NAB Study Guide (Online) Flashcards
AMD
Age-related Macular Degeneration
___________ __________ ____________ is a disorder of the eye characterized by inability to see anything that requires straight ahead vision, often resulting in blindness
Angina Pectoris
Severe pain about the heart, usually radiating to the left shoulder and down the arm.
Anorexia
Loss of appetite (seems under-stated).
Aphasia
Absence or impairment of the ability to communicate through oral and/or written language; it often occurs after brain damage in accidents and from strokes.
Apnea
Temporary cessation of breathing, a serious symptom sometimes occurring in the aged during profound sleep.
Arteriosclerosis
Thickening, hardening and loss of elasticity of the walls of the arteries; it is the most frequent metabolic disorder of the aged.
Arthritis
Inflammation of a joint, usually accompanied by pain, and frequently by changes in bone and joint structure.
Atrophy
A decrease in size of an organ or tissue can result from a number of factors including malnutrition and inactivity.
BDA
Benign Disequillibrium of Aging
a very common disorder in which the balance centers of the inner ear fail to function properly causing imbalance while walking.
Botulism
Food poisoning caused by toxin of bacillus that may infect preserved foods, sausage and canned meats.
Carcinoma
A new growth or malignant tumor that tends to give rise to metastasis; it is synonymous with the term cancer.
Cataracts
The darkening of the lens of the eye or its capsule or both; very common in the aged; the most common cause of blindness of adults. The only effective treatment is surgery.
Cerebrovascular accident (CVA)
A cerebrovascular condition resulting from a hemorrhage, a stroke - may result in paralysis.
Congestive Heart Failure (CHF)
A condition characterized by weakness, breathlessness, abdominal discomfort, and edema in the lower portions of the body due to reduced outflow of blood from the heart.
Coronary Heart Disease
Myocardial damage due to insufficient blood supply, caused by pathological changes in the coronary arteries.
Cystitis
Inflammation of the bladder, usually following urinary tract infection.
Dementia
Impairment of mental powers due to organic causes.
Depression
An emotional condition, an affective disorder characterized by feelings of hopelessness, sadness, inadequacy. It is the most frequent mental problem in nursing facilities. Residents may withdraw, isolate themselves, lack motivation, and/or show agitation.
Diabetes
A general term for disease characterized by many symptoms, one of which is excessive urination. There are many types but usually refers to diabetes mellitus (sugar diabetes) in which there is a deficiency of insulin.
End Stage Renal Disease (ESRD)
A permanent failure of the kidneys to perform essential functions that results in a need for dialysis.
Epilepsy
A recurring paroxysmal disorder of the brain characterized by sudden, brief convulsive seizures, altered consciousness, motor activity, or sensory phenomena.
Fecal Impaction
Constipation caused by a firm mass of feces in the colon or rectum. The size or firmness prevents its passage. Common in nursing home residents.
Glaucoma
Disease of the eye characterized by increase in pressure within the eye; may result in blindness. It can be controlled but generally has no cure.
Heart Attack
Descriptive term for a clinical condition caused by occlusion of a coronary artery(s), characterized by heavy pressure or squeezing pain in the chest that may spread to the shoulder and arm. There may also be sweating, nausea, vomiting, and shortness of breath.
Hemiparesis
Partial or incomplete paralysis of one side of the body.
Hemiplegia
Paralysis of one side of the body.
Hypertension
A condition in which a person has higher blood pressure than normal.
Hemophilia
Hereditary blood disease in which there is greatly prolonged coagulation time for blood; abnormal bleeding occurs.
Herpes
A general term used for a variety of infections of nerve endings caused by a number of different ______ viruses.
Methicillin-resistant Staphylococcus Aureus (MRSA)
Infection that is resistant to anti-infective agents. Patients with ____ should be isolated in a manner consistent with the state of infection.
Multiple Sclerosis
A chronic, slowly progressive disease of the nervous system, with many symptoms, that is degenerative.
Nephritis
Inflammation of the kidney.
Obesity
Abnormal amount of fat on the body, usually 20 to 30 percent over the average weight for a person’s age, sex, and height.
Osteoporosis
Disease of the bone characterized by a reduction in bone density associated with loss of calcium.
Paraplegia
Paralysis of lower portion of the body and of both legs.
Parkinson’s Disease
A chronic nervous disease characterized by a fine slowly-spreading tremor, muscular weakness and rigidity, and peculiar gait; common in the aged.
