services
Developed to help providers devise appropriate surveys for measuring Direct Care Worker's opinions about their jobs. Intended for providers in institutional, home care and other residential settings.
Date: 04 / 2005

Medicaid and Long-Term Care Services
Sponsoring organization: Kaiser Commission on Medicaid and the Uninsured
Covers services for both elderly and non-elderly persons in institutional settings and in homes and other community-based settings.
Date: 07 / 2006

Medicaid's Role in Long-Term Care: Q & A Fact Sheet
Sponsoring organization: Kaiser Commission on Medicaid and the Uninsured
Provides basic information on Medicaid's role for those with long-term care needs.
Date: 2005

Medicare Payment Basics: Long-term Care Hospitals Payment System
Sponsoring organization: Medicare Payment Advisory Commission
Overviews Medicare payments for long-term care services. Includes information on how payment rates are set.
Date: 10 / 2008

Nursing Home Selection: How Do Consumers Choose?
Sponsoring organization: U.S. Department of Health and Human Services
Reports on a study to: review the existence and accessibility of Internet-based resources intended to support the decision to enter a nursing facility and select the appropriate facility; examine how consumers select a nursing home; explore if and how existing information resources are used in the decision-making process; and identify gaps in needed information resources.
Date: 12 / 2006

Nursing Homes in Rural America
Sponsoring organization: Southwest Rural Health Research Center
Policy brief that discusses the main findings of a 2000 survey of 17,000 nursing homes related to rural elderly.
Date: 2003

Out of the Shadows: Envisioning a Brighter Future for Long-Term Care in America
Author(s): Vincent Mor, Edward Alan Miller
Sponsoring organization: National Commission for Quality Long-Term Care
Describes the current state of the long-term care problem. Examines six issue areas facing policymakers: financing and insurance, supporting and educating caregivers, the challenges of changing the physical and organizational environments in which services are delivered, recruiting and retaining a qualified workforce, designing a more effective regulatory control system, and adopting and integrating health information technology into long-term care.
Date: 11 / 2006

PACE Fact Sheet
Sponsoring organization: Centers for Medicare and Medicaid Services
Describes PACE (Program of the All-inclusive Care for the Elderly) and explains how to start a program in terms of application, eligibility, services, enrollment, payment, and restraints.
Date: 2008

PACE in Rural Areas: A Curriculum Development Guide for Training Health Professionals in Interdisciplinary Geriatric Care
Sponsoring organization: Rural PACE Technical Assistance Program
Assists rural PACE providers and their academic partners in designing and implementing an interdisciplinary training program that reflects their specific needs, communities and resources.
Date: 03 / 2007

Past, Present and Future of Managed Long Term Care
Author(s): Paul Saucier
Sponsoring organization: Muskie School of Public Service Institute for Health Policy
Reviews the experience to date, reports on the number of people enrolled nationally, describes the organizations that are contracting with states, and identifies new issues in light of the Medicare Modernization Act. This is a national study of Medicaid managed long term care conducted for the federal Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (ASPE).
Date: 04 / 2005

Place to Call Home: What the Future of Elder Care Should Be
Sponsoring organization: Robert Wood Johnson Foundation
Discusses the Green House, which is a place where elders can receive assistance and support with daily living and clinical care without the assistance and care becoming the focus of their existence. Also discusses the Green House model, developing a business plan, and how it could be replicated.
Date: 12 / 2007

Residential Care and Assisted Living Compendium: 2007
Author(s): Robert Mollica, Kristin Sims-Kastelein
Sponsoring organization: U.S. Department of Health and Human Services
Describes regulatory provisions and Medicaid policy for residential care settings in all 50 states and the District of Columbia.
Date: 11 / 2007

Rural Healthy People 2010: Access to Quality Health Services in Rural Areas - Long-Term Care
Author(s): Linnae Hutchison, Catherine Hawes, Lisa Williams
Sponsoring organization: Southwest Rural Health Research Center
Addresses rural health long-term care issues associated with the Healthy People 2010 focus area on access to quality health services.
Date: 2005

Rural Healthy People 2010: Access to Quality Health Services in Rural Areas - Long-Term Care: A Literature Review
Author(s): Linnae Hutchison, Catherine Hawes, Lisa Williams
Sponsoring organization: Southwest Rural Health Research Center
Details the literature review of rural health long-term care issues associated with the Healthy People 2010 focus area on access to quality health services.
Date: 2005

