David AmmonsDavid Ammons is president of Retirement Living Associates, Inc. (RLA), a company which provides planning, development, marketing, and management services for new and existing retirement communities. He has worked in and with Senior Living Communities since his graduation from Wake Forest University in 1985.
AL, SNF, ALZ, MC, Acute, Intermediate, ICU, Step Down, “Floor”…?
Retirement communities have certain names, labels and descriptors that seem to be agreed upon, but to many the range of labels and licenses can be confusing; however, sharing a big Inside Secret, there is not 100 percent agreement on all of the terms.
Some of the terms are licensed or regulated terms which are pretty consistent; their definitions can be researched. Often types of care or facilities that require licensing also require a Certificate of Need from the state. Other terms leave open much more gray and interpretive areas. They are not always used with the same meaning. I will try to point out when a term is legal versus regulated versus open for discussion. In the list below, I go a little beyond the senior industry, a dangerous step for me, so recognize that the information that follows is accurate as I see it.
Independent Living:
Congregate – A term often used to indicate that independent living apartments are “congregated” together like several multi-story buildings adjacent to each other.
High Rise – A term covering exactly what it is says, usually denoting Independent living apartments or condominiums in a tall building. Granted “tall” may mean anything from four stories to 30 or more, depending on the market.
ILU or IL or Independent – The most common term for senior designed and age restricted living communities, usually including basic services and amenities like food, utilities, housekeeping, activities, etc.
Independent Focused – Another term for Independent living or in an Assisted Living setting, it may indicate some units with minimal daily living support.
Licensed Categories:
Assisted Living (Adult Care, Home for the Aged, HA) – A regulated term indicating in North Carolina that the facility has an Adult Care Home license. In advertising and signage, it will be called Assisted Living. Provides Daily Living hands on care, food and activities.
Skilled Nursing Facility (SNF) – A licensed and regulated term meaning the facility has skilled nursing services provided by a licensed nurse (Registered or Licensed Practical Nurse) 24 hours a day, seven days a week.
Alzheimers, ALZ, Memory, Dementia, MC usually denotes Assisted Living licensed beds that have a dedicated design, program and staff training program to meet the unique needs of a patient with varying types of dementia. Often assumed to be Alzheimers, it is only one type of dementia in elderly patients. Skilled nursing beds may also be labeled and structured to provide dementia care, but most often dementia care is in a Assisted Living licensed bed.
ICU, Intensive Care is found predominantly in a hospital setting and denotes most acute care for the patients most in need of constant nursing and medical care.
Step Down, found predominantly in a hospital setting, is generally one “step down” from Intensive Care. Nursing and medical care is constant, but the patient is not in as much danger of a significant health problem.
Floor is found in a hospital setting and is a step below step down or two steps below Intensive Care. (Two steps figuratively, they are not measurable steps.)
Acute & Sub Acute are terms used to imply a high level of skilled nursing care. Some refer to Acute as hospital-level care; sub-acute is just below this. Generally these are short term in a rehabilitation situation.
Urgent Care and Emergency Care or Room:
I will leave these terms up to the industry that provides both urgent care centers and hospitals that provide emergency rooms. Generally, emergency room is hospital-provided and requires a Certificate of Need whereas Urgent Care can be physicians in private free-standing medical offices.