Assisted Living Facilities, Care Homes, Senior Housing Industry Terminology
Activities of Daily Living (ADLs)
Basic self-care tasks used to assess functional status and determine service levels: bathing, dressing, toileting, transferring, continence, and eating.
Resident requires assistance with 3 ADLs; ADL decline triggered a reassessment; ADL score supports Level 3 service plan.
Advance Directive
A legal document stating a person’s medical treatment preferences and designating a decision-maker if they cannot speak for themselves.
Copy of the advance directive is on file; Honor the resident’s advance directive for no feeding tube; Discuss advance directives at move-in.
Base Rate
The standard monthly rent that typically covers room/board and core hospitality services before additional care fees.
The base rate excludes medication management; Offer a promotional base rate for new move-ins; Base rate increase notice is sent 60 days prior.
Behavioral Health
Mental health and substance-use conditions that affect resident care, safety, and service planning.
Behavioral health consult ordered for agitation; Add behavioral health training to staff in-service; Coordinate with BH provider to manage depression.
Care Plan
An individualized plan detailing needs, interventions, schedules, goals, and responsible staff.
Update the care plan after a fall; Hold a care plan conference with family; Care plan specifies two-person assist for transfers.
Case Mix
The distribution of resident acuity/needs within a community, influencing staffing, pricing, and margins.
Our case mix shifted toward higher acuity; Compare case mix across sister communities; Case mix–adjusted pricing model.
Centers for Medicare & Medicaid Services (CMS)
Federal agency that administers Medicare/Medicaid and sets rules, surveys, and guidance that affect senior care settings (e.g., HCBS settings rule, infection control).
Follow the CMS HCBS settings rule; Review CMS infection prevention guidance; CMS policy changes may impact referral patterns.
Certified Nursing Assistant (CNA)
State-certified paraprofessional providing direct personal care under nurse supervision.
Hire two CNAs for the night shift; CNA scope includes vitals and ADL support; Audit CNA-to-resident ratios.
Dementia
Umbrella term for cognitive disorders (e.g., Alzheimer’s) that impair memory, executive function, and behavior, requiring specialized care.
Implement dementia-friendly design cues; State requires dementia training hours; Tiered dementia care fees apply.
Do Not Resuscitate (DNR)
A medical order directing providers not to perform CPR if breathing or heartbeat stops.
Verify DNR bracelet on admission; Respect the DNR during an arrest; DNR status documented in the chart and MAR.
Electronic Health Record (EHR)
Digital platform for assessments, care tasks, medication administration, outcomes, and reporting.
Implement EHR with eMAR; EHR alerts for missed ADL tasks; Export reports for state survey from the EHR.
Elopement Risk
Likelihood a resident may leave a safe area without supervision, potentially leading to harm.
Complete elopement risk assessment on admission; Install delayed egress hardware; Conduct elopement drills quarterly.
Falls Risk Assessment
Structured tool (e.g., Morse, Hendrich) used to estimate a resident’s probability of falling.
High fall risk triggers 15-minute checks; Reassess fall risk after med changes; Falls committee reviews monthly trends.
Fire Safety / Life Safety Code
NFPA 101 standards for egress, alarms, sprinklers, and fire protection; compliance is surveyed.
Passed the Life Safety survey; Document annual fire drills; Corrected cited life safety deficiencies.
Geriatric Care Manager
A professional (often RN or social worker) who coordinates services, advocates, and guides families through care transitions.
Referral came from a geriatric care manager; GCM joined the care conference; Engage GCM for complex cases.
Guardianship
Court-appointed authority for decision-making when a person is deemed incapacitated.
Obtain guardian consent for transfer; Send billing to court-appointed guardian; Guardianship hearing pending next month.
Health Care Proxy (HCP)
A designated individual authorized to make healthcare decisions when the resident lacks capacity.
Confirm HCP contact information; Notify the HCP after an incident; HCP signed the MOLST per state rules.
Home and Community-Based Services (HCBS)
Medicaid programs that fund services in home-like settings (including some ALFs) rather than institutions.
Apply for HCBS waiver slots; Ensure HCBS settings rule compliance; Negotiate HCBS reimbursement rates.
Hospice
Interdisciplinary, comfort-focused care for terminal illness, often delivered in the resident’s ALF apartment.
Hospice nurse coordinates meds; Weekly hospice IDT notes in the chart; Family educated on hospice levels of care.
Incident Report
A structured record of adverse events (e.g., falls, med errors, elopements) used for analysis and improvement.
Submit the incident report within 24 hours; Trend incident types monthly; Attach a root cause analysis.
Infection Control
Policies and practices to prevent, monitor, and manage infections (hand hygiene, PPE, isolation, surveillance).
Annual infection control risk assessment; Audit donning and doffing PPE; Report outbreak per state regs.
Instrumental Activities of Daily Living (IADLs)
More complex tasks necessary for independent living: meal prep, housekeeping, shopping, managing meds and finances, using transportation.
IADL support included in base rate; IADL impairment documented in assessment; IADL goals added to care plan.
Joint Commission (TJC)
An accrediting body whose standards and surveys are used by some senior living organizations to signal quality.
TJC survey scheduled next quarter; Align policies with TJC standards; Use tracer methodology to prepare for TJC.
Key Performance Indicators (KPIs)
Quantifiable operational and financial metrics used to monitor performance.
Weekly KPI dashboard review; KPIs include occupancy, NOI, turnover; KPI target set at 30% gross margin.
Level of Care (LOC)
A tiered classification of services required (and typically billed) based on assessment of resident needs.
