Glossary of Terms

It’s important to familiarize yourself with the wording and terms associated with Home Healthcare. Below you will find a list associated with Home Care by Black Stone.


Accelerated Death Benefit A life insurance policy benefit that lets the insured person use some of the policy's death benefit prior to death for purposes such as long-term care. Activities of Daily Living (ADLs) Everyday functions and activities that people usually do without help. Examples of ADLs are:
  • Bathing, Dressing, Grooming, Eating, Bed mobility, Transferring, Toileting, and Walking.
  • Many insurance policies use the inability to perform a certain number of ADLs (such as 2 of 6) to determine eligibility for benefits.
Acute Care The care provided for a medical condition from which a patient is expected to recover and resume a "normal" lifestyle, even though it may not be the same as before onset of the condition. Recovered patients usually do not require the assistance of another person in performing their normal activities of daily living. This term is one used by Medicare for coverage. Adult Day Care Center A structured program that is usually offered on weekdays and may offer activities, meals, and health and rehabilitative services for the elderly in a supervised setting which may include a mixture of health, social and support services. Specialized programs for individuals with Alzheimer's disease or related disorders might also exist. Some facilities offer a wide range of therapeutic and rehabilitative activities as well as social activities, meals, and transportation. Advance Directives These are ways for an individual to accept or refuse medical care. Prepared ahead of time, a health care advance directive is a written document that says how medical decisions are to be made if one loses the ability to make decisions. They can protect one's rights even if one becomes mentally or physically unable to choose or communicate wishes. Living Wills and Durable Power of Attorney for Health Care are two examples of advance directives. Alzheimer’s Disease Alzheimer’s Disease ("AD") is the most common of the dementia disorders. It is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking and behavior causing loss of short-term memory, the ability to reason, the ability to care for oneself and deterioration of language skills. Symptoms include:
  • Gradual memory loss,
  • Decline in ability to perform routine tasks,
  • Disorientation in time and space,
  • Impairment of judgment,
  • Personality change,
  • Difficulty in learning, and
  • Loss of language and communication skills.
As with all dementia, the rate of progression in Alzheimer’s patients varies from case to case. Area Agency on Aging (AAA) A nationwide network of State and local programs that help older people plan and care for their life-long needs. Services include information and referral for in-home services, counseling, legal services, adult day care, skilled nursing care/therapy, transportation, personal care, respite care, nutrition and meals. Assignment of Benefits A policy provision in long-term care insurance policy benefits that allows the insured person (or his/her legal representative) to make arrangements to have all or a portion of the benefits paid directly to the provider or providers of their care instead of to the insured person. Assisted Living (Non-Medical Senior Housing) Assisted living is a general term for living arrangements in which some services are available to residents (meals, laundry, medication reminders), but residents still live independently within the assisted living complex. In most cases, assisted living residents pay a regular monthly rent, and then pay additional fees for the services that they require. Assistive Equipment A range of products and technology designed to help elders or people with disabilities lead more independent lives. Some examples include special telephones for people with hearing impairments, walking aids, elevated toilet seats, communication devices, etc


Board and Care Homes These are group living arrangements (sometimes called group or domiciliary homes) that are designed to meet the needs of people who cannot live independently, but do not require nursing home services. In some states, these may be considered similar to assisted living programs. These homes offer a wider range of services than independent living options. Most provide help with some of the activities of daily living, including:
  • Eating,
  • Walking,
  • Bathing, and
  • Toileting.
In some cases, private long-term care insurance and medical assistance programs will help pay for this type of living.


