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Title 22: 2.5 & 3 > 3 From AITExamPrep > Flashcards

3 From AITExamPrep Flashcards

1
Q

SNF…..Advance of rent shall be returned no later than ____ after discharge or death of patient.

A

two weeks

  1. Liability for Rent and Return of Rental Advance.

(a) This section shall apply to all rental agreements executed on or after January 1, 1982.
(b) Whenever accommodations in a skilled nursing facility are rented by or for a patient on a month to month basis, the renter or his heir, legatee or personal representative shall not be liable for any rent due under the rental agreement for accommodations beyond the date on
which the patient died.
(c) Any advance of rent by the renter shall be returned to the heir, legatee or personal representative of the patient no later than two weeks after discharge or death of the patient.
(d) The rights described in (b) and (c) above shall not be modified or waived in the rental agreement.

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2
Q

SNF…..Emergency generators must be tested at least every ____ days?

A

14

  1. Emergency Lighting and Power System.
    (e) Emergency generators shall be tested at least every 14 days under full load condition for a minimum of 30 minutes.
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3
Q

SNF…..The attending licensed healthcare practitioner must be notified promptly of a change in weight of five _____ or more within a 30-day period unless a different stipulation has been stated in writing.

A

pounds

  1. Nursing Service–General
    (a) Nursing service shall include, but not be limited to, the following:

(3) Notifying the attending licensed healthcare practitioner acting within the scope of his or her professional licensure promptly of:
(A) The admission of a patient.
(B) Any sudden and/or marked adverse change in signs, symptoms or behavior exhibited by a patient.
(C) An unusual occurrence, as provided in Section 72541, involving a patient.
(D) A change in weight of five pounds or more within a 30-day period unless a different stipulation has been stated in writing by the patient’s licensed healthcare practitioner acting within the scope of his or her professional licensure.

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4
Q

SNF…..Can a patient smoke in his/her room if staff or a responsible adult is present?

A

Yes

  1. Smoking.
    (a) Patients shall not be permitted to smoke in or on the bed except when a facility staff member or responsible adult is present in the room to ensure safety against fire hazards.
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5
Q

SNF…..If a dishwasher is used to clean dishes the final rinse at manifold must be ______ degrees Fahrenheit.

A

180

  1. Dietetic Service–Cleaning and Disinfection of Utensils.
    (e) Results obtained with dishwashing machines shall be equal to those obtained by the methods outlined above and all dishwashing machines shall meet the requirements contained in Standard No. 3, as amended in April 1965, of the National Sanitation Foundation. Hot water at a minimum temperature of 83 degrees C (180 degrees F), shall be maintained at the manifold of the final rinse.
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6
Q

SNF…..Anti-infectives must be administered within _____ hours of the time ordered.

A

four

  1. Pharmaceutical Service–Requirements.

(a) Pharmaceutical service shall include, but is not limited to, the following:
(1) Obtaining necessary drugs including the availability of 24-hour prescription service on a prompt and timely basis as follows:
(B) Anti-infectives and drugs used to treat severe pain, nausea, agitation, diarrhea or other severe discomfort shall be available and administered within four hours of the time ordered.

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7
Q

SNF…..Does a patient room have to be labeled?

A

Yes

  1. Patient Rooms.

(a) Each patient room shall be labeled with a number, letter or combination of the two for identification.
(b) Patients’ rooms shall not be kept locked when occupied except in rooms approved by the Department for seclusion of psychiatric patients.
(c) Only upon the written approval of the Department may any exit door, corridor door, yard enclosures or perimeter fences be locked to egress.
(d) Patient rooms approved for use by ambulatory patients only shall be identified as follows:
The words “Reserved for Ambulatory Patient” in letters at least 1.25 centimeters (one-half inch) high shall be posted on the outside of the door or on the wall alongside the door where they are visible to persons entering the room.

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8
Q

SNF…..Seclusion is ______ allowed when a physical restraint is used.

A

Never

  1. Nursing Service–Restraints and Postural Supports.
    (f) Seclusion, which is defined as the placement of a patient alone in a room, shall not be employed.
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9
Q

SNF…..A person qualified by _________ and __________ shall be in charge of the housekeeping
department.

A

experience and training

  1. Housekeeping.
    (e) A person qualified by experience and training shall be in charge of the housekeeping department.
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10
Q

SNF…..How often are activity plans reviewed?

A

quarterly

  1. Activity Program–Activity Plan.

(a) An activity plan shall:
(1) Be developed and implemented for each patient and shall be integrated with the individual interdisciplinary patient care plan.
(2) Be reviewed quarterly and approved, in writing, by the attending physician as not in conflict with the treatment plan.

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11
Q

SNF…..Is ventilation to the outside required when caring for a patient with an infectious disease?

A

Yes

  1. Nursing Service–Patients with Infectious Diseases.
    (a) Patients with infectious diseases shall not be admitted to or cared for in the facility unless the following requirements are met:
    (1) A patient suspected of or diagnosed as having an infectious or reportable communicable disease or being in a carrier state who the attending officer determines is a potential danger, shall be accommodated in a room, vented to the outside, and provided with a
    separate toilet, hand-washing facility, soap dispenser and individual towels.
    (2) There shall be:
    (A) Separate provisions for handling contaminated linens.
    (B) Separate provisions for handling contaminated dishes.
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12
Q

SNF…..Moveable bins must have ______ fitting covers.

A

tight

  1. Solid Waste Containers.

(b) Movable bins when used for storing or transporting solid wastes from the premises shall have approval of the local health department and shall meet the following requirements:
(1) Have tight-fitting covers, closed when not being loaded.
(2) Be in good repair.
(3) Be leakproof.
(4) Be rodent proof unless stored in a room or screened enclosure.

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13
Q

SNF…..The resident has the right to ______ his/her physician.

A

choose

  1. Physician Services–General Requirements.
    (a) All persons admitted or accepted for care by the skilled nursing facility shall be under the care of a physician selected by the patient or patient’s authorized representative.
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14
Q

SNF…..Electronic thermometers must be _________.

A

Cleaned And Disinfected

  1. Nursing Service–Cleaning, Disinfecting and Sterilizing.

(e) Electronic thermometers shall be cleaned and disinfected according to the manufacturer’s instructions. Glass thermometers shall be cleaned and disinfected for at least 10 minutes with 70 percent ethyl alcohol or 90 percent isopropyl alcohol with 0.2 percent iodine. Oral
and rectal thermometers shall be stored separately in clean, labeled containers with fitted lids.

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15
Q

SNF…..Dietitians can be employed on a ______ basis.

A

fulltime, part-time or consulting basis

  1. Dietetic Service–Staff.

(a) A dietitian shall be employed on a full-time, part-time or consulting basis. Part-time or consultant services shall be provided on the premises at appropriate times on a regularly scheduled basis. A written record of the frequency, nature and duration of the consultant’s
visits shall be maintained.

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16
Q

SNF…..The director of nursing service shall have at least _____ year of experience in nursing supervision within the last ______ years.

A

one, five

  1. Nursing Service–Director of Nursing Service.

(a) The director of nursing service shall be a registered nurse and shall be employed eight hours a day, on the day shift five days a week.
(b) The director of nursing service shall have at least one year of experience in nursing supervision within the last five years.
(c) The director of nursing service shall have, in writing, administrative authority, responsibility and accountability for the nursing services within the facility and serve only one facility in this capacity at any one time.

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17
Q

SNF…..In a skilled nursing facility, within how many days following a death of a patient must the facility surrender all money and valuables to the person responsible for the patient or to the executor or the administrator of the estate (except in a coroner or medical examiner case)?

A

30

  1. Safeguards for Patients’ Monies and Valuables.

(a)(9) Within 30 days following the death of a patient, except in a coroner or medical examiner case, all money and valuables of that patient which have been entrusted to the licensee shall be surrendered to the person responsible for the patient or to the executor or the administrator of the estate in exchange for a signed receipt. Whenever a patient without known heirs dies, written notice within five working days, shall be given by the facility to the public administrator of the county as specified by Section 1145 of the California Probate Code and a copy of said notice shall be available in the facility for
review by the Department.

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18
Q

SNF…..Patient care plans must include:

A

measurable and time-limited objectives

  1. Nursing Service–General
    (a) Nursing service shall include, but not be limited to, the following:
    (1) Planning of patient care, which shall include at least the following:

(B) Development of an individual, written patient care plan which indicates the care to be given, the objectives to be accomplished and the professional discipline responsible for each element of care. Objectives shall be measurable and time-limited.

