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State Cards > 180-215 > Flashcards

180-215 Flashcards

1
Q

How often are physician visits required in an ICF?

A

At least every 60 days.

NOTE: SNF State says every 30 days.
NOTE: Fed regs say every 30 days for first 90 days then every 60.

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2
Q

Who can administer medications in an ICF?

A

Personnel who have completed a state approved training program in medication administration.

NOTE: SNF says licensed nurse only.

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3
Q

What are the required services in an ICF?

A
  1. Activities
  2. Physician
  3. Intermittent Nursing
  4. Pharmaceutical
  5. Dietary
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4
Q

Who reviews the medications in an ICF?

A

RN OR pharmacist every month

NOTE: SNF says only pharmacist every month.

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5
Q

Define UNUSUAL OCCURRENCES

A
  1. Epidemic outbreaks
  2. Poisonings
  3. Fires
  4. Major accidents
  5. Death from unnatural causes or
  6. Any other occurrence that threatens the welfare, safety or health of patient’s visitors or personnel.
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6
Q

What is the TIME FRAME for REPORTING an UNUSUAL OCCURRENCE?

A

Within 24 hours by phone or telegraph

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7
Q

What is the METHOD OF REPORTING?

A

Confirmed in writing

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8
Q

How long do you retain records for UNUSUAL OCCURRENCES?

A

In the facility for one year

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9
Q

In UNUSUAL OCCURRENCES explain reporting fire or explosion.

A

Also report to local fire authority or in the limited areas the State Fire Marshall

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10
Q

What are the requirements for speech pathology and audiology progress notes in an ICF?

A

Progress notes must be written monthly.

NOTE: SNF says weekly

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11
Q

How often must a social worker write progress notes in an ICF?

A

Monthly

NOTE: SNF says weekly

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12
Q

What is the square footage per bed in a single room and a multi-bed room?

A
  1. 110 square foot for SINGLE bed room

2. 80 square foot per bed for a MULTI BED room

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13
Q

Patient Care Policy Committee in an ICF must include who? And
Reviewed how often?

A 
1. 1 physician
    Administrator
    Supervisor of health services 
    Other disciplines as needed
2. Annually
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14
Q

ICF annual reports to DHS are due when?

A

On or before February 15th.
Must be on correct forms AND
discussing matters requested by the department

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15
Q

A receiver submits a written report to the department including the following:

A
  1. Physical condition of the plant including
    a. deficiencies affecting the facility operation AND
    b. recommendations of the current physical condition AND
    c. the capability of the continuing long term care.
  2. Assessment of the facilities probability of meeting State standards
    a. within four months OR
    b an alternate date approved by the Department.
  3. Number of patients
    a. remaining AND
    b. transferred during receivership
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16
Q

In issuing a citation in regards to correcting the alleged violation the department will consider the following:

A
  1. The seriousness of the violation
  2. Number of patients affected
  3. Available equipment and/or personnel needed to correct the problem
  4. An estimate of time needed for delivery and installation of needed equipment to make the correction.
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17
Q

A written citation shall include the following:

A
  1. Description of violation AND the area it occurred
  2. List of residents affected AND a list of residents with potential to be affected.
  3. If all residents are affected, specify in writing, no list of names required.
  4. Specify the shortest reasonable time to make correction.
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18
Q

Define a CLASS A citation

A

CLASS A is imminent danger

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19
Q

Define a CLASS B citation

A

CLASS B is a direct or immediate relationship

20
Q

Define a CLASS C citation

A

CLASS C is minimal relationship

21
Q

Class A violation shall be corrected when?

A

Immediately unless time is given by the department

22
Q

The civil penalty for a Class A violation is what?

A

Not less than a $1000.00 and not more than $5000.00 per violation

23
Q

In fixing the civil penalty to an A violation the following are considered:

A
  1. Gravity of violation
    a. Degree of substantial probability
    b. Severity of serious harm most likely to result or did result.
  2. Good faith
  3. Previous violations
24
Q

What are the civil penalties for a CLASS B citation

A

Not less $50.00 and not more than $250.00 for each violation.

NOTE: A separate civil penalty of $50.00 for each day beyond the set completion date for each (A or B violation).

25
Q

What are the requirements in a SNF for smoking?

A

Both ICF and SNF require supervision and or periodic supervision for smokers.
Both also require signs marking open flamed areas AND oxygen areas.
SNF requires DESIGNATED “smoking” and “non-smoking” areas.
ICF does not

26
Q

Who is in charge of re-stocking the emergency supply kit after the seal has been broken?

A

The pharmacist within 72 hours and will also re-seal the kit.

27
Q

Who approves the pharmaceutical emergency supplies for each nursing station.

A

Patient Care Policy Committee OR Pharmaceutical Committee.

NOTE: ICF says Patient Care Policy Committee ONLY.

