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LNHA > Management, Governance, and Leadership > Flashcards

Management, Governance, and Leadership Flashcards

1
Q

The most likely single cause for the series of bankruptcies among larger nursing home chains around the year 2000 was

A

During 1998 and 1999 the price paid per bed i nursing home purchases tended to be too high to sustain over the following years when reimbursements were squeezed by Medicare and Medicaid

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2
Q

In a chance conversation with the owner of an eight-facility chain, the newly hired administrator for the oldest facility in the chain indicates that, because the mortgage is fully retired, the administrator will concentrate more on being effective than efficient since the Quality Indicators are all at or above the state’s average. The owner would likely

A

It is nearly always desirable to be efficient as well as effective

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3
Q

Occupancy of Facility A has been a steady 70% since the Prospective Payment System was introduced. Two weeks ago, a new 120 bed, equally equipped facility opened several blocks away. The Facility A administrator tells the admissions counselor to continue the usual recruitment approach. The chain owners ought to

A

The administrator fails to anticipate that the occupancy rate of the facility is likely to fall and that, n any case, with the new competition a new approach to admissions will most likely be necessary

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4
Q

Bankruptcies among larger nursing home chains prior to 2000 were

A

From the founding of the large-scale nursing home industry in the 1960’s until the year 2000 very few bankruptcies were experienced

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5
Q

Under Prospective Payment System, nursing facilities’ reimbursed costs

A

Medicare (and Medicaid) forced facilities to give roe services for a single reimbursement rate than had been the case previously

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6
Q

In recent years, Medicare has

A

Medicare, to cut its own costs, has required facilities to give more services under the medicare reimbursement plan

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7
Q

The nurse newly promoted to director of nursing insists on giving four RN hours of patient care each day on the Alzheimers wing in the 175 bed facility. The administrator should

A

The director of nursing fails to understand that using expensive RN hours when less expensive licensed practical nurse and certified nurse’s assistant hours are the industry standard will be unsustainably expensive for the facility

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8
Q

The applicant for the administrator position in a facility near a large teaching hospital insists that, as before in his rural facility, if hired he would not let the Medicare reimbursement policies affect his case mix. This applicant

A

Case mix in the typical rural facility is hard to manipulate, but in the teaching hospital setting the facility normally must maximize the number of Medicare rehabilitation patients in order to remain competitive and solvent

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9
Q

The newly hired assistant to the administrator insists that the organizational chart dotted line between this position and the Department of Nursing be a solid line. The administrator should

A

The director of nursing normally reports directly to the administrator. The assistant administrator wants too much power or does not understand how normal nursing facilities function

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10
Q

The medical supplies provider tells the administrator of a facility that has not paid bills for the past 3 months but is now operating under a bankruptcy judge’s approved plan for restructuring, that no more deliveries will be made until past bills are fully paid. The medical supplies provider

A

Under bankruptcy plans, the court ensures that all current bills are paid. The medical supplies provider does not understand the bankruptcy laws

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11
Q

An administrator who adopts the leadership-by-walking-around LBWA approach by walking through the facility weekly and intently observing

A

Leadership by walking around (LBWA), to be effective, must be done daily; weekly is too infrequent

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12
Q

The nursing facility administrator who, using the LBWA technique, succeeds in actually making appropriate corrections on the spot during her rounds

A

It is normally better to go through the chain of command and let the employees’ immediate supervisor request the corrections

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13
Q

The rate of increase in the total number of nursing facilities in the United States during the years 2008-2012

A

A number of market forces have held down any significant building of new facilities in recent years. This may change

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14
Q

The applicant for administrator of the facility insists that he has successfully used democratic leadership to the exclusion of all other leadership styles. The interviewer should

A

The successful nursing home administrator will need to employ several administrative styles to get the facility’s work successfully accomplished

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15
Q

The candidate for administrator said that she used a variety of administrative styles, but could not say exactly which she would use in every circumstance. The interviewer should be

A

This candidate understands the need for flexibility in leadership styles and believes that several styles have been used effectively

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16
Q

The candidate for administrator indicated that he consistently chose the charismatic style of leadership. This should ___ the interviewer

A

Charismatic leadership is given to leaders by followers. A leader cannot just declare himself or herself charismatic

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17
Q

The costs of providing subacute care to nursing home residents

A

Yes, acute care reimbursement rate are higher than average, but so are the costs!

