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State Cards > 216-250 > Flashcards

216-250 Flashcards

1
Q

What is the nursing staffing requirement for a SNF?

A
  1. 59 or less beds RN or LVN on all shifts. No DON.
  2. 60 - 99 beds RN or LVN on all shifts plus DON 5 days a week 8 hours a day. The DON cannot serve as a charge nurse.
  3. 100 plus beds RN on all shifts plus DON. The DON cannot serve as a charge nurse.

NOTE: There must be sufficient nursing staff to provide a minimum daily average of 3.2 nursing hours per patient day. (See section 72329.1 (3) (a) (b) (c) (d))

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2
Q

What is a drawing account?

A

An account that holds a small amount of resident’s money ($50 or less) available to the resident whenever they want it. All monies are tracked with vouchers, receipts, debits, credits and balance filed in chronological order. Records are maintained in the facility for a minimum of 3 years after the date of the last transaction. The account can never be less than zero.

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3
Q

What is Demand Trust Account?

A

Account that holds resident money in a bank outside of the facility.
1. Must be over $500.00
(FED says over $50.00 and $100.00 for Medicare pt. [F-Tag 159]
2. All banking records for these funds will be maintained in the facility for a minimum of 3 years from date of transaction.
3. Checks to this account must be identified as a pt trust fund account and clearly printed on ea pt trust account checks and bank statements.
4. All outstanding checks for 45 days or more shall be maintained on a separate list and reflected on the most recent bank statement.
5. Pt funds maintained in a financial institution SHALL BE DEEMED TO BE ENTRUSTED TO THE FACILITY if the licensee or any agent or employee thereof is an authorize signatory to the set account

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4
Q

How long after a pt is discharged or deceased must the advance rent be returned to the pt, heir, legatee or personal representative?

A

2 weeks(NOT 14 DAYS) after the discharge or death

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5
Q

When shall money and valuables of a patient that have been entrusted to the licensee and kept within the facility be returned to the patient or authorized representative?

A

Immediately upon request or discharge with a signed receipt.

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6
Q

When must monies in a demand trust account be returned to the resident or resident representative?

A

Within 3 normal banking days.

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7
Q

In the event of a death when must money and valuables of a pt which have been ENTRUSTED to the licensee be surrendered to the responsible party of the executor of the estate in exchange for a signed receipt?

A

Within 30 days following the dearth of a resident except in a coroner or medical examiner case.

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8
Q

What happens if a patient dies with no heir?

A

A written notice within 5 working days will be given by the facility to the PUBLIC ADMINISTRATOR of the county and a copy shall be available in the facility for review.

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9
Q

How often must residents receive a financial statement reflecting their financial transactions?

A

At least quartterly

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10
Q

The functions of the Infection Control Committee shall include but not be limited to:

A
  1. Establishing, reviewing, monitoring and approving policies and procedures for investigating, controlling and preventing infections in the facility.
  2. Maintaining, reviewing and reporting statistics of the number, types, sources and locations of infections within the facility.
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11
Q

What is the difference between legend drugs and non legend drugs?

A

LEGEND DRUGS
are narcotics and/or prescription drugs and

NON LEGEND DRUGS
are everything else

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12
Q

What is co-mingling?

A

NEVER AT ANY TIME IS ANY RESIDENT’S MONEY TO BE MIXED WITH ANY OTHER MONEY.
IT MUST REMAIN COMPLETELY SEPARATE AND EXACT AT ALL TIMES.

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13
Q

What is the standard admission agreement?

A
  1. The licensee shall use the California Standard Admission Agreement for skilled nursing and intermediate care facilities form #HS327 as the sole contract admission between residents and the licensee.
  2. The licensee shall not alter this agreement without the prior written authorization of the department.
  3. No resident or legal representative shall be required to sign any other document as a requirement for admission into the facility or as a condition of continued stay.
  4. Any arbitration agreement shall be separate from the standard admission agreement and shall contain in a prominent place in bold face font of not less than 12 point type.

“RESIDENT’S SHALL NOT BE REQUIRE TO SIGN THIS ARBITRATION AGREEMENT AS A CONDITION OF ADMISSION TO THIS FACILITY AND CANNOT WAIVE THE ABILITY TO SUE FOR A VIOLATION OF THE RESIDENT BILL OF RIGHTS.”

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14
Q

How many days shall a skilled nursing facility afford the patient a bed hold?

A

7 days

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15
Q

What are the regulations for a bed hold?

A
  1. Upon transfer to a general acute care hhospital the patient or representative shall notify the skilled nursing facility with 24 hours if the pt or representative wants the 7 day bed hold.
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16
Q

What are the regulations for a bed hold?

A
  1. Any pt who exercises the bed hold option shall be liable to pay reasonable charges not to exceed the facility daily rate for bed hold days.
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17
Q

What are the regulations for a bed hold?

A
  1. The facility shall not be required to maintain the bed hold if the patient’s acting physician notifies the SNF in writing that the pt stay in the hospital is expected to exceed 7 days.
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18
Q

What are the regulations for a be hold?

A
  1. Pt or representative must be informed in writing of the right to exercise the bed hold provision upon admission and transfer.
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19
Q

What are the regulations for a bed hold?

A
  1. A licensee who fails to meet these requirements shall offer to the patient the next available bed appropriate for the patient’s needs.
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20
Q

What information is on a residents dietary profile card?

A

Each card is to include:

  1. Diet order
  2. Likes/Dislikes
  3. Allergies to foods
  4. Diagnosis
  5. Instructions or guidelines to be followed in preparation of food for the pt.
21
Q

How many meals shall be served in a day?

