LOS

Question 1

The ultimate goal of CMS in nursing Home us of restraints:

1. is the proper monitoring of all physical restraints
2. is restraint-free facility
3. is the minimum use of chemical restraints
4. are door locks that meet Life Safety Code regulations

Answer 1

is a restraint free facility

Question 2

Th primary purpose of Preadmission Screening and Resident Review (PASRR) is to:

1. clarify the difference between Mentally Ill and Intellectually Disabled clients
2. ensure the Mentally Ill and Intellectually Disabled are not admitted into nursing facility
3. ensure that individual are not inappropriately placed in nursing homes for long-term care
4. mandate that persons who are Intellectually Disabled receive the care and services require

Answer 2

ensure that individuals are not inappropriately placed in nursing homes for long-term care

Question 3

How long are nursing facilities required to keep all resident assessments in the resident's active record?
1/ 6 months
2. 12 months
3. 15 months
4. 18 months

Answer 3

15 months

Question 4

Which one of the following health care professionals is not required to be a member of the interdisciplinary team responsible for completing resident assessments?

1. Administrator
2. Physician
3. Registered Nurse
4. Certified Nurse Aide

Answer 4

Administrator

Question 5

Nursing facilities must develop and implement a baseline care plan for each resident that includes instruction needed to provide effective and person-centered care of each resident. What is the required time frame in which these care plans must be competed?

1. Within 8 hours of admission
2. Within 24 hours of admission
3. Within 48 hours of admission
4. Within the first 5 days of admission

Answer 5

Within 48 hours of admission

Question 6

Which of the following is true of Care Area Assessment (CAA)?

1. The CAA must contain care areas the resident is suffering from, as identified on the resident’s MDS, and those areas must be care planned
2. The CAA must contain care areas the resident is suffering from as identified on the resident’s MDS, but the assessment nurse determines it hey should be care planned
3. The CAA must contain a resident’s physical deficits that are triggered on the resident’s MDS and must be care planned after each MDS cycle
4. CAAs are completed only after the completion of the initial MDS and significant changes on the resident’s physical and/or psycho-social condition are noted.

Answer 6

The CAA must contain care areas the resident is suffering from as identified on the resident’s MDS, but the assessment nurse determines if they should be care planned

Question 7

What is the nursing home initially required to do when an incontinent resident is admitted or when a resident develops incontinence upon or after admission?

1. Complete an assessment to determine if the resident is appropriate for an incontinence training program
2. develop and implement a specific bowel and bladder training program that will enable the resident to regain the lost functions
3. Correct the underlying cause of incontinence by educating the resident on the use of kegal exercises and/or the introduction of medications
4. Notify the legally responsible party that neither Medicare nor Medicaid pays for disposable incontinent briefs , and the resident is responsible for supplying them should they prefer them over reusable briefs

Answer 7

Complete an assessment to determine if the resident is appropriate for an incontinence training program

Question 8

Ms. Michelle Jones is a long-term resident of a local nursing home. She slips in her bathroom one morning and fractures a hip. She is admitted to the local hospital and has surgery to repair the hip. She is readmitted to the nursing home a week later with physical therapy orders for 5 days per week. At what intervals will the registered nurse (RN) be responsible for completing Ms. Jones’ care assessments?

1. on the 5th, 14th, 30th, 60th, and 90th day after admission
2. on the 5th, 20th, and the 100th day after admission
3. By the 21st day, then every 60 days therafter
4. The 1st and 5th day after admission and every two weeks therafter

Answer 8

on the 5th, 14th, 30ths, 60th, and 90th day after admission

Question 9

In which of the following situations would a nursing facility be required to complete a Minimum Data Set on a resident in the facility?

1. Mr. Wilbert Thomas is a Medicaid recipient and has been a resident in the facility for a little over eight months. He has been prescribed an anti-biotic therapy for a Urinary Tract Infection
2. Ms, Mary Jane Jones is a Medicaid recipient and recently has suffered a fall with no apparent injuries. She has been a resident in the facility for six years and has had no previous falls
3. Mr. Johnny Branch had a medication change and is now seeing and hearing things that do not exist. His primary care physician orders labs and those labs show that Mr. Branch has a raging urinary tract infection
4. Mr. Steve Parker is admitted into the facility with multiple co-morbidities. However, within six months his health conditions improve to the point that his latest plan of care is no longer applicable

Answer 9

Mr. Steve Parker is admitted into the facility with multiple co-morbidities. However, within six months his health conditions improve to the point that his latest plan of care is no longer applicable

Question 10

Based on a comprehensive assessment, the facility must ensure that the residents who have not used psychotropic drugs are not given these drugs unless the medication is necessary to treat a specific condition as diagnosed and documented in the medical record. Which of the following is not the psychotropic family?

1. Anti-psychotics
2. Anti-depressants
3. Anti-emetics
4. Hypnotics

Answer 10

Anti-emetics

Question 11

Mr. Billy Ray Clement is an elderly resident in a nursing facility where he has resided for the past six years. Within the past six months, the nursing staff documented that he had lost his appetite and was losing weight. One day a CNA noticed that there was blood in a tissue into which Mr. Clement had coughed. She reported this to the nurse. The nurse spoke to Mr. Clement’s primary care physician, who ordered a battery of tests. The test resulted in a diagnosis of lung cancer. At his advanced age, Mr. Clement decided against any type of progressive therapy and accepted his prognosis of a life expectancy of less that six months, Mr, Clement has opted to sign up with hospice company to help him and his family during this transition. Which of the following is the most appropriate option for the nursing home?

1. The nursing home does not have a contract with a hospice company; therefore they will discharge Mr. Clement to a nursing facility that does have a contract
2. As the nursing home does not have a contract with a hospice company, the facility will provide palliative care services through its nursing and social work departments
3. The administrator will sign a one-time contract with a hospice company that will provide appropriate hospice services for Mr. Clement
4. The administrator will advise Mr. Clement that his care and services are being met by the facility and there is no need to transfer his care plan to a hospice company

Answer 11

The administrator will sign a one-time contract with a hospice company that will provide appropriate hospice services for Mr. Clement

Question 12

CMS requires nursing homes to post their most recent annual survey somewhere in the facility. Which of the following sites meets CMS approval?

1. a locked display case in the main lobby
2. behind the nurse’s station
3. In the director of Nursing’s office
4. In a binder on an open shelf in the main lobby

Answer 12

In a binder on an open shelf in the main lobby

Question 13

A surveyor is in a nursing home conducting the annual survey. She is scheduled to observe a medication pass. During that pass, she notes that 25 does of medication are scheduled to be administered. During the observation, the surveyor notes that the nurse administering the medications fails to give one dose that was prescribed, another dose was given in the wrong strength, and a PRN medication was not administered. What is the medication error rate?

1. 8%
2. 12 %
3. 16%
4. 20%

Answer 13

8%

Question 14

Which statement best describes what the pharmacist must do when she finds an irregularity in a resident’s drug regimen?

1. Take steps to ensure the irregularity is corrected immediately
2. report it to the medical director
3. report it to the attending physician or the director of nursing
4. report it to both the attending physician and the director of nursing

Answer 14

report it to both the attending physician and the director of nursing

Question 15

The Five Star rating system for nursing homes is based on the healthcare surveys, staffing, and quality measures. There is a direct relationship between late loss following is not considered a late loss ADL?

1. Bed mobility
2. Eating
3. Toilet use
4. Dressing

Answer 15

dressing

Question 16

On a Friday afternoon a resident requests that the facility provide a copy of his medical records for his review. When mist the facility make it available to him?

1. Monday afternoon
2. Tuesday afternoon
3. Wednesday afternoon
4. Thursday afternon

Answer 16

Tuesday afternoon

Question 17

Who is responsible for the implementation of the resident care policies in nursing homes?

1. Medical Director
2. Director of Nursing
3. Administrator
4. Board of Directors

Answer 17

Medical Director

Question 18

In those nursing homes required to use the Minimum Data Set as their standardized assessment tool, which of the following statements bests describes what must be done with these forms when completed?

