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NAB EXAM 1 Questions and
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what economic considerations should the administrator assess when appraising their community - CORRECT ANSWER are the residents apt to have the present and future income to keep occupancy levels high and with the desired mix of resident.. Would the facility be competitive with daily charges? what are the trends among third-party payers in the community? What market considerations should the administrator assess when appraising their community - CORRECT ANSWER the role of the proposed nursing facility in the environment. what is the niche off the community. What does a job list include? - CORRECT ANSWER the objectives the duties and authorities of the position its relationship to other positions in the organization What are the three available inputs among an organization? - CORRECT ANSWER people, materials and money What is a system? - CORRECT ANSWER an organized or complex whole, an assembling or combining of things or parts forming a complex or single whole
What is systems theory? - CORRECT ANSWER A tool for making sense out of our world by helping to make clearer the interrelationships within and outside of the organization. how do nursing homes use inputs - CORRECT ANSWER to get work done What are outputs? - CORRECT ANSWER desired or undesired/unintended result of the inputs What are the outputs compared to - CORRECT ANSWER what was sought what is the processor - CORRECT ANSWER the work the organization accomplishes What is control? - CORRECT ANSWER the corrective action taken after evaluation of outputs by the organizational decision makers. how does the administrator exercise control? - CORRECT ANSWER by comparing the actual care given to residents to the actual output with the care called for I the organizational policies and plans of action What is control of quality - CORRECT ANSWER the process of asking if the work accomplished by the facility is up to expected stands and if not taking corrective actions to remedy the problem what does the administrator use as guidelines for the output - CORRECT ANSWER the policies and plans of action What is feedback - CORRECT ANSWER a form of control
What is a policy? - CORRECT ANSWER verbal, written or implied overall guide that sets up boundaries supplying the general limits and direction in which managerial action will take place What is the difference between a policy and procedure - CORRECT ANSWER a policy is a statement that contains some degree of freedom, some further need for interpretation. Procedures are step-by-step instructions on how a specific task is to be carried out What happens if a facility receives a K or L deficiency? - CORRECT ANSWER the facility is typically given notice that Medicare/Medicaid certification will be terminated within 30 days if deficiencies are not satisfactorily corrected What is an effective leader? - CORRECT ANSWER a person who have foresight combined with an ability to guide the organization to successfully take advantage of the opportunities the future offers. What is the allowable medication error rate? - CORRECT ANSWER 5% What is polypharmacy - CORRECT ANSWER 9 or more meds What are types of thickened liquids - CORRECT ANSWER honey, nectar, pudding What is SPO - CORRECT ANSWER Structure Processes Outcome What is SPO - CORRECT ANSWER measures nursing home quality
What is PPS - CORRECT ANSWER Prospective Payment System (Medicare payment system) When was the National registry of Nursing Home Aides established - CORRECT ANSWER 1998 What is Phase I in the survey process - CORRECT ANSWER survey sample - used to select appropriate residents for survey - done through the resident level summary What is a torte? - CORRECT ANSWER a civil wrong Who brought about nursing home terminology in 1961? - CORRECT ANSWER Nursing Home Standards Guide What is working capital? - CORRECT ANSWER an organizations current assets or short-term assets Who added the affordable care act - CORRECT ANSWER Social security act Who came up with deficiency citations - CORRECT ANSWER HCFA (Health Care Financing Administration) What are the 5 elements of QAPI - CORRECT ANSWER Design and Scope Government and Leadership Feedback, Data Systems and Monitoring Performance Improvement Projects
