Facility Policies Flashcards
If a nursing facility has been certified by Medicare and Medicaid under Final Rules and federal requirements, in effect, it
Must still meet all state and local licensure requirements
Establishing and implementing policies regarding the management of the facility are assigned to
The governing body or persons designated as such
In order to begin collecting better data about the nursing home industry, federal legislation mandated development and use of
A Minimum Data Set
The comprehensive care plan does not include a
Medical director
Nurse’s aides who have completed a training and competency evaluation program and passed the required competency test(s)
Must still be judged by surveyors as competent to provide services
Responsibility for ascertaining professional performance standards for licensed, certified, or registered allied health persons used by the facility rests with the
Facility
Organizations that actually pay the Medicare claims submitted by doctors and other medical suppliers are called
Carriers
The facility is not required to use its resources effectively and efficiently to attain the highest practical
Profitability
A person who is determined by the state mental health authority to need nursing facility service but is receiving active treatment for mental illness
Can be admitted
Each facility must designate a physician to serve as medical director
On a part time or full time basis
The administrator believes that once the obligation to meet federal, state, and local laws is met the requirements applicable to the operation of the facility have been satisfied. The administrator is
Only partially correct
The terms for Medicare and Medicaid participating homes used in the Final Rules effect are
Skilled nursing facility and nursing facility
Having a transfer agreement with one or more hospitals is
A condition of participation requirement
Nursing homes are licensed by
The states
Regulations such as those implementing Medicare and Medicaid; Requirements for Long Term Care Facilities, are first published in the
Federal Register
All facilities are required to
Have a governing body or designated persons functioning as a governing body
The facility administrator establishes written transfer agreements with their local hospitals, one of which is approved only for participation under the Medicare program, and the second approved only for participation under Medicaid. The administrator has
Failed to meet transfer agreement requirements
The transfer agreements signed by the administrator ensure that the medical and other information needed for care and treatment of the resident is available and that a bed will be available for the resident on return from the hospital. This is the entire agreement. A visiting surveyor would
Require changes to the transfer agreement
The discharge social worker at the hospital determines that the resident cared for under the transfer agreement should return, not to the facility, but be placed din an assisted living facility that is a less expensive setting. Normally
This is appropriate
If persons with controlling interest in the facility, the company owning the facility or the administrator or DON change, the facility should
Inform the state licensing agency in writing
The administrator decides the trained therapeutic recreation specialist is too costly for the facility and hires instead a less expensive qualified occupational therapy assistant. This is
Within the federal hiring guidelines
The recently graduated social worker job applicant for a 140 bed facility states that she has a bachelor’s degree in psychology and 1 year’s experience as supervisor of four social workers at a nearby nursing hospital. The administrator should
Explore the applicant’s experience in more depth
The administrator of a 50 bed facility asks the director of nursing to serve as both director of nursing and as a charge nurse on the weekend shift
This is appropriate
If a facility provides the state minimum number of hours per resident day of care a state or federal inspector
May still cite nursing for insufficient staffing
If the administrator of an average daily total occupancy of 80 residents requires the DON to serve as charge nurse, the administrator
Has failed to meed Final Rules requirements
The consultant pharmacist at his monthly visit requires the director of nursing to provide him with a reconciliation report for all controlled drugs signed verified by the DON. The pharmacist
Should determine himself that drug records are in order
The personnel director recommends a part time nurse’s aide who has worked at the facility for the past 6 months and is nearing the end of her competency evaluation program be hired as a full time aide. The administrator should feel that the personnel director is
Not understanding the requirements
At least every 12 months the facility requires all full and part time nurses aides to fill in a report on the continuing education done by each aide in the facility. This report is then filed in the employees personnel file. The facility is
Failing to train based on outcome of these review
When the facility does not employ a qualified professional to furnish a service to be provided by the facility, the facility
Must have that service furnished
The facility must train ___ in emergency procedures___
all employees/when they begin to work
When a facility learns a court of law has taken action against one of its employees indicating unfitness for service, the facility must
report the courts’ action to licensing authorities
Ms. Brown alleges for the 12th documented time that she was abused by an employee. The facility
I negligent in protecting patients
If the facility does not employ a full-time qualified dietitian the facility
Designates a director of food services who receives consultation from qualified dietician
The facility must employ a ____ either full time, part time , or on a consultant basis
Qualified dietitian
Orders fro routine care or to improve th residents functional abilities must be available
At admission
If mental health rehabilitative services for mental illness or mental retardation are required in the resident’s plan of care, the facility
Must provide in house or obtain such services
