Adult Day Care Terms Glossary

Plain-English definitions of the most common terms used on ACD-HUB and throughout the adult day care, skilled nursing, and CMS data world.

Adult day care
A non-residential care program providing supervision, activities, meals, and limited health services during daytime hours for adults who cannot remain alone safely.
Activities of daily living (ADLs)
Basic self-care tasks: bathing, dressing, eating, transferring, toileting, and continence. CMS staffing ratings are partly based on how much help residents need with ADLs.
CCN (CMS Certification Number)
A six-character ID assigned by CMS to every certified nursing facility. Persists across ownership changes and is the canonical identifier in federal data.
CMS
The Centers for Medicare & Medicaid Services — the federal agency that certifies and inspects nursing facilities and publishes the Five-Star Quality Rating data.
Five-Star rating
CMS's quality scoring system, ranging from 1 ('much below average') to 5 stars ('much above average'). Composed of three sub-ratings: health inspection, staffing, and quality measures.
Health inspection rating
CMS rating based on the last three annual surveys plus complaint investigations, weighted toward the most recent survey.
HPRD (Hours per resident day)
Average number of nursing care hours each resident receives per day. CMS publishes this for registered nurses (RN), licensed practical nurses (LPN), and certified nursing assistants (CNA) separately.
Medicare vs Medicaid
Medicare is federal health insurance primarily for adults 65+ and covers limited skilled nursing stays. Medicaid is joint federal-state coverage for low-income individuals and covers long-term nursing home care.
Quality measures (QM) rating
CMS rating based on 15 clinical outcomes including hospital readmissions, falls, weight loss, and pain management.
Resident
A person who lives at a skilled nursing facility, as opposed to a short-stay patient receiving post-acute care.
Skilled nursing facility (SNF)
A licensed facility providing 24/7 medical care and rehabilitation. Typically used for short-term recovery after a hospital stay, but also for long-term residents who need ongoing medical care.
Special Focus Facility (SFF)
CMS designation for facilities with a sustained record of serious quality problems. SFFs are inspected twice as often as standard facilities and are publicly flagged.
Staffing rating
CMS rating based on RN, LPN, and CNA hours per resident day, adjusted for resident acuity.