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18
Q

The nurse supervisor who had just been appointed director of nursing announced at the first department head meeting that she had circulated a memo among the nurses that only formal communication were to be allowed in the nursing department. The administrator should

A

It is impossible to prevent informal communications among nurses. The nurse supervisor does not seem to have enough communication savvy to understand this

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19
Q

The department head was not surprised to learn that n employee had heard only the positive comments to the employee and ignored the criticisms. The department head’s grasp of the communication process is

A

The department head understands that employees often engage in selective hearing, that is, hearing good news and screening out anything unpleasant

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20
Q

The administrator routinely accepted as a nearly exclusive information source the director of nursing’s positive report that nursing was going well. The administrator is

A

The administrator must get information from all levels of management in order to know what is actually going on. It is is dangerous to rely solely on one person

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21
Q

Periodic shortage of nurses available for nursing home employment___

A

Nursing shortages come and go, but mostly there is a seemingly chronic shortage of good nurse candidates

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22
Q

Congress and the federal rule makers behave as if the facility will run successfully if Congress and the Centers for Medicare and Medicaid Services can write enough rues. They are ___

A

It is impossible and undesirable to try to write enough rules to make every facility function successfully

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23
Q

When the administrator notices that the director of nursing seeks to turn as many duties as possible over to housekeeping, the administrator should conclude that the director of nursing is

A

It is normal for the various departments such as nursing, housekeeping, and dietary to seek to ‘turn over’ as much work to other departments as they can

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24
Q

The administrator insists that a timely copy of all reports generated within the facility come across her desk before anyone signs them. The administrator is

A

The administrator may have all reports made available to him or her, but requiring that the administrator sees all reports before signing would likely be dysfunctional for getting the facility’s work done in a timely manner

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25
Q

The administrator notices that incident reports are being insufficiently filled out, but does nothing, believing that the situation will likely correct itself. The administrator is

A

Correctly filled-out incident reports are a must for the facility and this situation is not likely to ‘correct itself’ without the administrator’s active intervention

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26
Q

Corporate sends a directive to its flagship facility administrator directing the administrator’s attention more toward the outcome of resident care than the cost of resident care during the coming 12 months. Corporate is more concerned with ___ than ___

A

Corporate wants that facility to have as nearly deficiency-free inspection as possible and I swilling to pay a little more for that year’s performance to achieve this

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27
Q

The long-term care sector receiving increased funding and attention from the federal government is the

A

In recent years, federal and state governments have been seeking to reduce the proportion of funds that go to institutional care

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28
Q

The concept that nursing homes should be reimbursed by states for their actual costs was part of the

A

This was a part of the effort a few years ago to get nursing facilities reimbursed for the actual costs incurred in giving care

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29
Q

The intense health care cost-shifting efforts among providers such as Medicare, Medicaid, and local governments are

A

Expect that efforts to shift cost from Medicare and Medicaid onto facilities will continue

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30
Q

Worried about the level of actual resident care being achieved in the facility, the administrator directs the nurses to spend less time charting and more time focusing on the effectiveness of care being given to residents. The likely result will be

A

The residents may in fact get better care, but if it is not documented, the survey team has no real way to give credit for the care given. Give excellent care, but also document, document, document

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31
Q

The new social worker informs the head of nursing that admissions is all she has time for and that nursing must monitor and document each resident’s sociopsychological experiences. The new social worker is

A

The social worker has to do both if assigned both. The social worker needs to renegotiate the job description with the administrator

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32
Q

Today the twin forces of ___ and ___ are revolutionizing the delivery of health care

A

Technology/Patient data legislation

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33
Q

Most of the multiple new devices to monitor and diagnose each individual’s health status are creating new monitoring and diagnostic capacities

A

Outside the hospital and doctors office

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34
Q

For the nursing facility setting, the new capacities to monitor residents’ health offer dramatic new opportunities to improve

A

Chronic disease management

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35
Q

Patient data legislation, such as the most recent health care legislation, has set into motion a nationwide policy to promote patients access to their

A

Medical records

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36
Q

Under the Affordable Care Act, the residents can access their own lab test results within 30 days of request

A

Without going through the physician who ordered the test

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37
Q

The concept of lab-on-a-chip will

A

Speed up lab diagnoses in the nursing facility

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38
Q

Attempting to find the right person for each well-defined job is known as the management function of

A

Staffing

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39
Q

The administrator who takes steps that ensure that the goals are accomplished and that each job is done as planned is successfully

A

Controlling quality

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40
Q

The administrator’s job is to ensure that the ___ employees do the tasks of the organization at an acceptable quality level

A

Appropriate

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41
Q

The administrator who conducts a national search fro a director of nursing position and interviews 20 candidates from seven different surrounding states by phone is engaged in the managerial function of

