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A comprehensive guide covering regulations, policies, and best practices for nursing home operation and management. It delves into care planning, staffing, fire safety, medication management, financial management, and more. The level of detail and breadth of information suggest this document could be a valuable resource for nursing home administrators, staff, and students. Key regulations and standards set by governing bodies like CMS, OSHA, and NFPA are covered. It also touches on important concepts in nursing home management, such as risk management, utilization review, and stakeholder engagement. Overall, this document provides a thorough overview of the regulatory landscape and operational considerations for running a nursing home effectively and in compliance with relevant laws and industry standards.
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What is the best method to control monetary risks in a nursing home? - ✔ ✔ Purchase insurance What is the temp of a hot rinse dishwasher? - ✔ ✔ 180 What is the temperature of a hot rinse dishwasher? - ✔ ✔ 180 What is the width of a single wheelchair? - ✔ ✔ 30 inches What percentage of minorities must an employer according to the EEOC - ✔ ✔ 80% What percentage of residents must be interviewable to participate in surveyors interviews of facility residents? - ✔ ✔ 50% What reports do surveyors look ya from OSCAR prior to survey? - ✔ ✔ CASPER reports 3 and 4, QI report What two ratios tell you how much the facility has available immediately to pay urgent bills? - ✔ ✔ Quick ratio and the acid test ratio When a nursing home outsourced healthcare providers the facility should have which of the following to secure patient information? - ✔ ✔ A transfer agreement with the contractor When an administrator takes steps to resolve a deficient situation this is called - ✔ ✔ controlling quality When errors are discovered in other journals, they can be corrected in the - ✔ ✔ General journal When the supervisor and the employee jointly set goals, this is an example of - ✔ ✔ Management by objectives Where a manager and staff get together and jointly decide priorities to be worked on, this is called ____
Which federal law establishes adverse impact as the current standard for discrimination in employment?
A ___ tag would indicate substandard care was found. - ✔ ✔ F377 J A ___ violation is where the severity of negative outcomes that compromises a resident's ability to maintain the highest physical, mental and psychosocial well-being. - ✔ ✔ Level 3 A ___ would have interest in the financial well being of a compant - ✔ ✔ Shareholder A "Resource Utilization Group" is a type of - ✔ ✔ Resident classification system A blister filled with pus and the loss of skin and dermis is a stage ___ decubitus sore - ✔ ✔ 2 A broad statement of goals is a ___ - ✔ ✔ policy A care plan must be reviewed ___ and completed re-assessed ___ - ✔ ✔ Quarterly Annually A charge nurse is considered - ✔ ✔ lower mangement A colostomy bag is connect to the - ✔ ✔ stomach wall A complaint for violations of the EEOA is filed with the ___ - ✔ ✔ EEOC A complaint survey is a ___ survey - ✔ ✔ Abbreviated standard A complaint survey is a ____ survey - ✔ ✔ abbreviated standard survey A concept recognized in civil law that an employer is responsible for the acts of their employees where their parties are injured is called - ✔ ✔ Respondent Superior A contractor hired by a nursing home to input MDS data into the MDS data system would be bound by - ✔ ✔ Medicare and Medicaid rules A court appointed guardian is also called a - ✔ ✔ conservator A curtain or decoration that does not burn easily is called ___ - ✔ ✔ Fire resistant A debt to pay an obligation is called a - ✔ ✔ bond A device that measures the electrical functioning of the heart muscle is called - ✔ ✔ EKG