How are quality indicates different from quality measures? - CORRECT ANSWER Similar except quality indicators are provided to the consumer through CMS What part of the management function is developing job descriptions? - CORRECT ANSWER organizing How long must employee applications be kept on file - CORRECT ANSWER one year What is the Halo effect - CORRECT ANSWER rated on the presence or absence of one trait What is the leniency error - CORRECT ANSWER Rates all employees with high scores What is the error of central tendency - CORRECT ANSWER gives all employees mediocre ratings to avoid conflict What is the percentage to start a union - CORRECT ANSWER 50% + 1 What percentage of the US labor force is unionized - CORRECT ANSWER 20% Disparte impact and treatments are considered? - CORRECT ANSWER discrimination When is an accidental death need to be reported to OSHA? - CORRECT ANSWER within 8 hours
How often do employees receive health exams? - CORRECT ANSWER initially and yearly What is the maximum penalty for falsifying OSA records - CORRECT ANSWER $70, What percentage o the revenue for nursing home industry is Medicaid? - CORRECT ANSWER 50% What is the payback period - CORRECT ANSWER total investment divided by annual savings Under Medicaid and Medicare what accounting system must be used> - CORRECT ANSWER accrual What depreciation method is required by Medicare - CORRECT ANSWER straight line What is important to use when developing the capital budget? - CORRECT ANSWER debt or equity financing What percentage of nursing home costs is payroll? - CORRECT ANSWER 70% Who issues fraud alerts? - CORRECT ANSWER Office of inspector General What is listed on the 941 - CORRECT ANSWER FUTA, FICA for the employee/employer, and Medicare
What clause is the lock out/tag out located under? - CORRECT ANSWER General Duty Clause For workers compensation what must be reported and when - CORRECT ANSWER work related illnesses and injuries for the year. Needs to be reported between February 1 and April 30th. For OSHA where should form 200 be transferred to at the end of the year? - CORRECT ANSWER 300A According to the National Labor Relations Act how many days notice must healthcare workers give their employer before they strike? - CORRECT ANSWER 10 days What are examples of Medicare abuse or fraud - CORRECT ANSWER Up- coding Rug Creep What is cost shifting? - CORRECT ANSWER Charging private pay residents a higher rate that exceeds actual costs. What are two classifications of funds for statements used in a non-profit organization? - CORRECT ANSWER Restricted and unrestricted What is an example of a restricted fund? - CORRECT ANSWER endowment funds special purpose fund donor restoration fund
What is prospective rate setting - CORRECT ANSWER pre-determined rates to reimburse nursing facilities without adjusting payment to cover actual cost. What are safe harbors - CORRECT ANSWER permissible referral practices What is situational leadership? - CORRECT ANSWER having to make a choice without input from others What is SWAT - CORRECT ANSWER Strength, weaknesses, opportunities, threats part of strategic planning What is the time frame for strategic planning to develop and implement - CORRECT ANSWER 3 - 5 years What are the 3 dimensions of quality - CORRECT ANSWER structure processes outcomes What are the 4 steps in demings process for quality improvement - CORRECT ANSWER initiate action analyze confirm or plan do
What is a post-visit survey - CORRECT ANSWER on-site re-visit to verify corrections of deficiencies cited in prior survey What is a traditional survey - CORRECT ANSWER initial certification process Who approves the states to utilize quality indicators - CORRECT ANSWER CMS What is the main focus during QIS extended survey - CORRECT ANSWER administration physician and nursing services What is state 1 of the QIS - CORRECT ANSWER off-site and on-site data Observation and interviews record reviews of computer selected residents What is stage 2 of the QIS - CORRECT ANSWER Investigation of triggered issues and residents using the guidance to surveyors and critical elements protocol What is the purpose of the traditional survey - CORRECT ANSWER receive payment under Medicare receipt payment under Medicaid Medicare re-certification What do sanitary conditions prevent - CORRECT ANSWER foodborne illness What is the danger zone - CORRECT ANSWER Food temperatures
