Download DQA SMQT Exam Q&A: Healthcare Regulations and Medication Management and more Exams Survey Sampling Techniques in PDF only on Docsity!
DQA SMQT EXAM WITH COMPLETE QUESTIONS AND
ANSWERS
What is severity level 2 - ANSWER Noncompliance that has potential to cause more than minimal harm that is not IJ
resident has no more than minimal discomfort,
their is a potential to compromise residents ability to reach highest practicable level,
shame/embarassment without loss of interest
minimal episodic pain,
facility has no system to prevent problems
The TC must complete which tasks during offsite prep? - ANSWER Create/export shell from ACO
Import shell into ASE-q
Add team members
Complete offsite prep screen
Make unit assignments
Make mandatory task assignments
print documents
Share offsite prep with team
What documents are printed by the TC during offsite prep? - ANSWER 1 matrix with instructions
1 entrance conference worksheet
3 beneficiary worksheets
What is the purpose of the initial pool process? - ANSWER To briefly screen all residents and observe, interview and complete initial record review.
When should you share data? - ANSWER At the end of each day and when the team composition changes.
What must be done prior to Sample Selection - ANSWER The completed I.P data is shared and the TC confirms that the data is complete.
What are the 7 LTSCP steps? - ANSWER 1. Offsite prep
- Facility entrance
- Initial Pool Process
- Sample Selction
5.Investigation
- Ongoing and other survey activities
- Potential Citations
Name 3 antipsychotics - ANSWER Thorazine (chlorpromazine) Haldol (haloperidol) Abilify (aripiprazole) Clozaril (clozapine) Zyprexa (olanzapine) Latuda (lurasidone) Seroquel (quetiapine) Risperdal (risperidone)
Indications of unnecessary medication include? - ANSWER Excessive dose
excessive duration
without adequate monitoring
without adequate indication for use
use in the presence of adverse consequences
What is a psychotropic drug? - ANSWER Any drug that affects brain activities associated with mental processes and behavior-include anti-psychotic, antidepressant, anti-anxiety and hypnotic medications
What is "anticholinergic side effect"? - ANSWER an effect of a medication that may cause dry mouth, blurred vision, tachycardia, urinary retention, constipation, confusion, delirium, hallucinations, flushed and increased blood pressure
What is Extrapyramidal symptoms" (EPS)? - ANSWER a neurological side effect that may occur within a few day or years of treatment with antipsychotics. Includes various syndromes such as
,vomiting, visual changes, cardia arrhythmia, low heart rate
When must a Gradual Dose reduction (GDR) occur? - ANSWER Within the first year in which a resident is admitted or med is prescribed the facility must attempt a GDR in two separate quarters (with at least one month in between the attempts) unless clinically contraindicated.
Severe weight loss in 6 months - ANSWER greater than 10% weight loss
When finalizing the sample - ANSWER what do you do if other residents are marked FI for the complaint allegation care area?,sample 3 residents for the care area.
What residents are system selected? - ANSWER any offsite selected with at least one care area marked FI, any resident a surveyor marked as include in sample, any identified abuse concern from IP or history of abuse citation or allegation since last survey.
What areas are reviewed for non-interviewable residents? - ANSWER Pressure ulcers, dialysis, infections, nutrition, falls in last 120 days, ADL decline, low risk B&B, unplanned hospitalization, elopement, change of condition in last 120 days.
All residents are reviewed for which areas? - ANSWER Advanced directives, confirm specific information based on RI/RO, other concerns.
What act established Medicare and Medicaid - ANSWER Social Security Act of 1965 signed by Johnson established Medicare for aged over 65 and Medicaid health insurance for low income.
What is the survey process based on? - ANSWER Person centered care, resident centered outcomes, QOC and QOL.
What are the components of a deficiency statement? - ANSWER 1. regulatory reference
- deficient practice statement
3.relevance facts and findings
When should you export the survey shell from ACO? - ANSWER Export the shell as close to the survey as possible but no more than 5 business days before.
When should you contact the RAI coordinator? - ANSWER If the number of residents is unreasonable after exporting the survey shell
Which residents are included in the survey shell? - ANSWER 1. Offsite selected who make up 70% of the sample
- Residents with at least 1 MDS in the last 120 days
- Residents for closed record review
What is the CASPER report? - ANSWER Certification and Survey Provider Enhanced Reporting
What items are required upon entrance - ANSWER 1. Census excluding bed holds
- Matrix for new admits in the last 30 days
- Alphabetized list of resdients
- List of resident who smoke
When screening residents - ANSWER what other concerns should you pay attention to?,resident behavior, staff-resident interactions, resident grooming and cleanliness, strong urinary odors, evidence of abuse or neglect
How many compliant/FRI residents are in the initial pool? - ANSWER 5 residents
What types of residents must you include in the initial pool? - ANSWER 1. who smokes
Can the samlpe size exceed the sample size grid? - ANSWER Yes
How many residents does the system select for unnecessary medication review? - ANSWER 5
What should you ask for if Abuse is being investigated based on a history of abuse as noted on offsite prep screen? - ANSWER Ask facility for all allegations of abuse since the last survey.