A

Staffing

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42
Q

In the end, it can be said that the administrator’s responsibility to meet resident care needs and facility financial needs are

A

Both about equal

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43
Q

Superior performance depends on taking exceptional care of residents via superior service and

A

Constant innovation

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44
Q

Superior performance for a nursing facility comes through

A

Innovation in ways to serve residents

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45
Q

The superb nursing facility is superb by virtue of its

A

Success in serving the residents

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46
Q

Answering the phones and resident call bells with common courtesy and doing things that work are examples of

A

A blinding flash of the obvious

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47
Q

Giving every employee the space to innovate at least a little; listening to residents and acting on their ideas; and wandering around with residents, staff, and suppliers are examples of the difficult-to-achieve ___

A

Commonsense; obvious

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48
Q

In a facility of 120 beds, the administrator ___ personally perform each of the management tasks

A

Need not

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49
Q

To ensure that all the management tasks are successfully accomplished the administrator of a 120 bed facility will typically divide management into

A

Three layers

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50
Q

A licensed person responsible for formulating and enforcing policies that will be applied to an entire facility is thought of as a/an

A

Upper level manager

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51
Q

The staff member responsible for reporting to upper-level management and at the same time interacting significantly with several lower level managers int he

A

Director of Nursing

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52
Q

The staff person for whom both upward and downward communication skills are the most necessary is the

A

Director of Nursing

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53
Q

When the director of nursing makes an effective policy decision without consulting the administrator that impacts all nursing personnel, the administrator should

A

Be pleased

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54
Q

In the typical nursing facility, the decision-making process is ___ establishment of lower, middle, and upper levels of management

A

Noticeably more complicated than simple

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55
Q

Among the following positions, the ___ has no authority to make decisions for the facility

A

Assistant to the administrator

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56
Q

Decisions made by persons on the staff to whom the administrator has delegated line authority are, n the final. analysis, regarded as decisions by ___

A

The administrator

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57
Q

When a nurse practitioner, who is more highly qualified than the director of nursing, gives orders to nurses in the hallways, the director of nurses should feel

A

Undermined

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58
Q

In times of crisis, corporate representatives, who hold a staff or advisory relationship with their counterparts in the local facility, may expect that their advice as staff be

A

Acted on as carrying line authority

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59
Q

As a generalization, in can be asserted that managerial success belongs to those who

A

Successfully prepare for the future

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60
Q

Nursing home administrators should anticipate and successfully prepare for

A

Rapid change

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61
Q

The long term care industry has entered a period in which ___ change(s) can be expected

A

Rapid and far reaching

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62
Q

The ability to accurately predict the future implications for nursing facilities of new trends to which the present environment may offer small clues is the skill needed to successfully

A

Forcast

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63
Q

Historically, during the 1970s and early 1980s (until the introduction fo the diagnosis related group methods DRG of reimbursement) nursing facility administrators made long range projections during a periods of

A

Relative stability in the health care field

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64
Q

The rate of change in the health care field is believed to be

A

Increasing exponentially

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65
Q

Researchers have predicted that every 10 years ___ of all current knowledge and accepted practices in the health care and other industries will be ___

A

One fourth/Obsolete

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66
Q

It is conceivable that the core business of the nursing home in this decade will ___ the core business of the nursing home of the next decade

A

Be entirely different from

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67
Q

One should expect that over the next few decades the rules governing the nursing home will be

A

New, never experienced before

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68
Q

Nursing homes that stick to conventional formulas for success are/will

A

Miss new markets and be in a backwash

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69
Q

In the text it is argued that, for the first time in human history, the capacity exists to provide

A

More health care than any nation can afford

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70
Q

The roles possible for hospitals, nursing homes, home health agencies, and managed care organizations are

A

Endless and will remain up for grabs

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71
Q

The staff in nursing facilities, over the next two decades, will likely

A

Experience culture shock

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72
Q

Plans can be said to be statements of teh

A

Organizational goals of the facility

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73
Q

In order to survive, each facility must

A

Deal with the outside world

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74
Q

A major advantage associated with carefully developed plans is making it possible to

A

Compare what happens with what was predicted

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75
Q

When external conditions change, plans

A

Can be altered to meet the changed conditions

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76
Q

Each facility’s strategic plan must be endorsed by

A

The governing body

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77
Q

The average number of prescriptions for persons in the United States aged 65 years and older is six. In nursing facilities it is

