Misc Flashcards
Physical restraints must be moved
every 2 hours
regarding developmentally disabled HCFA recommends use of
justice system, consumer groups, etc. to determine type of active treatment
most significant aspect of resident care practice is
staff attitude towards residents
OBRA requires that rehab service
be prescribed by a licensed physician
Bodily fluid that does not transmit HIV
urine
facility cannot discharge resident if
court appointed guardian refuses transfer
If you have an Ethics committee
it must be free standing
discharge summary
may be the last progress note written
social workers do not provide
psychiatric therapy
stages of dealing with death
denial, anger, bargaining, depression, acceptance
initial responsibility to explain resident rights
is the social workers
Advanced Directives
1) Facility must have P&P
2) Not provide care that conflicts with directive
3) Resident must be informed of rights
Most nursing home residents are
widows
if a resident is declared legally incompetent
rights are assigned to legally responsible party
max hours between evening meal and breakfast
14 hours
primary purpose of having residents eat in dining room is
to provide socialization
Cause of liver damage is usually
poor diet
All menus must be approved by
the dietician
hot food should be served at what temperature
140F
opposite of acute condition is
a chronic condition
hearing loss refer to
ontologist
podiatrist may not be
attending physician
patients must be seen by doctor every
30 days for first 90 days then once every 60 days
who is responsible for paying dental service
family or resident
QA committee must include
1) physician
2) DON
3) three other staff members
RAI designed to
improve clinical assessments mandated by HCFA
Residents are most easily encouraged to participate in activities that are
personally satisfying
Primary IDT members usually include all but which of the following staff
1) activities director
2) rehab staff
3) therapy staff
but not Admin
Facility Administrator’s role in activities is to
visit, observe, and support
volunteer program best achieved by
granting awards for years of service
most volunteers come from
religious organizations
Best communication of activities is through
signs, posters, and calendars
primary purpose of medical records is to provide
continuity of care
the primary value of varied colors on records forms is
quick identification
an assessment of resident condition gives
current status
medical records belong to
the facility
prescription drugs can only be given by
the licensed person who prepared the drug
Schedule 1 drugs
have no medical use
Schedule 2 drugs
cannot be fulfilled without Dr. new prescription
If drug error is reported to administrator
admin should determine disciplinary action
If there is a damaged drug label
return drug to pharmacy
prescription drugs can only be dispensed by
a doctor or pharmacist
rehab needs of patients are met by
therapists
Accrual is
an accounting system
assets appear on
the balance sheet
after entering a transaction in the journal one must
periodically balance each account
Interest can be both
revenue and an expense
Bank statements should be reconciled immediately because
neither they nor the facility ledger may show the correct balance
Current ratio is
assets divided by current liabilities
Prepaid expenses are
things purchased but not yet consumed
Best way to maintain inventory is to
record in an inventory control system with reorder levels
an invoice is usually a
list
to determine ability to meet short term cash need
use a cash flow statement
a balance sheet contains
1) assets
2) liabilities
3) net worth/owners equity
FUTA is
unemployment tax
Current trial balance has
debits, credits, and names but NO zero balances
Annual audits do what
verify accuracy of financial records
Distance between beds should be
3 feet
Maintenance program should emphasize
preventative maintenance
when two government agencies have different rules
go with the more stringent one
work orders in housekeeping and maintenance help
schedule work to be done
waste management is monitored by
OSHA
lighting temperature and sound levels relate primarily to
comfort
standard precautions are given by
the CDC
Best theft prevention is to
limit the number of items that could be stolen
MSDS sheets are from
OSHA
the number of patients per bathroom is established by
the State
Flashover is
an out of control fire
Agencies over emergency power are
NFPA and OBRA
Primary fire defenses are
resident doors, walls, and smoke barriers
employees right to know relates to
hazardous communications
minimum amount of square footage per bed
80 sq ft
maximum corridor without a smoke stop door
150 ft.