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19
Q

SNF…..What are the five required services in skilled nursing facilities?

A

physician, skilled nursing, dietary, pharmaceutical, activity program

Article 3. Required Services

  1. Required Services.
    (a) Skilled nursing facilities shall provide, but shall not be limited to, the following required services: physician, skilled nursing, dietary, pharmaceutical and an activity program.
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20
Q

SNF…..What are the three required committee’s in a SNF?

A

patient care policy, infection control and pharmaceutical service

  1. Required Committees.
    (a) Each facility shall have at least the following committees: patient care policy, infection control and pharmaceutical service.
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21
Q

SNF…..How many complete bed changes must be provided for the facility’s licensed capacity?

A

not less than three

  1. Clean Linen.
    (a) Clean linen shall be stored, handled and transported in a way that precludes cross-contamination.
    (b) Clean linen shall be stored in clean, ventilated closets, rooms or alcoves, used only for that purpose.
    (c) Clean linen not in covered storage shall be covered.
    (d) Clean linen from a commercial laundry shall be delivered to a designated clean area in a manner that prevents contamination.
    (e) Linens shall not be threadbare and shall be maintained in good repair.
    (f) A supply of linen shall be provided sufficient for not less than three complete bed changes for the facility’s licensed capacity.
    (g) A supply of clean wash cloths and towels shall be provided and available to staff to meet the care needs of the patients.
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22
Q

SNF…..Drug order records must be kept for _________ year(s).

A

at least one

  1. Pharmaceutical Service–Drug Order Records.

Facilities shall maintain a record which includes, for each drug ordered by prescription, the name of the patient, the drug name, and strength, the date ordered, the date and amount received and the name of the issuing pharmacy. The records shall be kept at least one year.

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23
Q

SNF…..Activity schedules must be posted ________ , in large visible print, for the information of patients and staff.

A

conspicuously

  1. Activity Program–Requirements.
    (d) The activity leader, at a minimum, shall:
    (5) Post the activity schedule conspicuously, in large visible print, for the information of patients and staff.
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24
Q

SNF…..Can a patient be admitted without an assigned physician?