28
Q

Emergency drug supplies in a SNF shall meet the following requirement: Legend Drugs

A
  1. LEGEND DRUGS
    Shall NOT be supplied in the emergency supply unless except under the following conditions:
    a. Injectables shall be limited to a max of 3 single doses or 1 container of the smallest multi dose vial. Must be sealed and in unused containers.
    b. Sublingual or inhalation drugs shall be limited to single sealed containers of the smallest available size.
    c. No more than 6 emergency drugs in solid or oral dosage form or suppository form for anti-infective, anti-diarrheal, anti-nausea, or analgesic use may be stored if in sealed containers.
    d. NOT MORE THAN 4 doses of any drug may be stored.
29
Q

Emergency drug supplies in a SNF shall be the following requirement: Emergency Drugs

A
  1. EMERGENCY DRUGS
    Shall be in a portable container sealed with a tamper proof seal.
    DON OR charge nurse will notify the pharmacist when the seal has been broken.
    Drugs used from the kit shall be replaced within 72 hours and released by the pharmacist.
    Each nursing station must have an emergency drug supply kit.
30
Q

What is the 2 hour rule?

A
  • Medications cannot be administered more than 2 hours after the dose has been prepared.
  • Doses shall be administered within 1 hour of the prescribed time unless otherwise indicted by the prescriber AND
  • medications can only be administered by the person who prepared them.
31
Q

What is a stop order policy?

A

Drugs may be administered in the absence of a specific duration of therapy on a licensed prescribers new drug order if the facility applies its stop order policy for such drugs.
The prescriber shall be contacted prior to discontinuing therapy as established by stop order policy.

32
Q

Emergency drug supplies in an ICF shall meet the following requirements:

A
  1. Emergency legend drugs must be on at least 1 nursing station.
  2. The seal must be broken in the presence of a physician, pharmacist or licensed nurse.
  3. Supply kit must be checked at least monthly by the pharmacist.
  4. If the seal is broken, the supervisor of health services must notify the pharmacist and the pharmacist must replace the drugs and re-seal the kit within 72 hours.
33
Q

Emergency drug supplies in an ICF shall meet the following requirements:

A

LEGEND DRUGS shall be limited to a max of 3 single doses in either sealed ampules or vials of any 1 emergency drug. If emergency drugs are not available in parenteral form a supply of the drug in inhalation or sublingual form may be maintained in the smallest seal manufacturer’s package.

NO OTHER ORAL LEGEND DRUGS MAY BE STORED.

34
Q

What is the protocol for bowel and bladder management?

A
  1. Written assessment by a licensed nurse within 2 weeks after admission for an incontinent resident to determine the patient’s ability to participate in a B&B retraining program.
  2. Care plan for B&B training.
  3. Weekly written evaluations by a licensed nurse of patient progress in a B&B retraining program.
  4. Fluid intake and output shall be recorded for each patient as follows:
    a) If ordered by the physician
    b) For a patient with an indewlling catheter
  5. Intake and output evaluated weekly and included in weekly progress notes.
  6. After 30 days, re-evaluate the need to continue recording intake and output.
35
Q

Postural support vs. physical restraint

A

Postural support means a method other than an orthopedic brace used to assist patients to achieve proper body position and balance.
These methods are not considered restraints.
Treatment restraints may be used for the protection of the patient during treatment and diagnostic procedures such as IV therapy or catheterization procedures and may be applied for no longer than the time required to complete the treatment. No restraints with locking devices shall be used or available for use in a SNF.

36
Q

The attending physician shall be notified of the following:

A
  1. Admission of patient
  2. Any adverse changes
  3. Any unusual occurrence involving the patient
  4. Any changes in weight of 5 lbs or more within a 30 day period unless the physician says in writing otherwise.
  5. Any negative reaction to a medication or treatment.
  6. Any error in the administration of a medication or treatment.
  7. The inability to obtain or administer prescribed treatment to a patient.
37
Q

Can separate buildings owned by the same owner use the same license?

A

No they cannot. Separate premises must have separate licenses.

38
Q

Define agency.

A

A private school, organization or individual approved by the department to provide a continuing education course and a certification training program for nurse assistance.

39
Q

Define clinical training.

A

The portion of the orientation program and the certification training program which includes instruction and demonstration on a patient of the patient care skills by a Director of Staff Development or other competent instructor.

40
Q

Define gross negligence.

A

The failure of a person to exercise any care or the exercise of so little care that it is apparent the person is indifferent to the consequences of his or her conduct and to the welfare of others.

41
Q

Define an hour in an organized learning experience.

A

50 minutes

42
Q

Define continuing education.

A

Provision of structured courses for certified nurse assistants by an agency, a public educational institution or in a health care setting other than the nursing facility where the certified nursing assistant is employed.

43
Q

What are the rules regarding personal medications in a SNF?

A

Medication brought in by any means for a patient upon admission must be examined and identified by the patient’s physician of the facility pharmacist. The exception is drugs transferred from other licensed health facilities by any agent of the patient or pharmacy. They do not need to be examined by a physician or pharmacist.

NOTE: ICF says ALL MEDICATIONS brought in for a new admission must be examined by the patient’s physician or a facility pharmacist.

44
Q

How often shall a disaster drill (external disaster) be held by a facility?

A

6 month intervals for all shifts and written report ket in the facility for each drill

45
Q

Fire and internal disaster drills shall be how often?

A

Quarterly and on all 3 shifts

Total of 12 times per year

State Cards (6 decks)

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