Environment Flashcards
During the years 1993 to 2006 , the percentage of chain-owned nursing facilities
Varied between just less than and just more than half
During the years 1993 to 2006, the occupancy rates for US nursing facilities
Decreased
As a result of few new nursing homes being build in recent decades, it can be expected that occupancy rates in nursing homes ___ over the next 30. years
Will be near 100%
The projections of daily volume of long term care assistance by all categories of caregivers are expected to
Steadily increase
The projections of daily volume of long term care assistance needed in the year 2040 are about ___ the need identified in 1980
Four times
The percentage of Medicaid dollars spent on institutional care over the past couple of decades has
Decreased slightly
The American Association of Home and Services for the Aging ins the
National non-for-profit group
The proportion of Medicare nursing home residents who reside in facilities at any one time is ___ the proportion who are Medicaid
Far smaller than
The federal government matches state expenditures ranging from
50%-83%
In 2006 the federal government changed the ‘look back’ period for which Medicaid assistance may be denied due to ‘gifts’
From 3 years to 5 years look back
Knowing the Occupational Safety and Health Act OSHA standards applicable to a facility is the responsibility of the
Employer (admistrator)
Occupational Safety and Health Act OSHA inspectors examine the records of illnesses and injuries to the
Employees
Accidents and illnesses requiring first aid and not resulting in work loss___ reported
Do not have to be
The LIFE SAFETY CODE
Has the effect of law in most states
An employee hearing the fire code phrase must
Go to his or her assigned station
Under the LIFE SAFETY CODE movement of infirm patients to safe areas or the exterior is ___ in fire drills
Not required
On discovery of fire involving a person, personnel shall immediately
Aid the person while calling aloud an established code phrase
Basic action required of health care facility personnel is
All of the aforementioned
Often the most dangerous element threatening patient safety is
Smoke inhalation
Smoking by residents designated as “not responsible”
Is prohibited
The overall objective of the
life safety code
for new health care occupancies is to
Limit spread of fire to the room of fire origin
Facility personnel who shall be instructed in the use of and response to a fire alarm include
All personnel
When a facility locks exits, it must
Maintain adequate staff to release locks
A material that in the form in which it is used, will not aid combustion or add appreciable heat to spreading fire is defined as
Noncumbistible
In a determining occupant loads in exit requirements, the actual expected count or a projection using ___ square feet of floor space in sleeping areas and or a projection using ___ square feet of floor space in sleeping areas and ___ square feet of floor space in treatment areas shall be used
120/240
Handrails clearance from the wall must be at least
1 1/2 inches
The purpose of smoke proof towers is to
Limit infiltration of heat, smoke, and fire gases
The National Safety Council has suggested slopes of 7-20 degrees for a
Stairway and landings
Aisles, corridors, and ramps used for exit must be at least ___ in width, and clear and unobstructed
8 feet
Travel distance within a room to an exit must not exceed
50 feet
Each floor or fire section fo the facility shall have at least ___ located___ from each other
Two exits/remotely
Travel distance from within any patient room to an exit access must not exceed
200 feet
Illumination of the means of degrees must be continuous and must provide at least ___ foot candle(s) measured at the ___
1/floor
The emergency lighting system must provide pwer
Automatically
Exit signs must be placed so that a person is never more than ___ from the nearest exit sign
100 feet
Corridors throughout patient sleeping areas must have
Automatic smoke detection systems
A supervised automatic sprinkler system
Is required
Short persons must be able to reach
Fire extinguishers
A fixed, regularly serviced, automatic fire extinguishing system in nursing home kitchens over the cook stoves is
Required
Every building shall have a(an) ___ operated fire alarm system that shall be ___ supervised
Manually/electronically
Every story used by patients must be divided into
Two smoke compartements
Eery story with 50 or more occupants must be divided into at least
Two smoke compartmetns
Extinguishers should be checked ___ by the fire department and recharged and serviced ___ by a qualified person