Pulmonary Conditions
Disorders of the lungs and bronchial tubes, such as pneumonia, lung cancer and bronchitis.
Quadriplegia
Paralysis of all four limbs and usually the trunk of the body.
Senile Dementia
Deteriorative mental state due to organic brain damage occurring in the aged, characterized by loss of memory.
Shingles
Acute inflammation of peripheral nerves in the trunk of the body, and sometimes elsewhere, by a herpes virus.
Standing Orders
Physician orders that nurses can activate in specific situations without first having to notify the physician. These orders are specific to the individual attending physician, and the scope of the orders may vary greatly from one doctor to the next.
Stroke
Sudden loss of consciousness followed by paralysis caused by hemorrhage into the brain, formation of a blood clot, or rupture of an artery in the brain; a cerebrovascular accident (CVA).
The Diabetes Diet
This diet is designed to help control insulin and blood sugar levels. Meals are consistent and nutritionally balanced, typically focused on fiber rich foods, lean proteins, and fruit and vegetables
Therapeutic Diets
Designed to support the unique health needs of an individual. Often designed by dieticians, ____________ _____ can address specific needs such as chewing/swallowing abilities, vitamin deficiencies, allergies, and medication interactions.
The DASH Diet
Dietary Approaches to Stop Hypertension.
The hallmarks of the ____ diet are low-sodium and low-fat foods, which can help reduce blood pressure.
The Renal Diet
Helps support individuals with reduced kidney function. Low potassium is key to this diet and the DASH diet is common among some types of kidney patients
The Dysphagia Diet
This diet supports individuals with difficulty chewing and/or swallowing. Foods are often soft, and liquids can be thickened.
a-, an-
Without (anorexia)
ab-
from, off, away e.g. abnormal
ad-
toward, to, at
adeno-
gland e.g. adenoma - a benign epithelial tumor in which the cells form recognizable glandular structures
ambi-
both e.g. ambilateral (both sides) e.g. anabolism (building up metabolism)
ana-
up, toward e.g. angiofibrosis (hardening of a vessel wall) e.g. anabolism (building up metabolism)
What does the prefix ‘a-‘ or ‘an-‘ mean?
without
Commonly used in medical terminology to indicate absence.
Define ‘anorexia’.
Lack of appetite or desire to eat.
What does ‘abnormal’ signify?
Not normal; deviating from the standard.
What is ‘anoxia’?
Absence of oxygen supply.
What is an ‘adenoma’?
A benign epithelial tumor in which the cells form recognizable glandular structures.
Describe ‘ambilateral’.
Both sides.
What does the prefix ‘ana-‘ imply?
Up, toward.
Define ‘anabolism’.
Building up metabolism.
What does ‘angio-‘ refer to?
Relating to a vessel.
What is ‘angiofibrosis’?
Hardening of a vessel wall.
What does ‘ante-‘ mean?
In front of, before.
What is ‘ante cibum’?
Before a meal.
What does ‘anti-‘ signify?
Against.
Define ‘arthropathy’.
Any disease affecting the joints.
What does the prefix ‘auto-‘ mean?
Self, same.
What is ‘autoanalysis’?
Analysis by a person of their own disorder.
What does ‘bact-‘ refer to?
Relating to bacteria.
Define ‘bacteuria’.
Presence of bacteria in the urine.
What does ‘bi-‘ mean?
Two.
What is ‘bilateral’?
Relating to both sides.
What is a ‘biopsy’?
The process of removing tissue from living residents for a diagnostic examination.
What does ‘brady-‘ signify?
Slow.
Define ‘bradycardia’.
Slow heart rate.
What does ‘broncho-‘ refer to?
Relating to the trachea or windpipe.
What is ‘bronchoedema’?
Swelling of the mucosa of the bronchial tube.
What does ‘carcino-‘ mean?
Pertaining to cancer.
Define ‘carcinogen’.
Any cancer-producing substance.
What does ‘cardi-‘ or ‘cardio-‘ refer to?
Pertaining to the heart.
What is ‘cardioplegia’?
Paralysis of the heart.
What does ‘cata-‘ mean?
Downward, against.
Define ‘catabolism’.
The breaking down in the body of complex chemical compounds into simpler ones.
What does ‘celio-‘ refer to?
Pertaining to the abdomen.
What is ‘celiectomy’?
Excision of the stomach.
What does ‘cephalo-‘ mean?
Head.