below 135 degrees Fahrenheit above 41 degrees Fahrenheit What are the food contamination categories - CORRECT ANSWER biological chemical physical When does rapid death of most bacteria occur? - CORRECT ANSWER 165 degrees Fahrenheit how much time should you wait in between eye drops - CORRECT ANSWER 3 - 5 minutes how much time should you wait in-between inhaler puffs - CORRECT ANSWER 1 minutes What is the hot holding temperature required for fresh, frozen or canned fruits or vegetables? - CORRECT ANSWER 135 degrees Fahrenheit How long should the internal food temperature be monitored and maintained? - CORRECT ANSWER 15 seconds What is the internal temperature for poultry - CORRECT ANSWER 165 degrees Fahrenheit What is the internal temperature for ground meat, pork and fish? - CORRECT ANSWER 155 degrees Fahrenheit
how much notice is given for a facility closure? - CORRECT ANSWER 60 days What is step 1 in the survey process - CORRECT ANSWER on-line survey certification reports reviewed what is step 3 in the survey process - CORRECT ANSWER initial tour what is step 5 in the survey process - CORRECT ANSWER information gathering Hot water dishwasher wash cycle temperature 150⁰ F Hot water dishwasher rinse cycle temperature 160⁰ F Hot water dishwasher final rinse cycle temperature 180⁰ F 3rd compartment sink in kitchen contains: sanitizer 3rd compartment should be: 75⁰ F with 50 PPM if bleach is used or 12.5 PPM (parts per million) if iodine is used Pots and pans are washed in hot water of: 170⁰ F for 30 seconds Hot food should be kept at: 135⁰ F and above Cold food should be kept at: 41⁰ F and below
Freezer temperature should be: 0⁰ F Walk in fridge and all other refrigerators should be: 41⁰ F and below The steam table should be: 135⁰ F and above Milk should be: 41⁰ F and below The dietary section the MDS 3.0 is: Section K Kitchen must be open at least: 12 hours a day A max of hours between evening meal and breakfast without a snack 14 A Max of hours may pass between dinner and breakfast with a snack 16 A is required by federal law bedtime snack Must store pots and pans and all other items the floor. Nothing may be on the floor. 6 inches off Therapeutic Diet is any diet that deviates from the regular diet Only a can order a diet (the dietician must approve the diet or determine the specifics.)
A comprehensive assessment must be completed within of admission and then every or upon a in the resident's physical or mental condition 14 days, 12 months, significant change The comprehensive assessment is the same as the: MDS A involves a new MDS or comprehensive review so it must be done within. significant change, 14 days Each resident must be examined or have a physical exam no less than every and their comprehensive assessment must be revised to ensure the continuing accuracy of the comprehensive assessment. 3 months An must sign tor certify the accuracy of the comprehensive assessment RN The initial comprehensive assessment must be transmitted to the state within of completion of the assessment. After that, all MDS information must be transmitted to the state every. 7 days, 30 days The comprehensive care plan must be prepared within of completion of the comprehensive assessment. But Not later than from date of admission. 7 days, 21 days Care Plan is prepared with the participation of the: resident, family or legal representative, and the resident's attending physician and an RN responsible for the resident A care plan conference must be held quarterly
The care plan is updated whenever: the comprehensive assessment is reviewed or changed Preliminary interview: brief discussion to screen qualifications of applicants to determine if to interview them (i.e. telephone interview) Non structured interview: (open ended) - open ended questions and lets applicant talk and expand on answers In-depth interview: very structured interview - limits applicants responses to questions Patterned interview: all questions are highly structured and sequential We use Structured interviews (statistical interview) with lots of open-ended questions and use a rating scale to assign a number value for each response. A clinical interview is just walking into an interview with no set questions and using your gut instinct whether someone will fit in. We use interview and appraisal panels to have more than one person involved to adjust for bias and then assign a global score Interview CANS & CANNOT'S
- Can ask if they were convicted of a crime not if they were arrested.
- Can ask them if they drink but not if they south counseling or treatment
- Can ask if they can do the tasks of a job but not if they have physical limitations until after an offer of hire
- Can require medical info and medical exam or drug testing ONLY AFTER AN OFFER OF HIRE - CRITICAL!!!! Rating scale is:
