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162 Cards in this Set

  • Front
  • Back
If a nursing facility has been certified by Medicare and Medicaid under Final Rules and Federal Requirements, in effect, it what?
Must still meet all state and local licensure requirements
Establishing and implementing policies regarding the management of the facility is assigned to what?
The governing body or persons designated as such
In order to begin collecting better data about the nursing home industry, federal legislation mandated development and use of what?
A minimum data set (MDS)
The comprehensive care plan does not include a/an?
Medical Director
Nurse Aides who have completed a training and competency evaluation program and passed the required competency test(s)?
Must still be judged by surveyors as competent to provide services
Responsibility, for ascertaining professional performance standards for licensed, certified, or registered allied health persons used by the facility rests with the who?
The Facility
Organizations that actually pay the Medicare claims submitted by doctors and other medical suppliers are called what?
Carriers
The facility is not required to use its resources effectively and efficiently to attain highest practical
Profitability
A person who is determined by the state mental health authority to need nursing facility service but is receiving active treatment for mental illness?
Can be admitted
Each facility must designate a physician to serve as a medical director how many hours a week?
Full or Part time basis
The administrator believes that once his obligation to meet federal state and local laws is let he has satisfied the requirements applicable to the operation of his facility. The administrator is?
Only partially correct
The terms for Medicare and Medicaid participating homes used in the Final Rules effect are what?
Skilled nursing facility and nursing facility
Having a transfer agreement with one or more hospitals is what?
A condition of participation requirement
Nursing homes are licensed by what?
The states
Regulations such as those implementing Medicare and Medicaid; Requirements for Long-Term Care Facilities, are first published in the what?
Federal Register
All facilities are required to what?
Have a governing body or designated persons functioning as a governing body
The facility administrator establishes written transfer agreements with two local hospitals one of which is approved only for participation under the Medicare program, and the second approved only for participation under Medicaid. The administrator has what?
Failed to meet transfer agreement requirements
The transfer agreements signed by the administrator assure that the Medical and other information needed for care and treatment of residents, and guarantees that a bed will be available for the resident upon his return from the hospital. This is the entire agreement. A visiting surveyor would what?
Require changes to the transfer agreement
The discharge social worker at the hospital determines that the resident cared for under the transfer agreement should return, not to the facility, but be placed in an assisted living facility that is a less expensive setting. Normally, what?
This is appropriate
If persons with controlling interest in the facility, the company owning the facility or the administrator or director of nursing change, the facility should?
Inform the state licensing agency in writing
The administrator decides the trained therapeutic recreation specialist is too costly for the facility and hires instead a less expensive qualified occupational therapy assistant. This is what?
Within the federal hiring regulations
The recently graduated social worker job applicant for a 140-bed facility states she has a bachelor's degree in psychology and one year's experience as a supervisor of four social workers at a nearby nursing hospital. The administrator should?
Explore the applicant's experience in more depth.
The administrator of a 50-bed facility asks the director of nursing to serve as both director of nursing and as a charge nurse on the weekend shift this is what?
This is appropriate
If a facility provides the stated minimum number of hours per resident day of care, a state of federal inspector may?
May still cite nursing for insufficient staffing
If the administrator of an average daily total occupancy of 80 residents requires the director of nursing to serve as charge nurse, the administrator is what?
Has failed to meet Final Rules requirements
The consultant pharmacist at his monthly visit requires the director of nursing to provide to him a reconciliation report for all controlled drugs signed verified by the DON. The pharmacist has?
Should determine himself that drug records are in order
The personnel director recommends a part-time nurses aide who has worked at the facility for the past six months and is nearing the end of her competency evaluation program. The administrator should feel that the personnel director is?
Not understanding the requirements
At least every 12 months the facility requires all full-and part-time nurses aide to fill in a report on his/her continuing education done by each aide in the facility This report is then filed in the employee's personnel file. The facility is?
Failing to train based on outcome of these reviews.
( I don't know why this is the answer but it is)
When the facility does not employ a qualified professional to furnish a service to be provided by the facility, the facility what?
Must have that service furnished
The facility should train all employees in emergency procedures when?
The first day on the job.
The facility train (---) in emergency procedures (---)?
All employees/first day on the job
When a facility learns a court of law has taken action against one of its employees, indicating unfitness for service, the facility must what?