A nurse aide enrolled in a state approved training program but has not completed the program at time of hire has ___ to complete the program? - ✔ ✔ 4 months A nursing aide drops a resident and fractures a hip. Both the employee and the employer are responsible for money damages from the fall because of ___ liability. - ✔ ✔ Strict liability A nursing aide drops a resident and fractures a hip. Both the employee and the employer are responsible for money damages from the fall because of which of the following? - ✔ ✔ Vicarious liability A nursing facility must offer its employees ___ insurance - ✔ ✔ Unemployment A nursing home must have a ____ operated fire alarm system that is ___ monitored - ✔ ✔ manually electronically A parking lot with 100 parking spaces would require how many handicap accessible parking spots - ✔ ✔ 4 A passenger loading zone must be at least ___" wide and ___" long - ✔ ✔ 60 and 20 A railing in a stairway must be between __ and __ inchesq - ✔ ✔ 34 38 A request to inspect resident records or to get copies must be submitted by the resident either ______ - ✔ ✔ orally or in writing A resident has a right to request their clinical records and receive them in __ hours (excluding weekends and holidays) - ✔ ✔ 24 A resident has the right to copies of their medical records wtihin what time frame? - ✔ ✔ 48 hours (excluding weekends and holidays) A resident in restraints must be released from their restraints for how many minutes? - ✔ ✔ 10 A resident was admitted to a facility on June 5th. Her attending physician saw her on July 15th. Was the physicians visit timely? - ✔ ✔ Yes A resident who dies without leaving a will is said to have died: - ✔ ✔ Interstate A resident who enters a facility without an indwelling catheter can be catheterized when - ✔ ✔ the residents clinical condition demonstrates a need for one A respiratory condition where the lung tissue loses elasticity and the lungs cannot properly expand and deflate, causing breathing problems is called - ✔ ✔ Emphysema A significant weight loss within 3 months would be ___% - ✔ ✔ 7.
A smoke proof enclosure must have a _____ hour fire resistance and a door with _____ hour fire protection rating. - ✔ ✔ 2 hour ; 1 1/2 hour A specific law that mandates an employer is responsible for work related injuries and lost time for their employees is called - ✔ ✔ The Federal Employer Liability Act A summary of a facilities well being is reflected in the ___ - ✔ ✔ Balance sheet A testator is one who: - ✔ ✔ Dies leaving a will A third party that hears a dispute and then renders a decision that binds all parties is called - ✔ ✔ Arbitration A Union must give how many days notice before a strike? - ✔ ✔ 10 days A violation with no more than minimal physical, mental or psychological discomfort is a ___ deficiency - ✔ ✔ Level 2 A worker is entitled to ___ months of HIPPAA benefits - ✔ ✔ 12 A worker is entitled to ___ weeks of unemployment benefits - ✔ ✔ 26 According to OBRA, the facility is required to offer therapeutic activities that are based upon - ✔ ✔ past interests and hobbies Accounting Equation - ✔ ✔ Assets = Liabilities + Capital Accounts receivables over 69 days past due must not exceed __% of all accounts receivables - ✔ ✔ 5% Acid Test Ratio is used to calculate funds available in a few days to pay current liabilities and is expressed as - ✔ ✔ Cash and current receivables dived by current liabilities Adding baking soda to food will primarily affect its - ✔ ✔ Nutritional value Adequate required living space in a resident room does not include - ✔ ✔ the bathroom, vestibule or hallway Administrators consult ___ to compare outcomes to expectations - ✔ ✔ Policies and plans of action After a comprehensive assessment is done, a comprehensive care plan is due within ___ days - ✔ ✔ 7 All cost reports are due - ✔ ✔ 90 days after the end of the fiscal year All employee injuries that require medical attention or loss of time must be entered into the OSHA log within ___ - ✔ ✔ 7 days
