Management, Governance, and Leadership Flashcards
The most likely single cause for the series of bankruptcies among larger nursing home chains around the year 2000 was
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
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
It is nearly always desirable to be efficient as well as effective
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
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
Bankruptcies among larger nursing home chains prior to 2000 were
From the founding of the large-scale nursing home industry in the 1960’s until the year 2000 very few bankruptcies were experienced
Under Prospective Payment System, nursing facilities’ reimbursed costs
Medicare (and Medicaid) forced facilities to give roe services for a single reimbursement rate than had been the case previously
In recent years, Medicare has
Medicare, to cut its own costs, has required facilities to give more services under the medicare reimbursement plan
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
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
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
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
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
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
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
Under bankruptcy plans, the court ensures that all current bills are paid. The medical supplies provider does not understand the bankruptcy laws
An administrator who adopts the leadership-by-walking-around LBWA approach by walking through the facility weekly and intently observing
Leadership by walking around (LBWA), to be effective, must be done daily; weekly is too infrequent
The nursing facility administrator who, using the LBWA technique, succeeds in actually making appropriate corrections on the spot during her rounds
It is normally better to go through the chain of command and let the employees’ immediate supervisor request the corrections
The rate of increase in the total number of nursing facilities in the United States during the years 2008-2012
A number of market forces have held down any significant building of new facilities in recent years. This may change
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
The successful nursing home administrator will need to employ several administrative styles to get the facility’s work successfully accomplished
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
This candidate understands the need for flexibility in leadership styles and believes that several styles have been used effectively
The candidate for administrator indicated that he consistently chose the charismatic style of leadership. This should ___ the interviewer
Charismatic leadership is given to leaders by followers. A leader cannot just declare himself or herself charismatic
The costs of providing subacute care to nursing home residents
Yes, acute care reimbursement rate are higher than average, but so are the costs!
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
It is impossible to prevent informal communications among nurses. The nurse supervisor does not seem to have enough communication savvy to understand this
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
The department head understands that employees often engage in selective hearing, that is, hearing good news and screening out anything unpleasant
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
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
Periodic shortage of nurses available for nursing home employment___
Nursing shortages come and go, but mostly there is a seemingly chronic shortage of good nurse candidates
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 ___
It is impossible and undesirable to try to write enough rules to make every facility function successfully
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
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
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
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