Glossary of Terms
It's easier to make the right long-term care decisions when you understand the language that experts use to discuss the topic. Here's a glossary of terms commonly used by people in the nursing home and long-term care industries:
Admission Contract - A written, legal consumer contract that a resident or a resident's representative must sign when entering a nursing home or boarding care home. Residents should obtain a copy of the document ahead of time and read the document carefully before signing it. If you have questions or points you disagree with, be sure to have these answered or negotiated before signing.
Boarding Care Homes - These facilities are licensed to provide only personal or custodial care and related services such as meals, laundry, supervision of medication and activities. Unlike nursing homes, they provide minimal nursing care.
Care Conferences - Nursing homes are required to schedule a conference at least once every three months in which the resident's personal care plan is reviewed. A staff person from each discipline involved in the resident's care should attend. The resident, his representative or family members may also attend. Care conferences are a good opportunity for residents and family members to state suggestions, wishes and concerns and to ask questions.
Case Mix - Minnesota uses a case mix system developed by the federal government for use by state Medicaid programs. It is knows as RUGS, which stands for Resource Utilization Groups.
Equal Rates Law - Minnesota law requires that all residents in one home, regardless of payment sources, be charged the same rate for the same care. This means residents with the same case mix classification in the same home must be charged the same rate whether their bills are being paid privately, through insurance or by Medical Assistance. This law applies to rates for residents in double occupancy rooms. It does not apply in private or single rooms, and it does not apply to rates established by Medicare or the Veterans Administration.
Medical Assistance (MA) - MA, known nationally as the Medicaid program, helps pay the cost of medical care for those who have limited income and assets. About 75 percent of nursing home residents eventually receive Medical Assistance. Under state law, those residents receiving Medical Assistance may not be treated differently than private pay residents.
Preadmission Screening - Anyone applying to a certified nursing home or board and care home must receive a free preadmission screening (PAS). A public health or social service professional will schedule a visit or ask questions over the phone. The professional will then make recommendations about health care options that could meet the person's needs and explain ways to pay for that care. The professional can help the person access Medical Assistance or the Alternative Care program (helps pay for assistance received in the home) if the individual qualifies. A person being screened is not required to adhere to the professional's recommendations. But if the person chooses nursing home care and it was not recommended, Medical Assistance will not pay the cost of that care.
Resident Bill of Rights - Nursing home residents' rights are guaranteed protection by both federal and state laws because they depend on others to provide for their basic needs and are therefore more vulnerable to having the rights taken away or compromised. Resident rights include courteous treatment, information about medical situations an treatments, refusal of treatment, personal privacy and freedom from abuse. A copy of both the federal and state rights is available in all nursing homes. Ask for a copy when you visit.
Subacute Care - Nursing homes with subacute care units may offer a treatment program designed for people who, because of illness, injury or disease, require care that is more medical, high-tech or short-term rehabilitative in nature than regular nursing home care. Consumers should be aware that subacute care is not a recognized level of care by any government or regulatory agency. Therefore, find out from nursing home staff how services offered in their subacute unit differ from these in other units.
Similarly, terms such as transitional care and rehabilitative care are not licensed categories of care either but may refer to comprehensive, short-term care. Again, ask the staff to define these terms and the ways in which the services differ.
Source: Consumer Guide: Choosing a Nursing Home, Good Age Newspaper.