Glossary of Terms

Adult Care Facility (ACF) or more commonly known as assisted living, provides meals, personal care and medication supervision. ACEs for seniors are encompassed in different levels including adult homes, assisted living programs or enriched housing programs. Each is regulated differently through New York State. Most ACFs have nursing personnel on staff and possibly a medical director, however they do not have the capacity to provide intensive medical services. ACEs have become more popular because it allows residents to receive supportive services, when they do not yet need the level of care a nursing home provides, therefore it is more affordable.

Adult Home offers private rooms with either private or shared bathrooms. Usually meals are included along with supportive personal care services. Very similar to the other adult care facilities, with the primary difference being the housing accommodations.

Assisted living program (ALP) is a combination of an adult care facility and a home care agency. It allows a person living in an adult care facility to remain in that setting even if he or she becomes more frail and needs extra medical or personal care services. ALPs are the only adult care facility that accepts Medicaid.

Enriched housing provides assisted living where the resident receives meals, housekeeping and personal care services. For those individuals who can no longer perform activities of daily living, (including bathing, cooking, dressing, etc.) this environment provides the services they need in an apartment setting. Usually medication management is also offered.

Assisted Living refers to areas or services provided to residents who need assistance with activities of daily living, such as bathing, dressing, transferring, etc. Assisted living units do not have kitchens so residents receive three meals a day in the dining room.

Assumptions refer to those factors or variables, such as mortality or inflation rates, used to make estimates of future activity and experience. Assumptions used to estimate future activity need to be reviewed periodically to evaluate whether they reflect actual experience which can change.

Average Occupancy represents the average number of units or beds occupied during each year.

Cash Flow Projection is the process ofprojecting the timing and amount of asset and obligation cash flows beyond a given valuation date.

Closed Group is a population projection that reflects only the activity of the current group of residents, as of a given date. A closed group does not have any new residents entering the community, so as residents die or withdraw, the group size declines. These calculations are helpful in setting fees and estimating the present value of future liabilities.

Cohort is a single group of people with specific demographic characteristics. Most projections will involve several cohorts of people which when integrated create a population projection representative of the community's expected population.

Continuing Care Community (CCC) is very similar to a CCRC in that various levels of housing and care are located on the same campus. As a resident's needs change, they can move to the appropriate level of care. However unlike a CCRC, the resident only pays for the additional care, when and if they need the care. Some CCCs can require an entrance fee upfront, as well as a monthly service fee for utilities, services and amenities. Others require only a monthly service fee. They have become a popular option for seniors as their needs can be addressed on one campus.

Continuing Care Retirement Community (CCRC) - CCRCs are also referred to as life care communities. In a CCRC, a resident enters in at a low level of care, such as independent housing, and as their needs progress, they are able to receive additional care on the same campus and essentially are guaranteed that care. A CCRC usually consists of senior apartments, an assisted living facility and nursing care. A CCRC usually requires a substantial entrance fee and health care component to cover the costs associated with having all levels of care on one campus. This helps to pre-pay for the resident's anticipated health care needs. In addition, the resident usually pays a monthly maintenance fee to cover utilities, services and amenities.

Demographic Trends refer to specific characteristics of residents and how those characteristics change over time. Demographic characteristics include age, gender and density ratio.

Density Ratio is the number of persons per occupied living unit. The density ratio for units occupied by new residents will differ from that of units occupied by existing residents. Generally, the average density ratio for the community declines over time as residents transfer to health care and members of a couple become deceased.

Direct Admit is a resident who enters the community directly into a health care unit. Direct admit residents have never lived in the independent living units.

Existing Residents are people who have resided in the community for a period of time.

Home Care consists of medical or personal care services provided in an individual's home. Home care agencies are certified by the state to be either a licensed home heath care program or a certified home health agency Each would provide nursing and aide service for personal care needs. The primary difference is that a certified agency services can be billed to Medicare and these services are commonly provided after a hospital stay.

Independent Living Units (ILU) are the residential units occupied by persons with relatively little or no health care needs.

Morbidity Rate refers to the rate at which residents use the health care units.

New Residents are those residents who are expected to enter the community in the future, beginning on the date which the projection commences.

Nursing Care refers to health related care and services to residents who require skilled, intermediate or nursing care.

Nursing Homes or skilled nursing facilities provide 24-hour medical and social services to the frail elderly and chronically disabled individuals. These facilities are licensed to provide services to those who need high intensity medical care and supervision.

Open Group is a population projection that tracks residents in the community on the valuation date together with their expected replacements into the future. Occupancy rates generally remain consistent after the fill-up period if marketing is successful. Open group projections are used to anticipate financial performance of the total community.

Periodic Fees are contractual amounts payable periodically (usually monthly) by each resident.

Permanent Transfer refers to a change in living status that usually involves an administrative determination that a resident will not return to a previous level of care. Such determination usually results in a change of fees and in the case of a single person, it results in the release of a unit.

Population Projection is an actuarial based projection showing population activity relevant to the avenge occupancy or financial projections for the community. Relevant information includes morbidity, mortality, withdrawals, density ratios, and transfers to different levels of care.

Release refers to the occurrence of an independent living unit that becomes available to be reoccupied. Releases are due to death, withdrawal or permanent transfer to a higher level of care.

Refunds are the portion of the entrance fee, as designated in the residence and care agreement, that are returned to the resident upon termination of the agreement or upon resale of a unit.

Residential Housing, also referred to as independent living, offers apartment or cottage-style housing for active seniors. This type of housing often includes a variety of services such as a meal plan, housekeeping, transportation and activities. Residents usually do not need assistance with personal care but are looking to make life easier with added safety and security.

Respite Care provides a short-term stay in a residential-care setting such as a nursing home or assisted living facility The short-term stay gives a caregiver a break from their duties whether for personal or medical reasons.

Subacute Care or rehabilitation services offers comprehensive care designed to treat illnesses, injuries or disease processes that are inappropriate for acute care, such as a hospital. This care is usually provided immediately after hospitalization. Treatment is aimed at specific, active, complex medical conditions or to administer one or more technically complex treatments. Treatment can include physical, occupational and speech therapy. Subacute care is common after a joint replacement or a stroke.

Temporary Care represents the need for care in the health, care unit by residents that live permanently in an independent living unit. The need for care is not expected to exceed 90 days. Temporary stays do not result in the release of any living units.

Withdrawal is the result of a resident's voluntary decision to leave the community.