Budgets are usually prepared ___ - ✔ ✔ Annually Capital would not include - ✔ ✔ Gross income Cash flow will be improved if there is a decrease in - ✔ ✔ accounts receivables Which inventory method maintains the optimum amount of materials needed to be ordered and minimizes overstocking? - ✔ ✔ Economic order quality Which management style provides least direction and support to staff? - ✔ ✔ Delegation Which management type would be most effective for physicians, nursing and social workers? - ✔ ✔ Paternal Which of the following can delegate line authority to facility staff? - ✔ ✔ The governing body Which of the following determines the number of fire drills each year in a nursing home? - ✔ ✔ Life safety code Which of the following forms is the CMS resident census form? - ✔ ✔ HCFA form 672 Which of the following is an anti-psychotic side effect? - ✔ ✔ Hallucination Which of the following is best suited for residents with mild dementia? - ✔ ✔ Reality orientation Which of the following is the correct footage for a semi-private room? - ✔ ✔ 320 (160 square feet) Which of the following would not have the power to make healthcare decisions for a resident who lacks capacity? - ✔ ✔ Power of attorney Which organization developed the standards for the Life Safety Code? - ✔ ✔ NFPA Which organization enforces the life safety code? - ✔ ✔ The state licensing agency Which two management styles are most effective? - ✔ ✔ MBO & MBWA Which type of lines on an organizational chart would show line authority and staff authority? - ✔ ✔ straight lines and dotted lines Who is responsible for ensuring that resident rights are respected by the staff? - ✔ ✔ Administrator Who is responsible for the implementation of resident care policies? - ✔ ✔ Medical director Centralizing decision making to improve customer service is NOT an element of _____. - ✔ ✔ Total Quality Management TQM
Changing a company's fiscal year from Jan 1 to June 30 is an example of violating the ___ principal - ✔ ✔ Time period CIO stands for - ✔ ✔ Congress of Industrial Organizations Class A fire extinguishers are used for - ✔ ✔ burning paper, lumber, cardboard and plastics Class B fire extinguishers are used for - ✔ ✔ combustible or flammable liquids such as kerosene and gasoline Class C fire extinguishers are used for - ✔ ✔ electrical appliances, outlets and power tools Class D fire extinguishers are used for - ✔ ✔ metals such as magnesium and titanium Constant thirst and need for urination are symptoms of ___ - ✔ ✔ diabetes mellitus Controlled drugs must be stored in their original containers and placed under ___ protection - ✔ ✔ double lock Controlled drugs must be stored in their original containers and stored - ✔ ✔ in a separate compartment Coordination primary deals with unifying the ___ of people - ✔ ✔ efforts Current Ratio - ✔ ✔ current assets divided by current liabilities Depreciation is a ___ expense - ✔ ✔ operating Depreciation is what kind of expense... - ✔ ✔ Operating expense Destroying paper records of purchases made by the facility would violate the ____ principal - ✔ ✔ Objective evidence Discharged employees have right to present their case to ________. - ✔ ✔ Employment Security Commission Does FMLA provide leave for a sick sibling? - ✔ ✔ No Doors must be ___ thick - ✔ ✔ 1 & 3/4 " Doors must be at a ___" angle to an accessible route - ✔ ✔ 90 degree Doors must be solid bodied with a ____ core - ✔ ✔ wood Doors must have a fire resistance rating of - ✔ ✔ 20 minutes Doors must have a width of ___" at openings - ✔ ✔ 32"
HHS stands for - ✔ ✔ Health and Human Services High forward reach for a wheelchair - ✔ ✔ 48" Hospital case managers, referring physicians, the surrounding community and state surveyors are called
In 1973, the supreme court ruled with respect to collective bargaining that nurses were considered management and could not join a union.. true or false? - ✔ ✔ True In an administrator wanted a statement of the financial condition of a facility at year's end, the administrator would consult the - ✔ ✔ balance sheet Individuals, corporations, the surrounding community or governmental entities who are directly affected by the actions taken by a business are known as - ✔ ✔ Stakeholders Insurance that protects the facility against injuries sustained by visitors on facility property is - ✔ ✔ General liability insurance Insurance that protects the facility from employee accidents - ✔ ✔ Professional liability insurance Internal and external