A
  1. Not less than 3
  2. Not more than 14 hours between last meal and first meal of next day.

FED SAYS: 16 hours when substantial nourishments have been served in the evening.

22
Q

Who receives and records verbal dietary orders?

A

Qualified dietician and shall be signed by the prescriber within 5 days.

23
Q

What are the required hours for a dietician in the facility?

A

!. Full Time

  1. Part time
  2. Consultant

IF THE DIETICIAN IS NOT EMPLOYED FULL TIME THEN A FULL TIME DIETETIC (DSS) SUPERVISOR MUST BE EMPLOYED

24
Q

WHAT ARE SOME KITCHEN RULES (1&2)?

A
  1. Work schedules by job titles and weekly time schedules by job titles shall be posted
  2. Employee’s street clothing shall be stored in a closed area separate from food or items used in food service.
25
Q

What are some kitchen rules 3&4?

A
  1. Kitchen sinks shall not be used for hand washing. Must have separate hand washing facilities.
  2. Persons other than dietetic service personnel shall not be allowed in the kitchen unless necessary to do their job
26
Q

What are some kitchen rules 5&6?

A
  1. Smoking is not permitted.

6. Sufficient staff shall be employed.

27
Q

What are some kitchen rules 7&8?

A
  1. All foods are labeled and dated in tight fitted containers.
  2. Kitchen shall be ventilated to maintain comfortable working conditions, remove odors, fumes and prevent excessive condensation.
28
Q

What are the requirements of the Director of Nursing?

A
  1. Shall be a registered nurse AND
  2. Employed 8 hours a day on the DAY shift
  3. 5 days a week
  4. Have at least 1 year experience in nursing supervision in the last 5 years.
  5. DON can serve only 1 facility at any one time.
29
Q

When is an orientation program complete?

A

When there is:

  1. An orientation schedule
  2. A lesson plan
  3. A core curriculum.
30
Q

Bed pans and urinals shall be sanitized only by one of the following methods:

A
  1. Submerged in boiling water for a minimum of 30 minutes
  2. Autoclaving at 15 pound pressure and 250 degrees F for 20 minutes.
  3. Gas sterilization.
  4. All disposables shall not be re-used.
31
Q

What 5 changes must be reported to DHS? (1)

A
  1. Changes in information provided pursuant to the health and safety code within 10 days of sic changes in writing.
32
Q

What 5 changes must be reported to DHS? (2)

A
  1. When change of administrator occurs, the Department must be notified within 10 days in writing by the licensee. Shall include the name and license # of the new administrator.
33
Q

What 5 changes must be reported to DHS? (3)

A
  1. Notified within days in writing of any change of the mailing address of the licensee. Must include new mailing address
34
Q

What 5 changes must be reported to DHS? (4)

A
  1. Department shall be notified within 10 days in writing by the licensee of any changes of a principal officer.
    Must include the name and business address of the new officer.
35
Q

What 5 changes must be reported DHS? (5)

A
  1. Any decrease in license bed capacity shall require notification by letter to the department and shall result in the issuance of a corrected license.
36
Q

Physicians assistants working under a physician’s supervision, perform only those selected diagnostic and therapeutic tasks identified in

A

TITLE 16

of the California Administrative Code

37
Q

Records of hours and dates worked y ALL EMPLOYEES must be available during what time frame>

A

SNF says most recent 12 months.
ICF says most recent 6 months.

NOTE: Must be kept on site or centrally located and available on request.

38
Q

A permanent log of the temporary held services employed in the facility shall be kept for 3 years and shall include the following:

A
  1. Employee full name
  2. Name of temporary health services personnel agency.
  3. Professional license and registration # and date of expiration.
  4. Verification of health status.
  5. Record of hours and dates worked.
39
Q

Who is in your Quality Assurance Committee per State regulations?

A 
State does NOT require a QA Committee.
FED REG DOES.  FED reg for QA Committee says:
1. DON
    A physician
    3 other facility staff
2. Must meet quarterly
3. Focus is primarily on clinical issues
40
Q

What are the requirements for a Social Worker?

A

STATE says
Must have a Social Services Unit to meet the needs of the pts.

FED says
120 plus bed facility must have at least a Social Services Assistant with a BA in Social Work or related field.

41
Q

Each licensed bed shall have the following:

A
  1. Clean comfortable bed with adequate mattress, sheets, pillow case and blankets all in good repair.
  2. A bedside table, chair, over bed table and reading light all in good repair.
42
Q

When must the Department e notified of a new DSD?

A
  1. In 30 calendar days of employment.

2. In writing

43
Q

Who notifies the Pharmacist when the emergency supply seal is broken and supplies need to be replaced?

A

SNF:

  1. DON
  2. Charge Nurse.

ICF:
1. Supervisor of Health Services

44
Q

How often must an in-service program be renew?

A
  1. Submitted to Department every 2 years for renewal.

2. Department must be notified within 30 days prior to any changes in the program and/or program staff.

45
Q

What are the required nursing hours per patient, per patient day in a SNF?

A
  1. 3.2
46
Q

What are the required nursing hours per patient, per patient day in a ICF?

A
  1. 1.1
47
Q

What are the required nursing hours per patient, per patient day in a STP?

A
  1. 2.3
48
Q

What is a medication error?

A

Medications not given:

  1. as intended by prescriber
  2. as required by the drug manufacturer
  3. according to acceptable professional standards

State Cards (6 decks)

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