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Occupancy of Facility A has been a steady 70% since the Patient Driven Payment Model (PDPM) was introduced. Two weeks ago, a new 120 - bed, equally equipped facility opened several blocks away. The Facility A administrator tells the admissions counselor to continue the usual recruitment approach. The chain owners ought to. A. Rest comfortably B. Seek a new administrator C. Appoint a new admissions counselor D. Take no action - ✔✔B. Seek a new administrator. The administrator fails to anticipate that the occupancy rate of the facility is likely to fall and that, in any case, with the new competition a new approach to admissions will most likely be necessary. The administrator is failing to react appropriately to changes in the environment that will likely impact the facility. The nurse newly promoted to director of nursing insists on personally giving four RN hours of resident care each day on the Alzheimer's wing in the 175-bed facility. The administrator should. A. Praise the new director of nursing for their resident centeredness B. Appoint an assistant director of nursing C. Adapt the job description to fit the director of nursing's pattern D. Seek a new director of nursing - ✔✔D. Seek a new director of nursing. The director of nursing fails to understand that using expensive RN hours when less expensive licensed practical nurse (LPN) and certified nurse's assistant (CNA) hours are the industry standard will be unsustainably expensive for the facility. Additionally, the director of nursing is not a direct care role, and their time should be spent in other applicable areas for their position. The newly hired assistant to the administrator insists that the organizational chart dotted line between this position and the Department of Nursing should be a solid line. The administrator should.
A. Agree in general B. Agree to this special case C. Ask the director of nursing for their opinion D. Be forewarned - ✔✔D. Be forewarned. The director of nursing normally reports directly to the administrator. The assistant administrator wants too much power or does not understand how normal nursing facilities function The nursing facility administrator who, using the leadership by walking around (LBWA) technique, succeeds in making appropriate corrections on the spot during their rounds. A. Is effectively implementing the concept B. Gains additional power through the process C. Exhibits appropriate leadership D. Does not understand LBWA - ✔✔D. Does not understand LBWA. It is normally better to go through the chain of command and let the employees' immediate supervisor request the corrections. When the administrator notices that the director of nursing seeks to turn as many duties as possible over to housekeeping, the administrator should conclude that the director of nursing is. A. Behaving normally, but worthy of oversight B, Holding a grudge against housekeeping C. Unwilling to be cooperative D. Wielding power desirably - ✔✔A. Behaving normally, but worthy of oversight. It is normal for the various departments such as nursing, housekeeping, and dietary to seek to "turn over" as much work to other departments as they can. The administrator notices that incident reports are being insufficiently filled out, but does nothing, believing that the situation will likely correct itself. The administrator is. A. Practicing effective control
A. Two layers B. Three layers C. Eight cooperating teams D. Four teams - ✔✔B. Three layers. There are three layers of management: upper, middle, and lower. The administrator is part of the upper- level management. Nursing facility administrators should anticipate and successfully prepare for. A. Increased reimbursement B. New long-term care legislation C. Increased longevity D. Rapid change - ✔✔D. Rapid change. Change is truly the only thing we can guarantee in a facility. Being prepared for what comes is the job of the administrator. It is conceivable that the core business of the nursing facility in this decade will the core business of the nursing facility of the next decade. A. Be entirely different from B. Remain relatively stable and closely resemble C. Undergo change at a slower pace than D. Be remarkably similar to - ✔✔A. Be entirely different from. The nursing facility industry is under amazing scrutiny today, and because of this we have seen many new laws and regulations since the inception of the Affordable Care Act (ACA). Two presidents later, we are still feeling rapid change resulting from the 2010 legislation, as well as new directives meant to "help" nursing facilities, yet industry leaders believe some of these proposed changes are unsustainable. Nursing facilities that stick to conventional formulas for success will. A. Be more likely to survive
B. Miss new markets and be in a backwash C. Be more likely to produce a steady profit D. Survive while those introducing constant change will lose needed focus - ✔✔B. Miss new markets and be in a backwash. Everything in our industry changes quickly. Even the residents we serve are much different today than they were 20 years ago. We are seeing residents sicker and quicker in our nursing facilities, which have simply become subacute units today. These are entirely nonconventional residents and unless we change to meet the needs of our audience, we will miss opportunities which exist for success. The average number of prescriptions for persons in the United States aged 65 years and older is four. In nursing facilities, it is. A. Lower B. About the same C. Often double or more of that number D. Fewer due to closer medical monitoring - ✔✔C. Often double or more of that number. Nursing facilities deal with much sicker individuals than those who live outside the facility. This results in often double or more of the normal number of prescriptions we would see in the community. Nursing facility administrators who expect the unexpected and thrive on it. A. Exhibit an unnecessary anxiety about the future B. Are too pessimistic C. Will last in the profession D. Will not make enough plans - ✔✔C. Will last in the profession. The most successful administrators embrace change and expect it to happen before lunch. This mindset toward change helps the administrator stay successful in the industry, as opposed to others who might spend more time disagreeing with the inevitable. One must assume that other nursing facility administrators in the community.
Quality assessment and control, infection control, and physical plant health and safety are. A. New requirements B. Long-standing requirements C. Federally required committees D. Federally required committees and/or functions - ✔✔D. Federally required committees and/or functions. Quality assessment, infection control programs, and physical plant health and safety programs are mandated by federal requirements. In the typical nursing facility of 100 residents, the administrator normally has reporting to them. A. Seventeen department heads B, Six middle-level managers C. Eight or nine department heads D. Three or four department heads - ✔✔C. Eight or nine department heads. Usually, all department heads report directly to the administrator. In the typical 100 - bed nursing facility, the administrator will have eight or nine department heads reporting directly to them. Activities such as ensuring quality of care for all residents, advocating for all residents, and developing and managing the budget are normally associated MOST closely with the. A. Business office B. Admissions team C. Nursing area D. Administrator's office - ✔✔D. Administrator's office. There are a myriad of duties assigned to the administrator's office. The effective administrator does whatever it takes to have effective control of resident care in the facility. Activities such as empowering department heads, setting the tone, and settling territorial disputes are normally associated MOST closely with the.
A. Business office B. Admissions team C. Nursing area D. Administrator's office - ✔✔D. Administrator's office. The administrator is responsible for ensuring that all work is accomplished according to policy at an acceptable level of quality. They are responsible for a myriad of duties which include managing department heads and keeping the peace between them. Medical director requirements in the federal regulations have the physicians' burden to take a more active role in the facility. A. Increased B. Decreased C. Not changed D. Eased - ✔✔A. Increased. New medical director requirements issued in the Federal Requirements and Guidelines to Surveyors increase the physicians' burden to take a more active role in the nursing facility. The cause for concern regarding this burden is related to the dwindling numbers of physicians in the United States. In MOST nursing facilities of 100 to 200 beds, there is medical staff. A. Always an organized B. Usually no organized C. An open D. A closed - ✔✔B. Usually no organized. The predominant pattern for nursing facilities of approximately 100 to 200 beds is an open medical staff plan to allow any physician licensed to practice in the state to admit residents to the facility and provide their medical care while they reside there. One of the main advantages of a closed medical staff is that.