A

Often double that number

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78
Q

The observation about the idea ‘if it ain’t broke, don’t fix it’ is

A

That if it ain’t broke today, it will be tomorrow

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79
Q

The approach of planning know as SWOT refers to focusing on

A

Strengths, Weaknesses, Opportunities, and Threats

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80
Q

When considering building a new facility, necessary approvals by government agencies, such as zoning requirements, building codes, certificate of need, is/are

A

Sometimes difficult or impossible to obtain

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81
Q

In general, government purposes and the facility goal of providing high quality care are

A

The same

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82
Q

Looking at competitors’ expansion plans, occupancy levels, and local hospital plans when considering building a nursing facility is known as conducting a

A

Needs assessment

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83
Q

When planning a new nursing facility, the goal of being in operation within 4 months is best describes as a/an

A

Short range objective

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84
Q

As a general rule, the planning process moves from

A

General to specific

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85
Q

One view of the planning process includes the observation that

A

the future will change our plans

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86
Q

Nursing home administrators who expect the unexpected and thrive on it

A

Will last in the prfession

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87
Q

Facilities that embrace each new technology as it becomes available are knows as

A

Early adapters

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88
Q

The area offering the richest opportunities for innovation is

A

The unexpected

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89
Q

When one accepts the idea that change is a permanent part of life

A

One can take advantage of new opportunites

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90
Q

One must assume that other nursing home administrators in the community

A

Are ‘searching for new ways to climb the mountain

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91
Q

In the process of organizing the work of a facility it is of real importance to ensure that

A

There is no duplication of work

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92
Q

Organizing is the first step in implementation of a/an

A

Plan

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93
Q

What the worker does, how the worker does it, what aids are necessary, what is accomplished, and what skills are needed are parts of a

A

Job analysis

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94
Q

It can be argued that all nursing facility administrators organize their facility according to

A

Some theory of organization

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95
Q

Viewing organizations as systems has the advantage of offering the manager framework for visualizing the ___ of the organization

A

Internal and external environment

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96
Q

An organized or complex whole, an assembling or combining of things or parts forming a complex or single whole, best describes the

A

Systems concept

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97
Q

A primary advantage of systems theory is that it serves a s tool for making sense of the world by making clearer

A

Interrelationships within and outside the organization

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98
Q

If the outputs of the organization do not meet the administrators expectation he takes ___ actions to bring the outputs into line with those planned

A

Control

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99
Q

In essence, what nursing facilities do is ;use money to hire staff and provide materials needed to

A

Give patient care

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100
Q

The patient care that is given by the facility (output)

A

Can range from good to unacceptable

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101
Q

Asking if the work accomplished by the facility is up to expected standards and, if not, taking corrective actions is the act of

A

Controlling quality

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102
Q

The administrator uses___ as the guidelines to compare the output with the expected results

A

The facility’s policies and plans of action

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103
Q

Allocating resources is the process fo dividing resources among the various ___ of those resources

A

Competing possible uses

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104
Q

Optimizing resources is is allocating resources with the result that ___ use is achieved

A

Most effective possible

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105
Q

Suppliers, bank creditors, visiting regulators, and advocacy groups can be thought of as ___ who evaluate the facility

A

Stakeholders

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106
Q

The most direct and immediate stakeholders within the facility are the ___

A

Care recipients

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107
Q

The passage of the Nursing Home Reform Act can be viewed as a form of ___ the nursing home industry

A

External feedback of

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108
Q

The external environment of the nursing facility consists of ___

A

Opportunities and constraints

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109
Q

If something relates meaningfully to a nursing facility but is something over which the facility has no control, for example, enforcement of the federal certification requirements, ic can be said to be ___

A

A constraint in the external environment

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110
Q

Increasing availability of managed care contracts, new niches, and increasing numbers of elderly needing care can be considered to be

A

Opportunities

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111
Q

Systems analysis is most/equally useful to

A

The administrator, DON, and head of housekeeping

112
Q

Typically, the output of the nursing home as a system becomes the input for

A

The hospital or the resident’s home

113
Q

A nursing home and similar organizations can grow

A

Without any time limit

114
Q

The entropy process is considered universal law of nature that all organisms

A

Move towards death

115
Q

As a general characteristic of organizations, it has been argued that, in general, organizations seek to

A

Grow

116
Q

Once in place, organizations become creatures of habit and develop a tendency to ___ change

A

Resist

117
Q

The most predictable response of a nursing facility experience a ‘disruptive employee’ is to

A

Let the employee go

118
Q

When a nursing facility chain goes from being the leader to being behind the pack, this can likely be attributed to

A

A deep reservoir of outmoded attitudes and policies

119
Q

The training received in nursing school, medical school, and physical therapy school tends to