The care plan team determines that although they had not anticipated it, the resident needs physical therapy. The facility should
Get a physicians written order
A resident who has ben determined by the courts to be incompetent decides he no longer wants the court appointed representative to handle his personal funds and asks the facility to establish a personal funds account for him. The facility should
Establish a personal funds account for that resident
Perhaps the most basic purpose of the new management of personal resident funds rules is to
Avoid commingling resident fund with facility funds
Notifying ___ residents when their account reaches ___ less than the ___ resource limit for one person is required
Medicaid/$200/SSI
on discovering that the new intake social worker required the individual holding durables power of attorney for a patient’s funds to sign a contract guaranteeing payment from that patient’s funds, the administrator should
Praise the intake social worker
Rights of residents who are adjudged incompetent by a court are exercised by
A person appointed by the court
Under the Final Rules, the right to immediate access to any resident by representatives of the state, ombudsman, protection agencies, and advocacy agencies is
Unrestricted
A representative of the state ombudsman office demands to see the clinical record of a Medicaid resident who had written that he wanted no one to have access to his clinical record. On receiving the request, you, the administrator should
Deny permission to the ombudsman
The resident hangs a religious ornament above her bed. Several nurse’s aides are offended and feel it is inappropriate. The facility administrator should
Advise the aides that this is appropriate
A resident may refuse to release personal and clinical records when
Required by the duly appointed state ombudsman
A resident asks the afternoon nurse on duty to access his patient records. The nurse responds. that she will have the records made available by late tomorrow morning. The nurse’s response is
Appropriate
Congress intends that residents have the right to inspect, on 48 hours notice
All their records
A resident is concerned about her cognitive status and asks to see al the facility has in her records about her cognitive status including tests administered at admission 4 weeks earlier. The resident is
Within her rights
The new resident speaks only Japanese. Before the resident was admitted, the facility advised him through this interpreter that no one in the facility spike Japanese and that solely sigh language would be used. On examining this admission condition in the residents records, the surveyor would
Cite the facility
After the first of 10 scheduled physical therapy sessions following her surgery, the resident tells the physical therapist she is not going to keep the final nine appointments. The resident is
Within her rights
The resident decides to discontinue all the nine drugs being administered daily. The facility staff feel this may result in a coma likely followed by death. The facility
Must comply and maintain the resident at highest level within the decision
Informing a resident of his rights is required
Prior to or at admission
A resident may perform services for the facility if the services are
In the plan of care
When a physician decides to discontinue an existing form of treatment due to adverse consequences, the acility
Must notify the resident and the resident’s representative
The facility staff suspect family members are abusing a resident’s funds and requires that, for the resident’s protection, his funds must be deposited with the facility. This is
Not permitted
A resident routinely maintained $40 in her personal funds account and is upset to learn the facility has her funds in a non-interest bearing account. Placing this resident’s funds in a non interest bearing account is
Permitted
A facility that informs each resident who is entitled to Medicaid benefits, in writing, at admission, and when changes of services that are paid for under the state plan occur, has
Not fully met its notice of service obligations
On the death o fa Medicaid resident, the facility conveyed the residents funds within 14 days and promised to forward a final accounting in 3 weeks. This is
Within the required notification periods
As part of a larger chain, the local facility believes that self insurance plus use of Federal Deposit Insurance Corporation insured accounts is a reasonable protection of resident funds. The surveyor is likely
To issue a deficiency
The facility routinely charges all cosmetic and grooming items and services for private, Medicare, and Medicaid residents. This charging policy
Is not permitted for Medicare and Medicaid residents
The facility proudly installed flat screen TVs in all residents rooms and added a small surcharge to all residents monthly charges. This freed up significant floor space in each room and improved resident morale. This approach to improving resident life
Violates Medicaid and Medicaid rules
The resident reports the facility to the state for releasing his medical records to the local hospitals despite his refusal to release these records when he was transferred to the local hospital. The state is likely to
Inform the resident he has no right to refuse to release his records on transfer
The resident has complained numerous times about the disruptive behavior of a nearby resident. The facility assures the resident that nothing can be done. This is
An inadequate facility response
A resident demands to see both the most recent survey results and the plan of correction. The facility shows the survey results, but tells the resident that the plan of correction is confidential and not available. The facility is
Violating resident rights
The resident requested work delivering newspapers throughout the facility. The resident receives $5.00 an hour for this work. The facility is
Not meeting work requirements
The resident demands computer and Internet access, but the facility fails to provide this. The facility
Is within its rights
A representative of the secretary knocks on the locked front door at 5:30 am. and wants immediate admission The charge nurse tells the representative to wait until the facility opens at 6am. This is
A violation