What is a ‘cephalogram’?
X-ray image of the structure of the head.
What does ‘cervico-‘ refer to?
Neck or cervix.
Define ‘cerviovesical’.
Pertaining to the urinary bladder and the cervix.
What does ‘chiro-‘ mean?
Pertaining to the hand.
What is ‘chiroplasty’?
Plastic surgery on the hand.
What does ‘chole-‘ refer to?
Pertaining to bile.
What is ‘cholecystotomy’?
Incision into the gallbladder.
What does ‘circum-‘ mean?
Around.
Define ‘circumcorneal’.
Around or about the cornea of the eye.
What does ‘com-‘ or ‘con-‘ signify?
With, together.
What is a ‘complication’?
A disease or adverse condition associated with another disease or adverse condition.
What does ‘contra-‘ mean?
Against, opposite.
Define ‘contraindicated’.
Not recommended, advised against.
What does ‘counter-‘ refer to?
Against, opposite.
What is ‘counteraction’?
Action of a drug or agent opposed to that of some other drug or agent.
What does ‘cranio-‘ mean?
Pertaining to the head.
What is ‘cranioplasty’?
Any plastic operation on the skull.
What does ‘cysto-‘ refer to?
Pertaining to the bladder.
Define ‘cystitis’.
Inflammation of the urinary bladder.
What does ‘cyto-‘ mean?
Relation to a cell.
What is ‘cytolysis’?
The dissolution of a cell.
What does ‘de-‘ signify?
Down, away from.
Define ‘defibrillation’.
The arrest of fibrillation restored to normal rhythm.
What does ‘dent-‘ or ‘denti-‘ refer to?
Teeth.
What are ‘dentures’?
Artificial teeth.
What does ‘derm-‘, ‘derma-‘, or ‘dermi-‘ mean?
Pertaining to the skin.
Define ‘dermatitis’.
Inflammation of the skin.
What does ‘dextro-‘ refer to?
Toward or on the right side.
What is a ‘dextrocardiogram’?
The part of the ECG derived from the right ventricle of the heart.
What does ‘di-‘ signify?
Double, twice.
Define ‘diarthric’.
Relating to two joints.
What does ‘dia-‘ mean?
Through, apart.
What is ‘diagrastric’?
Through the stomach.
What does ‘dys-‘ signify?
Painful, difficult.
Define ‘dysphasia’.
Difficulty in swallowing
What does ‘ecto-‘ mean?
Out, away from.
What is ‘ectoderm’?
The outermost layer of the skin.
What does ‘em-‘ or ‘en-‘ refer to?
In front of, before.
Define ‘embolic’.
Pushing or growing in.
What does ‘encephalo-‘ mean?
Condition of the brain or head.
What is ‘encephalomyolitis’?
An acute inflammation of the brain and spinal cord.
What does ‘endo-‘ signify?
Within, inner.
Define ‘endocarditis’.
Inflammation of the endocardium or lining membrane of the heart.
What is ‘endoscopy’?
An examination of the lower intestinal tract.
What does ‘entero-‘ refer to?
Relating to the intestines.
Define ‘enterocolitis’.
Inflammation of the mucous membrane of both small and large intestines.
What does ‘epi-‘ mean?
Above, upon, over.
What is ‘epidermititis’?
Inflammation of the epidermis or the superficial layer of the skin.
What does ‘eu-‘ signify?
Good.
Define ‘euphoria’.
A feeling of well-being, commonly exaggerated.
What does ‘fibro-‘ mean?
Pertaining to fiber.
What is ‘fibromyalgia’?
A condition characterized by fatigue, stiffness, and chronic pain of the muscles, tendons, and ligaments.
What does ‘gastro-‘ refer to?
Stomach.
Define ‘gastrostomy’.
The establishment of an artificial opening into the stomach.
What does ‘gero-‘ mean?
Old age.
What is ‘gerontology’?
The study of aging.
What does ‘glyco-‘ signify?
Relationship to sweetness (sugar).
Define ‘glycogen’.
The chief carbohydrate storage material in animals formed by and largely stored in the liver.
What does ‘gyneo-‘ or ‘gyno-‘ refer to?
Pertaining to a female.
What is ‘gynecology’?
The science of diseases of women, especially those of the genital tract.
What does ‘hemato-‘, ‘hema-‘, or ‘hemo-‘ mean?
Pertaining to the blood.
Define ‘hemorrhage’.