What should you consider when adding residents when the sample size is not met?
- ANSWER Residents with the most concerns
Residents with concerns R/T QOL and RR
Residents selected for unnecessary med review
prior survey and complaint results
underrepresented areas of facility.
What is investigated when more than 5 complaint/fri residents are added to the sample? - ANSWER You will only investigate for the allegation
When finalizing the sample you must ensure that a surveyor is assigned to which residents? - ANSWER every resident in the sample, additional complaint/fri residents, non sampled unnecessary medication review residents
What are the 9 mandatory facility tasks - ANSWER 1. Beneficiary Protection Notification review
2.Dining observation
- Infection control
- Kitchen
- Medication Administration
- Medication Storage
- QAA/QAPI
- Resident Council Meeting
- Sufficient and Competent Nurse Staff
What 3 task are assigned to all surveyors? - ANSWER Dining observation, infection control, sufficient and competent nurse staff. (One surveyor is assigned primary responsibility for completion of each task)
Which facility tasks are triggered tasks? - ANSWER Environment, Personal Funds, Resident Assessment
483.24 - ANSWER Quality of Life- pertains to all care and services provided. Facilities must provide necessary care and services to attain or maintain highest practicable physical, mental, and psychosocial well being.
483.25 - ANSWER Quality of Care-facility must ensure residents receive care and treatment in accordance with professional standards of practice, person centered care and resident choice
What is included on a baseline care plan? - ANSWER Initial goals based on admission orders
MD orders and dietary orders
Therapy and social Services
PASARR
What is a PASARR - ANSWER Pre-Admission Screening and Resident review
Need to expand sample to r/o SQC?
Status of information for complaint/FRI
Pertinent findings
Work left to complete
Need to adjust workload
Whether 3 resident rep interviews are done
Concerns indicative of system failure
What is the importance of record review? - ANSWER Determine how negative outcomes are r/t the facilities failure to provide adequate care
Determine if the facility has enabled the resident to reach their highest practicable level
What is reviewed during the Infection Control task? - ANSWER All surveyors observe for breaks in infection control throughout the survey.
Assigned surveyor reviews IPCP, AB Stewardship, and the influenza/pneumococcal vaccination (5 residents), sample of 3 staff including at least 1 that was COVID 19 positive, and 3 residents for TBP(1 covid + or suspected) as well as screening, testing and reporting of COVID 19
What is reviewed for compliance with the Antibiotic Stewardship program? - ANSWER 1. AB use protocol on prescribing
- Protocols to determine if AB is indicated
- A process for review of AB use by prescribers
- Protocols to ensure resident are prescribed the appropriate AB
- A system for feedback reports
What are the factors in determining Noncompliance - ANSWER 1. specific action or lack of action relative to requirement
- Practice the facility implemented or failed to implement
- what the facility did or di not do to cause the noncompliance
- The actual or potential outcome that resulted from the noncompliance.
What factors should you consider in determining severity when harm has occured ? - ANSWER Is the harm at the level of serious injury, impairment or death?
did the resident experience a negative psychosocial outcome?
how did the facility practice in question cause, contribute, or perpetuate the harm?
What factors should you consider in determining severity when the is no actual harm? - ANSWER how likely is it that a resident could suffer harm, impairment, death or compromise/deterioration?
Does the deficient practice require immediate correction?
Could the noncompliance have an impact on many residents?
Use the psychosocial outcome grid and the reasonable person concept
What is the psychosocial outcome grid? - ANSWER guide designed to identify each residents psychosocial response to noncompliance as the basis for determining psychosocial severity of a deficiency
What is reasonable person concept? - ANSWER Used when a resident's psychosocial outcome may not be readily determined through the investigative process. The team should determine the severity of the psychosocial outcome that the deficient practice would have had on a reasonable person in a similar situation.
What are the 3 types of contamination - ANSWER Biological, chemical, physical
What is Critical Control Point (CCP) - ANSWER a specific point, procedure, or a step in food preparation and serving at which control can be exercised to reduce, eliminate, or prevent the possibility of a food safety hazard.
Cooking ,cooling, holding, reheating
What temperature should hot foods be held at? - ANSWER 135 degrees or higher
What temperature should cold foods be held at? - ANSWER 41 degrees or lower
What temperature should food be re-heated to? - ANSWER 165 degrees for 15 seconds within 2 hours
Should ABHS be used in food Service? - ANSWER No
What is the purpose of medication administration observation? - ANSWER Verify that the facility meets the requirements of error rate of 5% or less, and residents are free from significant medication errors.