Report court's action to licensing authorities
Ms. Brown alleges for the twelfth documented time that she was abused by an employee. The facility is what?
Is negligent in protecting patients
If the facility does not employ a full-time qualified dietitian, the facility can?
Designates a director of food services who receives consultation from a qualified dietitian
The facility must employ a (---) either full-time, part-time or on a consultant basis?
Qualified dietician
Orders for routine care or to improve the resident's functional abilities must be available when?
At admission
If mental health rehabilitative services for mental illness or mental retardation are required in the resident's plan of care, the facility what?
Must provide in house or obtain such services
The care plan team determines that, although they had not anticipated it, the resident needs physical therapy. The facility should what?
Get a physician's written order
A resident who has been determined by the courts to be incompetent decides he no longer wants the court appointed representative to handle his personal funds and asks the facility to establish a personal fund account for him. The facility should?
Establish a personal funds account for that resident.
Perhaps the most basic purpose of the new management of personal resident funds rules is to what?
Avoid commingling resident funds with facility funds
Notifying (----) residents when their account reaches (---) less than the (----) resource limit for one person is required?
Medicaid 200$ less than the SSI limit
Upon discovering that the new intake social worker required the individual holding durable power of attorney for the patient's funds to sign a contract guaranteeing payment from that patient's funds, the administrator should what?
Praise the intake social worker
Rights of Residents who are adjudging incompetent by a court are exercised by what?
A person appointed by the court
Under the Final Rules, right to immediate access to any resident by representatives of the State, ombudsman, protection agencies, and advocacy agencies is what?
Unrestricted
A representative of the state ombudsman office demands to see the clinical record of a medicaid resident who had written he wanted no one to have access to his clinical record. Upon receiving the request, you, the administrator, should?
Deny permission to the ombudsman
The resident hangs a religious ornament above his bed. Several nurse aides are offended and feel it is inappropriate. The facility administrator should what?
Advise the aides that this is appropriate
A resident may refuse to release personal and clinical records when what?
Required by the duly appointed state ombudsman
A resident asks the afternoon nurse on duty to access his patient records . The nurse responds that she will have the records made available by late tomorrow morning. The nurse's response is what?
Appropriate
Congress intends that residents have the right to inspect, upon 48 hours notice?
All their records
A resident is concerned about her cognitive status and asks to see all the facility has in her records about her cognitive status, including tests administrated at admission four weeks earlier. The resident is?
Within her rights
The new resident speaks only Japanese. Before the resident was admitted, the facility advised her through her interpreter that no one in the facility spoke Japanese and solely sign language would be used. Upon examining this admission condition in the resident's records, the surveyor would?
Cite the facility
After the first of 10 scheduled physical therapy sessions following his surgery, the resident tells the physical therapist he is not going to keep the final 9 appointments.The resident is?
Within his rights
The resident decides to discontinue all the 9 drugs being administered daily. The facility staff feel this may result in a coma likely followed by death. The facility should what?
Must comply and maintain resident at highest level within that decision
Informing a resident of his rights is required when?
Prior to or at admission
A resident may perform services for the facility if the services are what?
In the plan of care
When the physician decides to discontinue an existing form of treatment due to adverse consequences, the facility?
Must notify the resident and the resident's representative
The facility staff suspect family members are abusing a resident's funds and requires that for the resident's protection his funds must be deposited with the facility. This is what?
Not permitted
A resident routinely maintained $40 in his personal funds account and is upset to learn the facility has his funds in a non-interest-bearing account. Placing this resident's funds in a non-interest bearing account is what?
Permitted
A facility that informs each resident who is entitled to Medicaid benefits, in writing, at admission and when changes occur of services which are paid for under the State plan has what?
Not fully met its notice of service obligations
Upon the death of a Medicaid resident, the facility conveyed the resident's funds within 14 days and promised to forward a final accounting in three weeks. This is what?
Within the required notification periods
As part of a larger chain, the local facility believes that self-insurance plus use of Federal Deposit Insurance Corporation insured accounts is a reasonable protection of resident funds. The surveyor is likely what?
To issue a deficiency
The facility routinely charges all cosmetic and grooming items and services for private, Medicare and Medicaid residents. This charging policy is what?