Capitation A method of compensation for health care services under which doctors and other health care providers are paid a fixed monthly fee for each HMO member under their care, rather than for each service or treatment they perform. Care Manager (Case Manager) A social worker or healthcare professional who evaluates, plans, locates, coordinates and monitors services with an older person and the family. A care manager is defined by the National Association of Professional Geriatric Care Managers as a "professional with a graduate degree in the field of human services or a substantial equivalent, certified or licensed at the independent practice level of his or her state or profession, who is trained and experienced in the assessment, coordination, monitoring, and direct delivery of services to the elderly and their families." Centers for Medicare and Medicaid Services (CMS) The federal agency that runs the Medicare, Medicaid, and Children's Health Insurance Program, and works to make sure that the beneficiaries in these programs have access to high quality health care. Certified A long-term care facility, home health agency, or hospice agency that meets the requirements imposed by Medicare and Medicaid is said to be certified. Being certified is not the same as being accredited. Medicare, Medicaid and some long-term care insurance policies only cover care in a certified facility or provided by a certified agency. Certified Nursing Assistant (CNA) CNAs are trained and certified to help nurses by providing non-medical assistance to patients, such as help with eating, cleaning and dressing. Chore/Housekeeping Services These types of services include yard and house maintenance, home and appliance repair, housekeeping, meal preparation, shopping and transportation. No personal care is provided. This service is not covered by Medicare. Chronic Illness or Condition An illness or other condition with one or more of the following characteristics: permanency, residual disability, requires rehabilitation training, or requires a long period of supervision, observation, or care. Typically, it is a disease or condition that lasts over a long period of time and cannot be cured. Cognitive Impairment Deterioration of intellectual ability, such as disorientation as to people, places or time; impairment of short-term or long-term memory; and/or impairment of one's ability to reason; that has progressed to the extent that a person requires substantial supervision by another person. Cognitive impairment includes Alzheimer's disease and other types of dementia. Coinsurance For Medicare, it is the percentage of the Medicare-approved amount that one has to pay after paying the deductible for Part A and/or Part B. For other types of health insurance, it is usually a percentage of billed charges after the deductible is paid. For example, if the deductible was paid and the insurance company then pays 70 percent of the remaining amount of the claim, the coinsurance is 30 percent. ComCare Funded by the Human Services Tax Levy, a county funded program in Montgomery County, Ohio, this program assists in paying for in-home services to keep frail elders out of nursing facilities and living independently as long as possible. The program is for seniors who need supervision or limited assistance to remain independent at home. Once enrolled a case manager works with them to assure needs are met with quality services and that the plan of care is adjusted as needs change. Community-Based Services Services designed to help older people live independently in their own homes, such as adult day care, in-home care and senior centers. Companion A companion provides assistance with shopping, meal preparation, escorting, companionship, and home upkeep. No personal care or nursing care is provided. Conservator Person appointed by the court in a legal proceeding to act as the legal representative of a person who is mentally or physically incapable of managing his or her own affairs. Continuing Care Retirement Communities (CCRCs) CCRCs are housing communities that provide different levels of care based on the needs of their residents--from independent living apartments to skilled nursing in an affiliated nursing home. Residents move from one setting to another based on their needs, but continue to remain a part of their CCRC's community. Many CCRCs require a large payment prior to admission and charge monthly fees beyond that. For this reason, many CCRCs are too expensive for older people with modest incomes. Co-payment This is the portion of a medical expense that is the member's financial responsibility. HMOs generally have fixed low co-payments. Creutzfeldt-Jakob Disease Creutzfeldt-Jakob Disease is a rare, fatal brain disease (sometimes referred to as "mad cow" disease) caused by a transmissible infectious organism, probably a virus.