Closing doors in a fire is to
contain the smoke
generators must be checked how often
weekly
Major problem with fire drills is
there is no fire
Standard precautions, right to know, and HBV are under which agency
OSHA
all healthcare facilities must be
licensed
Respondiat Superior means
both employee and employer may be held responsible for employee screwup
It is not the role of the Ethics committee to
make decisions
Ethics committees usually do not include
residents
Strategic planning is
planning for future uncertainties
Residents rights are categorized by
OBRA
Ombudsman program funded by
the Administration on Aging
Resident and family should both participate in
the first meeting of the resident assessment
Nondirective counseling
guides person to discover the best action themselves
Privacy is required in
Records, treatment, and communication
Best time to inform patients of their rights is
before or during admission
Upon death, return funds to estate within
30 days
Must have residents rights in sign, audio, or other language but not
Braille
The hardest resident right to follow is
choosing physician
Public liability insurance covers
visitor injury on property
Two most important risk management tools are
education and quality control
ADA does not cover
illiteracy
Recreation therapy does not
count as treatment
the most overlooked aspect of communication is
confidentiality
Use written communication when information
goes through levels of management
most effective communication is
face to face
Best method to obtain honest feedback
resident survey
Must inform resident rights
orally and in writing in their own language
Major problem with on the job training is
day to day demands made on trainers
Personel management is
staffing
best hiring source is
other employee referrals
pregnancy discrimination is part of
the Civil Rights Act
Fair labor standards act requires
overtime pay
Minimum number of cards signed to initiate a union election is
30%
Fair labor standards act includes
equal pay
Agency responsible for Retirement Income Act is
EEOC
Must have a hazardous communication program to
evaluate the hazards of chemicals
Employee accidents are caused by
unsafe working conditions or behavior
Too little responsibility increases
risk of accidents and disease
Update budget
annually
Investigate accidents to
prevent reoccurrence
Accelerated depreciation means to
depreciate higher percentages of cost in the first year
Rectal temperature is higher than
oral or arm pit
Gerontology
the study of the aging process
More acute residents in SNF because of
increased Medicare rates
Cannot discharge or transfer a resident who
contracts HIV
Continued need for restraints reevaluated and documented
every 24 hours
DON can be charge nurse only in
60 residents or less
If residents wants to leave, we must
assist and arrange for information transfer
A curator is
a guardian
Highest protein food is
meat
Dishwater rinse water temperature
180F
Significant weight loss over 6 month period
10%
Syndrome is
a group of symptoms
Pathologist is involved in
causes and histories of diseases
Who is responsible for the implementation of care policies
Administrator
Social Security Act requires nursing home to have
a written transfer agreement with at least one hospital that takes Medicaid and Medicare
OBRA requires QA to meet
at least quarterly
Pet therapy should have
limited participation
Activity Coordinators must chart
in medical record
Keep medical records for
5 years after discharge or 3 years after resident turns 18
Medical Device Reporting keeps records for
2 years
Resident request for their records
24 hours to comply
Morphine, Codeine, and Ritalin are which type of drug
Schedule 2 drug
Medication with automatic stop order
must notify physician before last dose given
Prescription label must have
1) date dispensed
2) expiration date
3) lot number
The five drug schedules were established by
The Comprehensive Drug Abuse Prevention and Control Act
OBRA requires pharmacists to
1) determine drugs are in order
2) conduct reviews of each residents regimen
3) maintain and reconcile a record of all controlled drugs
Successful exercise program should
follow a routine
Bulletin boards are usually
outdated
Develop staff rapport by
establishing clear lines of authority and responsibility
Don’t have to offer COBRA if
employee is fired for gross misconduct
Employee productivity =
required staff divided by provide staff X 100
HCFA requires that
50% of residents selected for review in survey be interviewable
Must have full time Social Worker if
more than 120 beds
Best time to inspect and weigh food