1. Medicaid forms are electronically transmitted to the state Medicaid agency; Medicare is sent to CMS; and the completed form is kept in the resident’s medical chart for 15 months
2. Both Medicaid and Medicare forms must be sent to CMS; and the completed MDS is kept on the resident’s medical chart for 90 days
3. Both Medicaid and Medicare forms must be sent to the State Medicaid agency; and the completed MDS is kept in the resident’s medical chart for 15 months
4. Both Medicaid and Medicare require that the MDS’s are filed in the resident’s record for a minimum of 90 days; and a copy is sent to the state upon request

Answer 18

Both Medicaid and Medicare forms must be sent to the State Medicaid agency; and the completed MDS is kept in the resident’s medical chart for 15 months

Question 19

Ms. Albert Johnson is an 87-year-old lady who has been very active in her church as well as several civic groups. She has experienced excellent physical and mental health throughout her lifetime. On her way home from the grocery store one afternoon, she is involved in an automobile accident and fractures her right arm and right leg. She will require therapy after her hospital stay, so her physician recommends St Barbara’s Nursing and Rehabilitation Center, which is located only a few miles from her home. The nursing home admission director will request al of the following information except:

1. a level 2 Preadmission Screening
2. Physician Orders reflecting Ms. Johnson’s need for therapy
3. a current chest x-ray
4. verification of Ms. Johnson’s admit date to the hospital as an in-patient

Answer 19

a level 2 Preadmission Screening

Question 20

CMS regulations require physician visits to include all of the following except:

1. the physician must have face-to-face contact with the resident
2. after the initial visit, all physician visits to an SNF resident may be made by a nurse practitioner, clinical nurse specialist, or physician’s assistant, provided the visits are in compliance with the state regulations
3. all physician visits may be made for NF residents by a clinical nurse specialist, a clinical nurse practitioner, or a physician’s assistant, provided the visits are in compliance with state regulations
4. after the initial visit to the SNF resident, every other visit may be made by a qualified nurse practitioner, clinical nurse specialist, or physician’s assistant provided the visit is in compliance with state regulations

Answer 20

after the initial visit, all physician visits to an SNF resident may be made by a nurse practitioner, clinical nurse specialist, or physician’s assistant, provided the visits are in compliance with the state regulations

Question 21

Which of the following statements is not true in regards to dental services provided to residents in nursing homes?

1. The facility must ensure that a dentist is available for residents, either by employing a staff dentist or through a contractual basis
2. The facility must assist residents in obtaining routine dental services including limited prosthodontic procedures, such as taking impressions for dentures and fitting dentures
3. The facility must provide emergency dental care including the treatment of an episode of acute pain in teeth, gums, or palate
4. SNF’s must pay for the dental services rendered to a Medicare resident

Answer 21

SNF’s must pay for the dental services rendered to a Medicare resident

Question 22

Which of the following statements is true regarding the employment of a Certified Nursing Assistant?

1. A CNA must re-register every two years and must have worked at least 80 hours as a CNA within the past 24 months
2. The Affordable Care Act stipulates that nurse aide training includes initial and annual dementia management and resident abuse prevention training
3. Non-permanent persons can work as nursing aides regardless of their certification status
4. A facility can employ a person to work as a nursing assistant for up to 6 months as long as that individual is enrolled in a certification program

Answer 22

The Affordable Care Act stipulates that nurse aide training includes initial and annual dementia management and resident abuse prevention training

Question 23

Nursing facilities are required to employ Registered Nurses. Which of the following statements is not factual?

1. The Director of Nursing must be a Registered Nurse
2. The Director of Nursing may work as the charge nurse only when the facility is licensed and certified for 60 or fewer beds
3. The facility must have RN coverage in the facility for at least 8 hours per day, seven days a week
4. If a nursing facility has made a concerted effort to employ RN’s but cannot, the facility may be granted a waiver to that regulation

Answer 23

The Director of Nursing may work as the charge nurse only when the facility is licensed and certified for 60 or fewer beds

Question 24

Which of the following employees are prohibited from feeding residents in a nursing home?

1. The Director of Nursing
2. A Paid Feeding Assistant
3. The Speech Language Pathologist
4. The Registered Dietitian

Answer 24

The Registered Dietitian

Question 25

Nelson Smith is the administrator of a 130-bed nursing home in rural Indiana. His nursing home has had difficulty recruiting qualified staff members due to its remote location. The social worker of many years retires, thus creating a need to employ a new social worker for the facility. Which of the following is true in regards to qualifications needed to fill this professional position?

1. As the facility has less that 150 beds certified for Medicare and Medicaid, the social worker must meet the professional requirements as established by the state
2. The social worker must be qualified by having a Master’s degree in Social Work and at least one year’s supervised experience in a healthcare setting within the last 5 years.
3. As the facility notified the State that it has had difficulties hiring qualified professionals due to its rural location, the State can waive the federally required professional qualifications for the social worker
4. The social worker must be qualified by having a minimum of a bachelor’s degree in social work or a related human service field, and at least one year’s supervised experience in a healthcare environment

Answer 25

As the facility notified the State that it has had difficulties hiring qualified professionals due to its rural location, the State can waive the federally required professional qualifications for the social worker

Question 26

To serve as the Activities Director in a nursing home, which of the following is not true?

1. The candidate must have some experience in directing activities in a facility within the past 5 years
2. The candidate is certified as an Activities Director in the state in which he/she is working
3. The candidate can qualify as an Activities Director by being an Occupational Therapist or Occupational Therapist Assistant
4. The candidate is a Therapeutic Recreation Specialist

Answer 26

The candidate must have some experience in directing activities in a facility within the past 5 years

Question 27

Nursing homes are required to have a qualified professional managing its dietary operations. Which of the following does not qualify an applicant to manage the dietary department?

1. The applicant has a bachelor’s or higher degree granted by a regionally accredited college or university in the United States or equivalent foreign degree with completion of the academic requirements of a program in nutrition or dietetics accredited by an appropriate national accreditation organization
2. The applicant has completed at least 900 hours of supervised dietetics practice under the supervision of a registered dietitian or nutrition professional
3. The applicant has completed an executive chef program at an accredited program and must have worked for at least one year under the direct supervision of a certified dietary manager or a registered dietitian.
4. The applicant has an associate’s or higher degree in food service management or in hospitality, if the course study includes food service or restaurant management from an accredited institution of higher learning

Answer 27

The applicant has completed an executive chef program at an accredited program and must have worked for at least one year under the direct supervision of a certified dietary manager or a registered dietitian.

Question 28

Mary Davidson is a 77-year-old who is a Medicare recipient. During church services one Sunday she becomes ill and the pastor calls 911 on her behalf. She is rushed to the local hospital where she spends her first few hours under observation before suffered a CVA with left-side hemi-paralysis. After a week in the hospital, the attending physician recommends that Ms. Davidson be transferred to a local SNF. Ms. Davidson’s husband is a very doting, caring spouse and does not want her to go to a “nursing home” so he decides to bring her home so he can care for her. After two weeks Mr. Davidson determines that he cannot meet her needs and decides that a SNF placement is appropriate. Which of the following statements accurately reflects what the Davidson family can expect once Ms. Davidson is admitted to the SHF?

1. Since Ms. Davidson did not discharge from the hospital directly to the SNF, Medicare will determine that her condition obviously did not meet the standards for skilled services therefore Ms. Davidson will either pay for her stay privately or she must apply for Medicaid benefits under the Spousal Impoverishment criteria.
2. Medicare will reimburse the SNF for the first 20 days at 100 percent but the family will be responsible for a co-pay amount as set by CMS annually, starting on the 21st day through her discharge date
3. Medicare will reimburse the SNF for the first 20 days at 100 percent but there will be an 80 percent co-pay starting on day 21 through day 100
4. Medicare will reimburse the SNF for her entire stay up to 100 days at 100%

Answer 28

Medicare will reimburse the SNF for the first 20 days at 100 percent but the family will be responsible for a co-pay amount as set by CMS annually, starting on the 21st day through her discharge date

Question 29

Tom Jones is receiving skilled services at a nursing facility for deficits resulting from a severe brain bleed. He is 80 years old and is a recipient of Medicare Part A and Part B. Which of the following statements is not true of his Medicare services?