Bleeding, a flow of blood.
What is ‘hematuria’?
Blood in the urine.
What does ‘hemi-‘ signify?
Half.
Define ‘hemialgia’.
Pain affecting one entire half of the body.
What does ‘hepato-‘ refer to?
Liver.
What is ‘hepatitis’?
Inflammation of the liver.
What does ‘histo-‘ mean?
Relationship to tissue.
Define ‘histolysis’.
Disintegration of the tissue.
What does ‘hydro-‘ signify?
Pertaining to water.
What is ‘hydrocyst’?
A cyst or sore with clear, watery contents.
What does ‘hyper-‘ mean?
Excessive.
Define ‘hyperesthesia’.
Abnormal acuteness of sensitivity to touch, pain, or other stimuli.
What does ‘hypno(a)-‘ refer to?
Relating to sleep.
What is ‘hypnotherapy’?
The treatment of a disease by inducing prolonged sleep.
What does ‘hypo-‘ mean?
Deficiency, lack of.
Define ‘hypochondria’.
A false belief that one is suffering from a disease.
What does ‘hystero-‘ refer to?
Relating to the uterus.
What is ‘hysterogram’?
An x-ray of the uterus.
What does ‘ileo-‘ mean?
Relating to the ileum.
What is ‘ileocolitis’?
Inflammation of the mucous membrane of both ileum and colon.
What does ‘infra-‘ signify?
Below, beneath.
Define ‘infracardiac’.
Beneath the heart.
What does ‘inter-‘ mean?
Between.
What is ‘intercostal’?
Between the ribs.
What does ‘intro-‘ signify?
In, into.
Define ‘introgastric’.
Leading or passed into the stomach.
What does ‘kerato-‘ refer to?
Relating to the cornea, or horny tissue.
What is ‘keratoconjunctivitis’?
Inflammation of the conjunctiva at the border of the cornea of the eye.
What does ‘labio-‘ mean?
Relating to the lip.
Define ‘labiocervical’.
Pertaining to the lip and to the neck.
What does ‘macro-‘ signify?
Large, long.
What is ‘macrocyte’?
A giant red cell.
What does ‘mast-‘ refer to?
Relating to the breast.
What is ‘mastectomy’?
Amputation of the breast.
What does ‘mega-‘ mean?
Large, oversize.
Define ‘megacardia’.
Enlargement of the heart.
What does ‘meta-‘ signify?
After, beyond, transformation.
What is ‘metastasis’?
The shifting of a disease.
What does ‘micro-‘ mean?
Small.
Define ‘microinfarct’.
A very small infarct.
What does ‘mono-‘ signify?
One or single.
What is ‘monocular’?
Refers to one eye.
What does ‘multi-‘ mean?
Many.
Define ‘multicellular’.
Composed of many cells.
What does ‘myel-‘ refer to?
Pertaining to the spinal cord.
What is ‘myeloplegia’?
Spinal paralysis.
What does ‘myo-‘ signify?
Relating to muscle.
Define ‘amyotrophy’.
Muscular atrophy.
What does ‘naso-‘ mean?
Pertaining to the nose and nasal passages.
What is ‘nasogastric’?
Relating to the nose and stomach.
What does ‘necro-‘ signify?
Relating to death.
Define ‘necrocytosis’.
Death of cells.
What does ‘neuro-‘ mean?
Relating to the nerves.
What is a ‘neurogenic bladder’?
A bladder controlled by the nervous system.
What does ‘nephro-‘ refer to?
Pertaining to the kidney.
Define ‘nephritis’.
Inflammation of the kidney.
What does ‘odont-‘ signify?
Relating to the teeth.
What is ‘odontalgia’?
A toothache.
What does ‘omo-‘ mean?
Pertaining to the shoulder.
Define ‘omodynia’.
Pain in the shoulder joint.
What does ‘opthalmo-‘ refer to?
Relating to the eye.
What is ‘opthalmoplegia’?
A paralysis of the motor nerves of the eye.
What does ‘opto-‘ signify?
Relating to vision.
Define ‘optometer’.
An instrument for determining the refraction of the eye.
What does ‘ortho-‘ mean?
Straight.
What is ‘orthostatic’?
Standing upright from a sitting or reclining position.
What does ‘osteo-‘ refer to?
Pertaining to the bones.
Define ‘osteoporosis’.
Reduction in the quantity of bone.
What does ‘oto-‘ mean?
Pertaining to the ear.