LOC 1–4 used for pricing; LOC change triggers a rate adjustment; LOC determined by standardized tool.
Licensed Practical Nurse (LPN)
A licensed nurse who performs clinical tasks under RN/physician supervision, scope varies by state.
LPN oversees med pass; LPN scope limits IV therapy here; Recruit an LPN for evenings.
Life Plan Community (CCRC)
A campus offering a continuum (Independent Living, Assisted Living, Skilled Nursing) often under an entry-fee contract.
Type A CCRC contract includes future care; CCRC supports aging in place; Evaluate CCRC refund options.
Medicaid Waiver
State-specific waivers allowing Medicaid to fund services in assisted living or home-like settings.
Resident approved for waiver slot; Waiver assessment completed by caseworker; Review updated waiver reimbursement rates.
Medication Management
Processes for ordering, storing, administering, documenting, and monitoring medications safely.
Medication management fee schedule; Weekly med pass audits; High-risk medication monitoring protocol.
Memory Care
Specialized programming, environment, and staffing for residents with dementia or cognitive impairment.
Secure memory care neighborhood; Montessori-based memory care activities; Higher staffing ratios in memory care.
Net Operating Income (NOI)
Operating revenue minus operating expenses, before debt service and capital expenditures; key valuation metric.
NOI margin improved by 200 bps; Wage increases reduced NOI; Budget initiatives to grow NOI.
Occupancy Rate
The percentage of available units that are occupied; a primary driver of revenue and staffing.
Target occupancy of 92%; Occupancy dipped due to move-outs; Occupancy-based staffing model.
Ombudsman (Long-Term Care Ombudsman)
An independent advocate who investigates complaints and protects residents’ rights in long-term care settings.
Ombudsman attended the care meeting; Post ombudsman contact info in lobby; Filed concern with the ombudsman.
Palliative Care
Specialty care focused on symptom relief and quality of life at any disease stage (distinct from hospice).
Palliative consult for pain and dyspnea; Integrate palliative goals into the care plan; Educate families on palliative vs hospice.
Person-Centered Care
A philosophy and practice that honors resident preferences, routines, and life history in all aspects of care.
Flexible dining for person-centered care; Use life story boards; Measure outcomes tied to person-centered goals.
Power of Attorney (POA)
A legal document authorizing someone to act on the resident’s behalf (healthcare and/or financial).
Obtain a copy of the POA; POA provides consent for procedures; POA triggers upon incapacity per document.
Quality Assurance and Performance Improvement (QAPI)
A structured, data-driven approach to monitor processes and improve quality and safety.
Monthly QAPI committee meets; QAPI project targets fall reduction; Audit MAR errors as part of QAPI.
Resident Rights
Statutory rights ensuring dignity, privacy, choice, and grievance processes for residents.
Post resident rights prominently; Investigate alleged rights violations; Train staff on resident rights annually.
Respite Care
Short-term stays that provide caregiver relief or allow a prospective resident to trial the community.
Offer a 14-day respite program; Respite stay converted to a permanent move-in; Daily respite rate policy in place.
Return on Investment (ROI)
A financial measure that evaluates the efficiency or profitability of an investment.
Calculate ROI on EHR implementation; Marketing ROI improved after channel shift; Set ROI thresholds for capital projects.
Service Plan
A detailed list of services, frequency, and fees agreed upon with the resident/representative; often tied to billing.
Update service plan quarterly; Service plan signed by POA; Billing reconciled to service plan tasks.
Skilled Nursing Facility (SNF)
A licensed facility providing 24/7 nursing care and rehabilitation; frequent referral partner for ALFs.
Discharge from SNF to ALF planned; Coordinate with SNF for therapy continuation; Discuss SNF vs ALF scope limits with family.
Staff Turnover
The rate at which employees leave the organization; affects quality, cost, and culture.
Reduce turnover via wage adjustments; Track 90-day turnover separately; Department-level turnover KPIs reviewed monthly.
Sundowning
Late-day confusion, agitation, or restlessness in people with dementia, often tied to circadian rhythms.
Adjust activity schedule to reduce sundowning; Implement lighting interventions; Use calm, structured evening routines.
Telehealth
Remote clinical visits and monitoring via audio/video and connected devices.
Telehealth visit with NP reduced ER transfer; Implement a mobile telehealth cart; Add telehealth to the on-call protocol.
Transfer Trauma
Physical and psychological stress associated with relocating or changing care settings.
Mitigate transfer trauma during move-in; Provide staff training on transfer trauma; Coach families to ease transitions.
Universal Precautions
An infection-control approach treating all blood and certain body fluids as potentially infectious.
Wear gloves per universal precautions; Provide annual refresher training; Audit compliance quarterly.
Vacancy Loss
Revenue lost due to unoccupied units and concessions; used in budgeting and valuation.
Budget 5% vacancy loss; Marketing reduced vacancy loss this quarter; Concession strategy increased vacancy loss temporarily.
Value-Based Care
Payment and care models that reward outcomes, quality, and cost efficiency rather than volume.
Partner with MA plan for value-based pilots; Track quality metrics for shared savings; Align care pathways to value-based contracts.
Wandering Risk
Propensity to move about aimlessly; in dementia, can lead to unsafe exits and getting lost.
Add wander-alert wearables; Care plan includes redirection techniques; Enroll high-risk residents in secured neighborhood.
Related Topics
Further Reading
Was this page helpful? We'd love your feedback — please email us at feedback@dealstream.com.