F-tag Law only

Question 1

The resident has a right to manage his or her financial affairs. Medicare / Medicaid

Answer 1

x personal funds in excess of $100 in an interest bearing account

x The facility must maintain a resident’s personal funds that do not exceed $100 in a non-interest bearing account, interest-bearing account, or petty cash fund

x personal funds in excess of $50 in an interest bearing account

x personal funds that do not exceed $50 in a noninterest bearing account, interest-bearing account, or petty cash fund.

Question 2

Accounting and Records

Answer 2

resident through quarterly statements and upon request

Question 3

Notice of certain balances

Answer 3

When the amount in the resident’s account reaches $200 less than the SSI ( Supplemental Security Income ) resource limit for one person,

Question 4

Assurance of financial security

Answer 4

surety bond,

Question 5

Conveyance upon discharge, eviction, or death.

Answer 5

facility must convey within 30 days the resident’s funds, and a final accounting of those funds, to the resident, or in the case of death, the individual or probate jurisdiction administering the resident’s estate, in accordance with State law

Question 6

The resident has the right to access personal and medical records pertaining to him or herself.

Answer 6

x upon an oral or written request

x in the form and format requested by the individual

x within 24 hours (excluding weekends and holidays)

Question 7

The facility must allow the resident to obtain a copy of the records or any portions thereof

Answer 7

upon request and 2 working days advance notice to the facility

Question 8

The resident has the right to receive notices orally and

Answer 8

in writing (including Braille) in a format and a language he or she understands

Question 9

The facility must post, in a form and manner accessible and understandable to

Answer 9

x residents, resident representatives

x A list of names, addresses (mailing and email), and telephone numbers of all pertinent State agencies and advocacy groups, such as the State Survey Agency, the State licensure office, adult protective services where state law provides for jurisdiction in long-term care facilities, the Office of the State Long-Term Care Ombudsman program, the protection and advocacy network, home and community based service programs, and the Medicaid Fraud Control Unit

Question 10

Have reports with respect to any surveys, certifications, and complaint investigations made respecting the facility during the

Answer 10

x 3 preceding years, and any plan of correction in effect with respect to the facility, available for any individual to review upon request; and

x Post notice of the availability of such reports in areas of the facility that are prominent and accessible to the public

Question 11

Comfortable and safe temperature levels

Answer 11

must maintain a temperature range of 71 to 81°F

Question 12

Before a facility transfers or discharges a resident, the facility must—

Answer 12

x at least 30 days before the resident is transferred or discharged

Question 13

Admission orders

Resident Assessment

Answer 13

The facility must conduct initially and periodically a comprehensive, accurate, standardized reproducible assessment of each resident’s functional capacity

Question 14

Admission orders

A facility must make a comprehensive assessment of a resident’s needs, strengths, goals, life history and preferences, using
the

Answer 14

resident assessment instrument (RAI) specified by CM

Question 15

Admission orders

a facility must conduct a comprehensive assessment of a resident in accordance with the timeframes

Answer 15

(i) Within 14 calendar days after admission, excluding readmissions in which there is no significant change in the resident’s physical or mental condition.
iii) Not less than once every 12 months.

Question 16

Admission orders

Within 14 days after the facility determines, or should have determined, that there has been a significant change in the resident’s physical or mental condition.

Answer 16

significant change” means a major decline or improvement in the resident’s status that will not normally resolve itself without further intervention

Question 17

Admission orders

Quarterly Review Assessment
A facility must assess a resident using the quarterly review instrument specified by the State and approved by CMS not less frequently than

Answer 17

once every 3 months.

Question 18

Admission orders

A facility must maintain all resident assessments completed within the previous

Answer 18

15 months in the resident’s active record and use the results of the assessments to develop, review and revise the resident’s comprehensive care plan.

Question 19

Admission orders

Answer 19

At the time each resident is admitted, the facility must have physician orders for the resident’s immediate care.

Question 20

Automated data processing requirement-

Answer 20

Within 7 days after a facility completes a resident’s assessment, a facility must encode the following information for each resident in the facility:

Question 21

Transmitting data
a facility completes a resident’s assessment, a facility must be capable of transmitting to the CMS System information for each resident contained in the MDS in a format that conforms to standard record layouts and data dictionaries, and that passes standardized edits defined by CMS and the State.