What is ‘otology’?
The study of the ear.
What does ‘oxy-‘ signify?
Sharp, acute.
Define ‘oxyesthesia’.
A condition of increased acuity of sensation.
What does ‘pachy-‘ mean?
Thick.
What is ‘pachylosis’?
A condition of roughness and thickening of the skin.
What does ‘pan-‘ signify?
All.
Define ‘pancarditis’.
Diffuse inflammation of the heart.
What does ‘para-‘ mean?
Two like parts.
What is ‘paraplegia’?
Both legs paralyzed.
What does ‘patho-‘ refer to?
Disease.
Define ‘pathogenesis’.
The origin or development of a disease.
What does ‘per-‘ mean?
Through.
What is ‘perfusion’?
The act of pouring over or through.
What does ‘peri-‘ signify?
Around.
Define ‘peribronchitis’.
Inflammation of the tissues surrounding the bronchial tubes.
What does ‘phlebo-‘ mean?
Relating to a vein.
What is ‘phlebitis’?
Inflammation of a vein.
What does ‘pneumo-‘ refer to?
Lung.
Define ‘pneumonia’.
Inflammation of the lung.
What does ‘poly-‘ mean?
Many, much.
What is ‘polyarthritis’?
Inflammation of several joints.
What does ‘procto-‘ signify?
Relating to the anus.
Define ‘proctoscope’.
An instrument for inspecting the rectum.
What does ‘pseudo-‘ mean?
False.
What is ‘pseudo dementia’?
A condition of indifference to one’s surroundings without actual mental impairment.
What does ‘psycho-‘ refer to?
Pertaining to the mind.
What is ‘psychotherapy’?
Counseling help.
What does ‘pulmo-‘ mean?
Lung.
What does ‘pyo-‘ signify?
Signifying pus.
Define ‘pyoderma’.
An infection of the skin that contains pus.
What does ‘quadra-‘ mean?
Involving four.
What is ‘quadrepligia’?
All four limbs paralyzed.
What does ‘rachi-‘ refer to?
Spine.
Define ‘rachiocampsis’.
Curvature of the spine.
What does ‘rhino-‘ mean?
Nose.
What is ‘rhinoplasty’?
Repair of the nose.
What does ‘semi-‘ signify?
Partial, not full.
Define ‘semiconscious’.
Partially conscious.
What does ‘sub-‘ mean?
Under.
What is ‘subcutaneous’?
Under the skin.
What does ‘syn-‘ signify?
Loss.
Define ‘syncope’.
To faint; temporary loss of consciousness.
What does ‘tachy-‘ mean?
Rapid.
What is ‘tachycardia’?
Rapid beating of the heart.
What does ‘thermo-‘ refer to?
Heat.
Define ‘thermophobia’.
Morbid fear of heat.
What does ‘thoracic-‘ mean?
Pertaining to the chest or thorax.
What is ‘thoracectomy’?
Surgical removal of part or all of the thorax.
What does ‘tri-‘ signify?
Three.
What is ‘triceps’?
Muscle with three heads.
What does ‘uni-‘ mean?
One.
Define ‘unicellular’.
Composed of one cell.
What does ‘uro-‘ refer to?
Relating to the urine.
What is ‘urosepsis’?
Septic poisoning from retained and absorbed urinary substances.
What does ‘vaso-‘ mean?
Vessel.
Define ‘vasoconstriction’.
Narrowing of the blood vessels.
What does the suffix ‘-ac’ pertain to?
pertaining to
Example: cardiac - pertaining to the heart
What is neuralgia?
nerve pain
Define hernia.
protrusion of a portion of an organ or tissue through the wall that normally contains it
What does the suffix ‘-cele’ refer to?
hernia
What is paracentesis?
puncture of the body cavity for removing fluid
What does the suffix ‘-centesis’ indicate?
surgical puncture
What is thromboclasis?
breaking up of a blood clot
What does ‘-clasis’ mean?
breaking
What does enteroclysis refer to?
