THE EXTENDED CARE FACILITY—A COMMENTARY ON DEFINITIONS *

A bstract Discussions are presented of definitions for custodial care, the nursing home, the extended care facility, the nursing care institution, and personal care and sheltered care institutions. If the hospital is to become the “locus of total health organization” in any community, as recommended by the American Hospital Association, the continued fragmentation of services in long‐term care—justified on the basis of a variety of appellations—will frustrate the development of high‐quality care for the chronically ill aged. The hospital must be involved centripetally and centrifugally in all medical problems of the community concerning health and disease. If the medical needs of the populace are to be served, the hospital must educate the community in affairs related to health, train professionals involved in health care, set criteria for the performance and delivery of high‐quality medical services, and serve as a liaison between governmental agencies and the public. The ill aged, wherever housed, need diagnostic, medical, nursing and psychiatric services. The instability and complexities of their medical, psychiatric and social problems require all the talent and resources of the nonsurgical hospital for effective long‐term management. The multiplicity of new terminologies will not obviate the obligation of the hospital to broaden its perspectives and create a progressive care program for the chronically ill, who are afflicted with all gradations of disability. To fulfill this obligation, the hospital can build, acquire, merge, form partnerships, or affiliate with existing extended care facilities, public or private. If this generation is to be proud of its accomplishments in health care, then, by definition, any institution in which ill people are housed should have the status of a hospital.