A

Create resistance to change

120
Q

The real purpose of systems thinking is to

A

Empower people to introduce organizational change

121
Q

The movement of American medicine from 80% general practitioners in 1870 to 20% general practitioners in the 200s is an illustration of the tendency of organizations to

A

Grow increasingly complex

122
Q

Directing is the process of communicating to employees what is to be done by each of them and

A

Helping them to accomplish it

123
Q

It is ___ to make policies that direct the activities of employees everywhere in the facility 24 hours a daily

A

Possible

124
Q

It is neither possible nor desirable to establish policies for

A

Every conceivable situation

125
Q

The specific spelling out, step by step, of the intended implementation fo a policy is known as a

A

Set of procedures

126
Q

A detailed plan of actions expected of each employee upon hearing the fire alarm is known as

A

A set of procedures

127
Q

Normally, the ___ for the facility sets the mission and goals

A

Governing body

128
Q

Normally the facility’s role in implementing a facility’s mission to

A

Write and implement more specific policies and procedures

129
Q

The internal process by which managers make decisions is

A

Imprecise not well understood

130
Q

It is the administrator’s job to ensure that all employees make the right decisions for the facility

A

As often as possible

131
Q

Ethical practices throughout the facility are the ___responsibility

A

Administrator’s

132
Q

Organizations that thrive over an extended period of time depending on having

A

Effective leaders

133
Q

Compared to defining the concept DECIDING, defining the concept LEADING is

A

Much less difficult

134
Q

The concept that history is MADE or measurably influenced by individuals who become leaders is known as

A

The great leadership theory of history

135
Q

Democratic authoritarian and lassez-faire are

A

Types of leadership styles

136
Q

A supervising staff member whom the administrator might most want to provide leadership by walking around is the

A

DON

137
Q

A major information advantage to leadership by waling around is the opportunity to

A

Do naive listening

138
Q

It is ___ to maintain the chain of command when and administrator practices leadership by walking around

A

Entirely feasible

139
Q

An effective administrator does not overrule middle-level managers uless

A

Harm could result

140
Q

The administrators work begins once the board has set forth the ___ of the organization

A

Mission statement

141
Q

The best time for the administrator to introduce change in the facility is when

A

He or she does not have to

142
Q

The better administrator is the one who

A

Spends the most hours in the facility wings

143
Q

For every successful decision the administrator makes

A

He or she may experience two or three wipeouts

144
Q

One thing that the successful administrator remembers about the environment is that it

A

Remains beyond control

145
Q

One reason for the administrator not to give all attention to the most immediate opportunity is that

A

Better opportunities may also exist

146
Q

The best time to begin a move toward introducing a change into a facility when

A

Change is still on the horizon

147
Q

In the views of some contemporary corporate managers, change should be viewed more as a/an

A

Continuous process, not an event

148
Q

Being knowlegable about the field and having competence and experience will take today’s administrator to

A

A good level

149
Q

When nursing facility administrators have ‘that particular thing’ in their blood they have a fire int he heart for

A

Continuously improving the quality of daily life of each resident

150
Q

Manager-centered leadership retains a ___ degree of control and uses ___ extensively

A

High/Authority

151
Q

Permitting subordinates to make the decision and function within the limits defined by the manager is closest to a ___ style of management

A

Laissez-faire

152
Q

When deciding what style of management to employ in a given situation, administrators should consider factors within themselves, factors in the employees, and factors in the ___

A

Organization

153
Q

A manager who is responsible for the development of more specific policies that interpret administrations policies for the employees one supervises is closest to ___ managing

A

Middle level

154
Q

The charge nurse responsible for applying policies provided by the director of nursing services is functioning most closely at the ___ level of management

A

Lower

155
Q

Origination, change, creation, and elimination of structure are the responsibility of ___ management

A

Upper level

156
Q

Operational use of existing structure is the responsibility of ___ management

A

Middle level

157
Q

Successful leaders need to be keenly aware of relevant forces in the situation to understand themselves, and also ___ vis-a-vis the situation

A

Be able to behave appropriately

158
Q

The acts of the ___ leader are typically unexamined

A

Charismatic

159
Q

A valuable goal for each administrator is to deliver short term results while secuuring

A

Long term viability

160
Q

When one is able to motivate someone to do something he or she would not otherwise do, one is said to be weilding

A

Power

161
Q

In the american culture power is a/an

A

Complex concept

162
Q

The administrators ability to award or withold a year end bonus represents ___ power held by the administrator