Deductible A common cost-sharing arrangement of traditional indemnity insurers under which a policyholder must pay a set amount toward covered services before the insurer is required to pay claims. Typically, HMO members do not pay deductibles. Dementia Dementia is characterized by the loss of intellectual functions (e.g., vocabulary, abstract thinking, judgment, memory loss, physical coordination) to the extent that a person’s daily functioning is affected. It is not a disease in itself, but rather a group of symptoms which may accompany certain diseases or physical conditions. The cause and rate of progression of dementia vary. Some of the well-known diseases that produce it include:
  • Alzheimer’s Disease,
  • Multi-infarct Dementia
  • Huntington’s Disease,
  • Pick’s Disease,
  • Creutzfeldt-Jakob Disease, and
  • Parkinson’s Disease.
Dementia can be caused by degenerative diseases (e.g., Alzheimer's, Huntington's and Parkinson's diseases), vascular diseases or stroke, metabolic disorders (thyroid, liver kidney dysfunction and certain vitamin deficiencies), AIDS, drugs and alcohol, and psychiatric disorders. Depression Depression is a psychiatric disorder marked by sadness, inactivity, feelings of hopelessness, and sometimes suicidal tendencies. Many severely depressed individuals will have some mental deficits including poor concentration and attention. When dementia and depression are present together, intellectual deterioration may be exaggerated in the depressed person. Depression, whether present alone or in combination with dementia, can be reversed with proper treatment. It is one of the most undiagnosed conditions among seniors. Delirium A state of temporary but acute mental confusion that comes on suddenly. Symptoms may include:
  • Anxiety,
  • Disorientation,
  • Tremors,
  • Hallucinations,
  • Delusions, and
  • Incoherence.
Delirium can occur in older persons who have short-term illnesses, heart or lung disease, long-term infections, poor nutrition, or hormone disorders. Alcohol or drugs (including medications) also may cause confusion. Delirium may be life-threatening and requires immediate medical attention. Discharge Planner A social worker or other health care professional who assists hospital patients and their families in transitioning from the hospital to another level of care such as rehabilitation in a skilled nursing facility, home health care in the patient's home, or long-term care in a nursing home. Durable Medical Equipment (DME) Medical equipment that is ordered by a doctor for home use. These items must be reusable, such as walkers, wheelchairs, or hospital beds. Durable Power of Attorney A power of attorney that stays in effect even after the person whom the document represents becomes incompetent.


Elder Care A wide range of services provided at home, in the community and in residential care facilities, including assisted living facilities and nursing homes. It includes health-related services such as rehabilitative therapies, skilled nursing, and palliative care, as well as supervision and a wide range of supportive personal care and social services. Typically, elder care is provided over an extended period of time to people who need another person's assistance to perform normal activities of daily living because of cognitive impairment or loss of muscular strength or control. Elderly Services Program (ESP) A taxpayer-supported program funded by county tax dollars and administered by the Area Agencies on Aging in some Ohio counties for those who do not qualify for Medicaid, but still cannot afford to pay privately for in-home care. ESP clients can have a higher income level (some ESP clients have a co-payment) and a less-severe level of disability than PASSPORT clients. ESP is reserved for those who have no other options; it is the payer of last resort. In other words, ESP clients may not be eligible for services through another source such as Medicare, Medicaid or private insurance. In-home care services, including housekeeping, personal care, medical transportation and home-delivered meals are offered. Emergency Response Systems Allows for 24-hour monitoring and response to medical or other emergencies. Enrollment Area HMOs specify that an individual must reside in a particular area in order to be eligible for plan coverage. Estate All of a person's assets and debts at the time of his or her death. Estate Planning Steps one takes while living to determine what happens to property at death. Estate Tax A tax levied on a person's estate after that person's death. Exclusion A health condition, situation, item, service or expense that an insurance policy does not cover.


Federally Qualified HMO An HMO that has met certain standards established by the federal government pertaining to quality of care, financial soundness, member services, and similar criteria. Fee-for-service Method of payment under which providers are paid for each service performed. Fiduciary Someone, such as a trustee or guardian, who holds the assets of another person, often with the legal authority and duty to make decisions regarding financial matters on behalf of the other party.


Gatekeeper A term sometimes used to refer to HMO primary care physicians or nurse practitioners because of their responsibility for referring members to specialists or other services. Geriatrician A physician who specializes in the care of the elderly, primarily those who are frail and have complex medical and social problems. Group Practice HMO An HMO that contracts with medical groups to provide healthcare to HMO members. Guardian A person who is appointed by a court and charged with the legal duty to care for another person who is unable to care for himself or herself. Guardianship Similar to a conservatorship, yet severely restricts the legal rights of an elder based on a court's finding of legal incompetence.


