Glossary of Terms

The information below was provided by sources including the National Association for Home Care & Hospice, the WA Department of Health, WA DSHS Aging and Long-Term Support Administration, Healthier Washington Collaboration Portal, and others.

Adaptive equipment are devices that are used to assist with completing activities of daily living.

Bathing, dressing, grooming, toileting, and feeding are self-care activities that are including in the spectrum of activities of daily living (ADLs). A growing market for adaptive equipment is in the use of mobility vans. In this case, adaptive equipment, also known as assistive technology, can help a person with a disability operate a motor vehicle when otherwise they would not be able to.

Adult Family Homes are regular neighborhood homes where staff assumes responsibility for the safety and well-being of the adult. A room, meals, laundry, supervision and varying levels of assistance with care are provided. Some provide occasional nursing care. Some offer specialized care for people with mental health issues, developmental disabilities or dementia. The home can have two to six residents and is licensed by the state.

To explore an adult family home as an option, find out what kinds of services and supports are available at each home you are interested in. For more information about the types of questions to ask and things to look for when finding an adult family home, see DSHS' brochure: Choosing Care in an Adult Family Home or Assisted Living Facility.

The Centers for Medicare & Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov.

CMS Website

The Certificate of Need Program is a regulatory process that requires certain healthcare providers to get state approval before building certain types of facilities, or offering new or expanded services. For example, a certificate of need is required if a hospital wants to add to the number of its licensed beds.

The certificate of need process is intended to help ensure that facilities and new services healthcare providers propose are needed for quality patient care within a particular region or community.

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A Certified Home Health Aide (CHHA) is an aide that works for a home health agency. The aide must have completed a specific training program and be certified by the Department of Health Services. The CHHA provides personal care when a patient needs assistance in order to be maintained at home. Personal care includes assistance with ambulation, bathing, dressing and meal preparation. Aides also remind the patient to take self-administered medication as directed and report to the nurse about the patient's progress.

A companion is a professional, non-medical caregiver who provides assistance to disabled and older adults at home. Companions help with daily living activities such as, cooking, running errands, and household chores.

The Department of Social and Health Services (DSHS) is Washington's social services department located in Olympia, WA. Annually, 2.2 million children, families, vulnerable adults and seniors come to the department for protection, comfort, food assistance, financial aid, medical and behavioral health care and other services.

Washington State DSHS Website

People with developmental disabilities and their families are valued citizens of the state of Washington. The Developmental Disabilities Administration strives to develop and implement public policies that will promote individual worth, self-respect, and dignity such that each individual is valued as a contributing member of the community.

Washington State DDA Website

The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. Eligible employees are entitled to:
  • Twelve workweeks of leave in a 12-month period for:
    • the birth of a child and to care for the newborn child within one year of birth;
    • the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;
    • to care for the employee’s spouse, child, or parent who has a serious health condition;
    • a serious health condition that makes the employee unable to perform the essential functions of his or her job;
    • any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a covered military member on “covered active duty;” or
  • Twenty-six workweeks of leave during a single 12-month period to care for a covered servicemember with a serious injury or illness if the eligible employee is the servicemember’s spouse, son, daughter, parent, or next of kin (military caregiver leave).
US Department of Labor Website

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than two million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, and, beginning in 2020, the School Employees Benefits Board (SEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Washington State HCA Website

The Health Insurance Portability and Accountability Act (HIPAA) which gives you rights over health information and sets rules and limits on who can look at and receive your health information. It also permits the release of personal health information needed for patient care.

Home care encompasses a wide range of health and social services. These services are delivered at home to recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social, or therapeutic treatment and/or assistance with the essential activities of daily living. Home care is appropriate whenever a person prefers to stay at home but needs ongoing care that cannot easily or effectively be provided solely by family and friends.

Home care agencies provide non-medical services to people with functional limitations. Examples of non-medical services include:
  • Activities of daily living, such as assistance with ambulation, transferring, bathing, dressing, eating, toileting, and personal hygiene to facilitate self-care;
  • Homemaking such as assistance with ordinary housework, essential shopping, meal preparation, and travel to medical services; and
  • Respite care such as assistance and support provided to the family;
The Department of Health licenses home care agencies to ensure care is provided within health and safety standards established by statute and rule. The department enforces the standards by periodically conducting unannounced on-site surveys of these agencies.

Some home care agencies contract with the Department of Social and Health Services (DSHS) to provide services to Medicaid-eligible people in need of home-based services. These contracted agencies are surveyed by Area Agency on Aging (AAA) staff members using standards equivalent to the departments for evaluating the care and services provided. For more information on contracting with DSHS, please contact your local AAA at 1-800-562-3263 or the Division of Developmental Disabilities at 1-800-562-3022.

An individual who provides personal care. Home care aides may also be referred to as certified nurse assistants, personal care workers, nurse's aides and attendants.