when it is received
Peanuts have no
potassium
Nephritis is
inflammation of the kidneys
In emergency with no doctor
the administrator decides who will attend the resident
Medical Record Manager is not responsible for
the adequacy and accuracy of records
Patient can take medications home with
physician’s written permission
Drug storage and destruction is enforced by
DEA
Person responsible for checking all drug records
Pharmacist
Delegation leads to better
efficiency
the most essential step in decision making is
problem identification
development of training programs is the responsibility of
each supervisor
Wage evaluation is based on
merit
board and lodging may be part of
wages
Fatal or multiple (3 or more) hospitalizations must be
reported to OSHA in 48 hours
C Corporations can make their financial year
anytime they want
Employment tax records must be kept for
4 years
1099 form is for
contract workers
income statements are prepared from
the general ledger
Book Value =
Cost of Asset - Accumulated Depreciation
In finance, Control is a way to
identify problems when they occur
Minimum width of a bedroom is determined by
the State
Forced air ventilation must change air every
6 minutes
ANSI requires what for wheelchairs
60 inch diameter space for wheelchair to make a 180 degree turn
Life safety code published by
NFPA
Handrails on ramps and stairs must be how high
30”-34” inches
Must have 3 handicapped parking spaces if total is
60 spaces (one for every 20 regular parking spaces)
Angle of rise on a wheelchair ramp is determined by
ANSI
Medicare A coverage provides
1) Inpatient hospital
2) post hospital home health
3) post hospital rehab
Theory Y
Reward
Theory Z
Trust, Long Term Goals, and Incentives while working cooperatively
Mission Statement is set by
Governing Body
Ombudsman
1) funded by Administration on Aging
2) administered by State agencies
Organizing is guided by
1) Authority
2) Span of Control
3) Unity of Command
OBRA requires you report abuse within
5 days
Developing marketing plan is
not democratic
OBRA does not classify recreation therapists as
rehab
Occupational therapists spend most time on
ADLs
If special rehab service is required and you don’t have it
get it from outside source
In order to improve resident ability to eat independently, you must
provide assistive eating devices
Employees accept increased census and responsibility if
increase is linked to improvement
most documentation is done by
nurses in the charts
Placing a message in oral, written, or chart form is called
encoding
Key to understanding communication is
listening
Bulletin boards problem is that they are
outdated
An example of a communication problem is
the language barrier
Assessments and care planning
help communication
Most important part in communication in policy and procedure is
confidentiality
two most important skills for administrator
problem solving and communication
Purpose of disciplinary action is
to effect a desired behavior change
pay scales are required for
both salary and wage employees
Sexual harassment policy includes
1) Complaint procedure
2) Clear prohibition
3) description of conduct
ADA reasonable accommodation does not include
transportation
Workers comp rates depend on
claim experience, state regulation, and risk class of occupations
Amortization is defined as
a declining proration of asset cost
Depreciation is defined as
the decrease in value due to obsolescence, wear, and tear
Working capital is defined as
current assets minus current liabilities
Retained earnings are defined as
income left after taxes and dividends have been paid
Well capitalized companies should have a debt to equity ratio of
less than 1 to 1
Safe harbor prohibits
extra payments for items reimbursed under Medicare or Medicaid
Most accurate measure of net income
when accrued income is allotted to the period in which the expediters are incurred
60 day accounts outstanding should never exceed
5%
employees pay what % of FICA
50%
Corridor doors must have a fire protection rating of
1.5 hours
Major cause of fires in nursing homes is
smoking
Class C fires
fires involving electrical equipment
Life Safety Code requires all doors except for bathroom doors to have a clearance of
41.5 inches
State surveys are
outcome oriented
Most prevalent fall risk
weakness
therapeutic recreation
meant to increase capabilities
Medical records must be stored
under lock and key
work should be assigned on the basis of
individual abilities
Appraisal of a job in relation to standards
job evaluation
Max number of beds per room determined by
Medicare and Medicaid