A

no

  1. Physician Services–General Requirements.
    (a) All persons admitted or accepted for care by the skilled nursing facility shall be under the care of a physician selected by the patient or patient’s authorized representative.
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25
SNF.....The __________ of the violation is considered when fixing the amount of the civil penalty to be imposed for a class "A" violation.
gravity 72711. Penalties. (a) In fixing the amount of the civil penalty to be imposed for a class "A" violation, the district administrator or his designee, shall consider: (1) The gravity of the violation which shall include: (A) The degree of substantial probability that death or serious physical harm to the patient would result and if applicable, did result, from the violation. (B) The severity of serious physical harm to a patient or guest which was likely to result and if applicable, that did result, from the violation. (C) The extent to which the provisions of the applicable statutes or regulations were violated.
26
SNF.....One goal of an activity program is _________.
to support mental capabilities 72381. Activity Program--Requirements. (a) Patients shall be encouraged to participate in activities planned to meet their individual needs. An activity program shall have a written, planned schedule of social and other purposeful independent or group activities. The program shall be designed to make life more meaningful, to stimulate and support physical and mental capabilities to the fullest extent, to enable the patient to maintain the highest attainable social, physical and emotional functioning but not necessarily to correct or remedy a disability.
27
SNF.....When may an exit door, corridor door or perimeter fence be locked to egress?
upon written approval of the Department 72609. Patient Rooms. (a) Each patient room shall be labeled with a number, letter or combination of the two for identification. (b) Patients' rooms shall not be kept locked when occupied except in rooms approved by the Department for seclusion of psychiatric patients. (c) Only upon the written approval of the Department may any exit door, corridor door, yard enclosures or perimeter fences be locked to egress. (d) Patient rooms approved for use by ambulatory patients only shall be identified as follows: The words "Reserved for Ambulatory Patient" in letters at least 1.25 centimeters (one-half inch) high shall be posted on the outside of the door or on the wall alongside the door where they are visible to persons entering the room.
28
SNF.....What does ASHRAE stand for?
American Society of Heating, Refrigeration and Air Conditioning Engineers 72639. Air Filters. (a) The licensee shall be responsible for regular inspection, cleaning or replacement of all filters installed in heating, air conditioning and ventilating systems, as necessary to maintain the systems in normal operating condition. (b) A written record of inspection, cleaning or replacement, including static pressure drop, shall be maintained and available for inspection. The record shall include a description of the filters originally installed, the American Society of Heating, Refrigeration and Air Conditioning Engineers (ASHRAE) efficiency rating and the criteria established by the manufacturer or supplier to determine when replacement or cleaning is necessary.
29
SNF.....The Diet Manual must be revised at least every _____ year(s).
five 72337. Dietetic Service--Diet Manual. A current therapeutic diet manual, approved by the dietitian and the patient care policy committee, shall be readily available to dietetic personnel and licensed healthcare practitioners acting within the scope of their professional licensure or certification. It shall be reviewed annually and revised at least every five years.
30
SNF.....Temperatures for refrigerators in nursing stations should be: _____
45 degrees Fahrenheit 72325. Nursing Service--Space. (d) If a refrigerator is provided in a nursing station, the refrigerator shall meet the following standards: (1) Be located in a clean area not subject to contamination by human waste. (2) Maintain temperatures at or below 7 degrees C (45 degrees F) for chilling. (3) Maintain the freezer at minus 18 degrees C (0 degrees F). (4) Contain an accurate thermometer at all times. (5) If foods are retained in the refrigerator, they shall be covered and clearly identified as to contents and date initially covered.
31
SNF.....___________ relationship means one in which a significant risk or effect is created and does not include a remote or minimal risk or effect.
Direct 72701. Definitions. (a) The following definitions shall apply to this Article: (1) Substantial probability means that the likelihood of an event is real, actual and not imaginary, insignificant or remote. (2) Serious physical harm means that type of dangerous bodily injury, illness or condition in which: (A) A part of the body would be permanently removed, rendered functionally useless or substantially reduced in capacity, either temporarily or permanently and/or (B) A part of an internal function of the body would be inhibited in its normal performance to such a degree as to temporarily or permanently cause a reduction in physical or mental capacity or shorten life. (3) Direct relationship means one in which a significant risk or effect is created and does not include a remote or minimal risk or effect.
32
SNF.....Director of Nursing must be a __________.
RN 72327. Nursing Service--Director of Nursing Service. (a) The director of nursing service shall be a registered nurse and shall be employed eight hours a day, on the day shift five days a week. (b) The director of nursing service shall have at least one year of experience in nursing supervision within the last five years. (c) The director of nursing service shall have, in writing, administrative authority, responsibility and accountability for the nursing services within the facility and serve only one facility in this capacity at any one time.
33
SNF.....What is the minimum number of nursing hours per patient per day in a SNF?
3. 2 72329. Nursing Service--Staff. (f) Each facility shall employ sufficient nursing staff to provide a minimum of 3.2 nursing hours per patient day.
34
SNF.....How often must progress notes be written and dated by the activity leader?
quarterly 72547. Content of Health Records. (9) Progress notes written and dated by the activity leader at least quarterly.
35
SNF.....An 87 bed skilled nursing facility shall have at least one _____ , awake and on duty in the facility at all times, day and night, in addition to the director of nursing service.
registered nurse or licensed vocational nurse 72329. Nursing Service--Staff. (c) Facilities licensed for 60 to 99 beds shall have at least one registered nurse or licensed vocational nurse, awake and on duty, in the facility at all times, day and night, in addition to the director of nursing services. The director of nursing service shall not have charge nurse responsibilities.
36
SNF.....Preparation of doses for more than______ scheduled administration time shall not be permitted.
one 72313. Nursing Service--Administration of Medications and Treatments. (a) Medications and treatments shall be administered as follows: (4) Preparation of doses for more than one scheduled administration time shall not be permitted.
37
SNF.....Drugs used from the emergency kit must be replaced within _____ hours.
72 72377. Pharmaceutical Service--Equipment and Supplies. (b)(2) The emergency drug supply shall be stored in a portable container which is sealed in such a manner that the tamper-proof seal must be broken to gain access to the drugs. The director of nursing service or charge nurse shall notify the pharmacist when drugs have been used from the emergency kit or when the seal has been broken. Drugs used from the kit shall be replaced within 72 hours and the supply resealed by the pharmacist.
38
SNF.....How long must employee records be maintained after termination of employment?
three years 72533. Employee Personnel Records. (2) Such records shall be retained for at least three years following termination of employment. Employee personnel records shall be maintained in a confidential manner, and shall be made available to authorized representatives of the Department upon request.
39
SNF.....In a skilled nursing facility is a telephone required to be provided for each licensed bed?
No 72527. Patients' Rights. (21) To have reasonable access to telephones and to make and receive confidential calls.
40
SNF.....Physician services shall include a patient evaluation including a written report of a physical exam within _____ days prior to admission or within ______ hours following admission.
5, 72 72303. Physician Services--General Requirements. (b) Physician services shall mean those services provided by physicians responsible for the care of individual patients in the facility. Physician services shall include but are not limited to: (1) Patient evaluation including a written report of a physical examination within 5 days prior to admission or within 72 hours following admission. (2) An evaluation of the patient and review of orders for care and treatment on change of attending physicians. (3) Patient diagnoses. (4) Advice, treatment and determination of appropriate level of care needed for each patient. (5) Written and signed orders for diet, care, diagnostic tests and treatment of patients by others. Orders for restraints shall meet the requirements of Section 72319(b). (6) Health record progress notes and other appropriate entries in the patient's health records.
41
SNF.....Linen shall not be ______.
threadbare 72625. Clean Linen. (a) Clean linen shall be stored, handled and transported in a way that precludes cross-contamination. (b) Clean linen shall be stored in clean, ventilated closets, rooms or alcoves, used only for that purpose. (c) Clean linen not in covered storage shall be covered. (d) Clean linen from a commercial laundry shall be delivered to a designated clean area in a manner that prevents contamination. (e) Linens shall not be threadbare and shall be maintained in good repair. (f) A supply of linen shall be provided sufficient for not less than three complete bed changes for the facility's licensed capacity. (g) A supply of clean wash cloths and towels shall be provided and available to staff to meet the care needs of the patients.
42
SNF.....Destruction records for schedule II, III or IV drugs shall be kept for ______ years.
three 72371. Pharmaceutical Service--Disposition of Drugs. c) Patient's drugs supplied by prescription which have been discontinued and those which remain in the facility after discharge of the patient shall be destroyed by the facility in the following manner: (1) Drugs listed in Schedules II, III or IV of the Federal Comprehensive Drug Abuse Prevention and Control Act of 1970 shall be destroyed by the facility in the presence of a pharmacist and a registered nurse employed by the facility. The name of the patient, the name and strength of the drug, the prescription number, the amount destroyed, the date of destruction and the signatures of the witnesses required above shall be recorded in the patient's health record or in a separate log. Such log shall be retained for at least three years.
43
SNF.....Initial nursing assessments shall commence at the time of admission of the patient and be completed within ______days after admission.
seven 72311. Nursing Service--General (a) Nursing service shall include, but not be limited to, the following: (1) Planning of patient care, which shall include at least the following: (A) Identification of care needs based upon an initial written and continuing assessment of the patient's needs with input, as necessary, from health professionals involved in the care of the patient. Initial assessments shall commence at the time of admission of the patient and be completed within seven days after admission.