Rural Long Term Care: Providers' Perspective on Problems & Policy
Sponsoring organization: American Health Care Association
Examines challenges rural long term care facilities face and helps develop strategies specific to long term care issues.
Date: 03 / 2006

Setting the PACE for Rural Elder Care: A Framework for Action
Sponsoring organization: National PACE Association
Describes PACE (Programs of All-Inclusive Care for the Elderly), which works to assist senior citizens to live as independently as possible.
Date: 2003

Setting the PACE for Rural Elder Care: Three Rural PACE Case Studies
Sponsoring organization: National PACE Association
Highlights three case studies involving rural aging and health care providers who were in various stages of exploring PACE (Programs of All-inclusive Care for the Elderly).
Date: 2004

Trading Places: Real Choice Systems Change Grants and the Movement to Community-Based Long-Term Care Supports
Author(s): Cynthia Shirk
Sponsoring organization: National Health Policy Forum
Provides information about Systems Change grants and the kinds of activities state Medicaid agencies have undertaken to transform their institutionally based systems.
Date: 05 / 2007

Understanding Long-term Health Care Insurance
Sponsoring organization: AARP
Discusses steps to take when considering the purchase of long term care insurance.
Date: 2008

Valuing the Invaluable: A New Look at the Economic Value of Family Caregiving
Author(s): Mary Jo Gibson, Ari Houser
Sponsoring organization: AARP Public Policy Institute
Discusses the financial impact of caregiving on the caregivers themselves as well as the economic value of their contributions to society.
Date: 06 / 2007

Women & Long-Term Care Fact Sheet
Author(s): Ari Houser
Sponsoring organization: AARP Public Policy Institute
Identifies the major challenges affecting woman as they age.
Date: 04 / 2007

Journals

Caring for the Ages
Covers clinical, policy, research, risk management, infection control, palliation, strategies for improving quality of care, systems management, and articles by opinion leaders on the critical issues confronting long-term care today. This is a monthly newspaper. Sponsoring organization: American Medical Director's Association

Provider: For Long-Term Care Professionals
Delivers information on upcoming legislation, regulations, quality care and improving operating efficiencies. This is a monthly magazine for long term care professionals, and is available free of charge to qualified long term care professionals. Sponsoring organization: American Health Care Association

Organizations

Administration on Aging (AoA)
Federal government
Advocates for older persons and their concerns at the federal level. Administration on Aging (AoA) works closely with its nationwide network of State and Area Agencies on Aging (AAA). Provides home and community-based services to millions of older persons through the programs funded under the Older Americans Act.

Alliance for Quality Nursing Home Care
National organization
Coalition of 14 national provider organizations that care for 650,000 elderly and disabled patients annually and employ approximately 425,000 caregivers. Embraces a single set of voluntary principles beyond those required by law and pledges their commitment to the people they serve.

American Association of Homes and Services for the Aging (AAHSA)
National organization
Represents 5,600 mission-driven, not-for-profit nursing homes, continuing care retirement communities, assisted living and senior housing facilities, and home and community-based service providers. Committed to advancing the vision of healthy, affordable, ethical aging services for America.

American College of Health Care Administrators (ACHA)
National organization
Provides access to opportunities for long-term care administrators such as conferences, online educational programs and networking.

American Health Care Association (AHCA)
National organization
Advocates quality in long-term care. Comprised of a federation of affiliated state health organizations, together representing nearly 12,000 non-profit and for-profit assisted living, nursing facility, developmentally-disabled, and subacute care providers that care for more than 1.5 million elderly and disabled individuals nationally.

American Medical Director's Association (AMDA)
National organization
Dedicated to excellence in patient care by providing education, advocacy, information, and professional development. This is a professional association of medical directors and physicians practicing in the long term care continuum.

ARCH National Respite Network
National organization
Assists and promotes the development of quality respite and crisis care programs and helps families locate respite and crisis care services in their communities.

Center for Excellence in Assisted Living (CEAL)
Nonprofit/Foundation
Promotes high-quality assisted living and serves as a national clearinghouse, bringing together research, practices, and policy that foster quality and affordability in assisted living.

Commonwealth Fund
Nonprofit/Foundation
Supports independent research on health and social issues and makes grants to improve health care practice and policy. Dedicated to helping people become more informed about their health care and improving care for vulnerable populations such as children, elderly people, low-income families, minority Americans, and the uninsured.

Faith in Action (FIA)
National organization
Makes grants to local groups representing many faiths who volunteer to work together to care for their neighbors who have long-term health needs. This in an interfaith volunteer caregiving program of The Robert Wood Johnson Foundation.