Imaging of the intestines
What does the suffix ‘-cyte’ mean?
cell
What is a hematocyte?
any blood cell
What does ‘-ectasia’ indicate?
dilation, stretching
What is gastrectasia?
dilation of the stomach
What does ‘-emesis’ refer to?
vomiting
Define hyperemesis.
excessive vomiting
What does ‘-ectomy’ mean?
excision (cutting out)
What is a tonsillectomy?
cutting out of the tonsils
What does ‘-emia’ denote?
denoting a condition of the blood
What is glycemia?
sugar in the blood
What does ‘-genesis’ refer to?
condition of producing
What is carcinogenesis?
the origin or production of cancer
What does ‘-ism’ signify?
abnormal condition from excess of something
Provide an example of ‘-ism’.
alcoholism, botulism
What does ‘-itis’ indicate?
inflammation
What is dermatitis?
inflammation of the skin
What does ‘-lith’ refer to?
stone
What is a nephrolith?
kidney stone
What does ‘-lysis’ mean?
breakdown
What is hemolysis?
the destruction of red blood cells
What does ‘-malasia’ indicate?
softening
What is osteomalasia?
a disease characterized by gradual softening and bending of the bones
What does ‘-mania’ refer to?
madness or passion for
What is kleptomania?
compulsive stealing
What does ‘-megaly’ mean?
enlargement
What is cardiomegaly?
enlargement of the heart
What does ‘-odynia’ refer to?
painful condition
What is cardiodynia?
pain in the heart
What does ‘-ology’ signify?
study of
What is neurology?
study of the nervous system
What does ‘-oma’ denote?
tumor
What is carcinoma?
a malignant tumor
What does ‘-opsy’ refer to?
vision
What is a biopsy?
excision of a small piece of living tissue for microscopic examination
What does ‘-orexia’ mean?
appetite, desire
What is anorexia?
loss of appetite
What does ‘-orrhaphy’ refer to?
suture
What is gastrorrhaphy?
the suture of a perforation of the stomach
What does ‘-orrhea’ indicate?
flow, discharge
What is gastrorrhea?
excessive secretion of gastric juices or mucus by the stomach
What does ‘-osis’ mean?
abnormal or diseased condition
What is osteoporosis?
bone disease
What does ‘-ostomy’ refer to?
to make a new opening
What is a colostomy?
the establishment of an artificial anus by an opening into the colon
What does ‘-otomy’ mean?
incision, to cut into
What is nephrotomy?
an incision into the kidney
What does ‘-paresis’ indicate?
partial or incomplete paralysis
What is hemiparesis?
partial paralysis of one side of the body
What does ‘-path’ refer to?
morbid or diseased
What is a sociopath?
a person who feels no remorse or guilt about behaving in socially unaccepted ways
What does ‘-pathy’ mean?
disease
What is neuropathy?
any nerve disease
What does ‘-penia’ indicate?
deficiency
What is leukopenia?
any situation in which the total number of leukocytes in the circulating blood is less than normal
What does ‘-pepsia’ mean?
digestion
What is dyspepsia?
indigestion or upset stomach
What does ‘-pexy’ refer to?
fixation, to put into place
What is nephropexy?
a surgical attachment of a floating kidney
What does ‘-philia’ mean?
a liking or affinity for
What is hemophilia?
a bleeder
What does ‘-phobia’ refer to?
fear
What is claustrophobia?
fear of being closed in a small space
What does ‘-plasty’ mean?
surgical repair
What is thoracoplasty?
reparative or plastic surgery to the chest
What does ‘-plegia’ indicate?
paralysis
What is hemiplegia?
a paralysis of one side of the body
What does ‘-pnea’ mean?
breath
What is polypnea?
very rapid breathing
What does ‘arrhythmia’ refer to?
any variation from the normal rhythm of the heart
What does ‘-rrhage’ indicate?
abnormal or excessive discharge or flow
What is hemorrhage?
excessive bleeding
What does ‘-rrhea’ mean?
discharge
What is diarrhea?
excessive discharge of feces
What does ‘-spasm’ refer to?
sudden violent contraction of muscles
What is myospasm?
spasm of a muscle
What does ‘-stasis’ mean?
arrest, control
What is cholestasia?
an arrest in the flow of bile from the liver
What does ‘thermotaxis’ refer to?
regulation of the temperature of the body
What does ‘-tripsy’ mean?
crushing
What is lithotripsy?
the crushing of a stone in the kidney by a machine called a lithotripter
What does ‘-trophy’ indicate?
development, nourishment
What is hypertrophy?
an overgrowth or increase in the bulk of a body part or organ
What does ‘-uria’ refer to?
urine
What is albuminura?
the presence of protein in urine, chiefly albumin
What does the abbreviation ‘aa’ stand for?
of each
What is the meaning of ‘Abd’?
abdomen
What does ‘ac’ indicate in medical terms?
before meals
What is represented by the abbreviation ‘AD’?
advance directive
What does ‘ADL’ stand for?
activities of daily living
Fill in the blank: ‘Ad lib’ means _______.
as much as desired, at pleasure
What does ‘A/G’ refer to?
albumin/globulin ratio
What is the full term for the abbreviation ‘AIDS’?
acquired immunity deficiency syndrome
True or False: ‘A.M.A.’ stands for against medical advice.