Quarterly/annually
Doors protecting corridor openings must be made of 1 3/4 inches solid bonded core wood or constructed to resist fire for at least ___ minutes
20
Each patient room must have an outside window or door. If a window, it
Need not be operable
For changes in level: up to 1/4 inch ___, between 1/4 and 1/2 inch ___ is required, and more than 1/2 inch must meet ___ requirements
Permissible/beveled edge/ramp
On any given flight of stairs, riser heights and tread widths must be
Uniform
High forward reach limit is generally
48 inches
Minimum width for two wheelchairs to pass is ___ nches
60
Side reach should be between ___ inches of the floor
9 and 54
Handrails must extend at least ___ inches beyond a ramp or stair and be parallel to the floor or round surface
12
The generally specified maximum pounds of pressure required to operate doors, windows, and so on , is
5
Automatic doors and power assisted doors should be slow opening and low powered, not opening back to go back faster than ___ seconds nor with a force of more than ___ pounds
3/15
Grab bars located between ___ and ___ inches high must be provided for toilets on the side and back walls
33/36
Grab bars and handrails are to be ___ to ___ inches in diameter or width, with ___ inches of space between handrail and a wall, and a sheer stress point of ___ pounds or greater
1 1/4 - 1 1/2 - 1 1/2 - 250
The maximum allowable emergency alarm level is ___ decibels
120
The general requirement for knee clearance under tables, work surfaces, sinks, and lavatories is
19 inches
Title 7 of the Civil Rights Act of 1964 prohibited employers from discriminating on the basis of
Race/Color/Sex
In 1935 a major labor group emerged called the
CIO (Congress of Industrial Organiztoins
By 1947 unions represented about 31% of the workforce. In 2015 union membership represented about ___% of the total work force
16
The Taft Hartley Act prohibited managers from
- Giving tenure to employees to discourage unionization
- Giving wage increases to discourage unionization
- Firing employees who give testimony under the Wagner Act
The National Labor Relations Board (NLRB) does not
Make court decisions
In 1973 the hospitals and nursing facility interests did not seek
Exemption from the National Labor Relations Board NLRB oversight
In 1984 the National Labor Relations Board NLRB favored nursing home managers by ruling that the appropriate bargaining unit is
All professionals all nonprofessionals
Discrimination was interpreted initially by the courts as harmful action, later as unequal treatment, and more recently as
Unequal or adverse impact
The Civil Rights Act is enforced
By the Equal Employment Opportunity Commission
The Fair Labor Standards Act requires that an overtime rate of ___ times the hourly (or other basis) rates be paid for all hours more than ___ during the week
1 1/2 - 40
Minors younger than 16 years may not be employed in the nursing facility except under
A temporary permit issued by the Department of Labor
Funds for unemployment compensation come from a ___ payroll tax based on wages of each employee up to a certain
Federal/maximum
Under ERISA (Employee Retirement Income Security Act of 1975) employers ___ pension plan
Are not required to offer
In states where a local health planning agency believes a shortage of nursing home beds exists, it may
Issue a certificate of need
The most well known model fo the grieving process was developed by an American psychiatrist ____ in the book; On Death and Dying
Elisabeth Kubler Ross
The five stages of dying are thought to be denial, anger, bargaining, depression, and __
Acceptance
Basically under the Privacy Rule issued by the Department of Health and Human Services DHHS it is illegal fro any person to gain access to personal medical information for any reason other than health care delivery, operations, and
Reimbursement
The following are ___
- Hep B
- Influenza
- Measles
- Mumps
- Rubella
- Varicella
- Tetanus
- Diphtheria
- Pertussis
Recommended vaccines for health care workers
The ___ require insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of preexisting conditions or sex
Affordable Care Act
The ___ includes a requirement that both the federal Department of Health and Human Services and local law enforcement authorities must be notified of any suspicions of abuse regardless of whether or not that suspected abuse results in bodily harm
Elder Justice Law 2010
For nursing facilities, meeting requirements set by the Joint Commission on Accreditation of Healthcare Organizations JCAHO is
Voluntary