1. Medicare Part A reimburses the facility for the physical therapy, occupational therapy, and/or speech language pathology services Mr. Jones is receiving. Medicare Part A covers the therapy based on the Resource Utilization Group (RUG) level. Medicare will cease if Mr. Jones misses three consecutive days of any of the three therapies he is receiving
2. Once Mr. Jones has reached his fullest potential in each of his therapies, the facility must issue him a Notice of Medicare Non-coverage at least 2 days prior to discharging him from the therapies. He maintains the right to appeal the therapist’s decision through the Quality Improvement Organization(QIO) located in the state in which he resides
3. Should Mr. Jones expend his 100 days without any skilled services.
4. Mr. Jones remains a resident in the facility for 120 days before discharging home. The first 100 days were covered by Medicare Part A while Mr. Jones paid privately for the last 20 days. He is at home for 55 days before he falls and fracturs his hip. Even though this is a totally different diagnosis from which he was first admitted to the facility, since he did not have a 60 day wellness period, he does not qualify for Medicare coverage in a Skilled Nursing Facility

Answer 29

Medicare Part A reimburses the facility for the physical therapy, occupational therapy, and/or speech language pathology services Mr. Jones is receiving. Medicare Part A covers the therapy based on the Resource Utilization Group (RUG) level. Medicare will cease if Mr. Jones misses three consecutive days of any of the three therapies he is receiving

Question 30

Medicare certified nursing facilities are required to utilize which of the following types of accounting systems?

1. Cash basis
2. Accrual basis
3. Controlled basis
4. Cost and Revenue basis

Answer 30

Accrual basis

Question 31

Medicaid covers al but one of the following services provided to its recipients in a nursing home.

1. X-rays
2. PT and OT services
3. Private duty nursing
4. Toot brushes and toothpaste

Answer 31

Toot brushes and toothpaste

Question 32

Walnut Ridge Nursing and Rehabilitation Center is a dually certified nursing facility located in the same parking lot of its parent company, Walnut Ridge Medical Center. WRMC is the area’s designated trauma center. Walnut Ridge Nursing and Rehabilitation Center accepts an admission from its hospital. The resident qualifies for Medicare Part A services. Under consolidated billing, the nursing facility is responsible for most of the cost of care of the Medicare Part A resident. Which of the following is not a responsibility of Walnut Ridge Nursing and Rehabilitation Center?

1. An emergency ambulance trip to the Walnut Ridge Medical Center’s Emergency Department
2. Medication ordered for the resident upon admission to the facility
3. Physician services
4. Routine ancillary cost

Answer 32

Physician orders

Question 33

Albert Wright is a widower and is in the process of finalizing his financial planning. He knows that one day he may have to move into a nursing home. He seeks out counsel from an attorney friend on what he needs to do to qualify for Medicaid. Which of the following pieces of advice his attorney give him that is not factual?

1. He can own one car
2. He can own a house and it is considered an exempt asset as long as Mr. Wright’s equity in the home does not exceed state or federal limits.
3. With the exclusions of the car and house, he cannot have assets in excess of the state prescribed poverty level
4. To qualify for Medicaid, he must divest his assets to an amount below the state poverty level three years prior to applying for Medicaid

Answer 33

To qualify for Medicaid, he must divest his assets to an amount below the state poverty level three years prior to applying for Medicaid

Question 34

Nursing homes that utilize any type of life support equipment are required to have an onsite emergency generator. Regulations require the following except that the generator must:

1. start and transfer power within 10 seconds of the interruption of normal power
2. have at minimum of two fuel sources, one being natural gas and the other either propane or diesel
3. be started at least weekly
4. be tested for 30 minutes every month and properly documented

Answer 34

have at minimum of two fuel sources, one being natural gas and the other either propane or diesel

Question 35

CMS regulations that went into effect in 2016 require resident rooms in nursing homes meet all of the following standards except:

1. rooms must have direct access to a corridor
2. rooms must be equipped with air conditioners
3. nursing homes built after 2016 cannot have rooms that house more than two residents
4. rooms must have sufficient electrical outlets to accommodate a resident’s need to safely use electronic items

Answer 35

rooms must be equipped with air conditioners

Question 36

The number one cause of fires in nursing homes is:
1. lint build-up in facility dryers
2. residents smoking in restricted areas
3/ electrical equipment that isn’t maintained properly
4. grease fires in the kitchen

Answer 36

grease fires in the kitchen

Question 37

Nursing homes must comply with multiple regulations regarding infection control. Which of the following is not a federal requirement?

1. Employment of a full-time Infection Preventionist (IP)
2. Written policies and procedures to ensure adherence to CMS standards for Infection Control
3. Adherence by employees to the CDC guideline for proper hand hygiene
4. Provision of Personal Protective Equipment to all staff members

Answer 37

Employment of a full-time Infection Preventionist (IP)

Question 38

Nursing homes are required to conduct fire drills at least:

1. one per shift per quarter
2. one per month per shift
3. twelve times annually
4. twelve times annually with at least two on weekends

Answer 38

one per shift per quarter

Question 39

Byron Avant is an administrator of a nursing home located 600 yards from a railroad track. Each day at 3 a.m. a train passes by the nursing facility. At 5 o’clock on a Sunday morning he receives a call from his charge nurse informing him that the area emergency preparedness organization has notified the nursing home that there has been a train derailment and a cloud of unidentified chemicals has been released into the air. What is the administrator to instruct his staff to do?

1. Follow the emergency plans which call for a complete evacuation of the building
2. Call all scheduled day staff and ask them to come in early as the emergency plans call for “ all hands on deck”
3. Shut down any access points that allow outside air into the facility, as the emergency plans mandate sheltering-in-place
4. Instruct the charge nurse to notify all responsible parties of the situation and to call him when the emergency is over

Answer 39

Shut down any access points that allow outside air into the facility, as the emergency plans mandate sheltering-in-place

Question 40

Federal guidelines mandate that the air temperature is nursing homes be kept at which of the following levels?

1. At temperature levels comfortable for both staff and residents according to regional preferences
2. Between 75 degrees F and 81 degrees F during the winter months and 71 degrees F and 76 degrees F in summer months
3. Between 71 degrees F and 81 degrees F, at levels three feet above the floor
4. Temperature ranges in nursing homes are set by each State and approved by CMS

Answer 40

Between 71 degrees F and 81 degrees F, at levels three feet above the floor

Question 41

Ms . Barbara Huber is a 90-year-old resident in a nursing home in the community where she grew up. Because of her status in the community, the administrator has arranged for Ms. Huber to have a private room. Ms. Huber continuously complains that she is “freezing to death” and that her room is too cold. Maintenance has checked the room temperature and keeps it at the highest temperature level as allowed by regulations. What should the administrator do to satisfy Ms. Huber’s complaints?

1. Ask the staff to provide Ms. Huber additional blankets
2. Place a space heater in Ms. Huber’s room
3. Advise Ms. Huber that the room temperatures meet federal and state levels and nothing else can be done
4. Raise the temperature in Ms. Huber’s room to a level she is comfortable with and document in her plan of care

Answer 41

Raise the temperature in Ms. Huber’s room to a level she is comfortable with and document in her plan of care

Question 42

Contaminated sharps require special attention in nursing homes. A used sharp, such as a needle, must be disposed properly in what is universally referred to as a sharp contained. Which of the following is not true in respect to these sharp containers?

1. There must be at least one placed in each nursing care area
2. There must be one placed on every medication cart
3. There must be one located in the facility laundry
4. There must be one located in each public restroom as well as each bathing area

Answer 42

There must be one located in each public restroom as well as each bathing area

Question 43

A ventilator unit in a nursing home malfunctions and unfortunately causes the death of a resident. According to the Safe Medical Device Act, which of the following actions must be taken?

1. Notify the manufacturer of the equipment within 10 days of the incident
2. Notify the FDA within 48 hours of the incident
3. Notify the FDA and manufacturer of the equipment within 10 days of the incident
4. Notify CMS, the FDA, and the manufacturer within 48 hours of the incident

Answer 43

Notify the FDA and manufacturer of the equipment within 10 days of the incident

Question 44

The administrator of any nursing home must be aware of the various agencies which may visit the facility on a regular basis. The Older Americans Act of 1965 implemented a program that requires on Ombudsman to visit the facility on a regular basis. What is the primary duty of the Ombudsman?