Answer 21

Within 7 days after

Question 22

Transmittal requirements
a facility completes a resident’s assessment, a facility must electronically transmit encoded, accurate, and complete MDS data to the CMS System

Answer 22

Within 14 days after

x Admission assessment.
x Annual assessment.
x Significant change in status assessment.
x Significant correction of prior full assessment.
x Significant correction of prior quarterly assessment.
x Quarterly review.
x A subset of items upon a resident’s transfer, reentry, discharge, and death.
x Background (face-sheet) information, for an initial transmission of MDS data on resident that does not have an admission assessment.

Question 23

Coordination.

A registered nurse must conduct or coordinate each assessment with the appropriate participation of health professionals.

Answer 23

Coordination.

Question 24

Certification.

A registered nurse must sign and certify that the assessment is completed.

Answer 24

Certification.

Question 25

Each individual who completes a portion of the assessment must sign and certify the accuracy of that portion of the assessment.

Answer 25

correct

Question 26

pre-admission screening and resident review

Answer 26

(PASARR)

Question 27

Baseline Care Plans

Answer 27

Be developed within 48 hours of a resident’s admission

Initial goals based on admission orders.
Physician orders.
Dietary orders.
Therapy services.
Social services.
PASARR recommendation, if applicable.

Question 28

A comprehensive care plan must be—

Answer 28

Developed within 7 days after completion of the comprehensive assessment

Question 29

The physician must—

Answer 29

Sign and date all orders with the exception of influenza and pneumococcal vaccines,

Question 30

Frequency of physician visits

Answer 30

The residents must be seen by a physician at least once every 30 days for the first 90 days after admission, and at least once every 60 thereafter.

Question 31

Availability of physicians for emergency care

Answer 31

The facility must provide or arrange for the provision of physician services 24 hours a day, in case of emergency

Question 32

Data requirements

The facility must post the following information on a daily basis:

Answer 32

Facility name.

The current date.

The total number and the actual hours worked by the following categories of licensed and unlicensed nursing staff directly responsible for resident care per shift:

Registered nurses.

Licensed practical nurses or licensed vocational nurses (as defined under State law).

Certified nurse aides.

Resident census.

Question 33

Data requirements

Facility data retention requirements

Answer 33

The facility must maintain the posted daily nurse staffing data for a minimum of 18 months, or as required by State law, whichever is greater.

Question 34

Drug Regimen Review

Answer 34

The drug regimen of each resident must be reviewed at least once a month by a licensed pharmacist.

Question 35

The pharmacist must report any

Answer 35

irregularities to the attending physician and the facility’s medical director and director of nursing, and these reports must be acted upon.

Question 36

Any irregularities noted by the pharmacist during this review must be documented on a separate, written report that is sent to the

Answer 36

attending physician and the facility’s medical director and director of nursing and lists, at a minimum, the resident’s name, the relevant drug, and the irregularity the pharmacist identified.

Question 37

he attending physician must document in the resident’s medical record that the identified irregularity has been reviewed and

Answer 37

what, if any, action has been taken to address it.

Question 38

Unnecessary Drugs—General.

Each resident’s drug regimen must be free from unnecessary drugs. An unnecessary drug is any drug when used—

Answer 38

(1) In excessive dose (including duplicate drug therapy); or
(2) For excessive duration; or
(3) Without adequate monitoring; or
(4) Without adequate indications for its use; or
(5) In the presence of adverse consequences which indicate the dose should be reduced or discontinued; or
(6) Any combinations of the reasons stated in paragraphs (d)(1) through (5) of this section.

Question 39

A psychotropic drug is any drug that affects brain activities associated with mental processes and behavior. These drugs include, but are not limited to, drugs in the following categories:

Answer 39

Anti-psychotic;
Anti-depressant;
Anti-anxiety; and
Hypnotic

Question 40

Medication Errors. The facility must ensure that its

Answer 40

Medication error rates are not 5 percent or greater; and Residents are free of any significant medication errors

Question 41

Labeling of Drugs and Biologicals

Storage of Drugs and Biologicals

Answer 41

facility must store all drugs and biologicals in locked compartments under proper temperature controls