44
SNF.....The ____________or_____________shall be responsible for screening patients for admission to the facility to ensure that the facility admits only those patients for whom it can provide adequate care.
administrator or designee 72513. Administrator. (f) The administrator or designee shall be responsible for screening patients for admission to the facility to ensure that the facility admits only those patients for whom it can provide adequate care. The administrator, or designee, shall conduct preadmission personal interviews as appropriate with the patient's physician, the patient, the patient's next of kin or sponsor or the representative of the facility from which the patient is being transferred. A telephone interview may be substituted when a personal interview is not feasible.
45
SNF.....The disaster plan shall be reviewed at least ________and revised ____ _______.
annually, as necessary 72551. External Disaster and Mass Casualty Program. (c) The plan shall be reviewed at least annually and revised as necessary to ensure that the plan is current. All personnel shall be instructed in the requirements of the plan. There shall be evidence in the personnel files, or the orientation checklist, indicating that all new employees have been oriented to the plan and procedures at the beginning of their employment.
46
SNF.....During a Citation Review Conference can legal counsel represent a licensee?
Yes 72713. Citation Review Conference. (a) At a citation review conference: (1) The licensee shall have the right to be represented by legal counsel, or a person of the licensee's choosing, to present oral or written information on the licensee's behalf, and to explain any mitigating circumstances. (2) The representatives of the Department who issued the citation should attend the conference and present information, oral or written, in substantiation of the alleged violation.
47
SNF.....Health records may be stored off-site __________.
with prior Department approval 72543. Patients' Health Records. (h) Patient health records shall be filed in an accessible manner in the facility or in health record storage. Storage of records shall provide for prompt retrieval when needed for continuity of care. Health records can be stored off the facility premises only with the prior approval of the Department.
48
SNF.....Does a Tuberculosis screening done within 90 days prior to employment satisfy the regulatory requirement?
Yes 72535. Employees' Health Examination and Health Records. (b) The initial health examination and subsequent annual examination shall include a purified protein derivative intermediate strength intradermal skin test for tuberculosis. A chest X-ray is indicated if the employee has previously had a positive reaction to a tuberculosis skin test or is currently being treated for tuberculosis. Positive reaction to the skin test shall be followed by a 35.56 cm x 43.18 cm (14" x 17") chest X-ray. Evidence of tuberculosis screening within 90 days prior to employment shall be considered as meeting the intent of this Section.
49
SNF.....Are PRN orders for behavioral restraints ever allowed?
No 72319. Nursing Service--Restraints and Postural Supports. (2) Physical restraints for behavior control shall only be used on the signed order of a physician or unless the provisions of ....... which threatens to bring immediate injury to the patient or others. In such an emergency an order may be received by telephone, and shall be signed within 5 days. Full documentation of the episode leading to the use of the physical restraint, the type of the physical restraint used, the length of effectiveness of the restraint time and the name of the individual applying such measures shall be entered in the patient's health record. (A) Physical restraints for behavioral control shall only be used with a written order designed to lead to a less restrictive way of managing, and ultimately to the elimination of, the behavior for which the restraint is applied. There shall be no PRN orders for behavioral restraints.
50
SNF.....Does a phone at the nursing station satisfy the public telephone requirement?
No 72617. Public Telephone. (a) A telephone shall be installed to meet the requirements of Section E702-32 of Title 24. This may not be required in separate buildings having six beds or less which are restricted to occupancy by ambulatory patients. (b) The telephone at the nurses station shall not be considered as meeting the requirements of this section.
51
SNF.....A bed hold may last _____days.
seven (7) 72520. Bed Hold. (a) If a patient of a skilled nursing facility is transferred to a general acute care hospital as defined in Section 1250(a) of the Health and Safety Code, the skilled nursing facility shall afford the patient a bed hold of seven (7) days, which may be exercised by the patient or the patient's representative.
52
SNF.....The facility must notify the local health officer and the Department of an unusual occurrence within ____ hours.
24 72541. Unusual Occurrences. Occurrences such as epidemic outbreaks, poisonings, fires, major accidents, death from unnatural causes or other catastrophes and unusual occurrences which threaten the welfare, safety or health of patients, personnel or visitors shall be reported by the facility within 24 hours either by telephone (and confirmed in writing) or by telegraph to the local health officer and the Department. An incident report shall be retained on file by the facility for one year. The facility shall furnish such other pertinent information related to such occurrences as the local health officer or the Department may require. Every fire or explosion which occurs in or on the premises shall be reported within 24 hours to the local fire authority or in areas not having an organized fire service, to the State Fire Marshal.
53
SNF.....Must all licensed nurses have training in CPR?
Yes 72517. Staff Development. (b) In addition to (a) above, all licensed nurses shall have training in cardiopulmonary resuscitation.
54
SNF.....Infection control committee must meet _________.
at least quarterly 72525. Required Committees. (2) Infection control committee. (A) An infection control committee shall be responsible for infection control in the facility. (B) The committee shall be composed of representatives from the following services: physician, nursing, administration, dietetic, pharmaceutical, activities, housekeeping, laundry and maintenance. (C) The committee shall meet at least quarterly. (D) The functions of the infection control committee shall include, but not be limited to: 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.
55
SNF.....Name one responsibility of the medical director in a Skilled Nursing Facility?
consultant to the director of nursing service 72305. Physician Services--Medical Director. (a) The facility shall have a medical director who shall be responsible for standards, coordination, surveillance and planning for improvement of medical care in the facility. (b) The medical director shall: (1) Act as a liaison between administration and attending physicians. (2) Be responsible for reviewing and evaluating administrative and patient care policies and procedures. (3) Act as a consultant to the director of nursing service in matters relating to patient care services. (4) Be responsible for reviewing employees' preemployment and annual health examination reports.
56
SNF.....Drugs required to be stored at room temperature must be between ______and______.
59 degrees F and 86 degrees F 72357. Pharmaceutical Service--Labeling and Storage of Drugs. (f) Drugs shall be stored in appropriate temperatures. Drugs required to be stored at room temperature shall be stored at a temperature between 15 degrees C (59 degrees F) and 30 degrees C (86 degrees F). Drugs requiring refrigeration shall be stored in a refrigerator between 2 degrees C (36 degrees F) and 8 degrees C (46 degrees F). When drugs are stored in the same refrigerator with food, the drugs shall be kept in a closed container clearly labeled "drugs."
57
SNF.....Records pertaining to patient's money and/or valuables must be maintained for _____ year(s)?
three 72529. Safeguards for Patients' Monies and Valuables. (2) Each licensee shall maintain safeguards and accurate records of patients' monies and valuables entrusted to the licensee's care including the maintenance of a detailed inventory and at least a quarterly accounting of financial transactions made on the patient's behalf. (A) Records of patients' monies which are maintained as a drawing account shall include a control account for all receipts and expenditures, supporting vouchers and receipts for all expenditures of monies and valuables entrusted to the licensee, an account for each patient and supporting vouchers filed in chronological order. Each account shall be kept current with columns for debits, credits and balance. All of these records shall be maintained at the facility for a minimum of three years from the date of transaction. At no time may the balance in a patient's drawing account be less than zero.
58
SNF.....Water used to clean utensils must have a temperature of _______.
110 F 72347. Dietetic Service--Cleaning and Disinfection of Utensils. (a) All utensils used for eating, drinking and in the preparation and serving of food and drink shall be cleaned and disinfected or discarded after each usage. (b) Gross food particles shall be removed by careful scraping and prerinsing in running water. (c) Utensils not washed by mechanical means shall be placed in hot water with a minimum temperature of 43 degrees C (110 degrees F), washed using soap or detergent, rinsed in hot water to remove soap or detergent and disinfected by one of the following methods or equivalent, as approved by the Department: (1) Immersion for at least two minutes in clean water at 77 degrees C (170 degrees F). (2) Immersion for at least 30 seconds in clean water at 83 degrees C (180 degrees F). (3) Immersion in water containing bactericidal chemical as approved by the Department.
59
SNF.....Name one method of cleaning, disinfecting and sterilizing bedside equipment.
Gas Sterilization 72323. Nursing Service--Cleaning, Disinfecting and Sterilizing. (a) Each facility shall adopt a written manual on cleaning, disinfecting and sterilizing procedures. The manual shall include procedures to be used in the care of utensils, instruments, solutions, dressings, articles and surfaces and shall be available for use by facility personnel. All procedures shall be carried out in accordance with the manual. (b) Each facility shall make provisions for the cleaning and disinfecting of contaminated articles and surfaces which cannot be sterilized. (c) Bedside equipment including but not limited to washbasins, emesis basins, bedpans and urinals shall be sanitized only by one of the following methods: (1) Submersion in boiling water for a minimum of 30 minutes. (2) Autoclaving at 15 pounds pressure and 121 degrees C (250) for 20 minutes. (3) Gas sterilization.
60
SNF.....Can an ICF exist within a SNF?
yes Article 3. Required Services 72301. Required Services. (a) Skilled nursing facilities shall provide, but shall not be limited to, the following required services: physician, skilled nursing, dietary, pharmaceutical and an activity program. (b) Skilled nursing facilities caring for patients who are mentally disordered and whose needs for a special treatment program are identified shall also meet the requirements for a special treatment program service. (c) Skilled nursing facilities providing intermediate care services shall do so in a distinct part separately approved by the Department and shall be in conformity with the licensing regulations for the type of service provided in that distinct part. The facility license shall indicate approval of the distinct part by the Department.
