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It seem like everywhere we turn there are new acronyms and definitions to
hear. This is just a short list to get you acquainted with some of the
terms you may come across.
CBRF -
Community
Based Residential Facilities
Community
Based Residential Facilities (CBRF's) are state licensed supportive living
facilities where five or more unrelated adults reside. CBRF's provide assisted
living and health care services above normal room and board such as assistance
with bathing, dressing, toileting, mobility, nutrition, medications, health
monitoring, safety and security, socialization and companionship in an
environment that promotes and enhances independence.
Assisted living services may be provided up to 24 hours per day, seven days per
week. Skilled nursing care (nursing procedures that legally may only be
provided by a registered or licensed nurse) may be provided 3 hours per week.
For residents requiring more that 3 hours per week of skilled nursing care, the
Department of Health and Family Services may be contacted by the facility to
grant an exemption. The philosophy of a CBRF is to provide a home-like
environment and to keep each resident as dignified and independent as possible,
while maintaining a feeling of safety and security.
CBRF's provide assistance with activities of daily living to help residents
maintain as independent a lifestyle as possible. Typical services offered
include meals, housekeeping, laundry, linen exchange, medication monitoring and
assistance with dressing and bathing. CBRF's also offer residents the
opportunity to socialize. Each facility will offer some level of organized
activity based on resident interests. For the socially isolated senior, the move
to a CBRF can be a wonderful experience.
CBRF's provide an innovative approach to residential living for older adults.
Supportive living programs come in all shapes and sizes. The environment may be
a house that has been renovated to provide personal care for a small number of
people or a newly constructed building with private apartments for a large
number of residents. Some facilities furnish all but the residents clothing
whereas others have the resident fully furnish the apartment and even offer the
opportunity for customized decorating.
CBRF's are identified by licensure level or class. These licensure levels are
included in the website listings. The licensure level determines the type of
residents that may reside in the facility. Critical to those exploring CBRF
options is the ability of the program to handle residents with a diagnosis of
dementia- /Alzheimer's disease, specific ambulation difficulties and the need
for stand-by assistance. Certain facilities are designated as dementia-
/Alzheimer's specialty facilities. Some may also provide respite care when short
term stays are needed.
CBRF's also differ in terms of pricing structures. It is critical to fully
understand whether the program being explored has an all-inclusive fee, (room,
board and all personal care included in the cost) an ala-cart program, (a fee
for rent and all services are added to the monthly billing) or a modified fee
program, (rent and some services included in the monthly fee and some personal
care services added on). There may also be upfront costs in the form of an
entrance fee, endowment fee, application fee or security deposit.
Financial assistance for CBRF living may come in the form of Community Options
Program (COP) funds. COP funds are administered by each county Department on
Aging. In order to become eligible for COP funding, you must apply with the
Department on Aging in the county in which the facility you desire to live in is
located, not necessarily the county in which you live. Please note that most
counties have an extensive waiting list for COP funding and, although a facility
may accept COP funds, they do not have any control over availability or access
of same.
Licensure Level or Class:
Class AA: A Class A Ambulatory CBRF may serve only residents who are
ambulatory and are mentally and physically capable of responding to an
electronic fire alarm and exiting the facility without any help or verbal or
physical prompting.
Class AS: A Class A Semiambulatory CBRF may serve only residents who are
ambulatory or semiambulatory and are mentally and physically capable of
responding to an electronic fire alarm and exiting the facility without any help
or verbal or physical prompting.
Class ANA: A Class A Nonambulatory CBRF may serve residents who are
ambulatory, semiambulatory or nonambulatory, but only if they are mentally and
physically capable of responding to an electronic fire alarm and exiting the
facility without any help or verbal or physical prompting.
Class CA: A Class C Ambulatory CBRF may serve only residents who are
ambulatory, but one or more of whom are not mentally or physically capable of
responding to an electronic fire alarm and exiting the facility without any help
or verbal or physical prompting.
Class CS: A Class C Semiambulatory CBRF may serve only residents who are
ambulatory or semiambulatory, but one or more of whom are not mentally or
physically capable of responding to an electronic fire alarm and exiting the
facility without any help or verbal or physical prompting.