Meals on Wheels Association of America (MOWAA)
National organization
Works to bring meals to seniors in need including men and women who are elderly, homebound, disabled, frail, or at risk.

National Adult Day Care Services Association (NADSA)
National organization
Provides programs designed to meet the needs of functionally and/or cognitively impaired adults through an individual plan of care.

National Center for Assisted Living (NCAL)
National organization
Strives to serve the needs of the assisted living community through national advocacy, education, networking, professional development, and quality initiatives.

National Commission for Quality Long-Term Care
National organization
Develops and implements a national strategy for health care quality measurement and reporting and endorses a set of national voluntary consensus standards to measure the quality of care at nursing homes.

National PACE Association (NPA)
National organization
Exists to advance the efforts of Program of All-inclusive Care for the Elderly (PACE). PACE programs coordinate and provide all needed preventive, primary, acute and long term care services so that older individuals can continue living in the community.

National Resource and Policy Center on Rural Long-Term Care (NRPCRLTC)
National organization
Strives to improve the availability of and access to in-home and community-based long-term care services for elderly and disabled persons in rural areas across the United States.

Veterans-Express
Nonprofit/Foundation
Dedicated to assist qualified seniors and veterans interested in assisted living and receiving the benefits to help pay for their services and rent. Assists families in gathering knowledge about benefits they may be entitled to.

Visiting Angels
National organization
Consists of non-medical, private duty home care agencies providing senior care, elder care, personal care, respite care and companion care to help the elderly and adults continue to live in their homes across America. Provides up to 24 hour care.

Terms & Acronyms

Activities of Daily Living (ADL) Physical functions that an independent person performs each day, including bathing, dressing, eating, toileting, walking or wheeling, and transferring into and out of bed.

Adult Day Care Center Community based program offering structured activities and meals. Some health services may be offered for an additional fee. Transportation may be provided. Most programs operate during the week and can be attended full or part-time.

Adult Day Health Care Provision of care and services in a residential health care facility or approved extension site, on an outpatient basis, under the medical direction of a physician. Services are in accord with a comprehensive assessment of care needs and individualized health care plan.

Assisted Living Facility (ALF) Licensed residential facility that provides room, board and 24 hour personal care to individuals with long term care needs.

Caregiver Person who helps you accomplish the basic everyday activities you can no longer manage without assistance, due to illness, injury, or cognitive impairment.

Chronic Care Care provided to help maintain daily function. There is no expectation that the care recipient will improve or recover. Long term care is chronic care.

Community-Based Services Services, such as meals on wheels and adult day care, designed to help people remain independent and in their own homes.

Companion Care Nonmedical services that are provided in the patient's home. Examples include, but are not limited to: helping the senior with everyday activities, making meals, grooming, ensuring safety, etc. No medical care is provided.

Custodial Care Services aimed at maintaining your health and/or preventing deterioration in your functional status, provided on an extended basis. Long term care includes custodial care.

Durable Medical Equipment (DME) As defined by Medicare, is equipment which can 1) withstand repeated use, 2) is primarily and customarily used to serve a medical purpose, 3) generally not useful to a person in the absence of an illness or injury, and 4) is appropriate for use in the home (e.g. wheelchairs, hospital beds, walkers).

Formal Care Care which is provided by a home health aide or homemaker arranged or supervised by a home care agency, or provided by a nurse or therapist.

Geriatric Care Manager (GCM) A health and human services professional, such as a gerontologist, nurse, social worker, or psychologist with a specialized focus on issues related to aging and elder care. Geriatric care managers work privately with older adults and their families to create a plan of care that meets the needs of the older adult. They will meet with you to help you understand your loved one's needs and to learn what resources and options are available to meet those needs.

Hands-On Assistance When you require physical help by another person without whom you would not be able to perform the activities of daily living. Some insurance companies measure the inability to perform activities of daily living based on the need for hands-on assistance only.

Home Care Services provided at home which may include nursing care; occupational, physical, respiratory or speech therapy; personal care; and homemaker services.

Home Health Aides Individuals who provide care to older adults or people with disabilities at home such as assistance with activities of daily living, managing medications, and some household tasks.

Hospice Care Hospice/palliative care is provided to enhance the life of the dying person. Often provided in the home by health professionals, today there are many nursing facilities and acute care settings that also offer hospice services. Hospice care, typically offered in the last six months of life, emphasizes comfort measures and counseling to provide social, spiritual and physical support to the dying patient and his or her family.