1. To resolve problems made by or on behalf of the long-term care client
2. To report any incidents that may be deemed detrimental to the resident to the State Survey Agency
3. To report to the administrator after each visit with detailed information gained during the visit
4. To report back to the resident’s legally responsible party any information ascertained while visiting the long-term care resident

Answer 44

To resolve problems made by or on behalf of the long-term care client

Question 45

A facility undergoes its annual Health Survey, The survey team writes a deficiency both the Director of Nursing and the Administrator feel is not warranted. During the exit interview, the potential tag is discussed and the facility leaders express their opinions regarding the survey finding. Once the findings of the facility’s Standard Health Survey (CMS form 2567) are complete, the administrator notes that the deficiency they feel is unwarranted is cited. Which of the following options would be recommended?

1. Accept the Survey findings and submit a valid Pan of Correction based on the Director of Nursing’s recommendations
2. Notify the State Survey Agency that since the cited deficiency never existed the facility cannot submit a Plan of Correction
3. Submit within 10 days a request for an Informal Dispute Resolution
4. Submit within 2 weeks a request for a meeting with the State Survey Agency to dispute the survey findings

Answer 45

Submit within 10 days a request for an Informal Dispute Resolution

Question 46

Federal regulations require nursing homes have which one the following as a part of its management hierarchy?

1. A governing board, a licensed administrator, and a Medical Director who must be a Medical Doctor or Doctor of Osteopathy
2. An advisory committee, a licensed administrator, and a Medical Director, who must be a Medical Doctor
3. A licensed administrator, a Director of Nursing, who must be a Registered Nurse, and a Registered Dietitian
4. A licensed administrator, a Director of Nursing, who can be a Registered Nurse or a licensed Practical/Vocational Nurse, and a Medical Director who must be a Medical Doctor or Doctor of Osteopathy

Answer 46

A governing board, a licensed administrator, and a Medical Director who must be a Medical Doctor or Doctor of Osteopathy

Question 47

The Affordable Care Act (ACA) initiated many requirements for nursing homes. The administrator must ensure all but which one of the following to be in compliance with the ACA and other federal regulations.

1. Develop and have an active Quality Assurance and Performance Improvement (QAPI) Committee
2. Provide annual dementia management and resident abuse training for Certified Nurse Aides
3. Develop and initiate a formal Ethics Committee by a date prescribed by federal regulations
4. Develop and initiate a formal Pharmaceutical Service Committee by a date prescribed by federal regulations

Answer 47

Develop and initiate a formal Pharmaceutical Service Committee by a date prescribed by federal regulations

Question 48

Which one of the following is not a duty of the facility’s governing board?

1. To review and approve the facility’s policies and procedures
2. To oversee the day to day facility operations
3. To evaluate the overall effectiveness of management’s actions
4. To employ an administrator who serves as an agent to the board

Answer 48

To oversee the day to day facility operations

Question 49

Survey deficiencies will fall within a scope and severity grid. Which of the following statements about the scope and severity grid is not factual?

1. A level 4 deficiency means that immediate jeopardy to a resident’s health or safety has occurred
2. A Level 3 deficiency means that no actual harm has occurred but there is potential for actual harm
3. A level 2 deficiency means there is no actual harm with a potential for more than minimal harm that is not immediate jeopardy
4. A level 1 deficiency means that no actual harm has occurred and there is no potential for minimum harm

Answer 49

A Level 3 deficiency means that no actual harm has occurred but there is potential for actual harm

Question 50

The Nursing Home Compare 5-star rating is based on all of the following except:

1. Quality Measures which is comprised of 15 measures for long-term care residents and 9 for short-stay residents
2. healthcare surveys, including substantiated complaint surveys, for the previous 3 years
3. Life Safety Code Surveys, including substantiated complaint surveys, for the past 3 years
4. facility staffing hours per resident day, including RN hours

Answer 50

Life Safety Code Surveys, including substantiated complaint surveys, for the past 3 years

Question 51

Which of the following is a CMS requirement for staffing?

1. There must be a Registered Nurse or Licensed Practical Nurse to serve as the Director of Nursing on a full-time basis
2. A staffing ration that is set by each state and approved by CMA
3. Sufficient staff to meet direct care needs, assessment planning and evaluation, and provide supervision
4. An LPN must serve as the charge nurse only when there are 60 or fewer residents being served in the facility

Answer 51

Sufficient staff to meet direct care needs, assessment planning and evaluation, and provide supervision

Question 52

The medical care of each resident must be supervised by a physician. Which of the following statements is not true?

1. The resident has the right to select the physician of his/her choice as long as that physician meets the CMS requirements for physician participation
2. If the resident selects a physician who meets the CMS requirements for participation, the facility must honor that selection
3. The attending physician must be licensed as Medical Doctor or Doctor of Osteopathy
4. The resident must be seen by the attending physician at the time of admission to the facility

Answer 52

The resident must be seen by the attending physician at the time of admission to the facility

Question 53

Residents in nursing homes have a right to self-administer medications. Which of the following is not a facility responsibility?

1. The facility interdisciplinary team must assess the resident’s cognitive, physical, and visual ability to self-administer before allowing the resident to exercise that right
2. The facility must store and document the administration of medications even though the resident is self-administering
3. If medications are required to be administered before the interdisciplinary team completes it’s assessment, the medications may be administered by a nurse or medication aide under state law
4. Appropriate notations regarding the decision to allow self-medication must be made in the resident’s care plan

Answer 53

The facility must store and document the administration of medications even though the resident is self-administering

Question 54

Which of the following is covered under the Medicare Part B program while a person is a resident in a nursing facility?

1. Prescription drugs
2. Respiratory Therapy for those residents who do not qualify for Part A therapy services
3. Physical therapy for those residents who do not qualify for Part A therapy services
4. All personal care items that are necessary for the enhancement of the resident’s quality of care and quality of life

Answer 54

Physical therapy for those residents who do not qualify for Part A therapy services

Question 55

In which of the following circumstances does a nursing facility not have the right to execute an immediate, involuntary discharge of a resident?

1. The resident and his family are unrealistic about the services the facility offers and are so demanding that the nursing staff is threatening to resign
2. The resident has not resided in the facility for 30 days
3. the safety of the resident and others in the facility would be endangered by the continuing stay of the resident
4. An urgent medical need has presented itself

Answer 55

The resident and his family are unrealistic about the services the facility offers and are so demanding that the nursing staff is threatening to resign

Question 56

medication error rate

300 doses 4 incorrect medications and 2 residents missed medication

Answer 56

4+2= 6
6/300= 0.02 = 2%

Question 57

Percentage of weight loss

previous wt 180 now weighs 171

Answer 57

180 -171 = 9
9 / 180 = .05
5%

Question 58

Average percentage of Occupancy

A facility has 150 beds and during a 30 day period, they have 4,200 occupied-bed days.

Answer 58

4,200 / 30 = 140 /150 = .93 x 100 = 93%

Question 59

Employees Needed
Under Medicaid rules of this state, a resident in a non-skilled facility must have 2 hours of nursing care per day excluding care given by the director of nursing. The facility is licensed for 150 beds, has a 90 percent occupancy rate with 90 employees in the nursing department working 7.5 hour shifts ever day. Everyone has a 30 min lunch break, which is considered off-duty time. How many employees are required in the nursing department per day?

Answer 59

150 beds x 90% x 2 hours = 270

270 / 7.5 shifts = 36 employees per day

Question 60

Federal law states that facilities must retain menus of food actually served for at least:

1. 30 days
2. 60 days
3. 90 days
4. 6 months

Answer 60

30 days

Question 61

The medical director is not responsible for:

1. infection control and restraints
2. the release of clinical information
3. physician privileges and practices
4. supervising the checking in/out of all resident records

Answer 61

supervising the checking in/out of all resident records

Question 62

OBRA envisions that the function of many previously free-standing committees can now be included in the quality improvement committee. If desired, which one of the following must be a free-standing committee?

1. Safety
2. Ethics
3. Pharmaceutical
4. Infection control

Answer 62

Ethics

Question 63

a woman is admitted to your facility with a living will and durable power of attorney specifying that she wants to receive CPR if necessary. One year later the resident requires CPR. However, she is now mentally incompetent and her children request she not be given CPR. As an administrator , what must you do?