A

Reward

163
Q

Fear that the administrator may write a negative report and place it in one’s personnel file represents teh administrator’s power

A

Punishment

164
Q

Employees identifying and admiring the administrator yield ___power to the administrateor

A

Referent

165
Q

Two types of power available to all staff members are

A

Expert and referent

166
Q

As a general rule, it is better if an administrator can possess and exercise ___ power

A

Expert and referent

167
Q

The presence of numerous professions such as the medical, nursing, dental, and pharmaceutical professions in the facility tend to ___ the administrators power

A

Constrain

168
Q

Communication is the exchange of information and the transmission of

A

Meaning

169
Q

The administrator initiates a communication and it is transmitted from its source to its destination. Communication has

A

Not yet taken place

170
Q

Listening with intensity, acceptance, empathy, and a willingness to assume responsibility for understanding the speaker’s complete message is sometimes called

A

Active listening

171
Q

Two systems of communication usually exist side by side in an organization and are known as

A

Formal and informal

172
Q

Two nurses chatting while on break in the nurse’s lounge about a patient’s status is ___ communication

A

Horizontal

173
Q

Two nurses chatting about the most recent events in the administrator’s office while on break in the nurses’ lounge are engage in ___ communication

A

Informal

174
Q

It can be reasonably argued that every communication is likely to have

A

Multiple levels of meaning

175
Q

The informal communication process most closely resembles

A

The nurse assistant chatting with a resident while making the bed

176
Q

The director of nursing giving instruction to the nurse supervisor is considered

A

Downward communication

177
Q

The nurse assistant reporting to the nurse supervisor about an incident in a patient room is an example of ___ communication

A

Upward

178
Q

The closer one gets to the organization center of control, the administrators office, for example, the

A

More pronounced the emphasis is on the exchange of information

179
Q

The nurse assistant, preoccupied and angry over unsettled matters at home, interprets the comments by the nurse as hostile comments. This illustrates a barrier to communication known as

A

Agenda carrying

180
Q

The charge nurse who remembers the words of praise from the director-of nursing but ignores the criticisms also received from the director of nursing illustrates a barrier to communication known as

A

Selective hearing

181
Q

A nurse assistant realizes that her fellow nurse assistant is sleeping much of the night shift, but decides not to resort her. This illustrates

A

Subgroup allegiance

182
Q

The nurse’s aide realized taht the patients condition should be pointed out to the attending physician who had just popped into the patients room, but hesitated to approach the physician. This illustrates the effects of

A

Status distance

183
Q

The medication nurse thought she understood what the pharmacist had just said about the side effects of a medication, but found the technical jargon used by the pharmacist to be intimidating. This illustrates

A

The language barrier

184
Q

The charge nurse decided not to write up an incident on her shift because four incidents had already been written up that week on her shift. This illustrates

A

Self protection

185
Q

The new 30 page long policy on universal precautions contained so many new requirements that staff soon began to revert to their time tested approaches conducting patient care. This illustrates

A

Information overload

186
Q

Under Tag F241 the government defines dignity as caring for residents in a manner that maintains full recognition of the residents

A

Individuality

187
Q

Dignity has been interpreted by states examiners

A

With wide variations

188
Q

Standardized patterns of required behaviors developed by the facility to enable staff to accomplish necessary work defines a

A

Role

189
Q

Since about the year 2000 the percentage of nursing facilities in the US given deficiencies in quality of life, dignity

A

Varied widely by state and over time

190
Q

Treating all residents with respect is best described as a

A

Value

191
Q

A statement broadly defining the purposes and values held by a facility is a

A

Mission statement

192
Q

When the administrator concentrates on getting paperwork done, meeting regulations, and saving money, the staff

A

Do the same

193
Q

The area in which it is especially important for the administrator to implement a ‘no excuses’ approach is

A

Patient care

194
Q

It is easier for staff to buy into and be motivated by a

A

Dream or vision

195
Q

If a facility administrator can communicate a vision or dream

A

Goals can be more easily set and achieved

196
Q

Each state legislature publishes standards of practices and sets the ___ behavior expectations for nursing home administrators

A

Ethical

197
Q

Corporate generated goals or mission statements generally

A

Have difficulty motivating local facility workers

198
Q

Organizations need the leadership of the administrator because in the final analysis

A

All organizational designs are imperfect

199
Q

The actual behavior and functioning of an organization such as a nursing facility

A

Are infinitely more complex and incomplete than the plan

200
Q

The concept of delegation is permitting decisions to be made

A

At the lowest level possible

201
Q

How people relate to each other in the organization and the overall style or feel of an organization are referred to as

