Management, Governance, Leadership Flashcards
output
the results of the work (caring for residents) that nursing facilities do … the product of the work accomplished by the organization
RUG -IV or current version of the Resource Utilization Group
A resident classification system that identifies the relative resource use of providing care for different types of residents in nursing facilities based on their resource use.
a line position
such employees are line managers. They are empowered to make decisions on behalf of the administrator.
Organizing
the first step in implementation of a plan
Total Quality Management (TQM)
is difficult to define precisely because it is a philosophy of total organizational involvement in improving all aspects of quality of service
SOM State Operation Manual
The title given to the current set of requirements and guidelines to surveyors. Current edition with changes in red can be downloaded from the CMS website www.cms.gov
strategic planning
conceiving and implementing the pattern or plan that integrates the facilities’ major goals, policies and action sequences into a cohesive whole
the basic benefits of leading by walking around are
listening (finding out what’s happening on the firing line), teaching (communicating the facility’s values), and facilitating
Forecasts
projects trends and needs which the facility management must meet in the future
Marketing
identifying and attracting the persons served
PPS Prospective Payment System
A payment system developed for Medicare for skilled nursing facilities which pays facilities an all-inclusive rate for all Medicare Part A beneficiary services. Payment is determined by a case mix classification system (RUG-IV or current version).
Definition of Marketing
the process of planning and executing the conception, pricing, promotion, and distribution of ideas, goods and services to create exchanges that satisfy both individual and organizational objectives
the environment
is both a set of constraints within which the facility must operate and a set of opportunities that the facility administration may seize
The Upper-level Manager
the nursing facility’s upper level administrator is primarily responsible for creating and changing the organization’s structure
MDS Minimum Data Set
a core set of screening, clinical, and functional status elements, including common definitions and coding categories that form the foundation for the comprehensive assessment for all residents of long term care facilities certified to participate in Medicare and/or Medicaid
Code of Federal Regulations (CFR)
The federal Congress passes laws for which implementing rules are written and enforced….these are the Federal Requirements and Guidelines to Surveyors.
market segmentation
using the audit information to divide the potential persons served into identifiable subgroups
RAI Resident Assessment Instrument
The designation for the complete resident assessment process mandated by CMS (Centers for Medicare and Medicaid Services), including the comprehensive MDS, Resident Assessment Protocols (RAPS) , and care planning decisions.
Referent Power
power to influence is often based on liking or identifying with another person
the basic functions of administrators/managers
forecasting, planning, organizing, staffing, directing, evaluating, controlling, innovating, and marketing
market specialization
i.e. serve only one market segment such as persons who need rehabilitative care and are expected to return home within a specified brief period of time
a staff position
is an advisory role. None of the administrator’s authority to make decisions on behalf of the facility is delegated to persons in a staff position.
the steps in marketing are
1) the audit; 2) market segmentation; 3) choosing a market mix; 4) implementing the plan; 5) evaluation of results; 6) control
Reward Power
given to induce or persuade employees or residents to do what the administrator asks
MDCN Medicare Data Communication Network
A secure connection that is used to transmit MDS data to each state’s repository. A user ID and password is issued and for each person who requires access to the CMS (Centers for Medicare and Medicaid Services) MDS intranet.
Auditing
the process of identifying, collecting and analyzing information about the external environment
a marketing strategy includes
selecting a target market or markets, choosing a competitive position and developing an effective marketing mix to reach and serve the identified customers
QIS Quality Initiative Survey
CMS intends to move surveys in the facility to a process of doing surveys on laptops using wireless technology. This will enable the surveyors to communicate with each other via laptop throughout the survey process itself.
Charismatic Leadership
a magical aura with which people sometimes endow their leaders
Evaluating
comparing actual to expected results
Efficiency
the ability to produce the desired effect with a minimum of effort, expense, or waste
the concept of unity of command
emphasizes the importance of each person being accountable to only one supervisor
delegation
is permitting decisions to be made at the lowest possible level
Innovating
the effective administrator is always an innovator. The administrator develops new ideas, combines old ideas to form new ones.
Comparing
judging the extent to which actual results of the facility’s efforts achieve the outcomes proposed in the plans
Planning
deciding what is to be done
procedures
a highly detailed plan of specific actions that each employee would be expected to follow
Organizing
a method of ensuring that the work necessary to achieve a goal is broken down into segments, each of which can be handled by one person
Sub Group Allegiance
each one of the sub groups in the organization (nurses, housekeepers, residents on a hall) demands allegiance from its members
a long-range objective
a new wing of 60 additional beds within 10 years
Innovating
the process of bringing new ideas into the way an organization accomplishes its purposes
The Great Leadership Theory of history
that history is ‘made’ or measurably influenced by individuals who become leaders
The Middle-level Manager
the head of dietary, head of housekeeping, or other department head is responsible for development of more specific policies that interpret administration policy implications for their departments
Evaluates
judges the extent to which the organization is accomplishing its goals (usually set by corporate)
Who defines the system?