61
SNF.....When must patients be screened for tuberculosis?
upon admission 72523. Patient Care Policies and Procedures. (c) Each facility shall establish and implement policies and procedures, including but not limited to: (2) Nursing services policies and procedures which include: (C) Screening of all patients for tuberculosis upon admission. These procedures shall be determined by the patient care policy committee. A tuberculosis screening procedure may not be required if there is satisfactory written evidence available that a tuberculosis screening procedure has been completed within 90 days of the date of admission to the facility. Subsequent tuberculosis screening procedures shall be determined by the attending physician.
62
SNF.....May married couples reside in the same room?
Yes 72527. Patients' Rights. (16) If married, to be assured privacy for visits by the patient's spouse and if both are patients in the facility, to be permitted to share a room.
63
SNF.....Who can admit a patient to a skilled nursing facility?
A physician 72303. Physician Services--General Requirements. (a) All persons admitted or accepted for care by the skilled nursing facility shall be under the care of a physician selected by the patient or patient's authorized representative.
64
SNF.....Written assessment to determine if a patient can participate in a bowel and/or bladder management program shall commence within ________ ________ after the admission of an incontinent patient.
two weeks 72315. Nursing Service--Patient Care. (i) Measures shall be implemented to prevent and reduce incontinence for each patient and shall include: (1) Written assessment by a licensed nurse to determine the patient's ability to participate in a bowel and/or bladder management program. This is to be initiated within two weeks after admission of an incontinent patient.
65
SNF.....Narrative notes are _______.
Written 72547. Content of Health Records. (5) Nurses' notes which shall be signed and dated. Nurses' notes shall include: (A) Records made by nurse assistants, after proper instruction, which shall include: 1. Care and treatment of the patient. 2. Narrative notes of observation of how the patient looks, feels, eats, drinks, reacts, interacts and the degree of dependency and motivation toward improved health. 3. Notification to the licensed nurse of changes in the patient's condition.
66
SNF.....Is the skilled nursing facility required to maintain a bed hold for a patient if the attending physician, in writing, notifies the skilled nursing facility that the patient's stay in the acute care hospital is expected to exceed seven days?
No 72520. Bed Hold. (a) If a patient of a skilled nursing facility is transferred to a general acute care hospital as defined in Section 1250(a) of the Health and Safety Code, the skilled nursing facility shall afford the patient a bed hold of seven (7) days, which may be exercised by the patient or the patient's representative. (3) If the patient's attending physician notifies the skilled nursing facility in writing that the patient's stay in the general acute care hospital is expected to exceed seven (7) days, the skilled nursing facility shall not be required to maintain the bed hold.
67
SNF.....Can a physical therapist be an activity leader?
No 72385. Activity Program--Staff. (a) Activity program personnel with appropriate training and experience shall be available to meet the needs and interests of patients. (b) An activity program leader shall be designated by and be responsible to the administration. An activity program leader shall meet one of the following requirements: 2) Be an occupational therapist, art therapist, music therapist, dance therapist, recreation therapist or occupational therapy assistant.
68
SNF.....A public telephone shall be installed according to Title _____.
24 72617. Public Telephone. (a) A telephone shall be installed to meet the requirements of Section E702-32 of Title 24. This may not be required in separate buildings having six beds or less which are restricted to occupancy by ambulatory patients. (b) The telephone at the nurses station shall not be considered as meeting the requirements of this section.
69
SNF.....The diet manual shall be reviewed _____ and revised at least every _____ years.
annually and 5 72337. Dietetic Service--Diet Manual. A current therapeutic diet manual, approved by the dietitian and the patient care policy committee, shall be readily available to dietetic personnel and licensed healthcare practitioners acting within the scope of their professional licensure or certification. It shall be reviewed annually and revised at least every five years.
70
SNF.....Medications shall be administered as soon as possible, but no more than _____ hours after doses are prepared, and shall be administered by the same person who prepares the doses for administration.
two 72313. Nursing Service--Administration of Medications and Treatments. (a) Medications and treatments shall be administered as follows: (6) Medications shall be administered as soon as possible, but no more than two hours after doses are prepared, and shall be administered by the same person who prepares the doses for administration. Doses shall be administered within one hour of the prescribed time unless otherwise indicated by the prescriber.
71
SNF.....Which type of water may be used in humidifier bottles?
distilled, de-mineralized or de-ionized 72313. Nursing Service--Administration of Medications and Treatments. (d) Oxygen equipment shall be maintained as follows: (1) Humidifier bottles on oxygen equipment shall be changed and sterilized at least every 24 hours. (2) Only sterile distilled, demineralized or de-ionized water shall be used in humidifier bottles.
72
SNF....Physicians available to furnish emergency medical care if the attending physician, or designee, is unavailable must have their telephone numbers posted _________________.
conspicuously Article 3. Required Services 72301. Required Services. (g) The facility shall make arrangements for a physician or physicians to be available to furnish emergency medical care if the attending physician, or designee, is unavailable. The telephone numbers of those physicians shall be posted in a conspicuous place in the facility.
73
SNF....."STAT" drugs ordered will be available within _____ hour(s) of the time ordered during normal pharmacy hours.
one 72355. Pharmaceutical Service--Requirements. (a) Pharmaceutical service shall include, but is not limited to, the following: (1) Obtaining necessary drugs including the availability of 24-hour prescription service on a prompt and timely basis as follows: (A) Drugs ordered "Stat" that are not available in the facility emergency drug supply shall be available and administered within one hour of the time ordered during normal pharmacy hours. For those hours during which the pharmacy is closed, drugs ordered "Stat" shall be available and administered within two hours of the time ordered. Drugs ordered "Stat" which are available in the emergency drug supply shall be administered immediately.
74
SNF.....At least _____ week's supply of staple foods are required to be maintained on the premises.
one 72349. Dietetic Service--Equipment and Supplies. (d) Food supplies shall meet the following standards: (1) At least one week's supply of staple foods and at least two days' supply of perishable foods shall be maintained on the premises. Food supplies shall meet the requirements of the weekly menu including the therapeutic diets ordered.
75
SNF.....Can a patient be allowed not to wear a nametag or identification?
Yes with physician documentation 72555. Patient Identification. Each patient shall be provided with a wristband identification tag or other means of identification which shall be worn at all times unless the attending physician notes in the health record that the patient's condition would not permit such identification. Minimum information shall include the name of the patient and the name of the facility.
76
SNF.....Patient monies not kept in the facility must be deposited in a ________trust account.
demand 72529. Safeguards for Patients' Monies and Valuables. (3) Patients' monies not kept in the facility shall be deposited in a demand trust account in a local bank authorized to do business in California, the deposits of which are insured by the Federal Deposit Insurance Corporation, or in a federally insured bank or savings and loan association under a plan approved by the Department. If a facility is operated by a county, such funds may be deposited with the county treasurer. If a facility is operated by the State, such funds may be deposited with the State Treasurer. All banking records related to these funds, including but not limited to deposit slips, checks, cancelled checks, statements and check registers, shall be maintained in the facility for a minimum of three years from the date of transaction. Identification as a patient trust fund account shall be clearly printed on each patient's trust account checks and bank statements.
77
SNF.....A copy of the disaster plan shall be available on the premises for review by the ___________.
Department 72551. External Disaster and Mass Casualty Program. (a) A written external disaster and mass casualty program plan shall be adopted and followed. The plan shall be developed with the advice and assistance of county or regional and local planning offices and shall not conflict with county and community disaster plans. A copy of the plan shall be available on the premises for review by the Department.
78
SNF.....Should an employees social security number be included in his/her personnel record?
Yes 72533. Employee Personnel Records. (a) Each facility shall maintain current complete and accurate personnel records for all employees. (1) The record shall include: (A) Full name. (B) Social Security number. (C) Professional license or registration number, if applicable. (D) Employment classification. (E) Information as to past employment and qualifications. (F) Date of beginning employment. (G) Date of termination of employment. (H) Documented evidence of orientation to the facility. (I) Performance evaluations.
79
SNF.....Can milk only be served in the orginal container?
no 72349. Dietetic Service--Equipment and Supplies. (d) Food supplies shall meet the following standards: (4) Milk shall be served in individual containers or from a dispensing device which has been approved for such use, by the local health department or from the original container. Milk shall be dispensed directly into the glass or other container from which the patient drinks.
80
SNF.....Nursing notes shall be written as often as the patient's condition warrants and ________.
weekly 72547. Content of Health Records. (a)(5) Nurses' notes which shall be signed and dated. Nurses' notes shall include: (A) Records made by nurse assistants, after proper instruction, which shall include: 1. Care and treatment of the patient. 2. Narrative notes of observation of how the patient looks, feels, eats, drinks, reacts, interacts and the degree of dependency and motivation toward improved health. 3. Notification to the licensed nurse of changes in the patient's condition. (B) Meaningful and informative nurses' progress notes written by licensed nurses as often as the patient's condition warrants. However, weekly nurses' progress notes shall be written by licensed nurses on each patient and shall be specific to the patient's needs, the patient care plan and the patient's response to care and treatments.
81