A

The corporate culture

202
Q

The concept of unity of command emphasizes the importance of each person

A

Being accountable to one supervisor

203
Q

When the board of directors gives equal authority to manage the facility to the medical director and the administrator, the board has ignored the ___ concept

A

Unity of command

204
Q

The principle that there should be as few levels of management between the chief administrator and the rank and file is the

A

Short chain of command

205
Q

When the number of interpreters through whom information must be filtered before it reaches top management is minimized, the concept of ___ has been implemented

A

Short chain of command

206
Q

The administrator who pays attention to the size of the various departments, centralization and decentralization, span of control, and short chain of command is paying attention to

A

The concept of balance

207
Q

The administrator who begins with the nursing assistants ideas then moves upward through the director of nursings ideas and does so for each department is utilizing the concept of

A

Management by objectives

208
Q

In determining the need for information; sources of information and the amount, form, and frequency of information, the administrator is considering his or her

A

Management information system

209
Q

The administrator tells the admissions director to drop the daily reporting and to report only on days census drops below 90%. the administrator is utilizing the ___ concept

A

Management by objectives

210
Q

Mapping out time estimates for the completion of each step in renovating a wing is using

A

Delegation

211
Q

The administrator in the chain who is achieving the best level of resident care, but not necessarily the lowest cost per patient day, can be said to be___ although perhaps not the most efficient administrator

A

Effective

212
Q

Studies of top corporate administrators suggest that these persons feel that they can

A

Manage almost anyting

213
Q

The administrator who focuses on the time it takes for each housekeeper to clean an area and the time it takes for a nurse assistant to make a bed identifies with the

A

Scientific management school

214
Q

Administrators who believe that human factors exercise the most powerful influences due to worker need to participate in social groups identify with the ___ school of management theory

A

Human relations

215
Q

Security of residents medical records is of special concern because it is covered under

A

HIPPA

216
Q

Encoding data into unrecognizable streams of data while data are in transit is known as

A

Cryptology

217
Q

Web based technologies to create interactive platforms through which individuals and communities share, create, and discuss ideas is known as

A

Social media

218
Q

An administrator judging the extent of actual results of the facility efforts to achieve the outcomes proposed in its plans is

A

Comparing

219
Q

The administrator who is successfully taking the steps necessary to adjust policies and plans of actions to more satisfactorily achieve stated goals is engaged in

A

Controlling

220
Q

Translating goals into clearly stated policies, identifying appropriate measures, and stating limits to deviation are some of he requirements for

A

Effective control of quality

221
Q

Getting information in a useful form to staff at appropriate levels, stating policies of actions to be taken when limits are exceeded, and taking corrective actions are some of the requirements for

A

Effective control of quality

222
Q

Setting up a system for constant renewal of quality measures, finding control measures that are functional and valued by staff, and knowing the limitations of the scope and capabilities of a system are some of he requirements for

A

Effective control of quality

223
Q

Physicians diagnose and treat patient illnesses; administrators diagnose and treat ___ illnesses

A

Organizational

224
Q

When an administrator studies an determines what is believed to be a problem adversely affecting the nursing facility, the administrator is engaged in a study of

A

Organizational pathology

225
Q

Which of the following is not a federal quality measure

A

Percent of staff having a good feeling about patients

226
Q

Managers have always sought to achieve quality control in their organizations and

A

This remains an elusive aspect of managing

227
Q

Ensuring that all the organizational arrangements believed to be needed are in place puts the emphasis on ___ as a quality measure

A

Process

228
Q

Focusing on the results of the effort made and the measurable impact on the patient given care places the emphasis on ___ as a quality measure

A

Outcome

229
Q

The federal focus on the idea that a resident’s abilities in activities of daily living do not diminish unless circumstances indicate it is unavoidable places the focus o n

A

Outcome measures

230
Q

Quality, argued Deming, comes from

A

Improvement in the process

231
Q

Deming observed that too often nurses and nurses aides

A

Learned their job from workers who were never trained properly

232
Q

The nurse supervisors job according to Deming is to

A

Lead

233
Q

An atmosphere, according to Deming, in which employees feel secure enough to ask questions, take positions, and admit errors is free of

A

Fear

234
Q

The best source of slogans or work goals, in Deming’s view is

A

The facility

235
Q

Deming would ___ of setting the number of beds to be made each day or the number of rooms to be cleaned or floors scrubbed

A

Disapprove

236
Q

In Deming’s view, workers are

A

Eager to do a good job

237
Q

Evaluation by performance, merit rating, and annual review of performance in Deming’s view

