In the United States health care system, there are a wide array of institutional and home and community-based providers that deliver specialized care to elderly, frail, or disabled persons and to individuals who require ongoing treatment or care, often following an acute health episode. There is no single agreed upon definition that encompasses this wide array of services. Recently, the concept of "Long-Term Services and Supports" has emerged as a way to describe certain institutional and community-based services such as nursing homes/skilled nursing facilities (SNFs), care management, adult day care, home-delivered meals, transportation providers, and other services.3, 4 LTPAC is another concept that has been used to describe services such as nursing homes/SNFs, long-term care hospitals (LTCHs), inpatient rehabilitation facilities, and home health agency (HHA) providers.1 For the purposes of this report, both concepts are used.
LTPAC and LTSS providers deliver services to people with functional and/or cognitive limitations and/or chronic illnesses who may need assistance to perform routine daily activities such as bathing, dressing, preparing meals, and administering medications; and may require medical and skilled nursing care.3
Given the diverse range of institutional and community-based LTPAC/LTSS, for the purposes of this report persons who receive LTPAC/LTSS will described as "patients," "residents," or "clients," depending on the setting, and these terms may be used interchangeably. A glossary with definitions of these and other key terms used in this report is included in Appendix M.
1. Accountable Care Organizations (ACOs). See http://www.acofp.org/Practice_Management/ACO/Medical_Home/, accessed March 2013.
3. Continuity of Care Document. See http://en.wikipedia.org/wiki/Continuity_of_Care_Document
4. Dolin, RH, L Alschuler, C Beebe, PVBiron, SL Boyer, D Essin, and JE Mattison. (2001). The HL7 clinical document architecture.Journal of the American Medical Informatics Association, 8(6): 552-569. The National Alliance for Health Information Technology. Available at: U.S. Department of Health and Human Services. Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms. http://healthit.hhs.gov/defining_key_hit_terms, accessed June 4, 2012.
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