1. Provide the CPR
2. contact the family attorney
3. Honor the children’s request
4. Honor the physician’s request

Answer 63

Provide the CPR

Question 64

Nursing facilities are responsible for providing and/or obtaining dental services for the residents. Who is usually responsible for payment of these services?

1. Medicaid
2. Medicare
3. The facility
4. The resident/family

Answer 64

The resident /family

Question 65

How do you calculate the average percent of occupancy?

1. Divide the total number of beds by the number of days and multiply by 100
2. Divide the number of occupied beds by the number of total beds and multiply by 100
3. Subtract the number of vacant beds from the number of occupied beds and divide by the total number of beds and multiply by 100
4. Divide the number of occupied-bed days by the total number of days in the period and then divide by the total number of beds and multiply by 100

Answer 65

Divide the number of occupied-bed days by the total number of days in the period and then divide by the total number of beds and multiply by 100

Question 66

The Resident Assessment Instrument (RAI) was developed to improve the quality of clinical assessments and monitor quality care. This process was mandated by:

1. CMS
2. OBRA
3. Medicaid
4. Medicare

Answer 66

CMS

Question 67

Ideally, resident rights should be discussed with the resident:

1. after admission
2. before admission
3. within 5 days after admission
4. within 10 days after admission

Answer 67

before admission

Question 68

The DON is not responsible for:

1. daily rounds
2. in-service training
3. preparation of medication
4. visits with residents and family members

Answer 68

preparation of medication

Question 69

A facility may not impose a charge against a resident’s personal funds for which payment is made under Medicaid or Medicare except for:

1. meals
2. laundry services
3. activity programs
4. Medicaid co-insurance

Answer 69

Medicaid co-insurance

Question 70

In case of an emergency when neither the attending physician or the back up physician is available, the decision as to who will attend the resident is to be made by the:

1. charge nurse
2. administrator
3. any nurse on duty
4. director of nursing

Answer 70

administrator

Question 71

A resident requests to see her medical records. However, the physician states that under no circumstances can the resident see the records. As the administrator, what should you do?

1. Tell the resident to change physicians
2. Tell the resident to contact the director of nursing
3. Tell the resident she must have the permission of the physician to see the records
4. Tell the physician the law requires that the records be made available to the resident within 24 hours

Answer 71

Tell the physician the law requires that the records be made available to the resident within 24 hours

Question 72

A cardiologist relates to the:

1. skin
2. heart
3. brain
4. nervous system

Answer 72

heart

Question 73

Medical records belong to the:

1. facility
2. resident
3. the state
4. whomever pays the bill

Answer 73

facility

Question 74

If your facility has physicians who do not sign telephone orders as required, what must you do as an administrator?

1. Have the DON sign for the physician
2. Request the resident change physicians
3. Request the physician sign in advance and authorize the RN to complete the form
4. Require the RN and LPN to ask the physician to issue a telephone order and agree to sign the form on his next visit

Answer 74

Require the RN and LPN to ask the physician to issue a telephone order and agree to sign the form on his next visit

Question 75

The dietary supervisor must:

1. serve all meals
2. be licensed by the state
3. determine the menus for all residents
4. supervise the preparation of the food

Answer 75

supervise the preparation of the food

Question 76

The resident activity director does not:

1. write orders
2. prepare care plans
3. write progress notes
4. complete the resident’s assessments

Answer 76

write orders

Question 77

Depression is the most common condition associated with the aging process. All of the following are psychological changes related to the aging process except:

1. paranoia
2. hallucinations
3. feelings of worthlessness
4. loss of hearing and some sight problems

Answer 77

loss of hearing and some sight problems

Question 78

Loss of vision increases with aging in about:

1. one-seventh of all residents
2. one-fifth of all residents
3. one-fourth of all residents
4. one-third of all residents

Answer 78

one-third of all residents

Question 79

Upon the death of a resident with a personal fund deposited with the facility, the facility must convey the resident’s fund and a final accounting of those funds to the individual or probate jurisdiction administering the resident’s estate within:

1. 10 days
2. 15 days
3. 30 days
4. 60 days

Answer 79

30 days

Question 80

In the medical community there are many prefixes and suffixes is algia which refers to:

1. pain
2. apathy
3. phobias
4. inflammation

Answer 80

pain

Question 81

Which of the following is a physiological change found in the aging population?

1. Loneliness
2. Incontinence
3. Hallucination
4. Incompetence

Answer 81

Incontinence

Question 82

Physical restraints must be removed every:

1. hour
2. shift
3. two hours
4. 30 minutes

Answer 82

two hours

Question 83

The term “ nosocomial infections” is associated with:

1. food
2. activities
3. restraints
4. institutionalization

Answer 83

institutionalization

Question 84

A comprehensive MDS assessment for a private pay or Medicaid resident must be completed no later than:

1. 5 days after admission
2. 7 days after admission
3. 14 days after admission
4. 21 days after admission

Answer 84

14 days after admission

Question 85

Quality control refers to:

1. reviewing all job descriptions
2. developing all of the resident activities
3. developing programs for daily resident care
4. policies and procedures to maintain quality care

Answer 85

policies and procedures to maintain quality care

Question 86

A Medicaid resident near the age of 90 frequently receives letters from an old friend requesting financial help to pay bills. The son of the resident learns about it and requests that the mail be screened because it is disrupting the resident and the resident has no money. What should the administrator do?

1. Nothing
2. Tell the family the mail must be delivered
3. Screen the mail and destroy mail from that individual
4. Contact the person and request that they discontinue the letters

Answer 86

Tell the family the mail must be delivered

Question 87

Which of the following identifies the incidence of disease?

1. Mortality
2. Modality
3. Morbidity
4. Malignant

Answer 87

Morbidity

Question 88

A new resident must have a physical examination within 48 hours of admission or:

1. within 10 days prior to admission
2. within 5 days prior to admission
3. within 72 hours prior to admission
4. immediately prior to admission

Answer 88

immediately prior to admission

Question 89

Social workers in a nursing facility may provide all of the following services except:

1. counseling
2. psychiatric therapy
3. utilization of community resources
4. services provided by the interdisciplinary team

Answer 89

psychiatric therapy

Question 90

The facility must promptly notify the resident, and if known, the resident’s family or the resident’s legal representative when there is a change in:

1. staff
2. menus
3. activites
4. roommate

Answer 90

roommate

Question 91

A resident’s individual financial record must be available:

1. monthly
2. annually
3. on request
4. semi monthy

Answer 91

semi monthly

Question 92

The facility must notify each resident that receives Medicaid benefits when the amount in the resident’s account is a specific amount less than the SSI resources limit for one person. That amount is:

1. $ 250.00
2. $200.00
3. $150.00
4. $100.00

Answer 92

$ 200.00

Question 93

routine personal hygiene items and services as required to meet the needs of residents include all of the following except:

1. perfume
2. denture cleanser
3. razor and shaving cream
4. toothbrushes and toothpaste

Answer 93

perfume

Question 94

If a pharmacy delivers a medication with a marred label:

1. the empty container should be returned to the pharmacist
2. the nurse should call the pharmacist and request new labels
3. the medication and container must be returned to the pharmacy
4. only the DON can replace the label with the pharmacist’s approval

Answer 94

the medication and container must be returned to the pharmacy

Question 95

The steps necessary to achieve a resident’s interdisciplinary goals must be created and approved by the facility staff and the:

1. resident’s physician
2. quality control committee
3. quality assessment surveyors
4. quality improvement guidelines

Answer 95

resident’s physician

Question 96

The nursing facility must examine each resident’s assessment no less than once every:

1. year
2. month
3. six month
4. three months

Answer 96

three months

Question 97

During the first 90 days after admission, a resident in a skilled nursing facility must be seen by a physician:

1. one
2. weekly
3. every 30 days
4. every 60 days

Answer 97

every 30 days

Question 98

Regarding the care-planning process, the director of nursing should:

1. insist that the attending physician attend all meetings
2. require surrogates to attend the care-planning meeting
3. request that therapists (physical, speech, and occupational) be involved
4. schedule and assign staff, considering skill levels and acuity levels, to meet resident needs

Answer 98

schedule and assign staff, considering skill levels and acuity levels, to meet resident needs

Question 99

All resident records must be retained for at least:

1. one year after discharge
2. three years after discharge
3. five years after discharge
4. ten years after discharge

Answer 99

five years after discharge

Question 100

A legend drug is not:

1. named
2. generic
3. branded
4. non-generic

Answer 100

generic

Question 101

The labeling of a prescription drug does not require:

1. strength
2. date of expiration
3. cautionary statement
4. specific time of day to administer

Answer 101

specific time of day to administer

Question 102

A durable power of attorney for health care does not need to:

1. be signed by the resident
2. be signed in front of two witness
3. be executed by an attorney-at-law
4. have the witnesses’ signatures certified by a notary

Answer 102

be executed by an attorney-at-law

Question 103

In a 100-bed facility 300 doses of medication were to be administered in a given time period. However, 2 doses ordered were not given and 4 doses were incorrectly administered as prescribed. What was the medication error rate?