True
What does ‘AMD’ refer to?
age-related macular degeneration
What is the abbreviation ‘amp’ short for?
ampule
What does ‘amt’ mean?
amount
What does ‘aq’ stand for?
water
What does ‘aq dist’ mean?
distilled water
What is indicated by the abbreviation ‘ASH.D.’?
arteriosclerotic heart disease
What does ‘BE’ refer to in medical terminology?
barium enema
Fill in the blank: ‘bId’ means _______.
twice a day
What does ‘BMR’ stand for?
basal metabolic rate
What is the meaning of ‘BP’ or ‘B/P’?
blood pressure
What does ‘BRP’ indicate?
bathroom privileges
What does ‘c’ mean in medical abbreviations?
with
What is the term represented by ‘Ca’?
carcinoma
What does ‘CAD’ refer to?
coronary artery disease
What does ‘caps’ stand for?
capsules
What is the abbreviation ‘cath’ short for?
catheter
What does ‘CBC’ mean?
complete blood count
What does ‘c c’ indicate?
cubic centimeter
What does ‘cf’ mean?
compare
What is the meaning of ‘CHF’?
congestive heart failure
What does ‘CMP’ refer to?
comprehensive metabolic panel
What does ‘CNS’ stand for?
central nervous system
What is indicated by the abbreviation ‘COLD’?
chronic obstructive lung disease, same as COPD
What does ‘comp’ mean?
compound
What is the full term for ‘COPD’?
chronic obstructive pulmonary disease
What does ‘CVA’ refer to?
cerebral vascular accident
Fill in the blank: ‘d/c’ means _______.
discontinued
What does ‘decub’ indicate?
lying down
What does ‘Diab’ refer to?
diabetic
What is the abbreviation ‘Diag’ or ‘Dx’ short for?
diagnosis
What does ‘Diff’ mean?
differential blood count
What does ‘Dil’ indicate?
dilute
What does ‘Disc’ stand for?
discontinue
What does ‘Disch’ or ‘D/C’ refer to?
discharge
What does ‘DM’ mean?
diabetes mellitus
What does ‘DNR’ stand for?
do not resuscitate
What is indicated by ‘dx’?
diagnosis
What does ‘EEG’ stand for?
electroencephalogram
What is the abbreviation ‘EKG’ or ‘ECG’ short for?
electrocardiogram
What does ‘EMS’ refer to?
emergency medical service
What does ‘ESRD’ stand for?
end stage renal disease
What does ‘exam’ refer to?
examination
What does ‘fl’ or ‘fld’ indicate?
fluid
What does ‘FUO’ mean?
fever of unknown origin
What does ‘Fx’ refer to?
fracture
What does ‘GI’ stand for?
gastrointestinal
What does ‘gm’ mean?
gram
What is the abbreviation ‘gr’ short for?
grain
What does ‘gtt’ or ‘gtts’ indicate?
drop(s)
What does ‘H’ or ‘hr’ refer to?
hour
What does ‘HBP’ stand for?
high blood pressure
What does ‘HBV’ refer to?
Hepatitis B virus that infects the liver; highly contagious
What does ‘HIV’ stand for?
human immunodeficiency virus
Fill in the blank: ‘hs’ means _______.
at bedtime
What does ‘hypo’ refer to?
Beneath or below, less than normal
What is indicated by ‘IDDM’?
insulin dependent diabetes mellitus
What does ‘IM’ stand for?
intramuscular
What does ‘inf’ mean?
infusion
What is represented by ‘I & O’?
intake and output
What does ‘IV’ stand for?
intravenous
What does ‘KUB’ refer to?
kidney-ureter-bladder
What is the abbreviation ‘l’ short for?
liter
What does ‘lab’ mean?
laboratory
What does ‘Lat’ indicate?
lateral
What is the meaning of ‘lb’?
pound
What does ‘liq’ mean?
liquid
What does ‘mg’ stand for?
milligram
What does ‘min’ refer to?