Home health agencies provide skilled nursing and therapy related services Examples of services include:
  • Nursing;
  • Home health aide
  • Physical therapy
  • Occupational therapy
  • Respiratory therapy
  • Speech therapy
  • Medical social work
  • Nutrition
  • Home medical supplies and equipment
  • Professional medical equipment assessment
The Department of Health licenses home health agencies to ensure care is provided within health and safety standards established by statute and rule. The department enforces the standards by periodically conducting unannounced on-site surveys of these agencies.

Many home health agencies operate on a private pay basis as well as establishing contracts with health insurance companies. Home health agencies interested in Medicare reimbursement for services must become Medicare-certified. Washington State requires home health agencies to receive approval from the department’s Certificate of Need program before they can apply for Medicare certification.

Medicare-certified home health agencies are required to conduct comprehensive assessments of all patients and participate in the federal program Outcome Assessment Information Set (OASIS). Home health agencies electronically submit OASIS health information on Medicare patients to measure patient outcomes for quality improvement. Public reporting on selected outcome measures is available on the Centers for Medicare & Medicaid Services' website.

Supplies and equipment (hospital bed, wheelchair, patient lift equipment, oxygen and its delivery systems, bedside commode) that support the unique needs of a patient at home.

A model of care that focuses on relieving symptoms and supporting patients with a life expectancy of six months or less. Hospice involves an interdisciplinary approach in the provision of medical care, pain management and emotional and spiritual support. The emphasis is on comfort, not curing. It can be provided in the patient’s home as well as freestanding hospice facilities, hospitals, nursing homes and other long-term care facilities.

Hospice focuses on improving the quality of life for people and their families faced with a life-limiting illness. The primary goals of hospice care are to provide comfort, relieve physical, emotional, and spiritual suffering and promote the dignity of terminally ill people.

Although typically provided in a person's home, hospice care can also be provided in freestanding hospice centers, hospitals, nursing homes and other long-term care facilities. Hospice services are available to patients of any age, religion, race or illness. Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs and other managed-care organizations.

Hospice agencies provide the following types of services:
  • Hospice agency staff members work with the family or nursing home staff to provide patient care. Goals of care are established with the patient and family and a care plan developed to help meet these goals.
  • HThe hospice team provides the patient with medical care to relieve pain and other symptoms arising from a life-limiting illness.
  • Medications are ordered by the primary physician or hospice doctor but are usually picked up by family members at a designated pharmacy.
  • Counseling is available to patients to help them cope with their illness, address depression, grief, and anxiety, as well as spiritual issues, such as loss of meaning and fear of death.
  • Counseling services to help with caregiver stress, role changes, depression, anxiety, family conflict, grief and spiritual concerns.
  • Education to help family provide hands-on care to patients, proper usage of medications, knowledge about disease progression, signs and symptoms of dying, normal grief response and coping with stress, etc.
  • Religious care is available either directly by the hospice chaplain or through community resources.
  • Assistance with cremation/burial arrangements and with funeral/memorial services.
The Department of Health licenses hospice agencies to assure care is provided within health and safety standards established by statute and rule. Hospice services may also include the provision of home health and home care services. The department enforces the standards by periodically conducting unannounced on-site surveys of these agencies.

Medicare may pay for services provided by hospice agencies who voluntarily seek and are approved for certification by the federal Centers for Medicare & Medicaid Services (CMS). CMS contracts with the department to evaluate compliance with the federal hospice regulations by periodically conducting unannounced on-site surveys of these agencies.

Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.

Medicaid sends payments directly to your health care providers. Medicaid can pay for medical services in your own home or if you live in a residential care facility that takes Medicaid residents.

US Medicaid Website
Washington State DSHS Website

Medicare is the federal health insurance program for:
  • People who are 65 or older
  • Certain younger people with disabilities
  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
The different parts of Medicare help cover specific services:
Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance)
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Medicare Part D (prescription drug coverage)
Part D adds prescription drug coverage to:
  • Original Medicare
  • Some Medicare Cost Plans
  • Some Medicare Private-Fee-for-Service Plans
  • Medicare Medical Savings Account Plans
These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

US Medicare Website

Services provided by an Occupational Therapist (OT) to a patient who has suffered an injury or illness which has affected perceptual motor skills or the ability to perform activities of daily living, such as dressing, eating or cooking.

Palliative care is specialized care for people living with serious illness. Care is focused on relief from the symptoms and stress of the illness and treatment—whatever the diagnosis. The goal is to improve and sustain quality of life for the patient, loved ones and other care companions. It is appropriate at any age and at any stage in a serious illness and can be provided along with active treatment. Palliative care facilitates patient autonomy, access to information, and choice. The palliative care team helps patients and families understand the nature of their illness, and make timely, informed decisions about care.

Additional Resources:
Top 10 Things Palliative Care Clinicians Wished Everyone Knew About Palliative Care
Home and Community-based Palliative Care: Best Practices and Resources for Providers

Services provided by a physical therapist (PT) to a patient who has suffered an injury or illness affecting motor skills or function.

Private duty home care provides a broad range of services from nursing, home care aide, homemaker, and other supportive services such as bill paying and transportation. Their goal is to provide whatever the aged, ill or disabled or their families need in order for their loved ones to remain where they most want to be-in their homes.

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