SNF.....Discontinued drugs must be disposed of within _____ days of the date the drug order was discontinued unless the drug is reordered within that time.
90 72357. Pharmaceutical Service--Labeling and Storage of Drugs. (n) Discontinued drug containers shall be marked, or otherwise identified, to indicate that the drug has been discontinued, or shall be stored in a separate location which shall be identified solely for this purpose. Discontinued drugs shall be disposed of within 90 days of the date the drug order was discontinued, unless the drug is reordered within that time.
82
SNF.....The director of nursing or ______ ______ shall notify the pharmacist when drugs have been used from the emergency kit or when the seal has been broken.
charge nurse 72377. Pharmaceutical Service--Equipment and Supplies. (b) (2) The emergency drug supply shall be stored in a portable container which is sealed in such a manner that the tamper-proof seal must be broken to gain access to the drugs. The director of nursing service or charge nurse shall notify the pharmacist when drugs have been used from the emergency kit or when the seal has been broken. Drugs used from the kit shall be replaced within 72 hours and the supply resealed by the pharmacist.
83
SNF.....Can a psychiatric technician receive verbal orders for drugs and treatments?
Yes 72361 Pharmaceutical Service--Orders for Drugs. (c) Verbal orders for drugs and treatments shall be received only by licensed nurses, psychiatric technicians, pharmacists, physicians, physician's assistants from their supervising physicians only, and certified respiratory therapists when the orders relate specifically to respiratory care. Such orders shall be recorded immediately in the patient's health record by the person receiving the order and shall include the date and time of the order. The order shall be signed by the prescriber within five days.
84
SNF.....Destruction records for schedule II, III or IV drugs shall be kept for _____ years.
three 72371. Pharmaceutical Service--Disposition of Drugs. (c) Patient's drugs supplied by prescription which have been discontinued and those which remain in the facility after discharge of the patient shall be destroyed by the facility in the following manner: (1) Drugs listed in Schedules II, III or IV of the Federal Comprehensive Drug Abuse Prevention and Control Act of 1970 shall be destroyed by the facility in the presence of a pharmacist and a registered nurse employed by the facility. The name of the patient, the name and strength of the drug, the prescription number, the amount destroyed, the date of destruction and the signatures of the witnesses required above shall be recorded in the patient's health record or in a separate log. Such log shall be retained for at least three years.
85
SNF.....Director of Nursing must work on the_____ shift.
day 72327. Nursing Service--Director of Nursing Service. (a) The director of nursing service shall be a registered nurse and shall be employed eight hours a day, on the day shift five days a week. (b) The director of nursing service shall have at least one year of experience in nursing supervision within the last five years. (c) The director of nursing service shall have, in writing, administrative authority, responsibility and accountability for the nursing services within the facility and serve only one facility in this capacity at any one time.
86
SNF.....After the initial health exam employees must have a health exam ______ ______ thereafter.
at least annually 72535. Employees' Health Examination and Health Records. (a) All employees working in the facility, including the licensee, shall have a health examination within 90 days prior to employment or within seven days after employment and at least annually thereafter by a person lawfully authorized to perform such a procedure. Each such examination shall include a medical history and physical evaluation. The report signed by the examiner shall indicate that the person is sufficiently free of disease to perform assigned duties and does not have any health condition that would create a hazard for himself, fellow employees, or patients or visitors.
87
SNF.....Arrangements shall be made for an advisory dentist to participate at least _______ in the staff development program.
annually 72301. Required Services. (e) Arrangements shall be made for an advisory dentist to participate at least annually in the staff development program for all patient care personnel and to approve oral hygiene policies and practices for the care of patients.
88
SNF.....Infection Control Policies and Procedures must be reviewed ______.
at least annually 72321. Nursing Service--Patients with Infectious Diseases. (b) The facility shall adopt, observe and implement written infection control policies and procedures. These policies and procedures shall be reviewed at least annually and revised as necessary.
89
SNF.....When planning menus ______ _______ and food habits of patients should be considered.
cultural background 72341. Dietetic Service--Menus. (f) Menus shall be planned with consideration of cultural background and food habits of patients.
90
SNF.....The pharmacist is required to review the drug regimen of each patient at least ________________.
monthly 72375. Pharmaceutical Service--Staff. (c) A pharmacist shall review the drug regimen of each patient at least monthly and prepare appropriate reports. The review of the drug regimen of each patient shall include all drugs currently ordered, information concerning the patient's condition relating to drug therapy, medication administration records, and where appropriate, physician's progress notes, nurse's notes, and laboratory test results. The pharmacists shall be responsible for reporting, in writing, irregularities in the dispensing and administration of drugs and other matters relating to the review of the drug regimen to the administrator and director of the nursing service.
91
SNF.....What posting requirements are necessary for all services and special programs provided by the facility?
conspicuously posted in a prominent location accessible to the public 72503. Consumer Information to Be Posted. (a) The following consumer information shall be conspicuously posted in a prominent location accessible to the public. (1) Name, license number and date of employment of the current administrator of the facility. (2) A listing of all services and special programs provided in the facility and those provided through written contracts. etc.
92
SNF.....Medications brought by or with the patient on admission to the facility shall not be used unless the contents of the containers have been examined and positively identified after admission by the patient's ______.
physician or a pharmacist retained by the facility 72367. Pharmaceutical Service--Personal Medications. (a) Medications brought by or with the patient on admission to the facility shall not be used unless the contents of the containers have been examined and positively identified after admission by the patient's physician or a pharmacist retained by the facility. (b) The facility may use drugs transferred from other licensed health facilities or those drugs dispensed or obtained after admission from any licensed or governmental pharmacy and may accept the delivery of those drugs by any agent of the patient or pharmacy without the necessity of identification by a physician or pharmacist.
93
SNF.....How many foot candles of light are required to be delivered to reading or working surfaces in a patient room?
a minimum of 30 72653. Lighting. (a) All rooms, attics, basements, passageways, and other spaces shall be provided with artificial illumination. As set forth in Parts 2 and 3 and Sections E702-e and E702-4, Part 3, Title 24, California Administrative Code. (b) All patient rooms shall have a minimum of 30 foot candles of light delivered to reading or working surfaces and not less than 20 foot candles of light in the rest of the room. (c) All accessible areas of corridors, storerooms, stairways, ramps, exits and entrances shall have a minimum of 20 foot candles of light.
94
SNF.....When may bedpans be emptied in the bathroom adjoining patient rooms?
When the bathroom is equipped with flushing attachments and vacuum breakers 72629. Provisions for Emptying Bedpans. Bedpans shall be emptied and cleaned in utility rooms unless toilets adjoining patients' rooms are equipped with flushing attachments and vacuum breakers. Bathtubs, lavatories or laundry sinks shall not be used for cleaning and emptying bedpans.
95
SNF.....In a 59 bed or less Skilled Nursing Facility does a RN or LVN need to be on duty day and night?
either 72329. Nursing Service--Staff. (a) Nursing service personnel shall be employed and on duty in at least the number and with the qualifications determined by the Department to provide the necessary nursing services for patients admitted for care. ............The Department may require a facility to provide additional staff as set forth in Section 72501(g). (b) Facilities licensed for 59 or fewer beds shall have at least one registered nurse or a licensed vocational nurse, awake and on duty, in the facility at all times, day and night.
96
SNF.....Pesticides and other toxic substances and drugs shall not be stored in the kitchen area or in storerooms for ____ or _______ ________ equipment and utensils.
food, food preparation 72343. Dietetic Service--Food Storage. (d) Pesticides and other toxic substances and drugs shall not be stored in the kitchen area or in storerooms for food or food preparation equipment and utensils.
97
SNF.....How often must a physician evaluate the patient?
as needed and at least every 30 days unless there is an alternate schedule 72307. Physician Services--Supervision of Care. (a) Each patient admitted to the skilled nursing facility shall be under the continuing supervision of a physician who evaluates the patient as needed and at least every 30 days unless there is an alternate schedule, and who documents the visits in the patient health record. (b) Alternate schedules of visits shall be documented in the patient health record with a medical justification by the attending physician. The alternate schedule shall conform with facility policy.
98
SNF.....An administrator cannot manage more than _____ facilities or a total of more than _____ beds.
three and 200 72513. Administrator. (a) Each skilled nursing facility shall employ or otherwise provide an administrator to carry out the policies of the licensee. The administrator shall be responsible for the administration and management of only one skilled nursing facility unless all of the following conditions are met: (1) If other skilled nursing facilities for which the administrator is responsible are in the same geographic area, and within one hour surface travel time of each other, and are operated by the same governing body. (2) The administrator shall not be responsible for more than three facilities or a total of no more than 200 beds.
99
SNF.....Facilities must accept and retain only those patients for whom _____ care can be provided.
adequate 72515. Admission of Patients. The licensee shall: (a) Admit a patient only on physician's orders. (b) Accept and retain only those patients for whom it can provide adequate care.
100
SNF.....How often must the therapeutic diet manual be revised?
at least every five years 72337. Dietetic Service--Diet Manual. A current therapeutic diet manual, approved by the dietitian and the patient care policy committee, shall be readily available to dietetic personnel and licensed healthcare practitioners acting within the scope of their professional licensure or certification. It shall be reviewed annually and revised at least every five years.
101
SNF.....A 187 bed skilled nursing facility shall have at least one _____, awake and on duty in the facility at all times, day and night, in addition to the director of nursing service.