Class CNA: A Class C Nonambulatory CBRF may serve residents who are
ambulatory, semiambulatory or nonambulatory, but one or more of whom are not
mentally or physically capable of responding to an electronic fire alarm and
exiting the facility without any help or verbal or physical prompting.
Article provided by: Kari Ajack, Administrator, Avalon Square
RCAC -
Residential
Care Apartment Complexes
Residential
Care Apartment Complexes (RCAC's) offer each resident services unique to their
needs. This type of assisted living is based in individual apartments and as
each persons need for care increases, services can increase accordingly. This
gives residents an opportunity to remain in the apartment setting for a greater
length of time.
RCAC's offer private residences with the features of a traditional apartment.
Unit sizes vary from studio to one bedroom and larger. All units must have a
kitchenette with cooking facilities. Apartments are generally furnished by the
individual, however some facilities may offer furnished or semifurnished
apartments.
RCAC's are meant to be as service intensive as needed by the individuals
residing in the facility. Individuals generally choose an assisted living
program based on the services offered to meet the needs they have. Typical
services being offered include (but are not limited to) meals, housekeeping,
laundry service, medication administration, assistance with dressing and
assistance with personal hygiene and grooming. RCAC's can provide up to four
hours of skilled and/or supportive care per day or 28 hours per week.
Another benefit of RCAC's is the availability of social activities. Many people
moving to an assisted living program have been socially isolated, presenting a
need for companionship and interaction. Programming for activities is provided
by the facility staff. Activities should be based on interests of the resident
population, taking into account the physical and cognitive abilities of the
participants. Many programs offer card clubs, shopping trips, outings to local
points of interest, cultural and educational activities, religious programming,
exercise and wellness groups and more.
RCAC's are a cost effective alternative to community based care. Each individual
facility decides how to package services and programs. Some communities will
offer a single monthly fee inclusive of all meals, care and services. Others
will break the fee into a base rate with service packages added on or completely
ala carte where fees are charged based on services utilized.
Assisted living may mean something different to each person exploring this
option. RCAC's offer each individual service choices to meet their personal,
social, spiritual and health care needs. This lifestyle option offers the best
of both worlds, continuing care services in an apartment home setting.
Article Submitted by: Kari Ajack, Administrator, Avalon Square
RC -
Retirement Communities
Retirement
communities are self-contained housing communities designed and designated for
older adults. These communities offer meal programs and typically have a focus
on social and recreational activities.
Retirement Communities differ greatly in terms of services and amenities
offered. Continuing Care Retirement Communities provide differing levels of care
such as long term care and/or assisted living on the same campus if these levels
of care are needed. These facilities may require an entrance or endowment fee.
Some CCRC's also offer Life Care Programs which eliminate the financial
liability for the cost of long term care in a persons later years. Independent
Retirement Communities offer campus-like settings with many of the same services
and amenities provided by CCRC's under a monthly rental agreement (no endowment
fee). Room and Board Facilities may provide efficiency style apartment units
that provide meals, emergency response, and common space to its residents.
Usually no kitchen is available in the individual units.
ISLU -
Independent Senior Living Units
Independent
Senior Living Units are typically multi-unit apartment style settings that are
designed for and marketed to independent older adults. Room sizes typically
range from studio/efficiency units to one and two bedroom apartments. Most
facilities have a recreation room or common space for social gatherings. There
may be a manager available to make referrals, organize social events, or assist
with independent living. Minimum age limits usually apply in these facilities.
Certain facilities may also require a resident's annual income to fall below
certain annual income guidelines. While these units are not considered
subsidized housing, they may offer below market rental rates if an individual's
or couple's annual income falls below certain limits. These facilities are
identified within the detailed listings. Contact each facility directly for more
information.
Also included in this section are independent town homes and condominiums that
are available for purchase by independent older adults. Although there are not
many at this time, the number of these developments strictly for older adults
continues to grow. These communities may be entirely restricted by age or have a
certain percent of the units set aside for older adults.
As in any housing situation, supportive services may be brought in to assist
with daily living, but these facilities are designed for and marketed to
independent older adults. Facilities will differ based on services and amenities
offered. Most will offer opportunities for social activities and the ability to
interact with other residents.