A. Dental technician B. Dentist C. Dental assistant D. Dental hygienist - ✔✔D. Dental hygienist. It is customary for the dental director to assist the facility in hiring a dental hygienist who will make monthly rounds on residents and train the nursing staff to observe and meet oral needs. As the nursing facility population's mobility becomes more restricted, the need for periodic visits by a(an) becomes a true healthcare need. A. Optician B. Hematologist C. Orthopedic surgeon D. Physical therapist - ✔✔A. Optician. Eye care needs are like those for teeth and feet. As the nursing facility population's mobility becomes more and more restricted, arrangements for periodic visits by a local optician are also a routine healthcare need. Observing medication passes and recording and reporting drug error rates falls to the. A. Director of nursing B. Consulting pharmacist C. Administrator's office D. Medical director - ✔✔B. Consulting pharmacist. The consulting pharmacist is responsible for reviewing the drug regimen, including observing medication passes and recording and reporting drug error rates and any other problems observed. A facility of 120 residents with 30 to 40 new admissions each month would likely physical therapy services. A. Offer in-house
B. Contract for a few hours per week any C. Not offer D. Routinely send residents out for - ✔✔A. Offer in-house. Larger facilities often find it more cost effective to have in-house therapy services, where therapists are employees of the facility. Increasingly, facilities needing x-rays are. A. Calling 911 B. Using local buses for the handicapped C. Using mobile x-ray services D. Installing their own x-ray department with staff - ✔✔C. Using mobile x-ray services. Today, a stat x-ray can be taken at the facility and sent digitally to a radiologist for reading. Results are often obtained within 15 minutes or less—faster than a trip to the hospital in an ambulance. X-ray staff can remain until the reading is complete in case there is a need for further imaging studies. At a minimum, nursing facilities must provide 24-hour licensed nursing services which are to meet the nursing needs of each of its residents. A. Expected B. Sufficient C. High enough D. Adequate - ✔✔B. Sufficient. Nursing facilities must provide 24 - hour licensed nursing services which are sufficient to meet the nursing needs of each of its residents. Some states (such as California and an increasing number of other states) have specific requirements for numbers of nursing hours per day. Generating reports on the financial standing of the nursing facility is generally assigned to. A. The accountant B, The director of finance
The new administrator in a private pay for-profit facility is told by the accountant that the accounts receivable are $105,800 and the net operating revenues are $334,000. On calculating the average collection period ratio, which turns out to be days, the administrator should be. A. 29/pleased B. 20/displeased C. 115/pleased D. 115/upset - ✔✔D. 115/upset. Average collection period = 365 × Accounts receivable / Net operating revenuesAverage collection period = 365 × 105,800 / 334,000 = 115 daysThis is a long collection period, which should leave the administrator upset. Because most insurers reimburse the nursing facility sometimes up to 3 to 5 months after billing, an average collection period of 58 days may be appropriate for a facility with a majority of public-paid residents. The length of time between billing Medicaid and receiving payment varies radically among the states, with some paying immediately and some deliberately delaying payment for months to manage the state's own cash flow A facility with long-term debt of $4,000,0 00 and a total equity of $3,000,000 has a debt-to-equity ratio of , which is the industry average. A. 1.33/considerably above B. 1.33/considerably below C. 2.33/far above D. 2.33/well below - ✔✔A. 1.33/considerably above. Debt-to-equity ratio = Long-term debt / Total equityDebt-to-equity ratio = 4,000,000 / 3,000,000 = 1.33, ratio is largeThe debt-to-equity ratio is a measure of the long-run liquidity of the facility, or the ability of the facility to meet its long-term debts. A "small" proportion of debt to equity indicates that the facility could incur more long-term debt, other things being equal, if needed; a high debt-to-equity ratio (when compared to the industry) probably shows that the facility may have more debt than may be advisable, all other things being equal. This ratio is of particular interest to would-be creditors. A useful form that summarizes the facility's occupancy, listing daily admissions, discharges, and transfers, is known as the. A. Daily census form B. Headcount
C. Weekly census report D. Occupancy ratio - ✔✔A. Daily census form. The routine charge may be determined on a daily, weekly, or monthly basis and is calculated with the aid of the daily census form. This is a summary of the facility's occupancy that lists, for each day, admissions, discharges, and transfers by level of care, if more than one is offered by the facility. are often the largest source of deductions from revenue in nursing facilities. A. Write-offs B. Charity care days C. Bad debts D. Contractual discounts - ✔✔D. Contractual discounts. Contractual discounts are often the largest source of deductions from revenue in nursing facilities. Because most deductions cannot be confirmed until payment has been received, they are accounted for in the Billings Journal when known rather than estimated. The frozen food contractor arrives, places the order in the freezer, checks off the receiving slip, and hands it to the appropriate kitchen employee; this person thanks the contractor and hands the receiving slip and purchase order copy to the director of food services. The administrator, on observing this, should. A. Be pleased with the smoothness of the working relationship B. Compliment the contractor for an efficient delivery C. Be upset D. Continue to enjoy their cup of coffee - ✔✔C. Be upset. Orders should be delivered by the contractor; the receiving slip should then be checked off, then verified by appropriate staff members as correct and accurate. This is only after the order is checked for damage, spoilage, and being within date. Only then does the staff member accept the order and hand the documentation off to their supervisor for processing.