medications must be kept in - ✔ ✔ separate areas Labor costs in a nursing home usually total approximately ___ to ___ % - ✔ ✔ 50 to 60 Liabilities that will be paid within 16 months are - ✔ ✔ Non-current liabilities Lighting of the means of egress must be continuous with exit floor surfaces illuminated ag the levels of ___ foot candle light from the floor - ✔ ✔ 1 foot Low blood pressure is called ____ High blood pressure is called ____ - ✔ ✔ Hypotension ; Hypertension Management by Walking Around DOES NOT include - ✔ ✔ Taking action on the spot Management by Walking Around is a concept developed by - ✔ ✔ Peters Marketing of healthcare is a new trend that focuses on the recognition of the provision of health care services and is increasingly becoming a - ✔ ✔ buyers market Medicaid resident funds totaling less than $50 in funds may be maintained in ---- - ✔ ✔ Non-interest bearing account Medicaid would not cover individuals ___ - ✔ ✔ disabled Medical records belong to the ___ - ✔ ✔ facility Medicare Part __ pays for drugs outside of an inpatient setting - ✔ ✔ Part D Medicare resident funds totaling in excess of ____ must be deposited in an interest bearing account. - ✔ ✔ $ Middle managers do not - ✔ ✔ adopt policies
OSHA form 300A must be posted during what time frame? - ✔ ✔ Feb 1 - April 30 OSHA log ____ is a summary of all employee illnesses and injuries - ✔ ✔ 300 OSHA records other than medical records must be kept for ___ years - ✔ ✔ 5 Palatable refers to the ____ of food served - ✔ ✔ Tastiness Parking spaces must be at least ___" wide with an accessible handicap aisle at least ___" wide - ✔ ✔ 96; 60 Per ANSI the telephone cord on a public phone must be at least - ✔ ✔ 29 inches Per GAAP, the ___ does not need to be distributed to investors - ✔ ✔ Chart of accounts Per OBRA 1987, a resident has the right to review all their records within ___ of an oral or written request. - ✔ ✔ 24 hours Per OBRA 1987, air temp is measured where in a building..? - ✔ ✔ Just above the floor Per OBRA, the ___ is not required to attend the QA meetings. - ✔ ✔ Administrator Per the IRS, employee tax records must be kept for - ✔ ✔ 4 years Per Title XIX of the Social Security Act, menus for food actually served residents must be retained for ___ days - ✔ ✔ 30 PHS stands for - ✔ ✔ Public Health Service Physician visits are required every ___ days for the first 90 days from date of admission and then every ___ days thereafter - ✔ ✔ 30 60 Pots and pans sanitizer using just hot water is sanitized in a 3 compartment sink then must be submerged in hot water at a minimum temp of ___ degrees for 30 seconds - ✔ ✔ 170 Prepaid insurance is what type of expense? - ✔ ✔ indirect expense PRN stands for: - ✔ ✔ pro re nata meaning as needed, or as the occasion arises Procedures should be prepared by - ✔ ✔ Supervisors Protecting residents and staff from accidental or inadvertent electrical discharge from electrical outlets and devises is the purpose of the ___ - ✔ ✔ Lock out/tag out Protein is not a carbohydrate, true or false? - ✔ ✔ True Railings a grab bars must bear the weight of ___ Ibs or more - ✔ ✔ 250 Ibs
Reality orientation is most appropriate for residents who have ___ stage dementia - ✔ ✔ Early Required knee clearance under tables, sinks and countertops - ✔ ✔ 19" Resident abuse must be investigated and reported to the state licensing authority within___ days - ✔ ✔ 5 working days ___ is the federal law that prohibits a Medicare provider from self referring patients to diagnostic center they own or fixing prices for services provided to Medicare beneficiaries - ✔ ✔ Robinson Patman Act ___ is the most comprehensive and effective improvement model - ✔ ✔ Total Quality Mangement ___ mandates that policies in nursing homes must be approved by the governing bodies - ✔ ✔ OBRA ___ measures the purchasing power of worker paychecks and is used to determine a cost of living adjustment for workers. - ✔ ✔ CPI (Consumer Price Index) ___ uses the social environment as treatment - ✔ ✔ Milieu therapy ____ % of workers is needed in a company to sign a union interest card or union card which is