Hands-On Assistance The physical assistance of another person without whom the person needing assistance would be unable to perform an activity of daily living. Health Care Power of Attorney Allows a designated representative to decide on the health care of an incompetent person. HMO (Health Maintenance Organization) A health plan that both pays for and provides--or arranges to provide--access to comprehensive medical services. HMOs are reimbursed for services on a fixed monthly basis. Home Health Care (Home Care) Supportive services in the home ranging from skilled nursing care and occupational, physical, respiratory and speech therapy ... to assistance with activities of daily living and housekeeping. This support allows many older people to remain living somewhat independently in their own homes. Homebound A term meaning one is normally unable to leave home or cannot leave home without considerable and taxing effort. A person may leave home for medical treatment or short, infrequent absences for nonmedical reasons, such as a trip to the barber. Home Health Agency An organization that provides home care services, including skilled nursing care, physical therapy, occupational therapy, speech therapy, and care by home health aides. Home Health Aide A home health aide provides services that support any services that the nurse provides. These services include help with personal care, such as bathing, using the toilet, or dressing. These types of services do not need the skills of a licensed nurse. Medicare does not cover home health aide services unless one is also getting skilled care such as nursing care or other therapy. Training or certification requirements vary from state-to-state, but typical services include assistance with activities of daily living, managing medications and some household tasks. In some states, only licensed home health aides can provide hands-on assistance. Hospice Medical and social programs for terminally ill patients and families either at home or in a facility. The care includes physical care, counseling and support services, but does not attempt to cure any illness. Huntington’s Disease Huntington’s Disease ("HD") is an inherited, degenerative brain disease which affects the mind and body. It currently affects more than 25,000 Americans. HD usually begins during midlife, and is characterized by intellectual decline, and irregular and involuntary movements of the limbs or facial muscles. Other symptoms of HD include:
  • Personality change,
  • Memory disturbance,
  • Slurred speech,
  • Impaired judgment, and
  • Psychiatric problems.
Although there is no treatment available to stop the progression of the disease, the movement disorders and psychiatric symptoms can be controlled by drugs.


Incapacity Can be mental or physical, temporary or permanent. A person can be incapacitated without being incompetent. Incompetence Requires a legal declaration of being found incapable of handling assets and exercising certain legal rights. Incontinence The inability to control urination, bowel movements or both. Independent Practice Association (IPA) HMOs that contract with individual physicians in private practice who provide care to HMO members within a private office setting. Irrevocable Trust A trust that, once executed, cannot be revoked or changed without the consent of the beneficiary. Instrumental Activities of Daily Living (IADLs) These are tasks that, in addition to activities of daily living, one must be able to perform in order to live independently (without the assistance or substantial supervision of another person). Examples include grocery shopping, meal preparation, using the telephone, laundry, light housekeeping, bill paying, and managing medications. Most long-term care insurance policies will not pay benefits solely for the loss of ability to perform IADLs. Intermittent Care Skilled nursing and home health aide services furnished up to 28 hours per week any number of days per week so long as they are less than 8 hours per day. For example: If a patient receives one nursing visit every day along with a home health aide for 2 hours each day, this would equal 21 hours for the week. (7 nursing visits + 14 home health aide hours = 21) Intestate Dying without a legal will.




Licensed Health Care Practitioner A physician (as defined by the Social Security Act) or a registered professional nurse, licensed social worker, or any other health care worker who meets the requirements of the U.S. Treasury Department. Live-in Service When appropriate, a round-the-clock homemaker can be placed in the home for long or short- term care needs. This Live-in service is perfect when a primary caregiver needs to be away so peace of mind is created for all involved in care. MJ Nursing provides this service in the Black Stone Family of care services. Living Trust A trust created during someone's lifetime to hold assets during that person's lifetime, thereby removing those assets from probate at death. A living trust can be either revocable or irrevocable. It avoids probate and therefore gets assets distributed significantly faster than a will. Assets that a person wants to move to a living trust, such as real estate and bank or brokerage accounts, must be retitled so that the trust becomes the owner. Living Will A legal document that makes known a person’s wishes regarding medical treatments at the end of life. Long Term Care A variety of services provided over an extended period of time to people who need help to perform normal activities of daily living because of cognitive impairment or loss of muscular strength or control. Care may include rehabilitative therapies, skilled nursing, and palliative care, as well as supervision and a wide range of supportive personal care and social services. Long-term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities. Regardless of where it is provided, most long-term care is custodial care, the type of care that is not paid for by Medicare. Long-Term Care Facilities Institutions that provide nursing care to people who are unable to care for themselves and who may have health problems ranging from minimal to serious. These facilities are often used for short-term rehabilitation after hospitalization. Long-Term Care Insurance Long-Term Care Insurance is private insurance designed to cover long-term care costs. Plans vary widely, and it is wise to do some research before purchasing any long-term care policy. Generally, only relatively healthy people may purchase long-term care insurance. Because Medicare generally does not pay for long-term care, this type of insurance policy may help pay for long-term care needed in the future.