registered nurse 72329. Nursing Service--Staff. (d) Facilities licensed for 100 or more beds shall have at least one registered nurse, awake and on duty, in the facility at all times, day and night, in addition to the director of nursing services. The director of nursing service shall not have charge nurse responsibilities.
102
SNF.....The pharmacist serves on the pharmaceutical service committee and the _______________ committee.
patient care policy 72375. Pharmaceutical Service--Staff. (a) Facilities shall retain a consulting pharmacist who devotes a sufficient number of hours during a regularly scheduled visit, for the purpose of coordinating, supervising and reviewing the pharmaceutical service committee, or its equivalent, at least quarterly. The report shall include a log or record of time spent in the facility. There shall be a written agreement between the pharmacist and the facility which includes duties and responsibilities of both. (b) A pharmacist shall serve on the pharmaceutical service committee and the patient care policy committee.
103
SNF.....Infection control committee meets ________.
at least quarterly 72525. Required Committees. (c)(2) Infection control committee. (A) An infection control committee shall be responsible for infection control in the facility. (B) The committee shall be composed of representatives from the following services; physician, nursing, administration, dietetic, pharmaceutical, activities, housekeeping, laundry and maintenance. (C) The committee shall meet at least quarterly.
104
SNF.....Can laundry chutes be used to transport soiled linen?
yes 72627. Soiled Linen. (d) When laundry chutes are used to transport soiled linen, they shall be maintained in a clean, sanitary state.
105
SNF.....Freezers in a refrigerator must be maintained at ______.
0 degrees Fahrenheit 72343. Dietetic Service--Food Storage. (c) All readily perishable foods or beverages shall be maintained at temperatures of 7 degrees C (45 degrees F) or below, or at 60 degrees C (140 degress F) or above, at all times, except during necessary periods of preparation and service. Frozen foods shall be stored at minus 18 degrees C (0 degrees F) or below at all times. There shall be an accurate thermometer in each refrigerator and freezer and in storerooms used for perishable foods. All foods stored in walk-in refrigerators and freezers shall be stored above the floor on shelves, racks, dollies or other surfaces that facilitate thorough cleaning.
106
SNF.....The emergency kit should be checked _______ by the pharmacist.
monthly 72377. Pharmaceutical Service--Equipment and Supplies. (4) The supply shall be checked at least monthly by the pharmacist.
107
SNF....Must cleaning supplies and equipment be stored in rooms for housekeeping only?
Yes 72621. Housekeeping. (c) Cleaning supplies and equipment shall be available to housekeeping staff. Such cleaning supplies and equipment shall meet the following requirements: (1) Cleaning supplies and equipment shall be stored in rooms for housekeeping use only. (2) A commercial detergent germicide shall be used for all cleaning. (3) Mop heads shall be removable and changed at least daily.
108
SNF.....Electronic thermometers shall be cleaned according to __________ instructions.
manufacturer's 72323. Nursing Service--Cleaning, Disinfecting and Sterilizing. (e) Electronic thermometers shall be cleaned and disinfected according to the manufacturer's instructions. Glass thermometers shall be cleaned and disinfected for at least 10 minutes with 70 percent ethyl alcohol or 90 percent isopropyl alcohol with 0.2 percent iodine. Oral and rectal thermometers shall be stored separately in clean, labeled containers with fitted lids.
109
SNF.....Are postural supports restraints?
No 72319. Nursing Service--Restraints and Postural Supports. (k) "Postural support" means a method other than orthopedic braces used to assist patients to achieve proper body position and balance. Postural supports may only include soft ties, seat belts, spring release trays or cloth vests and shall only be used to improve a patient's mobility and independent functioning, to prevent the patient from falling out of a bed or chair, or for positioning, rather than to restrict movement. These methods shall not be considered restraints.
110
SNF.....How long is a permanent log of temporary health services personnel (registry) employed in the facility kept?
three years 72533. Employee Personnel Records. (c) A permanent log of the temporary health services personnel employed in the facility shall be kept for three years, .....
111
SNF.....Mop heads shall be changed at least ________.
daily 72621. Housekeeping. (c) Cleaning supplies and equipment shall be available to housekeeping staff. Such cleaning supplies and equipment shall meet the following requirements: (1) Cleaning supplies and equipment shall be stored in rooms for housekeeping use only. (2) A commercial detergent germicide shall be used for all cleaning. (3) Mop heads shall be removable and changed at least daily.
112
SNF.....Do restraints require recording the time of application and removal?
Yes 72547. Content of Health Records. (E) Record of type of restraint and time of application and removal. The time of application and removal shall not be required for postural supports used for the support and protection of the patient.
113
SNF.....Does the Medical Director act as a consultant to the director of nursing service?
Yes 72305. Physician Services--Medical Director. (a) The facility shall have a medical director who shall be responsible for standards, coordination, surveillance and planning for improvement of medical care in the facility. b) The medical director shall: (1) Act as a liaison between administration and attending physicians. (2) Be responsible for reviewing and evaluating administrative and patient care policies and procedures. (3) Act as a consultant to the director of nursing service in matters relating to patient care services. (4) Be responsible for reviewing employees' preemployment and annual health examination reports.
114
SNF.....Corridors shall be equipped with _____ handrails.
firmly secured 72635. Handrails. Corridors shall be equipped with firmly secured handrails as required by Section T17-058(e), Title 24.
115
SNF.....Patient care policies and procedures shall be reviewed _________________.
annually 72523. Patient Care Policies and Procedures. (a) Written patient care policies and procedures shall be established and implemented to ensure that patient related goals and facility objectives are achieved. (b) All policies and procedures required of these regulations shall be in writing, made available upon request to physicians and other involved health professionals, patients or their representatives, employees and the public shall be carried out as written. Policies and procedures shall be reviewed at least annually, revised as needed and approved in writing by the patient care policy committee.
116
SNF.....How often must an evaluation be done on the progress of an incontinent patient in his/her bowel and bladder program?
Weekly 72315. Nursing Service--Patient Care. (i) Measures shall be implemented to prevent and reduce incontinence for each patient and shall include: (1) Written assessment by a licensed nurse to determine the patient's ability to participate in a bowel and/or bladder management program. This is to be initiated within two weeks after admission of an incontinent patient. (2) An individualized plan, in addition to the patient care plan, for each patient in a bowel and/or bladder management program. (3) A weekly written evaluation in the progress notes by a licensed nurse of the patient's performance in the bowel and/or bladder management program.
117
SNF.....Consumer information must be posted _________.
Conspicuously, prominently and accessible to the public 72503. Consumer Information to Be Posted. (a) The following consumer information shall be conspicuously posted in a prominent location accessible to the public.
118
SNF.....How soon must the Department be notified if patient records are defaced or destroyed before the retention period is over?
within three business days 72543. Patients' Health Records. (d) The Department shall be informed within three business days, in writing, whenever patient health records are defaced or destroyed before termination of the required retention period.
119
SNF.....Which committees must the administrator be a member of?
patient care policy and pharmaceutical service 72525. Required Committees. (c)(1) Patient care policy committee. (B) The committee shall be composed of: at least one physician, the administrator, the director of nursing service, a pharmacist, the activity leader and representatives of each required service as appropriate. (3) Pharmaceutical service committee. (B) The committee shall be composed of the following: a pharmacist, the director of nursing service, the administrator and at least one physician.
120
SNF.....After a normal power failure, automatic restoration of power for emergency circuits should occur within______ ______.
ten seconds 72641. Emergency Lighting and Power System. (d) The emergency lighting and power system shall be maintained in operating condition to provide automatic restoration of power for emergency circuits within ten seconds after normal power failure.
121
SNF.....The facility must have _____________ supply of perishable foods maintained on the premises.
two days' 72349. Dietetic Service--Equipment and Supplies. (d) Food supplies shall meet the following standards: (1) At least one week's supply of staple foods and at least two days' supply of perishable foods shall be maintained on the premises. Food supplies shall meet the requirements of the weekly menu including the therapeutic diets ordered.
122
SNF.....The attending physician must be notified when there is a _____ change in weight within _____ days unless otherwise ordered.
5 pounds or more..... within 30 72311. Nursing Service--General (3) Notifying the attending licensed healthcare practitioner acting within the scope of his or her professional liensure promptly of: (A) The admission of a patient. (B) Any sudden and/or marked adverse change in signs, symptoms or behavior exhibited by a patient. (C) An unusual occurrence, as provided in Section 72541, involving a patient. (D) A change in weight of five pounds or more within a 30-day period unless a different stipulation has been stated in writing by the patient's licensed healthcare practitioner acting within the scope of his or her professional licensure. (E) Any untoward response or reaction by a patient to a medication or treatment. (F) Any error in the administration of a medication or treatment to a patient which is life threatening and presents a risk to the patient.
123
SNF.....Milk products shall be processed or manufactured in milk product plants meeting the requirements of ______.
Division 15 of the California Food and Agricultural Code 72349. Dietetic Service--Equipment and Supplies. (d) Food supplies shall meet the following standards: (3) Milk, when served as a beverage, shall be pasteurized Grade A or certified unless otherwise prescribed by the physician's diet order. Milk, milk products and products resembling milk shall be processed or manufactured in milk product plants meeting the requirements of Division 15 of the California Food and Agricultural Code. Powdered milk shall not be used as a beverage but may be used in cooking.
124
SNF.....Cleaning supplies may be stored in rooms for_____________ use only.