Is not permitted for Medicare and Medicaid residents
The facility proudly installed flat screen TVs in all resident rooms and added a small surcharge to all residents' monthly charges. This freed up significant floor space in each room and improved resident morale. This approach to improving resident life is?
Violates Medicare and Medicaid rules
The resident reports the facility to the State for releasing his medical records to the local hospital. Despite his refusal to release these records when he was transferred to the local hospital. The state is likely to?
Inform the resident he has no right to refuse his records upon transfer.
The resident has complained numerous times about the disruptive behavior of a nearby resident. The facility assures the resident there is nothing that can be done. This is what?
An inadequate facility response
A resident demands to see both the most recent survey results and the plan of correction. The facility shows the survey results but tells the resident that the plan of correction is confidential and not available. The facility is?
Violating resident rights
The resident, upon his request, requested work delivering newspapers through-out the facility. This is an approved part of the resident's care plan. The resident receives $5.00 an hour for his work. The facility is what?
Not meeting work requirements
The resident demands computer and internet access, but the facility fails to provide this. The facility is?
Is within its rights
A representative of the Secretary knocks on the locked front door at 5:30 a.m. and wants immediate admission. The charge nurse tells the representative to wait until the facility opens at 6:00 a. m.. This is what?
A violation
The administrator refuses to permit a large piece of furniture to be placed in the resident's room arguing that it overly obstructs movement. The administrator is what?
Within his rights
Consenting married residents have a right to share a room is?
Regardless of their health conditions
An individual resident can self-administer his drugs if what?
If the interdisciplinary team has determined it to be safe.
The facility may transfer a resident when?
If the facility will close within a year
When a facility notifies a resident of a transfer on February 1, to be accomplished March 1 the facility has
Failed to meet Final Rules requirements
The facility seeking to transfer a resident must?
Record the reasons in the resident's clinical record
When the nurse gives complete verbal notice of the duration of the bed-hold policy under the State plan to a resident and his family before transfer to a hospital, the facility can be said to have what?
Failed to meet Final Rules requirements
Regarding group or family meetings, after providing space and privacy to resident families and any persons they invite in, the facility obligations are?
Partially met
The facility is by policy a 100% private pay residents facility. The facility informs prospective residents both in writing and orally in a language they can understand. This is?
Is not permitted
The facility requires only private paying patients to designate a third party who will pay the bills. Medicare and Medicaid patients are billed only from their own funds. This is?
Violates Medicare Medicaid standards
The new administrator announces that after two weeks no restraints will be allowed, even those required to meet the residents' medical symptoms. This is?
Permitted
To lessen the risk incidents of resident abusive treatment of other residents, the facility permits Mr. Jones to remain in his room throughout the day. This is what?
Abusive treatment
The administrator who learns that the director of nurses obtained physicians' orders for physical restraints on three "too time-consuming 'wander' " residents should what?
Ask the physician to remove the restraint orders
An alleged violation on neglect of a resident has been lodged. The administrator has reported this to the state, conducted and investigated the next day, and concluded no violation occurred. The administrator should?
Report results to state officials within 5 days of the alleged violation.
The facility sets up mechanisms to listen to the views and record grievances and recommendations of residents and families concerning proposed policy. The facility has?
Failed to meet requirements
A uniform data set describing the resident's capability to perform daily life functions and functional impairments is known as what?
The uniform (minimum) (Comprehensive) data set
Resident assessments must be conducted within (---) days after admission, after a significant mental or physical change, at least every (---) months
14 days and 12 months
The resident assessment must be conducted or at least coordinated by and signed by who?
A registered nurse
A resident enters a facility continent. Due to new clinical conditions, catherization becomes necessary. the facility's entire response is to provide services "to prevent urinary tract infections" and treat them if occurring. The facility has what?
Failed to meet Final Rules standards
A resident's clinical condition demonstrates that a nasogastric tube is unavoidable. The facility documents this and begins a permanent program designed to prevent aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers. A Medicare inspector would consider the facility have?
Failed to implement the intent and spirit of Final Rules
To accommodate a resident returning from the hospital, the facility informs Ms. Brown that in half an hour the staff will be moving in a new roommate. The facility?
Is failing to meet its obligations to residents
The facility appoints the director of nursing, the medical director's Physician Assistant, and four additional staff members to serve on the Quality Assessment and Assurance Committee. This what?