What should a medication administration observation include? - ANSWER 25 opportunities
variety of residents, staff on different shifts and units
Variety of routes (PO, SC, ophthalmic etc.)
What does a med observation assess for? - ANSWER MD orders-reconcile
observed meds with the MD orders
manufacturers specifications
professional standards
verify med expiration date
How do you calculate med error rate - ANSWER number of errors /opportunities X 100
F 759 - ANSWER 5% or more medication error rate
F760 - ANSWER Significant medication error
What is a significant medication error? - ANSWER error which causes the resident discomfort or jeopardizes health and safety
What amount of money must be kept in an interest bearing account? - ANSWER $
When must a facility notify a Medicaid resident of the amount of money in their account? - ANSWER When the account reaches $200 of the eligibility limit.
How can the software help determine the new admissions? - ANSWER Any residents on the alphabetical list from the facility that are not in the software should be the admissions in the last 30 days
When should QAPI/QAA task be completed? - ANSWER At the end of the survey
How many hours upon Oral or Written request does a facility have to provide clinical records excluding weekends and holidays - ANSWER 24
How many days should a request for medical records take - ANSWER 2 working days with advance notice
Funds in excess of how much should be in an interest bearing account - ANSWER $
A provider must notify a resident when the amount of money in anaccount is - ANSWER $200 less the SSI limit
A resident must receive mail within how many hours of its arrival in the home - ANSWER 24 hours
The facility has how many days to convey funds after the death of a resident - ANSWER 30 days
A provider must give how many days day advance notice before transfer or discharge - ANSWER 30 days
How many beds does a facility have to have for a full time social worker - ANSWER 120 beds
The MDS assessment must be conducted no later than how many days after admission - ANSWER 14 days after admission
Annual assessments must be done every - ANSWER 12 months
Review of assessments occur - ANSWER every 3 months or quarterly
Comprehensive care plan must be developed within how many days after completion of what - ANSWER Within 7 days after completion of the MDS Assessment
How often should a physician visit? - ANSWER Every 30 days for 90 days and then every 60 days
Timely MD visits occur - ANSWER within 10 days after the visit was required
MD services are required - ANSWER 24/
Drug reviews occur - ANSWER once a month
CNA's should have how many hours of inservice training every year - ANSWER 12 hours per year
QA committee members - ANSWER DON, MD and 3 staff
Clinical records are kept for how long - ANSWER 5 years after discharge (3 years for a minor after discharge)
QA meets every - ANSWER 3 months or quarterly
the blood sugar over time.
What is a lab draw for iron, hemoglobin and hematocrit going to tell you - ANSWER This measures if someone has anemia.
What drugs would you measure iron or hemoglobin for? - ANSWER These are measured when someone may be taking iron. Many people on dialysis have low iron and need replacement
What are electrolytes? - ANSWER This is potassium or magnesium for example.
People with cardiac issues what electrolyte is commonly measured? - ANSWER potassium or K+
What is BUN? - ANSWER blood urea nitrogen. This can measure function of kidneys.
An elevated BUN can mean - ANSWER person is dehydrated, kidneys are not working, person is having congestive heart failure
What is albumin - ANSWER Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn't leak into other tissues. It is also carries various substances throughout your body, including hormones, vitamins, and enzymes. Low albumin levels can indicate a problem with your liver or kidneys.
Why is albumin important for medications? - ANSWER Medications can attach to albumin. so if you have have low or high albumin levels you may have more or less drug available in a persons system. Too much drug can cause more side effects. Too little of the drug and it can't work
What is a corticosteroid? - ANSWER These are drugs like prednisone or hydrocoritsone.
What do corticosteroids do? - ANSWER reduce inflammation
What is anticholinergic symptoms? - ANSWER Anticholinergic symptoms dry people out. So dry eyes, consitpation, dry brain so confusion, less urine so infections or retention, dry mouth so swallowing difficulties, dry skin
Anticholinergic drugs - ANSWER Oxybutynin (Ditropan, Gelnique), tolterodine (Detrol), Darifenacin (Enablex), Solifenacin (Vesicare), Trospium (Sanctura), Fesoterodine (Toviaz)
What is digoxin used for? - ANSWER increase heart contractility
what are symptoms of digoxin toxicity? - ANSWER -GI upset, anorexia, ectopic heart beats, A. fib, heart blocks, VISUAL DISTURBANCES and disorientation.
What is a common side effect from corticosteroid? - ANSWER GI bleeds
What are some common electrolytes? - ANSWER magnesium, sodium, magnesium, potassium