The predominant payer for nursing facility care is. A. Medicare B. Medicaid C. Private pay D. Health maintenance organizations (HMOs) - ✔✔B. Medicaid. For many years now, Medicare and Medicaid have been the predominant payers for nursing facility care given in the United States. The predominant payer has been and is likely to remain Medicaid. Knowing the Occupational Safety and Health Act (OSHA) standards applicable to a facility is the responsibility of the. A. OSHA board B. Employer (the administrator) C. State Enforcement Commission D. Staff - ✔✔B. Employer (the administrator). In addition to meeting all standards set, OSHA imposes on employers a general duty to provide each employee a safe workplace, free from recognized hazards causing or likely to cause death or serious physical harm. Accidents and illnesses requiring first aid and NOT resulting in work loss reported. A. Do not have to be B. Must be C. Should be D. Must always be - ✔✔A. Do not have to be. Accidents and illnesses that do not have to be reported require only first aid and do not result in any work time lost.
An employee hearing the fire code phrase must. A. Exit the facility B. Help fellow employees as needed C. Go to their assigned station D. Ask nearby persons where the fire is located - ✔✔C. Go to their assigned station. A fire code phrase is used when the individual who discovers the fire must immediately go to the aid of a resident and cannot activate the fire alarm themselves, or when the fire alarm system is malfunctioning (18.7.2.3.2.). When the code phrase is utilized, employees will then go to their assigned station to execute duties as required in the fire safety plan. On discovery of fire involving a person, personnel shall immediately. A. Assist the person B. Transmit a fire alarm C. Aid the person and call aloud "fire" D. Aid the person while calling aloud an established code phrase - ✔✔D. Aid the person while calling aloud an established code phrase. When a fire directly involves a person, staff must aid the endangered person immediately while calling out the established code phrase to alert others to activate the fire alarm system (18.7.2.3.2). Often the MOST dangerous element threatening resident safety is. A. Unavailability of the correct type of extinguisher B. Slow-thinking responses by personnel C. Smoke inhalation D. First- and second-degree burns - ✔✔C. Smoke inhalation. Smoke inhalation is often the most dangerous part of a fire, as the residents can be affected by smoke inhalation anywhere in the facility, not just where the active fire is located. The overall objective of the Life Safety Code (LSC) for new healthcare occupancies is to.
B. Contain construction costs C. Improve the visual appeal of the building D. Totally eliminate smoke and gases - ✔✔A. Limit infiltration of heat, smoke, and fire gases. Any means of egress should be a smokeproof enclosure. This limits infiltration of heat, smoke, and fire gases, but also assists in ensuring a clear means of egress that is safer from the fire which surrounds it. Travel distance within a sleeping room to an exit must NOT exceed. A. 25 yards B. 50 feet C. 200 feet D. Local fire marshal rules - ✔✔B. 50 feet. The travel distance between any point in a sleeping room and an exit access door shall not exceed 50 feet (18.2.6.2.3). Each floor or fire section of the facility shall have at LEAST located from each other. A. Three exits/remotely B. Two exits/remotely C. Two ramps/away D. Three ramps/remotely - ✔✔B. Two exits/remotely. Every corridor will provide access to not less than two exits without passing through any intervening rooms or spaces other than corridors or lobbies (18.2.5.4).