Medigap Insurance Private health insurance policies that supplement Medicare coverage, covering health care costs above those covered by Medicare Part A or Part B. Does not provide benefits for long term care, covering primarily hospital and doctor bills. Managed Care A method of delivering and paying for health care through a system of networks of providers that is a combination of insurance and a health care delivery system. Managed care seeks to ensure the quality and contain the cost of comprehensive medical care, the basic goal of which is to coordinate all health care services received to maximize benefits and minimize costs. Managed care plans use their own network of health care providers and a system of prior approval from a primary care doctor in order to achieve this goal. Managed care plans include HMOs, preferred provider organizations, point of service plans, and similar coordinated care networks. Providers include: specialists, hospitals, skilled nursing facilities, therapists, and home health care agencies. Medicaid/Medical Assistance A jointly funded medical financial Federal-State health insurance assistance program, offering benefits to individuals with limited financial resources, the disabled, and the elderly. Programs vary from state to state, but most health care costs are covered if one qualifies for both Medicare and Medicaid. Medicare Federal program providing health care coverage/insurance for people over 65 years of age, certain younger people with disabilities, and people with End-Stage Renal Disease (ERSD) (permanent kidney failure that must be treated with dialysis or a transplant). Part A covers inpatient care, skilled nursing facility, hospice and short-term health care. Part B covers doctors’ services, outpatient hospital care, and durable medical equipment. It does not provide for long-term care of the elderly except under limited conditions. Medically Necessary Services or supplies that:
  • Are proper and needed for diagnosis, or treatment of a medical condition;
  • Are provided for the diagnosis, direct care, and treatment of a medical condition;
  • Meet the standards of good medical practice in the medical community of one's local area; and
  • Are not mainly for the convenience of the beneficiary or his/her doctor.
Medical Social Services Help with social and emotional concerns one may have related to one's illness. This might include counseling or help in finding community resources Medicare Supplemental Insurance This is private insurance (often called Medigap) that pays Medicare's deductibles and co-insurances, and may cover services not covered by Medicare. Most Medigap plans will help pay for skilled nursing care, but only when that care is covered by Medicare. Medigap Policies A Medigap policy is the most common way that a health insurance policy helps one pay for some nursing home costs. A Medigap policy pays for the ‘gaps,’ or co-insurance, left by Medicare such as the Co-Pay owed for days 21 through 100 of a Medicare Benefit period. Multi-Infarct Dementia Multi-Infarct Dementia, or vascular dementia, is a deterioration of mental capabilities caused by multiple strokes (infarcts) of the brain. These strokes may damage areas of the brain responsible for a specific function and may produce generalized symptoms of dementia.


Network The doctors, clinics, health centers, medical group practices, hospitals, and other providers that an HMO or other managed care plan employs or contracts with to care for its members. Non-Ambulatory Inability to ambulate, walk around, and usually bedridden or hospitalized. Nursing Home A nursing home is a residence that provides room, meals, recreational activities, help with daily living, and protective supervision to residents. Generally, nursing home residents have physical or mental impairments which keep them from living independently. Nursing homes are certified to provide different levels of care, from custodial to skilled nursing (services that can only be administered by a trained professional). One step below hospital acute care, a nursing home provides regular medical supervision and rehabilitation therapy.