anybody can define any set of interrelationships as the system for purposes of description or analysis
a service is
an activity or benefit that one person can offer to another which is intangible and does not result in ownership of anything
MDS Completion Date
the date at which the RN assessment coordinator attests that all portions of the MDS have been completed
An approach to leadership of particular value in the nursing facility setting is
leading by walking around (LBWA)
Controls Quality
takes steps to assure that the goals are accomplished and that each job is done as planned
middle-level management
middle-level managers report to upper level managers and at the same time interact significantly with lower-level managers
short chain of command
this principle asserts that there should be as few levels of management as possible between the chief administrator and the rank and file
Organizations
systems of interactions among the three available inputs
lower-level management
lower-level managers have direct supervisory responsibilities for the staff who do the actual work
CASE MIX INDEX
Each RUG-IV (or current RUG version) group is assigned a weight, or numeric score, which reflects the relative resources predicted to provide care to a resident. The higher the case mix index (weight) the greater the resource requirements are for the resident. Payment for each resident is made monthly to the facility based on the case mix index for the facility.
job list for each position usually includes the following
the objectives (result to be accomplished); the duties and authorities of the position; its relationship to other positions in the organization
quality of the source
to achieve this, responsibility for quality is ultimately placed with the workers who actually produce the service or product
Expert Power
power can derive from recognition by the employees and residents that the administrator is very skillful, has had considerable training, and is quite knowledgeable in the field of nursing home administration
The outputs of one system
normally become the inputs for the next system
Directs
provides direction (preliminary training and ongoing supervision) through communication to each employee who thereby learns what is expected.
CMS Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration)
The federal agency that administers the Medicare, Medicaid, and Child Health Insurance Programs.
subliminal perceptions
factors of which the decision maker is not consciously aware, such as general appearance of the facility, absence of odors, friendliness of the staff, appearance of the patients
policies and plans of action
the guidelines the administrator uses to compare the output (e.g. actual patient care or financial results achieved) with the expected
the entropic process
a universal law of nature that all organisms move toward death
feedback
refer to the external responses to the output (“good” or “bad” resident care provided, etc.) by the nursing facility
Effectiveness
the power or ability to bring about the desired results
span of control
how many immediate subordinates with interrelated work should a manager supervise
directing
the process of communicating to employees what is to be done by each of them and helping them to accomplish it
RAPS Resident Assessment Protocol
A problem oriented framework for organizing MDS information and additional clinically relevant information about an individual’s health problems or needs
OBRA Omnibus Reconciliation Act of 1987
A law that enacted reforms in nursing facility care and provided the statutory authority for the MDS.
Control
the corrective action taken after evaluation of outputs by the organizational decision makers
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Punishment Power
when employee believes that unacceptable behaviors will be punished; the ultimate punishment power is firing the employee or requiring the resident to leave the facility, but there are many intermediate, less drastic means
staffing
the human resources function
upper level management
is responsible for the overall functioning of the facility
Punishment Power
when employee believes that unacceptable behaviors will be punished; the ultimate punishment power is firing the employee or requiring the resident to leave the facility, but there are many intermediate, less drastic means
benchmarking
a management tool by which an organization seeks to improve its business practices by comparing them with the best practices of other organizations
a system has been described as
an organized or complex whole, an assembling or combining of things or parts forming a complex or single whole
Controlling
successfully taking the steps necessary to adjust the policies and plans of action to more satisfactorily achieve stated goals
processor
the work the organization accomplishes
Innovates
leads the staff to develop new ideas that enable the facility to enhance its attractiveness to the community served.
CASE MIX
A measure of the intensity of care and services used by a group of residents in a nursing facility. “Case” refers to the overall data collected and used regarding an individual person under study. “Used “describes the combination of variables (observations) used for classifying an observation according to distinctive characteristics on the basis of a dependent variable, such as time or costs.
inputs
money, people, material
Markets
assures that the facility successfully attracts and admits to the extent feasible the persons it seeks to serve
Budgeting
deciding acceptable costs
Communication
the transmission of information
Staffs
attempts to find the right person for each defined job.
the Lower-level Manager
(e.g. the charge nurse who supervises a specific group of nurses/nursing assistants) has the responsibility of applying the policies provided by the director of nursing to the hour-by-hour care given
Budgets
projects costs and establishes categories with dollar amounts for each
the Filter Effect
the manager may be told what the employees believe he/she wants to hear
a short range objective
might be set to have a 100 bed facility in operation within 18 months
Forecasting
projecting trends into the future
involves trend identification and analysis
a means with coping with uncertainty
plans
hierarchy
a RUG methodology of assessment classification where an assessment is placed in the first classification category (there are over 40 reimbursement categories) where a match is found by evaluating resident conditions and services
Directing
providing daily supervision employing good communication, people skills
the market mix
deciding what types of residents to approach and in what proportions
Plans
decides what needs to be done and makes a set of plans to accomplish it
Controlling Quality
taking necessary corrective actions
Organizing
deciding the scheme of the organization and the staffing it will require
Organizing
a method of ensuring that the work necessary to achieve a goal is broken down into segments, each of which can be handled by one person
Legitimate Power
authority given to a particular position and is associated with the person’s position in the organization