1. 2.0 percent
2. 2.5 percent
3. 2.8 percent
4. 3.0 percent

Answer 103

2%

Question 104

During a one month interval, to be considered significant a resident’s weight loss must be:

1. 2%
2. 5%
3. 6 %
4. 10%

Answer 104

5%

Question 105

Food must be cooked at the proper temperature. When meat is cooked at a high temperature there can be as much as a:

1. 50% shrinkage
2. 35 % shrinkage
3. 25 % shrinkage
4. 15 % shrinkage

Answer 105

35 % shrinkage

Question 106

What is considered to be an adequate amount of fluid consumed by a resident each day?

1. 1,000 cc
2. 1,500 cc
3. 2,400 cc
4. 4,200 cc

Answer 106

2,400cc

Question 107

Dialysis means:

1. diagnosis
2. hemorrhaging
3. blood analysis
4. cleaning the blood

Answer 107

cleaning the blood

Question 108

What percentage of residents need some help in eating?

1. 25 %
2. 45 %
3. 60%
4. 75%

Answer 108

75%

Question 109

The Eden Alternative is a tool used to:

1. reduce the use of Schedule II drugs
2. give residents several different choices for meals.
3. assess the physical surroundings of the resident from a safety point of view
4. improve the quality of life for residents by providing a more homelike setting

Answer 109

improve the quality of life for residents by providing a more homelike setting

Question 110

A syndrome is a :

1. back injury
2. cause of tumors
3. set of symptoms
4. state of confusion

Answer 110

set of symptoms

Question 111

The term bedfast means confined to bed for at least:

1. 7 days
2. 20 days
3. 12 days
4. 15 days

Answer 111

7 days

Question 112

Who sets forth the standards to protect a person’s medical records and other health information provided to doctors, hospitals and nursing homes.

1. OBRA
2. HIPAA
3. Facility
4. Resident’s responsible party

Answer 112

HIPAA

Question 113

Which of the following assessments is based upon height , weight, prescriptions, and documents relating to the resident’s well-being?

1. Clinical assessment
2. Medicare assessment
3. Admission assessment
4. Comprehensive assessment

Answer 113

Admission assessment

Question 114

The federal Patient Self-determination Act 1990 requires healthcare providers and some insurance plans to tell residents about their specific rights to:

1. refuse medications
2. choose a roommate
3. issue Advance Directives
4. participate in facility activities

Answer 114

issue Advance Directives

Question 115

The MDS 3.0 contains all data needed to classify a resident for purposes of determining which of the 66 RUG categories the resident will fit. This information is used to determine:

1. if a resident has Alzheimer’s
2. the length of stay in a skilled nursing home
3. when the resident needs to be transferred to a hospital
4. the per diem rate that will be paid for services provided

Answer 115

the per diem rate that will be paid for services provided

Question 116

The facility must make available for examination in a place readily accessible to residents and post a notice of the availability of:

1. the daily menus for all meals for each monthly period
2. the results of all cases reviewed by the facility Ethics Committee
3. a list of all residents and their classification as Medicare or Medicaid
4. the results of the most recent survey of the facility conducted by Federal or State Surveyors

Answer 116

the results of the most recent survey of the facility conducted by Federal or State Surveyors

Question 117

Wasted time
In a 120-bed facility there are a total of 110 employees working 8 hours each day at an average salary of $7 per hour. If they waste 5% of their time, what would be the annual cost of that waste?

Answer 117

110 x 8 x $7.00 x 365 x .o5 = $112,420

Question 118

Turnover
During 2002, a 100-bed facility with 90 employees experienced 25 resignations and had to discharge 10 employees. What was the annual employee turnover rate of 1997?

Answer 118

35 / 90 = .39 = 39%

Question 119

Daily Absentee Rate
What is the average daily absentee rate for a facility having 100 employees per day and 90 lost-work days or absences in a 30-day month?

Answer 119

90 / (30 x 100) = 0.03 daily absentee rate

Question 120

The first person to resolve employee problems and grievances is the :

1. department head
2. personnel director
3. immediate supervisor
4. nursing home administrator

Answer 120

immediate supervisor

Question 121

Fringe benefits are usually outlined in the :
1. job analysis
2. job descriptions
3. personnel policies
4, procedure manuals

Answer 121

personnel policies

Question 122

In a health-care facility, the most important aspect of communication which is often over looked is:

1. timing
2. filtering
3. commitment
4. confidentiality

Answer 122

confidentiality

Question 123

Supervisors contribute most effectively to good morale in their department when they:

1. permit only self-discipline
2. discipline consistently and fairly
3. arrange salary increases at regular intervals
4. make a point of having coffee with the employees

Answer 123

make a point of having coffee with the employees

Question 124

In any designated unit, the minimum percentage of employees who are required to sign cards calling for a union election is:

1. 30 %
2. 33.33%
3. 50 %
4. 50 % + 1

Answer 124

30 %

Question 125

A job application may ask for any of the following items except:
1. race
2. education
3, citizenship
4. work history

Answer 125

race

Question 126

During the interview process, which of the following cannot be asked?

1. References
2. Place of birth
3. Amount of education
4. Previous employment

Answer 126

Place of birth

Question 127

Which of the following is not one of the most common causes of turnover?

1. Salary
2. Poor orientation
3. Poor supervision
4. Inflexible scheduling

Answer 127

salary

Question 128

The primary purpose of a job description for each employee is to:

1. establish job procedures
2. establish a work schedule
3. standardize job performance
4. outline the duties of each job

Answer 128

outline the duties of each job

Question 129

To be eligible for the FMLA provision, during the least 12 months an employee must have worked at least:

1. 2,500 hours
2. 1,250 hours
3. 1,000 hours
4. 625 hours

Answer 129

1,250 hours

Question 130

For what percentage of an administrator’s problems are employees responsible?

1. 25 %
2. 35 %
3. 50 %
4. 75 %

Answer 130

75 %

Question 131

About what percent of turnover is unavoidable?

1. 5 - to %
2. 15 - 20 %
3. 25-35 %
4. 50 - 60 %

Answer 131

25- 35 %

Question 132

The best source of new employees is usually through:

1. employment agencies
2. newspaper advertisements
3. state unemployment offices
4. referrals from current employees

Answer 132

referrals from current employees

Question 133

Which of the following is required by the Fair Labor Standards Act?

1. Holiday pay
2. Vacation pay
3. Overtime pay
4. Sick leave pay

Answer 133

Overtime pay

Question 134

Most employee accidents are caused by either unsafe working conditions or:

1. behavior
2. lack of training
3. faulty equipment
4. misuse of equipment

Answer 134

behavior

Question 135

A female employee states to the administrator that a male maintenance employee frequently comments about her clothes and indicates that they are revealing. What action should the administrator take?

1. Fire the maintenance employee
2. Tell the employee to change her clothing
3. Investigate the matter, take the proper action and document your findings
4. Explain that the male maintenance employee tells all the female employees the same thing

Answer 135

Investigate the matter, take the proper action and document your findings

Question 136

The minimum penalty per deficiency for any finding that OSHA considers a hazard to employee safety and health is:

1. $500.00
2. $1,000.00
3. $1,200.00
4. $ 1,500.00

Answer 136

$500.00

Question 137

When an employee makes an error or requires discipline, he or she should be corrected:

1. at a staff meeting
2. immediately and in private
3. off the job on the employee’s time
4. only after the matter has become serious

Answer 137

immediately and in private

Question 138

What is the best type of question to ask an employee while conducting non-directive counseling?