Long Term Care (LTC) Personal care and other related services provided on an extended basis to people who need help with activities of daily living or who need supervision due to a severe cognitive impairment. It can be provided at home, in a nursing home, assisted living facility, or an adult day care center.

Long Term Care Insurance Insurance that helps defray the costs of assistance with the activities of daily living or the costs of supervision due to a severe cognitive impairment. Benefits are often paid in the form of a fixed dollar amount (per day or per visit) for covered expenses and may exclude or limit certain conditions from coverage.

Medicaid Federal assistance program that helps pay for medically necessary services for needy and low income individuals. The program uses state and federal funds to compensate medical providers serving these populations.

Medicare Federal health care insurance program for most adults age 65 and older and certain disabled individuals. It pays for long term care under limited circumstances and for limited periods of time.

Medicare Part A Hospital insurance that helps pay for inpatient hospital care, limited skilled nursing care, hospice care, and some home health care. Most people get Medicare Part A automatically when they turn 65.

Medicare Part B Medical insurance that helps pay for doctors' services, outpatient hospital care, and some other medical services that Part A does not cover (like some home health care). Part B helps pay for these covered services and supplies when they are medically necessary. A monthly premium must be paid to receive Part B.

Nursing Home Licensed facility that provides 24-hour-a-day room and board, nursing care and personal care services. Nursing homes also provide medical care, therapy, and other health related services.

PACE PACE (Program of All-Inclusive Care for the Elderly) programs serve individuals with long term care needs by providing access to the entire continuum of health care services, including preventive, primary, acute and long term care. A basic tenet of the PACE philosophy is that it is better for both the senior with long term care needs and the health care system to focus on keeping the individual living as independently as possible in the community for as long as possible.

Personal Care Involves services rendered by a nurse's aide, dietician or other health professional. These services include assistance in walking, getting out of bed, bathing, toileting, dressing, eating and preparing special diets.

Plan of Care Plan prescribed by a licensed health care practitioner that identifies ways of meeting a person's need for long term care services.

Preexisting Conditions Medical conditions that existed, were diagnosed or were under treatment before an insurance policy was taken out. Long term care insurance policies may limit the benefits payable for such conditions.

Private Pay Patients Patients who pay for their own care or whose care is paid for by their family or another private third party, such as an insurance company. The term is used to distinguish patients from those whose care is paid for by governmental programs (Medicaid, Medicare, and Veterans Administration).

Resident A person living in a long-term care facility. Since nursing facilities are licensed health care facilities, residents are often also referred to as patients.

Respite Services Scheduled short-term nursing facility care provided on a temporary basis to an individual who needs this level of care but who is normally cared for in the community. The goal of scheduled short-term care is to provide relief for the caregivers while providing nursing facility care for the individual. Short-term stay beds used for respite care must be distinct from general nursing facility beds.

Senior Housing Independent living units, generally apartments. Any supportive services, if needed, are through contract arrangement between tenant and service provider.

Skilled Nursing Care Nursing and rehabilitative care that can be performed only by, or under the supervision of, licensed and skilled medical personnel.

Skilled Nursing Facility (SNF) Provides 24-hour nursing care for chronically-ill or short-term rehabilitative residents of all ages.

Standby Assistance Requirement of the presence of another person, within arms reach, to help perform the activities of daily living. Some insurance companies measure the inability to perform activities of daily living based on the need for standby assistance, rather than or in addition to hands-on assistance.

Terminal Illness An illness or injury determined by a physician or other licensed healthcare professional to be likely to result in your death within 6 months.

Contacts

For further assistance:
Peter Fitzgerald, VP, Strategic Initiatives National PACE Association 703-535-1521

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Page last updated 11/19/2009
Topic last reviewed 12/18/2008

Events
Dec 3, 2009
CMS Skilled Nursing Facility (SNF)/Long-Term Care (LTC) Open Door Forum
Centers for Medicare and Medicaid Services
2:00 PM Eastern
There are 2 ways to participate, onsite or by phone.
To participate by phone: Dial: 1.800.837.1935
Reference Conference ID: 40384200
Persons participating by phone are not required to RSVP.
Hubert H. Humphrey Building
Washington, DC

About this Page
Credits

Thanks goes to: Peter Fitzgerald, VP, Strategic Initiatives National PACE Association

Andy Coburn, Institute for Health Policy Muskie School of Public Service

Maintained by:
Aubrey Madler, RAC Information Specialist



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