Fails to satisfy the Federal guidelines
The Quality Assessment and Assurance Committee chair informs the administrator that the committee meets every four months and has developed and implemented appropriate plans of action. The administrator should?
Be concerned
During a Medicare survey, the director of nursing refuses to disclose the records of the Quality Assessment and Assurance Committee to enable the surveyor to review the actions taken. The director of nursing is?
Within her rights
The facility identifies low potassium as a nutritional problem, provides a therapeutic diet to correct the potassium deficiency. The resident refuses the therapeutic diet and insists she wishes to eat a regular diet just like the other residents around her. The facility should?
Serve an enriched diet
In January Mrs. Green weighed 112 pounds. In June she weighed 98 pounds. This is?
A severe weight loss.
Mrs. gray refused to eat the meat served for lunch. The facility offered Mrs. Brown a second salad. This is?
Inappropriate
The registered dietitian prescribes a therapeutic diet for Mrs. blue because the dietitian noticed some weight loss in the past two months. As lunch was about to be served anyway, the kitchen staff was able to implement the new diet within 10 minutes of the nutritionist's recommendation. The administrator should?
Meet with the dietitian
During a periodic mid-afternoon visit, the consultant dietitian writes out therapeutic diets for the four new residents and hands them individually as soon as she writes them to the director of food services for preparing food for those residents that evening. Upon being informed of this that afternoon, the administrator should?
Tell the director of food services to serve regular diets to those four new residents that night.
Snacks at bedtime?
Must be offered to all residents
The air conditioning roof unit fan shaft has run dry and required quick oiling for several months. The facility is?
Failing to do preventive maintenance
A facility initially certified under Final Rules, which at the request of the resident council, maintains a winter temperature of 83 degrees despite protests from staff that this is too hot for the staff is?
Not in noncompliance with Final Rules
The resident has mentioned to the administrator several times that he is tired of waiting for a room with a window to the outside. The facility is?
Failing to meet building requirements
each resident room must have what?
At least one window to the outside
The call systems representative's recommendations for installing a call system to the bathroom facilities in addition to the present resident room and toilets call systems were turned down by the administrator as too expensive. This is?
Is not meeting standards
The facility has an infection control program that has effectively investigated and controlled every infectious outbreak. When the state visits and evaluates this program the state will likely what?
Issue a deficiency
Such details as size of committee, scope of work, and reporting requirements for the infection control function are?
Left to the facility
Maintaining record of incidents and corrective actions related to infections is assigned under Final Rules to who?
The infection control program
The general approach of the Federal Requirements is to state federal requirements, for example, infection control, and budgets required, (----)?
In general (less specific or detailed) terms
The nurse was miffed that she could not get a medical decision until the attending physician was to return from a medical convention and mentions this to the administrator. The administrator should?
Meet immediately with the Director of Nursing
A Physician visit occurring 14 days after the date the visit was required is what?
not considered timely
If a facility policy prohibits use of physician assistants, but three physicians routinely use physician assistants for most visits, the Medicare inspector will?
Cite the facility
Ultimate responsibility for obtaining and reporting laboratory, radiology, and other diagnostic services is assigned to the what?
Nursing facility
The charge nurse notices that lab work recommended for a particular medication has not been ordered and places the order. The administrator should?
Be upset
A facility need not first consult with the resident's physician when there is what?
A medical emergency
The medical director declined to take responsibility for monitoring and ensuring implementation of resident care policies feeling this was too time consuming. The administrator would be well advised to?
Find a new medical director
Upon learning that, to save expenses, the director of nurses has determined that drug records are in order and that all controlled drugs are accounted for, the administrator should?
Call the consulting pharmacist
Permitting a resident, whose physician permits drugs judged unnecessary but demanded by the resident, to continue to take unnecessary drugs is?
Is not permitted
New facilities certified under Final Rules must meet the applicable provisions of the?
Life Safety Code of 2000
Plan D, implemented in 2008, was intended to what?
Provide relief from Medication expenses
An individual who can prove he or she recently successfully completed a training and competency evaluation program, but who is not actually registered in the required registry?
Can be hired
Responsibility for determining whether the nurses aide training and competency evaluation requirements are met in a facility falls to the?
State survey agency
the owner of a facility providing nearly the best nurses aide training and competency evaluation program in the state, declines to permit an unannounced visit by the State. The State will?