Observed Tasks of Daily Living Observing older adults performance in three IALD domains. Adherence to medication, use of the telephone, self feeding and preparing hot foods are among the most important tasks for independent living for older adults. Occupancy Agreement Generally, assisted living facilities have occupancy agreements that outline terms of residency. The terms should clearly define specific living arrangements for the community and for individuals. Occupational Therapy Occupational therapy helps one to perform daily activities independently. An occupational therapy patient might learn new ways to eat, put on clothes, comb one's hair, and new ways to do other usual daily activities. Ombudsman Independent, nationwide, federally-funded services that work to resolve problems between residents and assisted living facilities, nursing homes and other residential care facilities. Nationwide, there are more than 500 local ombudsman programs. Ombudsmen visit nursing homes on a regular basis. The ombudsman's job is to investigate complaints, advocate for residents, and mediate disputes. Ombudsmen often have very good knowledge about the quality of life and care inside each nursing home in their areas. Open Enrollment Period A one-month period during which employees can enroll in or switch health plans. Opt-out An option available in some types of managed care networks, such as point-of-service plans, in which members can seek treatment from providers outside the network and pay more to do so. Out-of-Pocket Costs Costs for medical services not covered by an insurer or an HMO. Unlike persons with conventional insurance, HMO members incur minimal out-of-pocket costs.


Paraprofessional A trained aide who assists a professional person. Paratransit Services Specialized transportation, such as a wheelchair accessible van, for seniors and other people with disabilities. These services may offer transportation to senior centers, medical care, shopping malls, or specific appointments. Parkinson’s Disease Parkinson’s Disease ("PD") is a progressive disorder of the central nervous system which affects more than one million Americans. Individuals with PD lack a substance called dopamine, which is important in the central nervous system’s control of muscle activity. PD is often characterized by:
  • Tremors,
  • Stiffness in limbs and joints,
  • Speech impediments, and
  • Difficulty in initiating physical movement.
Late in the course of the disease, some individuals develop dementia and eventually Alzheimer’s disease. Medications such as levodopa, which prevents degeneration of dopamine, are used to improve diminished motor symptoms in PD patients but do not correct the mental changes that it causes. Passport Pre-Admission Screening System Providing Options and Resources Today (PASSPORT) is a program provided by the State of Ohio through the Area Agencies on Aging that helps people age 60+ who are in need of hands-on help with dressing, bathing, toileting, grooming, eating or mobility. If eligible for Medicaid, one may qualify for PASSPORT and care would be free, or set at an affordable level, depending on income and assets. Personal Emergency Response System An electronic devise that enables the user to contact help 24-hours-a-day simply by pressing a button. Physical Therapy Process that includes individualized programs of exercise to improve physical mobility, often administered following a stroke, fall, or accident. Physical therapists plan and administer prescribed physical therapy treatment programs to help restore function and strength. Physical Therapist A rehabilitation professional who utilizes various therapies to help people maximize mobility, and restore strength and body movement after an illness or injury such as a stroke, fall, back injury, etc. Plan of Care A written plan that describes the services and care needed for a health problem, or for in-home services for chronically ill. Power of Attorney A written legal document in which one person (the principal) appoints another person to manage the principal's financial affairs. Power of Attorney for Health Care A written legal document in which one person (the principal) appoints another person to make health care decisions on behalf of the principal in the event the principal becomes incapacitated (the document defines incapacitation). Primary Care Physician A doctor trained to give basic care. A primary care physician is the one seen first for most health problems. He or she also may talk with other more specialized doctors and healthcare providers and make referrals. In many Medicare managed care plans, a primary care physician must be seen first before seeing other healthcare providers. Primary Caregiver The person, usually the spouse or adult child, who takes on the primary day-to-day responsibility of caring for the physical, psychological and social needs of another person. Private Duty Services performed by a range of in-home care personnel from non-medical to skilled and for which the patient or client normally pays out of pocket, or are covered by long term care insurance, some Veterans programs or workers’ compensation insurance. MJ Nursing is the private pay arm of the Black Stone family of care services. Private Pay Method of payment under which providers are paid for each service performed. Provider A properly-licensed doctor, health care professional, hospital, or other health care facility, including a home health agency, that provides health care or related social services.


Qualified Long-Term Care Insurance Policy A policy that conforms to federal law and, as a result, offers potential federal tax advantages for some people. Sometimes referred to as a Tax-Qualified Long-Term Care Insurance Policy. Qualified Long-Term Care Services Defined by federal law, these are necessary diagnostic, preventive, therapeutic, curing, treating, mitigating, and rehabilitative services, and maintenance or personal care services, that are required by a chronically ill individual, and are provided pursuant to a plan of care prescribed by a licensed health care practitioner. Maintenance or personal care services means any care the primary purpose of which is to provide needed assistance with any of the disabilities as a result of which the individual is a chronically ill individual (including the protection from threats to health and safety due to severe cognitive impairment).