A

Destroys teamwork and nurture rivalry

238
Q

If the administrator tells the director of nursing to compare how the facility’s nursing services are organized with what is considered the best organized nursing services int eh area, the administrator is

A

Benchmarking

239
Q

A benchmarking effort ___ be justified by seeking out significantly better practices rather than solely focusing on best practices

A

Can

240
Q

When Deming warned not to simply copy others’ efforts when benchmarking, he was advocating

A

Adapting, rather than copying, benchmarked ideas

241
Q

Total organizational involvement in improving all aspects of quality of service is the goal of

A

Total quality management

242
Q

The approach in total quality of management of placing responsibility with the workers who produce a service is sometimes knows as

A

Quality at the source

243
Q

Employee empowerment in decision making, use of teams, and use of individual responsibility for services characterizes

A

Total quality managemtn

244
Q

In the American Hospital Association’s view the goal of total quality management is to ___ customer expectations

A

Exceed

245
Q

Visionary chief executive officers acting as coaches, commitment to customers, and trained teams characterize

A

Total quality management

246
Q

Managing for quality consists of quality planning, quality control, and

A

Quality improvement

247
Q

Bringing new ideas into the away an organization accomplishes its purposes is the result of

A

Innovating

248
Q

The role of innovator is

A

Available to all employees

249
Q

One writer suggests that managers should ___ specific objectives that will guide the organization over an extended period of time

A

Avoid trying to set out too

250
Q

In the nursing facility, innovation is

A

Finding new solutions to creating quality of life for residents

251
Q

Innovation can be expected

A

From all levels in a nursing home again

252
Q

Google’s Android and Apple’s iOS have facilitated unprecedented development of

A

Apps

253
Q

In the nursing facility the microphone on the smartphone can be used to quantify components of

A

Lung function

254
Q

In the near future, ultrasound will be available to

A

Nursing home nurses

255
Q

Daughters and the government are increasingly likely to ___ timely diagnosis of changes in health conditions

A

Force nursing facilities into

256
Q

Due to new technologies, health care provided by nursing facilities will be increasingly

A

Multilayersd

257
Q

A social graph of information such as demographics, location, family, likes, are part of the medical information of the future know as the

A

Phenome

258
Q

The residents individual anatomy, documenting the individuals heterogene

A

Anatome

259
Q

All the environmental exposures of the resident has experienced are described as the residents

A

Exosome

260
Q

Like many hospitals, nursing homes are increasingly turning to ___ to maintain satisfactory income

A

Filling a market niche

261
Q

When a facility has archived the premier status as the best caregiver in the community, experience suggests that it will likely

A

Lull itself into coplacency

262
Q

In today’s competitive market, good nursing facilities

A

Abound

263
Q

The downside of being a good nursing facility is that it

A

Only puts you with the rest of the pack

264
Q

Several years ago, the US Supreme Court ___ self imposed restrictions by health and other professionals against advertising services or prices that result in keeping the public ignorant or inhibiting free flow of information

A

Ruled illegal

265
Q

Competition occurs when tow or more organizations seek to serve ___ in an exchange process

A

The same individual or group

266
Q

The audit, market segmentation, choosing a market mix, implementing the plan, evaluation of results, and control are the steps in

A

Marketing

267
Q

The marketing of the nursing facility is in a special context because of

A

Public ambivalence toward the nursing facility

268
Q

Selecting a target market or markets, choosing a competitive position, and developing an effective marketing mix to reach and serve the identified customers is

A

Developing a mareketing strategy

269
Q

A marketing strategy includes

A

Seleting a target

270
Q

The administrator asks a committee to engage in the process of identifying, collecting, and analyzing information about the external environment. In marketing terminology the administrator is seeking an

A

Audit

271
Q

When the administrator decides to serve only longer term residents, Medicare residents, and Alzheimer residents, in marketing terminology the administrator has selected the

A

Product mix

272
Q

The steps of problem recognition, information search, alternative evaluation, purchase decision, and post purchase evaluation are, in marketing texts identifies as the steps in

A

Consumer decision making

273
Q

Factors such as general appearance of the facility, absence of odors, and the appearance of the patients may be those about which the decision maker may not be consciously aware while visiting a facility into which to place a relative. These are referred to as ___ factors

A

Subliminal

274
Q

Normally one of the most effective marketing tools is

A

A tour through the facility

275
Q

Cognitive readiness, affective readiness, and behavioral readiness are

A

The goals of advertising

276
Q

Which staff should normally talk to the press

A

The administrator

LNHA (26 decks)

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