The facility must provide separately locked, permanently affixed compartments for storage of controlled drugs listed in Schedule II of the Comprehensive Drug Abuse Prevention and Control Act of 1976

quantity stored is minimal

Question 42

The facility must—

Provide or obtain laboratory services only when

Answer 42

ordered by a physician; physician assistant; nurse practitioner or clinical nurse specialist in accordance with State law, including scope of practice laws

Question 43

Promptly notify the ordering physician, physician assistant, nurse practitioner, or clinical nurse specialist of laboratory results that

Answer 43

fall outside of clinical
reference ranges in accordance with facility policies and procedures for notification of a practitioner or per the ordering physician’s orders

Question 44

___________ refer residents with lost or damaged dentures for dental services.

Answer 44

Must promptly, within 3 days

Question 45

If a referral does not occur within

Answer 45

3 days, the facility must provide documentation of what they did to ensure the resident could still eat and drink adequately while awaiting dental services and the extenuating circumstances that led to the delay;

Question 46

Therapeutic Diets

Answer 46

Therapeutic diets must be prescribed by the attending physician.

Question 47

The attending physician may delegate to a registered or licensed dietitian the task of prescribing a resident’s diet, including

Answer 47

a therapeutic diet, to the extent allowed by State law.

Question 48

Frequency of Meals

facility must provide at least three meals daily, at regular times comparable to normal mealtimes

There must be no more than________

Answer 48

14 hours between a substantial evening meal and breakfast the following day

Question 49

when a nourishing snack is served at bedtime,

Answer 49

up to 16 hours may elapse between a substantial evening meal and breakfast the following day if a resident group agrees to this meal span

Question 50

Medical director.

The facility must designate a physician to serve as medical director.

The medical director is responsible for________

Answer 50

Implementation of resident care policies; and

The coordination of medical care in the facility

Question 51

Medical records.

Answer 51

Complete;
Accurately documented;
Readily accessible; and
Systematically organized

Question 52

Medical records must be retained for—

Answer 52

Five years from the date of discharge when there is no requirement in State law;

or For a minor, 3 years after a resident reaches legal age under State law.

Question 53

Facility closure-Administrator.
Any individual who is the administrator of the facility must:

Submit to the State Survey Agency, the State LTC ombudsman, residents of the facility, and the legal representatives of such residents or other responsible parties, written notification of an impending closure:

Answer 53

At least 60 days prior to the date of closure

Question 54

Facility closure.

Answer 54

The facility must have in place policies and procedures to ensure that the administrator’s duties and responsibilities involve providing the appropriate notices in the event of a facility closure

Question 55

Social worker.

Answer 55

Any facility with more than 120 beds must employ a qualified social worker on a full- time basis.

Question 56

Quality assessment and assurance.

A facility must maintain a quality assessment and assurance committee consisting at a minimum of:

Answer 56

The director of nursing services;

The Medical Director or his/her designee;

At least three other members of the facility’s staff, at least one of who must be the administrator, owner, a board member or other individual in a leadership role; and

The infection preventionist.

Question 57

QAPI program required

Answer 57

Meet at least quarterly and as needed to coordinate and evaluate activities under the QAPI program,

Question 58

Influenza and pneumococcal immunizations

Answer 58

Before offering the influenza immunization, each resident or the resident’s representative receives education regarding the benefits and potential side effects of the immunization;

October 1 through March 31 annually

Question 59

Compliance and ethics program

Required components for all facilities

Physical Environment.

Life safety from fire.

A long term care facility must:

Answer 59

Install, at least, battery-operated single station smoke alarms in accordance with the manufacturer’s recommendations in resident sleeping rooms and common areas.

Question 60

When a sprinkler system is shut down for more than

Answer 60

10 hours, the LTC facility must:

Evacuate the building or portion of the building affected by the system outage until the system is back in service, or

Establish a fire watch until the system is back in service

Question 61

Emergency Power

Answer 61

at least for lighting all entrances and exits

life support systems

Question 62

Dining and Resident Activities

The facility must provide one or more rooms designated for resident dining and activities.

Answer 62

These rooms must–

(1) Be well lighted;
(2) Be well ventilated;
(3) Be adequately furnished; and
(4) Have sufficient space to accommodate all activities.

Question 63

Required in-service training for nurse aides. In-service training must—

Answer 63

Be sufficient to ensure the continuing competence of nurse aides, but must be no less than 12 hours per year