Registered Nurse (RN) Graduate trained nurse who has both passed a state board examination and is licensed by a state agency to practice nursing. Rehabilitation Therapeutic care for persons requiring intensive physical, occupational, or speech therapy. Residential Care Facility A generic term for a group home, specialized apartment complex or other institution that provides care services where individuals live. The term is used to refer to a range of residential care options including assisted living facilities, board and care homes and skilled nursing facilities. Respiratory Therapy Respiratory therapy consists of exercises and/or treatments that are designed to help patients regain lung function. Respite Care Temporary or periodic care provided by a third party for people with disabilities, illnesses, dementia or other health problems while their usual caregivers take an occasional break from their caregiving responsibilities. Respite care can be provided at home, in the community (e.g., adult day care centers or special respite programs) or overnight in a facility.


Senior Levy A county funded program in Ohio that is part of the Human Services Senior Levy and assists frail elderly citizens to remain independently at home and avoid or delay nursing home placement. Skilled Nursing Care Skilled care that must be given or supervised by Registered Nurses. Examples of skilled nursing care are intravenous injections, tube feeding, and changing sterile dressings on a wound. Any service that could be safely done by an average non-medical person without the supervision of a Registered Nurse is not consider skilled care. Skilled Nursing Facility (SNF) A nursing facility (in most cases, a nursing home; sometimes a special unit inside a hospital) that has been certified by Medicare, with the staff and equipment to give skilled nursing care and/or skilled rehabilitation services and other related health services. SNF SNF stands for "skilled nursing facility." Speech Therapist A rehabilitation professional who provides therapy to overcome speech and communication problems, such as speech difficulties following a stroke. A speech therapist may also provide assistance for managing swallowing problems. Speech Therapy Speech therapy involves the treatment of speech or communication disorders. The approach used depends on the disorder. Physical exercises designed to improve muscle strength and speech practice to improve clarity are two examples of speech therapy techniques. Spend Down A requirement that an individual use up most of his or her income and assets to meet Medicaid eligibility requirements. Standby Assistance The presence of another person, within arm's reach, to prevent, by physical intervention, injury to someone needing assistance while they are performing an activity of daily living (such as being ready to catch them if they fall while getting into or out of the bathtub or shower, or being ready to remove food from their throat if they choke). State Tested Nursing Aides (STNA) A state exam given in Ohio following training as a nurse’s aide. All care providers who work at Home Care by Black Stone have passed the STNA exam. Subacute Care Subacute suggests a condition that is neither acute (characterized by a very sudden change) nor chronic (a condition characterized as one that lasts three months or more.) Subacute care is care that is necessitated by conditions that are not severe enough to be acute, and are not categorized as chronic. Typically following a stay in a hospital, this is maintenance care for serious medical conditions that are not urgent or life-threatening. Hospitals typically do not provide sub-acute care on an ongoing basis. Sub-acute care may include long-term ventilator care or other procedures provided on a routine basis either at home or by trained staff at a skilled nursing facility. Support Group A group of people with a common experience, such a disease, disorder, caregiving, etc., where one can share one's thoughts, feelings and concerns and receive information and support from other members of the group. Groups may or may not be facilitated by an expert.


Telephone Reassurance Calls made by agencies or volunteers to an elderly person to check up on them and offer reassurance, contact and socialization. The calls are typically made at a predetermined time each day. Therapy Services Physical, occupational, and speech therapists are licensed and available through our Medicare certified offices if the situation warrants Medicare coverage, or we can arrange for private duty services as needed. TTY A text telephone system that allows a hearing-impaired user to type messages to another person and read responses on a small screen. Similar to today's text messaging, a "read only" conversation can exist between two people who each use TTY equipment. Otherwise, a non-hearing-impaired caller can use a relay service where a special operator acts as a go-between to translate the speaker's words into text and text print into voice communication.