Secondary care

Services provided by medical specialists who generally do not have first contact with patients. These can include cardiologist, urologists, dermatologists, etc.


The generalized characterization of progressive decline in mental functioning as a condition of the aging process. Within geriatric medicine, this term has limited meaning and is often substituted for the diagnosis of senile dementia and/or senile psychosis.

Senior center

Provides a variety of on-site programs for older adults, including recreation, socialization, congregate meals and some health services. Usually a good source of information about area programs and services.

Seniors housing

Typically meant to be independent living units, generally apartments. Any supportive services, if needed, are through contract arrangement between tenant and service provider.

Service Plan

Service Plan – see care plan

Side rail

Horizontal bars on a hospital-type bed that are meant to protect a person from climbing or inadvertently rolling out. A concern for possible accidental entrapment and resultant injury.

Skilled care

"Higher level" of care (such as injections, catheterizations and dressing changes) provided by trained medical professionals, including nurses, doctors and physical therapists.

Skilled nursing care

Daily nursing and rehabilitative care that can be performed only by, or under the supervision of, skilled medical personnel.

Skilled nursing facility (SNF)

A facility that is certified by Medicare to provide 24-hour nursing care and rehabilitation services, in addition to other medical services. See also “nursing home.”


See State Operations Manual

Special care units

Long-term care facility units with services specified for persons just with Alzheimer's disease, dementia, head injuries or other conditions.

Speech therapy

Exercises designed to help restore the ability to talk properly. May be covered by Medicare.

Spend down

The depletion of income and assets to meet eligibility requirements for Medicaid.

Spousal impoverishment

Federal regulations preserve some income and assets for the spouse of a nursing home resident whose stay is covered by Medicaid.

State Operations Manual (SOM)

A manual that state surveyors use to examine whether nursing homes are abiding by necessary regulations to receive Medicare or Medicaid reimbursements.

State survey process

The inspection process outlined in the SOM to measure nursing home compliance with federal regulations. States may conduct surveys on behalf of CMS to certify compliance.

State unit on aging

Authorized by the Older Americans Act. Each state has an office at the state level that administers the plan for services to the aged, and coordinates programs for the aged with other state offices.

State/private insurer long-term care partnerships

Arrangements between some states and certain private insurance companies to provide long-term care insurance. These partnerships help protect the assets of insured individuals who typically must become nearly impoverished before qualifying for Medicaid.

Subacute care

Also called post-acute care or transitional care. A type of short-term care provided by many long-term care facilities and hospitals that may include rehabilitation services, specialized care for certain conditions (such as stroke or diabetes) and/or post-surgical care and other services associated with the transition between the hospital and home. Residents on these units often have been hospitalized recently and typically have more complicated medical needs.

Subsidized senior housing

A program that accepts federal and state money to subsidize housing for older individuals with low to moderate incomes.

Supplemental Security Income (SSI)

A program of support for low-income aged, blind and disabled persons, established by Title XVI of the Social Security Act. SSI replaced state welfare programs for the aged, blind and disabled in 1972 with a federally administered program, paying a monthly basic benefit nationwide of $284.30 for an individual and $426.40 for a couple in 1983. States may supplement this basic benefit amount.

Support groups

Groups of people who share a common bond (such as caregivers) who come together on a regular basis to share problems and experiences. May be sponsored by social service agencies, senior centers, religious organizations, as well as organizations such as the Alzheimer's Association.


An investigation in which information is systematically collected. Nursing home surveys are annual surveys by state or federal regulators.

Swing beds

Beds that can be used in multiple treatment categories as licensed by the Department of Health and Human Services.