1. Open ended
2. True or false
3. work related
4. Family oriented

Answer 138

Open ended

Question 139

The period of insurance continuation under COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) shall begin on the date coverage would otherwise have ended and may continue up to a maximum of:

1. 6 months
2. 12 months
3. 18 months
4. 24 months

Answer 139

18 months

Question 140

Average cost Per Resident Day
A 100-bed facility with an average of 90 % occupancy has a total 30 day monthly expense of $135,00. What is the average cost per resident per day?

Answer 140

$135,00 / 30 days = $4,500 / 90 % = $50 per day

Question 141

Gross profit
What is the approximate percentage of gross profit for a facility with a gross income of $486,000, fixed expenses of $ 300,00, and variable expenses of $150,00?

Answer 141

$486,000 - (300,00 + $150,00) = $36,000

$36,000 / $486,00 = 7.4 %

Question 142

Straight line Depreciation
Using the straight line method of depreciation over an 8-year for equipment costing $88,000 with an $11,200 salvage value, the monthly depreciation will be:

Answer 142

$88,000 - $11,200 = $76,800 / 8 / 12 = $800 per month

Question 143

Payback period
A period of equipment is purchased costing $15,000. However, it will reduce operating costs (salaries and supplies) by at least $3,000 per year. What is the payback period?

Answer 143

$15,000 / $ 3,000= 5 year payback period

Question 144

Percent of Occupancy
A facility has 150 beds and during a 30-day period they have 4,200 occupied-bed days. What is their average percentage of occupancy?

Answer 144

4,200 / 30 = 140 / 150 = .93 x 100 = 93%

Question 145

Operating costs

During a period of one year, the facility has 36,000 resident days. The operating costs during this same period are $1,440,000. What is the cost of operation per resident day?

Answer 145

$1,440,000 / $36,000 = $40.00

Question 146

A capital budget relates to:

1. real estate and equipment
2. monthly projections
3. all forms of corporate budgets
4. annual purchases of operating supplies

Answer 146

real estate and equipment

Question 147

Working capital:

1. is investment capital
2. relates to the balance sheet
3. is the same as operating assets
4. is the excess of current assets over current liabilities

Answer 147

is the excess of current assets over current liabilities

Question 148

Which of the following is an intangible asset?

1. Property
2. Leasehold
3. Money markets
4. Accounts receivable

Answer 148

Leasehold

Question 149

Current debts are classified as:

1. long-term
2. due within one year
3. payable within 30 days
4. subtracted from liabilities

Answer 149

due within one year

Question 150

All of the following are types of reimbursement methods except:

1. fixed
2. variable
3. prospective
4. comprensation

Answer 150

compensation

Question 151

All of the following are fringe benefits except:

1. holidays
2. vacations
3. overtime
4. insurance

Answer 151

overtime

Question 152

Personnel requirements are based upon needs and make up about:
1. 30-40% of the facility expenses
2, 40-50% of the facility expenses
3. 50-60 % of the facility expenses
4. 60-70 % of the facility expenses

Answer 152

50-60 % of the facility expenses

Question 153

The Current Ratio is sometimes referred to as working capital and equals:

1. Owner Equity / Total Equity
2. Current Assets/ current Liabilities
3. Quick Assets/ Current Liabilities
4. Return on Investment

Answer 153

Current Assets / Current Liabilities

Question 154

A ledger is a complete listing of:

1. depreciation items
2. outstanding mortgages
3. net profit and before taxes
4. accounts payable and receivable

Answer 154

accounts payable and receivable

Question 155

To determine the payback period for a piece of equipment:

1. divide the operating cost by the cost of the equipment
2. divide the cost of the equipment by the annual reduction of operating cost
3. subtract the salaries and supplies from the cost of equipment and divide by the payments per year
4. reduce the cost of equipment by the monthly payments times 12 and subtract the salaries and divide by the total cost

Answer 155

divide the cost of the equipment by the annual reduction of operating cost

Question 156

Which of the following resources usually provides the least amount of revenue?

1. Medicare
2. Medicaid
3. Insurance
4. Veterans Administration

Answer 156

Insurance

Question 157

Past due accounts receivable should not exceed:

1. 2 %
2. 5 %
3. 8%
4. 10%

Answer 157

5%

Question 158

A pro forma is primarily:

1. a budget
2. an annual report
3. a monthly report
4. a financial statement or prediction

Answer 158

a financial statement or prediction

Question 159

An integrate budget:

1. is a year end summary
2. is changed only annually
3. is a periodic financial plan
4. requires input from staff members

Answer 159

is a periodic financial plan

Question 160

Which of the following is not a fixed cost?

1. Leases
2. Staffing
3. Insurance
4. Depreciation

Answer 160

Staffing

Question 161

Risk management is designed to do all of the following except:

1. follow up on accidents
2. control infectious diseases
3. prevent serving outdated food
4. establish a risk committee for each department

Answer 161

establish a risk committee for each department

Question 162

Which of the following reimbursement methods can be negotiated?

1. Managed
2. Mix Case
3. Medicaid
4. Medicare

Answer 162

Medicaid

Question 163

Which of the following is not a value of budgeting?

1. Budgeting reduces expenses and increases profits
2. Budgeting provides criteria for performance evaluations
3. Budgeting indicates how resources will be allocated to attain the goals
4. Budgeting expresses in financial terms the goals and programs of the facility and provides financial guidance

Answer 163

Budgeting reduces expenses and increases profits

Question 164

Nursing homes participating in the Medicare program must use:

1. a means test
2. ratio analysis
3. cash accounting
4. accrual based accounting

Answer 164

accrual based accounting

Question 165

The regulations that govern all aspects of a building’s structure as it relates to fire safety are:

1. LSC
2. ANSI
3. OSHA
4. OBRA

Answer 165

LSC

Question 166

An organized maintenance program that will save time and money emphasizes:

1. adequate inventory
2. maintenance contracts
3. preventive maintenance
4. employing competent personnel

Answer 166

preventive maintenance

Question 167

The purpose of an enunciator panel is to:

1. control odor
2. control temperature
3. indicate the zone of a fire
4. indicate general hall lights

Answer 167

indicate the zone of a fire

Question 168

The Infection Control Committee should meet at least:

1. weekly
2. monthly
3. quarterly
4. annually

Answer 168

quarterly

Question 169

Generators must be checked:

1. daily
2. weekly
3. monthly
4. periodically

Answer 169

weekly

Question 170

Class C fires involve:

1. paper
2. wood
3. grease
4. electricity

Answer 170

electricity

Question 171

On the average how many pounds of laundry are used by a resident everyday?

1. 4-6 pounds
2. 6-8 pounds
3. 8-10 pounds
4. 10-12 pounds

Answer 171

8-10 pounds

Question 172

Regarding isolation rooms which of the following statements is true?

1. The room must have a private bath
2. The room must be vented to the inside
3. A sign must be posted when the room is in use
4. Federal guidelines specify standards for isolation rooms

Answer 172

A sign must be posted when the room is in use

Question 173

All handrails must be:

1. 30 -32 inches high
2. 30-34 inches high
3. 32-34 inches high
4. 32-36 inches high

Answer 173

30-34 inches high

Question 174

The travel distance between Class B and Class C fire extinguishers cannot be more than:

1. 25 feet
2. 50 feet
3. 100 feet
4. 150 feet

Answer 174

50 feet

Question 175

Draperies and bed cubicle curtains must not interfere with smoke detectors and sprinkler head. Therefore, a thin mesh that will not interfere with their functioning can be used and they must be hung below the sprinkle and detectors by a lest:

1. 12 inches from the ceiling
2. 18 inches from the ceiling
3. 24 inches from the ceiling
4. 30 inches from the ceiling

Answer 175

18 inches from the ceiling

Question 176

Safe Medical Devices Act requires that a facility report to the FDA any incident that suggests a medical device or drug contributed to the death or serious illness or injury of a resident or employee within:

1. 24 hours
2. 5 days
3. 7 days
4. 10 days

Answer 176

10 days

Question 177

The primary fire-defense tools of a health-care facility staff are:

1. sprinkler systems and alarm pulls
2. smoke detectors and direct telephone lines
3. smoke barriers, corridor walls, and resident rooms
4. internal fire-fighting equipment such as hoses and extinguishers

Answer 177

smoke barriers, corridor walls, and resident rooms

Question 178

When State and Federal laws, rules and regulations conflict and create doubt as to adherence, always follow the:

1. State Law
2. Federal Law
3. most stringent law
4. regulation that is in place in the facility

Answer 178

most stringent law

Question 179

All doors except bathroom doors must swing to the egress and be at least:

1. 32 inches wide
2. 36 inches wide
3. 38 inches wide
4. 42 inches wide

Answer 179

42 inches wide

Question 180

work orders should include all of the following except”

1. the location
2. the problem
3. an authorized signature
4. the equipment needed to complete the job

Answer 180

the equipment need to complete the job

Question 181

The “employee’s right to know” relates to:

1. resident rights
2. hepatitis B virus
3. standard precautions
4. hazardous communication

Answer 181

hazardous communications

Question 182

Standard precautions were developed by:

1. CDC
2. ANSI
3. OBRA
4. OSHA

Answer 182

CDC

Question 183

In a multi-bed room, how many feet are required between beds?