SNF -
Skilled Nursing Facilities
The decision
to seek placement in a Skilled Nursing Facility can be difficult. Selecting the
right facility is important. This section is intended to assist those who are
searching for skilled nursing care.
Most Skilled Nursing Facilities still offer long term care for residents who
require daily assistance on a long term basis. In addition, many facilities now
offer programs to assist individuals whose needs are more rehabilitative in
nature. These facilities may offer short term rehabilitation programs on an
inpatient or an outpatient basis. Almost all facilities will offer some type of
rehabilitation to their residents. Therapies will usually include, at a minimum,
physical, occupational and speech therapies.
With the trend toward shorter hospital stays, Subacute Care has emerged to
bridge the gap between hospital and home. Many facilities also provide Respite,
or short term care, usually for a month or less to provide a break for
caregivers. Some facilities also have specialized units, such as
Alzheimer's/Dementia units, to care for residents with special needs.
In
addition to assessing medical and financial considerations, there are other
factors to consider. Some of these include:
 | Does the location of the facility allow for frequent visits by friends
and family members?
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| Does the facilities' environment foster the participation in social or
religious activities?
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These are just some of the questions that should be answered before
selecting a Skilled Nursing Facility. Although it may be a trying time,
there are many advocates who can assist with guidance. When coming from a
private home, it is prudent to seek a thorough examination, including a
chest X-ray by the attending physician. Obtain a copy of the history and
physical and bring these with you to specific facilities of interest. This
information will allow prospective facilities to assess specific medical
needs.
Hospital Discharge Planners can be a wealth of vital information. They can
clarify and coordinate resource options to meet individual's discharge
needs.
Local Departments on Aging can also be an excellent source of information on
Skilled Nursing Facilities.
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Hospice
Hospice
is a philosophy of comfort care, a program, a team of professionals caring
for any patient with a life limiting illness and providing support for
family and friends.
Hospice allows the patient to remain in their chosen place of residence, be
it a home, apartment, nursing home or residential facility/retirement home.
Hospice works with your family physician when providing care, or you can
choose to work with the agency's Physician Medical Director.
Hospice is not 'giving up'. The team, in coordination with family, friends
and facility staff, work with a common goal of adding dignity, showing
compassion, providing comfort and adding peace for any patient who is
beginning this final life's journey.
Hospice Services
A wide range of services are provided by nurses and other health care
providers within the hospice program.
These services include:
| Nursing Care
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| Social Worker Services
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| Physician Services
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| Spiritual Support and Counseling
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| Home Health Aide and Homemaker Services
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| Therapies
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| Continuous Care in the Home
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| Trained Volunteers for Support Services
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| 24-Hour On-Call Availability
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| Hospice In-Patient Care
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| Respite Care
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| Bereavement Support
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| Medical Equipment
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| Supplies and Prescription Drugs related to the life limiting illness.
Hospice Payment
Hospice services are covered by Medicare and Medicaid as well as being
offered as a part of most traditional insurance plans.
For further information on hospice services, contact one of your local
hospices or write to the Hospice Association of America, 228 Seventh
Street, SE, Washington, DC 20003 or National Hospice Organization, 1901 N.
Moore St., Suite 901, Arlington, VA 22209.
Article submitted by Joanne Klinko, RN, BSN, Executive Director with
Hospice Preferred Choice.
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ADL: Activities of
daily living.
POA: Power of Attorney
(A designated person or persons who would act on behalf of the resident if they
are incapable of making their own decisions. A POA can be set up for health and
financial.
FCP: Family Care Plan:
Financial assistance through the Department on Aging.
T18: Medicare
(Coverage on medical and must be approved).
T19: Medicaid (When
all funds are exhausted and you need help from the state and federal
government).
PT: Physical Therapy
(Lower extremities).
OT: Occupational
Therapy (Upper extremities).
RN: Registered Nurse
with a 4 or more year degree.
LPN: Licensed
Practical Nurse with an associates degree.
Please call us if you have any questions about these or any others you may
hear. Again, we are here to help and answer any questions you may have.
Many of the definitions provided by
Senior Resources.
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