Withdraw approval of the training program
The required curriculum for a nurses aide training program does not have to include what?
Diet management
Candidates for nurses aide competency evaluation are normally examined by who?
A State-approved entity
Under federal guidelines a candidate for nurses aide registration has what chance to take the evaluation?
At least three
A finding by the State survey agency of abuse or neglect by a nurses aide remains recorded in the nurse aide registry for?
Forever
Ensuring that nurse aides are able to demonstrate competency in skills and techniques necessary to care fir residents' needs is the responsibility of?
The facility
Under Final Rules, routine and emergency dental services are?
Mandated
The director of nursing mentions to the administrator that although Ms. Brown had no significant change in her physical or mental condition upon readmission, a full comprehensive assessment was completed within 5 days of her return. the administrator might feel what?
Facility resources might not be utilized efficiently
to stretch resources, the care planning team decides to conduct comprehensive assessments on the healthiest patients every 15 months. the administrator should feel?
A deficiency is in his future
Standards of quality for care given in the nursing facility is?
May be found in several venues
the nurse on duty has informed Ms. Brown that Mr. Brown must make arrangements for transportation to her audiologist. This is what?
Not permitted facility policy
Psychosocial adjustment difficulties
Must be treated by the facility
For several months in succession it is noted in the resident's records that the resident is becoming more withdrawn. The facility?
Must develop a plan of care to address this
For nasogastrically fed patients, the facility program is to provide treatment and services to prevent aspiration, pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities. This is?
Is insufficient
Ms. Green has been shouting incoherently at nearby residents. Her physician prescribes an antipsychotic drug to calm her down. This is?
Is unacceptable
The facility must provide a separately locked, permanently affixed compartment for storage of controlled drugs listed in Schedule (----) of the Drug Act?
2
Controlled drugs listed in Schedule 1 of Comprehensive Drug Abuse Act of 1970 are what?
Not permitted in the facility
The administrator's policy is to discard all clinical records after ten years. This policy is?
Flawed
The Resident Assessment Instrument is a set screening, clinical, and functional status elements that form the basis for?
A comprehensive assessment of each resident
Specific resident responses for one or a combination of MDS elements are?
The Care Area Triggers
The MDS care planning process can be visualized as: assessment, decision making, and what?
Care plan
In planning an annual survey the surveyor begins with reviewing current government data records on the facility, current complaints, Ombudsman information, and what?
Current MDS data
The surveyors expect information on contact persons for complaints or abuse, a list of ventilator dependent residents, a list of residents on hospice, a list of dialysis patients within (---) hours of entering a facility for survey?
Four hours
The administrator can expect surveyors to generate (----) lists of residents to be interviewed?
Three or more
As a matter of policy, at an exit conference (----) are/is invited to attend?
The resident council president
If a facility plan of correction is found unacceptable?
A new plan of correction must be submitted
Normally, a plan of correction is?
Triggers a revisit
Hoping to delay an enforcement action, the administrator asks for an Informal Dispute Resolution. The administrator what?
Does not understand the process
A finding by surveyors that in both wings of the facility the water to resident room and baths is 8 degrees above the upper limit, but that no one had yet been burned, would result in a deficiency characterized as?
Widespread, not actual harm with potential for more than minimal harm
The CMS goal is to reimburse based on how much (----) is required to care for each patient each month.
Staff time
There are (---) levels and types of care if reimbursing nursing facility care given?
Sixty-Six
The MDS contains items that reflect the (------) of the resident?
Acuity level
The Medicare-required assessments provide information about the clinical condition of beneficiaries. These assessments can?
Can be scheduled or unscheduled
Readmission/return assessment, start of therapy, and end of therapy are?
Standardized assessment dates
The RUG-IV classification system has (---) major categories?
Eight categories
The scheduled PPS assessments ( performed around Day 5, 14, 30, 60, and 90) established (----) for associated standard payment periods?
Per diem payment rates
The ADL score is based upon the ADL's what?
Bed mobility, transfer, toilet use, and eating
A cancer patient receiving intensive therapies may?
Cost the facility more than it will be reimbursed
The current long-term health care delivery system is one in which each player seeks to minimize its own costs at the possible expense of what?
Other players in the system
How much a facility can charge for care given can be characterized as?
A moving target
Establishing transfer and discharge policies according to source of payment (------) under Final Rules?
Is forbidden