1. 3 feet
2. 5 feet
3. 7 feet
4. 10 feet

Answer 183

3 feet

Question 184

Comfortable temperature in a nursing home for residents, staff and visitors should:

1. range between 68 and 78 degrees according to the season
2. range between 70 and 80 degrees according to the season
3. range between 71 and 81 degrees according to the season
4. be adjusted depending upon the room and types of activity

Answer 184

range between 71 and 81 degrees according to the season

Question 185

As required by the Medical Device Reporting for User Facilities, all records relating to death, serious injury, and illness caused by a medical device must be maintained by the facility for:

1. one year
2. two years
3. three years
4. five years

Answer 185

two years

Question 186

Fire and disaster programs require in-service training:

1. every 30 days
2. every quarte
3. at least annually
4. as deemed necessary by the administrator

Answer 186

at least annually

Question 187

Which of the following applies if the administrator and the board of governors carry out their respective duties?

1. The governing body should be equally concerned about management techniques and their effectiveness
2. The governing body not only hires the administrator, but also should review and approve the management techniques he/she will use
3. The administrator is responsible for management and the governing body is responsible for determining effectiveness of management
4. The governing body is concerned with the management techniques the administrator uses and the administrator is concerned about effectiveness

Answer 187

The administrator is responsible for management and the governing body is responsible for determining effectiveness of management

Question 188

In which type of business entity does the owner have the most limited liability?

1. Partnership
2. Corporation
3. Joint venture
4. Sole proprietorship

Answer 188

Corporation

Question 189

The first step in decision-making is:

1. reviewing the facts
2. evaluating solutions
3. identifying the solution
4. identifying the problem

Answer 189

identifying the problem

Question 190

One of the functions of management is controlling which means:

1. correcting employee errors
2. developing plans by a specific set of guidelines
3. listening but maintaining control of the conversation
4. the measurement of behavior, achievement, and the product to a predetermined and agreed-upon standard

Answer 190

the measurement of behavior, achievement, and the product to a predetermined and agreed-upon standard

Question 191

A major responsibility of the governing body is:

1. hiring employees
2. establishing job descriptions
3. establishing and approving policies
4. establishing orientation requirements

Answer 191

establishing and approving policies

Question 192

The bylaws of the corporation seldom include the :

1. composition of the board of directors
2. review of overall financial management
3. facility staff meeting attendance requirements
4. election of officers and selection of committee members

Answer 192

facility staff meeting attendance requirements

Question 193

The concept of community relations is to:

1. inform the community
2. insure high occupancy rates
3. replace public relation programs and marketing
4. involve the facility and the community in an interrelationship

Answer 193

involve the facility and the community in an interrelationship

Question 194

“Management by Objectives” is a system that:

1. reduces overtime
2. trains new employees
3. schedules adequate staff
4. determines goals and objective

Answer 194

determines goals and objectives

Question 195

Short-range goals can be accomplished in less than:

1. one year
2. six months
3. three months
4. one month

Answer 195

one year

Question 196

Policies should be developed by the:

1. staff
2. administrator
3. governing body
4. administrator and executive staff

Answer 196

administrator and executive staff

Question 197

Bylaws usually contain all of the following except:

1. rules
2. regulations
3. job descriptions
4. the missions statement

Answer 197

job descriptions

Question 198

Which of the following is seldom handled by the governing board?

1. Hiring all staff
2. Practicing stewardship
3. Establishing goals and objectives
4. Appointing the licensed administrator

Answer 198

Hiring all staff

Question 199

Respondent superior states that the:

1. facility is legally responsible for the acts of its employees
2. facility must have adequate insurance to cover all employees
3. administrator is responsible for the acts of the facility employees
4. department chairperson is responsible for the acts of the employees

Answer 199

facility is legally responsible for the acts of its employees

Question 200

The key to success in reducing the problems of turnover is :

1. salary
2. training
3. scheduling
4. fringe benefits

Answer 200

training

Question 201

With regard to levels of management, the charge nurse is included in the:

1. top level management
2. line level of management
3. middle level of management
4. corporate level of management

Answer 201

line level of management

Question 202

Unity of command means:

1. the delegation of authority
2. to dispense decision making
3. the number of employees that can be supervised
4. that each employee is responsible to only one supervisor

Answer 202

that each employee is responsible to only one supervisor

Question 203

One of the function of leadership is coaching which relates to:

1. listening
2. inspiring
3. commitment
4. solving problems

Answer 203

inspiring

Question 204

Leadership is al of the following except:

1. coordinating
2. solving problems
3. making decisions
4. hiring new employees

Answer 204

hiring new employees

Question 205

Theory X and Theory Y relate to:

1. leadership
2. production
3. management tools
4. attitudes towards work

Answer 205

attitudes towards work

Question 206

Decision making requires all of the following except:

1. reviewing facts
2. planning action
3. controlling behavior
4. identifying solutions

Answer 206

controlling behavior

Question 207

Which of the following is not regarded as a leadership style?

1. Parental
2. Democratic
3. Controlling
4. Laissez-faire

Answer 207

Controlling

Question 208

To be successful, the tour of a facility by potential residents should be:

1. as short as possible
2. planned and involve staff members
3. scheduled for groups in order to save time
4. very comprehensive and include the entire premises

Answer 208

planned and involve staff members

Question 209

One of the major functions of a board of directors is stewardship which is defined as:

1. budgeting
2. forecasting
3. performance appraisals
4. conscientious use of assets

Answer 209

conscientious use of assets

Question 210

Disclosure of ownership is required of:

1. corporations
2. governmental
3. non-profit organizations
4. individuals operating as sole propreietors

Answer 210

corporations

Question 211

Public relations has been defined as:

1. very costly
2. a source of income
3. the management of communication
4. maintaining a high visibility in the community

Answer 211

the management of community

Question 212

The goal of marketing is to:

1. increase staff
2. increase income and profit
3. provide community orientation
4. obtain and maintain a higher census

Answer 212

obtain and maintain a higher census

Question 213

The rules, regulations, mission and goals of a corporation are contained in the :

1. bylaws
2. state charter
3. corporation minutes
4. licensing application

Answer 213

bylaws

Question 214

Employees who are committed to the job and accept responsibility are identified:

1. in Theory X
2. in Theory Y
3. as visionaries
4. as laissez-faire

Answer 214

in Theory Y

Question 215

The five functions of management include all of the following except:

1. staffing
2. planning
3. leadership
4. organizing

Answer 215

leadership

Question 216

A simple definition of strategic planning is:

1. long-range budget planning
2. marketing and public relations
3. the utilization and allocation or resources
4. preparing for future eventualities and uncertainties

Answer 216

preparing for future eventualities and uncertainties

Question 217

Which of the following is sometimes considered to be the sixth managerial function?

1. Planning
2. Directing
3. Controlling
4. Coordinating

Answer 217

Coordinating

Question 218

Which of the following is not a recognized type of management?

1. Scalar Chain Management
2. Management by Objective
3. Total Quality Management
4. Management by Walking Around

Answer 218

Scalar Chain Management