housekeeping 72621. Housekeeping. (a) Each facility shall routinely clean articles and surfaces such as furniture, floors, walls, ceilings, supply and exhaust grills and lighting fixtures. (b) Schedules and procedures shall be posted which indicate the areas of the facility which shall be cleaned daily, weekly or monthly. The cleaning schedules and procedures shall be implemented. (c) Cleaning supplies and equipment shall be available to housekeeping staff. Such cleaning supplies and equipment shall meet the following requirements: (1) Cleaning supplies and equipment shall be stored in rooms for housekeeping use only. (2) A commercial detergent germicide shall be used for all cleaning. (3) Mop heads shall be removable and changed at least daily.
125
SNF.....Is an administrator's license required to be posted conspicuously in a prominent location?
No 72503. Consumer Information to Be Posted. (a) The following consumer information shall be conspicuously posted in a prominent location accessible to the public. (1) Name, license number and date of employment of the current administrator of the facility.
126
SNF.....The Pharmaceutical Service Committee must meet at least ________.
Quarterly 72525. Required Committees. (3) Pharmaceutical service committee. (A) A pharmaceutical service committee shall direct the pharmaceutical services in the facility. (B) The committee shall be composed of the following: a pharmacist, the director of nursing service, the administrator and at least one physician. (C) The committee shall meet at least quarterly. (D) The functions of the pharmaceutical service committee shall include, but not be limited to: 1. Establishing, reviewing, monitoring and approving policies and procedures for safe procurement, storage, distribution and use of drugs and biologicals. 2. Reviewing and taking appropriate action on the pharmacist's quarterly report. 3. Recommending measures for improvement of services and the selection of pharmaceutical reference materials.
127
SNF.....Can bathtubs, lavatories or laundry sinks be used for cleaning bedpans?
No 72629. Provisions for Emptying Bedpans. Bedpans shall be emptied and cleaned in utility rooms unless toilets adjoining patients' rooms are equipped with flushing attachments and vacuum breakers. Bathtubs, lavatories or laundry sinks shall not be used for cleaning and emptying bedpans.
128
SNF.....What is the minimum daily average nursing hours per patient day for a patient certified for a Special Treatment Program?
2.3 72329. Nursing Service--Staff. (1) Facilities which provide care for mentally disordered patients and in which licensed psychiatric technicians provide patient care shall meet the following standards: (A) If patients are not certified for special treatment programs, facilities shall employ sufficient staff to provide a minimum of 3.2 nursing hours per patient day. (B) For patients certified for special treatment programs, facilities shall employ sufficient staff to provide a minimum of 2.3 nursing hours per patient day for each patient certified to the special treatment program, exclusive of additional staff required to meet the staffing standards of the special treatment program.
129
SNF.....Written ______________ ____________ must be in place prior to transferring a patient to a nearby health facility.
transfer agreement 72519. Patient Transfer. (a) The licensee shall maintain written transfer agreements with other nearby health facilities to make the services of those facilities accessible and to facilitate the transfer of patients. Complete and accurate patient information, in sufficient detail to provide for continuity of care shall be transferred with the patient at time of transfer.
130
SNF.....Each toliet area must have _______ readily accessible for patient use.
Grab bars 72651. Water Supply and Plumbing. (g) Grab bars, readily accessible to patients, shall be maintained at each toilet, bathtub and shower used by patients.
131
SNF.....Who is responsible for determining what information is material for a decision to be made to accept or refuse a proposed treatment or procedure?
the attending licensed healthcare practitioner acting within the scope of his or her professional licensure 72528. Informed Consent Requirements. (a) It is the responsibility of the attending licensed healthcare practitioner acting within the scope of his or her professional licensure to determine what information a reasonable person in the patient's condition and circumstances would consider material to a decision to accept or refuse a proposed treatment or procedure. Information that is commonly appreciated need not be disclosed. The disclosure of the material information and obtaining informed consent shall be the responsibility of the licensed healthcare practitioner who, acting within the scope of his or her professional licensure, performs or orders the procedure or treatment for which informed consent is required.
132
SNF.....What is the minimum span in hours between the last meal and the first meal of the following day?
14 72335. Dietetic Service--Food Service. (a) The dietetic service shall provide food of the quality and quantity to meet each patient's needs in accordance with the physicians' orders and to meet "The Recommended Daily Dietary Allowance," the most current edition, adopted by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences, and the following: (1) Not less than 3 meals shall be served daily and with not more than a 14-hour span between the last meal and the first meal of the following day.
133
SNF.....Patient money and/or valuables cannot be _____ with that of the licensee or facility.
mingled 72529. Safeguards for Patients' Monies and Valuables. (a) Each facility to whom a patient's money or valuables have been entrusted shall comply with the following: (1) No licensee shall mingle patients' monies or valuables with that of the licensee or the facility. Patients' monies and valuables shall be maintained separate, intact and free from any liability that the licensee incurs in the use of the licensee's or the facility's funds. The provisions of this section shall not be interpreted to preclude prosecution for the fraudulent appropriation of patients' monies or valuables as theft, as defined by Section 484 of the Penal Code.
134
SNF.....A 100 bed Skilled Nursing Facility requires a RN and the __________to be on duty day and night.
director of nursing 72329. Nursing Service--Staff. (d) Facilities licensed for 100 or more beds shall have at least one registered nurse, awake and on duty, in the facility at all times, day and night, in addition to the director of nursing service. The director of nursing service shall not have charge nurse responsibilities.
135
SNF..... A physical restraint shall only be used with a ______order.
written 72319. Nursing Service--Restraints and Postural Supports. (a) Written policies and procedures concerning the use of restraints and postural supports shall be followed. (b) Restraints shall only be used with a written order of a licensed healthcare practitioner acting within the scope of his or her professional licensure. The order must specify the duration and circumstances under which the restraints are to be used. Orders must be specific to individual patients. In accordance with Section 72317, there shall be no standing orders and in accordance with Section 72319(i)(2)(A), there shall be no P.R.N. orders for physical restraints.
136
SNF.....Is one of the duties of the medical director to approve the dietetic service manual?
No 72337. Dietetic Service--Diet Manual. A current therapeutic diet manual, approved by the dietitian and the patient care policy committee, shall be readily available to dietetic personnel and licensed healthcare practitioners acting within the scope of their professional licensure or certification. It shall be reviewed annually and revised at least every five years.
137
SNF.....True or False - Preparation of medication doses for more than two scheduled administration times shall not be permitted.
False 72313. Nursing Service--Administration of Medications and Treatments. (a) Medications and treatments shall be administered as follows: (4) Preparation of doses for more than one scheduled administration time shall not be permitted.
138
SNF.....Menus must be approved by the _______.
dietitian 72341. Dietetic Service--Menus. (a) Menus for regular and therapeutic diets shall be written at least one week in advance, dated and posted in the kitchen at least one week in advance. (b) All menus shall be approved by the dietitian.
139
SNF.....The pest control should be conducted in the_______________________, ________________ and ________________________.
main patient buildings, all outbuildings on the property and all grounds 72637. General Maintenance. (f) The facility shall be maintained free from vermin and rodents through operation of a pest control program. The pest control program shall be conducted in the main patient buildings, all outbuildings on the property and all grounds.
140
SNF.....How often must the patient care policy committee meet?
at least annually 72525. Required Committees. (c)(1) Patient care policy committee. (A) A patient care policy committee shall establish policies governing the following services: Physician, dental, nursing, dietetic, pharmaceutical, health records, housekeeping, activity programs and such additional services as are provided by the facility. (B) The committee shall be composed of: at least one physician, the administrator, the director of nursing service, a pharmacist, the activity leader and representatives of each required service as appropriate. (C) The committee shall meet at least annually.
141
SNF.....Does the Director of Nursing get his/her own office or other suitable space?
Yes 72325. Nursing Service--Space. (a) An office or other suitable space shall be provided for the director of nursing service.
142
SNF.....Alterations to an existing building must be in conformance with Title ______.
24 Article 6. Physical Plant 72601. Alterations to Existing Buildings or New Construction. (a) Alterations to existing buildings licensed as skilled nursing facilities or new construction shall be in conformance with Chapter 1, Division 17, Part 6, Title 24, California Administrative Code and requirements of the State Fire Marshal.
143
SNF.....Controlled Drugs are listed in Schedules ____, ____ and ____ of the Federal Comprehensive Drug Abuse Prevention and Control Act of 1970.
II, III, IV 72369. Pharmaceutical Service--Controlled Drugs. (a) Drugs listed in Schedules II, III and IV of the Federal Comprehensive Drug Abuse Prevention and Control Act of 1970 shall not be accessible to other than licensed nursing, pharmacy and medical personnel designated by the licensee. Drugs listed in Schedule II of the above Act shall be stored in a locked cabinet or a locked drawer separate from noncontrolled drugs unless they are supplied on a scheduled basis as part of a unit dose medication system.
144
SNF.....Are drugs ever used to restrain behavior?
Yes 72319. Nursing Service--Restraints and Postural Supports. (j) When drugs are used to restrain or control behavior or to treat a disordered thought process, the following shall apply: (1) The specific behavior or manifestation of disordered thought process to be treated with the drug is identified in the patient's health record. (2) The plan of care for each patient specifies data to be collected for use in evaluating the effectiveness of the drugs and the occurrence of adverse reactions. (3) The data collected shall be made available to the prescriber in a consolidated manner at least monthly. (4) PRN orders for such drugs shall be subject to the requirements of this section.
145
SNF.....In a SNF is refusal of treatment a resident right?
Yes 72527. Patients' Rights. (4) To consent to or to refuse any treatment or procedure or participation in experimental research.

Title 22: 2.5 & 3 (3 decks)

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