the first step in getting the NLRB to hold a union election - ✔ ✔ 30% ____ develops and publishes the life safety code. - ✔ ✔ NFPA ____ has the least impact on influencing a resident or their family member in choosing a facility. - ✔ ✔ Media ads ____ is identifying and solving problems that only involve a legal risk - ✔ ✔ risk management ____ is required of dietary managers per OBRA 87? - ✔ ✔ The ability to communicate with a qualified dietician ____ requires a facility to pay for money damages caused by facility employees to residents or third parties - ✔ ✔ Respondents superior _____ protects workers from injury from unexpected hazardous energy discharge by the use of energy isolating devises - ✔ ✔ Lockout/tagout A ___ is the most comprehensive way to measure a job applicant's skills - ✔ ✔ Aptitude test The ___ is permitted to dispense medications - ✔ ✔ Pharmacist The ___ is responsible for the day to day management of the facility - ✔ ✔ Administrator The ___ is responsible to review and implement resident care policies and coordinate the medical care in a facility - ✔ ✔ Medical director
The Age Discrimination in Employment Act applies to employers with ___+ employees and workers ___ years and over - ✔ ✔ 20 40 The Age in Discrimination in Employment Act protects workers ___ years and older - ✔ ✔ 40 The air in a nursing home must be changed every ___ minutes - ✔ ✔ 6 The American Health Care Association is the national association that advocates for - ✔ ✔ For-profit health care organizations The Americans with Disabilities Act construction standards were developed by - ✔ ✔ ANSI The amount on the balance sheet representing ownership would not include - ✔ ✔ Revenue The attending physician must visit their nursing home patients how often - ✔ ✔ Every 30 days for first 90 days and then 60 days thereafter The automatic smoke and fire detection systems must be connected to eachother ___ - ✔ ✔ Electronically The automatic smoke and fire detection systems must be connected to eachother ____ - ✔ ✔ electronically The best investment vehicle for funds that must remain liquid is usually a ___ - ✔ ✔ Money Market Fun (MMF) The best way to assess a resident with complicated medical conditions is to do a ___ - ✔ ✔ RAI The best way to maintain _____ is to limit access to supplies - ✔ ✔ inventory The Board of Governors has ___ type of authority - ✔ ✔ Line Resident water temperature should not exceed - ✔ ✔ 110° Sensitivity training has not proven to be effective for residents with ___ - ✔ ✔ Dementia side reach from a wheelchair is between _____ & _______ off the floor. - ✔ ✔ 9/ SMDA stands for - ✔ ✔ Safe Medical Devises Act Smoke detectors must be located no further than ___ feet apart and no more than ___ feet from any wall - ✔ ✔ 30; 15 State surveyors cite a facility for substandard care during a complaint survey. The facility will then be subject to what type of federal survey? - ✔ ✔ A partial extended federal survey Strategic planning takes ___ years - ✔ ✔ 3-
Strategies are plans of action that largely focus on - ✔ ✔ Long range goals subpoena duces tecum - ✔ ✔ an order to appear with evidence Subtracting current liabilities from current assets would tell you the facilities - ✔ ✔ Working capital Terminated workers are entitled to ___ weeks or unemployment benefits - ✔ ✔ 26 The ___ act granted rights to unions and allowed collective bargaining - ✔ ✔ Wagner Act The ___ and ___ must be listed on the resident trust fund surety bond - ✔ ✔ Resident and state The ___ has the legal responsibility to adopt and implement facility policies. - ✔ ✔ Governing Body The ___ has the ultimate legal responsibility for the OPERATION of a nursing facility. - ✔ ✔ Governing Body ___ fire drills are required in a facility per year - ✔ ✔ 12 (1 / shift every quarter) ___ incontinence is characterized by urine leakage with coughing or laughing - ✔ ✔ stress ___ is not an OBRA approved indication for anti-psychotic usage? - ✔ ✔ Itching The Civil Rights Act of 1964 is enforced by the - ✔ ✔ EEOC The cost to maintain capital equipment in a nursing home will justify replacement within ___ - ✔ ✔ 10 years The decrease in value due to obsolescence, wear and tear is called - ✔ ✔ Depreciation The designated parking space for the handicapped must be at least ___ - ✔ ✔ 13 ft wide The dietitian must be registered with the ____ - ✔ ✔ American Dietetic Association The DON is considered ___ management - ✔ ✔ middle The Eden Alternative focuses on care of the human ___ and human body - ✔ ✔ Spirit The EEOC does not enforce the Fair Labor Standards Act, true or false? - ✔ ✔ True The emergency electrical generators must switch on within ___ seconds of a loss of power - ✔ ✔ 10 The emergency generator must be run under full load for ___ every ___ - ✔ ✔ 30 minutes every month The emergency generator must be VISUALLY inspected and checked how often.. - ✔ ✔ weekly The emergency generator must run on full load for __ every __. - ✔ ✔ 30 minutes every month
The minimum hot water temperature required by a low temperature dish washer is ___ degrees - ✔ ✔ 120 The minimum staffing level required by CMS is ___ - ✔ ✔ 3. The monitoring and enforcement of ANSI standards is the responsibility of - ✔ ✔ The agency within the state The most common cause of pressure sores in ___ - ✔ ✔ shearing and friction The national standard to budget housekeeping staff to clean a facility is one hour of staff time per ___ square feet - ✔ ✔ 1000 The NFPA does not enforce the - ✔ ✔ life safety code The nosing of a stair must project no more than... - ✔ ✔ 1 & 1/2 " The number of disaster drills is determined by: - ✔ ✔ Life safety code The nursing home survey inspection process focuses on - ✔ ✔ Outcomes The ombudsman must have patient consent to access their medical records, true or false? - ✔ ✔ True The payroll based journal must be submitted to CMS every ___ - ✔ ✔ Quarter The physician must write, sign and date progress notes - ✔ ✔ at each visit The primary purpose of a ___ budget is to provide a method for ongoing study and control - ✔ ✔ operating The primary purpose of medical records is - ✔ ✔ provide for continuity of care The process in which an administrator can contest in writing a citation for non-compliance? - ✔ ✔ Informal dispute resolution process The RAI consists of - ✔ ✔ RAPs, Utilization Guidelines and MDS The RAI is now called the - ✔ ✔ CAA (Care Area Assessment) The Resident Self-Determination Act should be given to the resident at - ✔ ✔ admission The resident's quality of life and physical condition is the focus of a. Structure b. Process
c. Outcomes d. All of the above - ✔ ✔ Outcomes The safety program in a nursing home would fall under the ___ program - ✔ ✔ Risk management The Social Security Act was enacted in - ✔ ✔ 1935 The suffix "otomy" means - ✔ ✔ incision The sum of all activities to create desired changes in quality care is the definition of - ✔ ✔ Quality improvement The system responsible for circulating blood throughout the body is called the - ✔ ✔ Cardiovascular system The term lockout tagout refers to controlling ____ - ✔ ✔ Hazardous energy The time period in which a lawsuit may be filed is called the - ✔ ✔ Statute of limitations The travel distance between a class B and C fire extinguishers cannot be more than - ✔ ✔ 50 feet The wash cycle of a hot water dishwasher is ___ degrees - ✔ ✔ 150 The width required for 2 wheelchairs to pass is ___ - ✔ ✔ 60 inches Title 18 of Social Security Act is the __ program - ✔ ✔ Medicare Title XIX of the Social Security Act - ✔ ✔ is Medicaid (an assistance program based on need) Title XVII of the Social Security Act is an - ✔ ✔ insurance program To calculate the value of an investors investment in a business you need to look at the - ✔ ✔ Balance sheet To determine if revenues are sufficient to cover expenses, you would review the - ✔ ✔ Profit/loss statements Toe clearance under the ADA is __ inches - ✔ ✔ 9 Transmission difficulties, premature evaluations and filtering are all forms of ____ barriers - ✔ ✔ communication Travel distance from within any resident room to an exit access door must not exceed - ✔ ✔ 200 ft. Two doors separating two fire areas in a horizontal exit must be _______ in. wide each. - ✔ ✔ 41.5"