minute
What is indicated by ‘ml’?
milliliter
What does ‘mm’ stand for?
millimeter
What does ‘MN’ mean?
midnight
What is the full term for ‘MRSA’?
methicillin-resistant Staphylococcus aureus
What does ‘N’ refer to?
noon
What does ‘NIDDM’ stand for?
noninsulin dependent diabetes mellitus
What does ‘no’ indicate?
number
Fill in the blank: ‘noct.’ means _______.
at night
What does ‘NPO’ stand for?
nothing by mouth
What does ‘NV’ refer to?
nausea and vomiting
What does ‘od’ mean?
right eye
What does ‘OOB’ indicate?
out of bed
What does ‘os’ refer to?
left eye
What is the abbreviation ‘OT’ short for?
occupational therapy
What does ‘ou’ mean?
each eye
What does ‘oz’ stand for?
ounce
What does ‘p’ refer to?
pulse
What does ‘pc’ mean?
after meal
What does ‘PEARL’ stand for?
pupils equal and reactive to light
What is indicated by ‘PEG’?
percutaneous endoscopic gastrostomy
Fill in the blank: ‘po’ means _______.
by mouth
What does ‘prn’ stand for?
as needed
What does ‘prog’ refer to?
prognosis
What does ‘PROM’ stand for?
passive range of motion
What does ‘pt’ refer to?
pint
What does ‘PT’ mean?
physical therapy
What does ‘PX’ stand for?
physical exam
What does ‘qd’ mean?
every day
What does ‘qh’ indicate?
every hour
What does ‘qhs’ refer to?
each bedtime
What does ‘qid’ mean?
four times a day
What does ‘qn’ stand for?
every night
What does ‘qod’ mean?
every other day
Fill in the blank: ‘qs’ means _______.
sufficient quantity
What does ‘ROM’ stand for?
range of motion
What does ‘Rx’ refer to?
prescription
What is indicated by ‘s’?
without
What does ‘SOB’ mean?
shortness of breath
What does ‘sol’ refer to?
solution
What does ‘sos’ stand for?
one dose, if necessary
What does ‘spec’ mean?
specimen
What does ‘SS’ stand for?
soap solution
What does ‘ss’ indicate?
half
What does ‘stat’ mean?
immediately
What does ‘surg’ refer to?
surgery
What does ‘T’ stand for?
temperature
What is the abbreviation ‘tab’ short for?
tablet
What does ‘TB’ refer to?
tuberculosis
What does ‘TID’ mean?
three times a day
What does ‘tinct’ or ‘tr’ stand for?
tincture
What does ‘TO’ refer to?
telephone order
What does ‘TPR’ stand for?
temperature, pulse and respiration
What does ‘u’ refer to?
unit
What is the abbreviation ‘ung’ short for?
ointment
What does ‘URI’ stand for?
upper respiratory infection
What does ‘UTI’ refer to?
urinary tract infection
What does ‘VO’ mean?
verbal order
What does ‘vol’ indicate?
volume
What does ‘vs’ stand for?
vital signs
What does ‘WBC’ refer to?
white blood cells
What does ‘W/C’ mean?
wheel chair
What does ‘wt’ stand for?
weight
What are the 5 Rights of Medication Administration?
-Right Drug: Verify that it’s the correct medication in name and form. Many medications have similar names but very different purposes.
-Right Patient: Confirm that it’s the correct patient to be receiving the medication. Did you ask their name and/or check their identification?
-Right Dose: Validate the dosage of the medication by checking the prescription or doctor’s order.
-Right Route: Administer the medication through the prescribed method. Should it be oral, IV,IM, or another format?
-Right Time: The order or prescription will specify when the medication should be administered.
What is an Minimum Data Set (MDS)?
Primarily used to implement a standardized approach for assessment and facilitation of care of those individuals admitted into in both nursing homes (NHs) and non-critical access hospital swing beds (non-CAH SBs) across the United States.
What are some of the responsibilities of the Medical Director?
-Identify and evaluate health related issues related to an individual’s quality of life
-Observe and provide strategic vision for quality assurance and process improvement (QAPI)
-Serve as the direct supervisor of all medical professionals who provide direct patient care.
What is a DNR?
Is legal documentation that states your wishes regarding the use of life-saving measures in the event of an emergency. In order to be an active, legal document, a DNR must be signed by both the individual named in the order as well as their physician. These orders are usually for patients with serious health conditions.
What must be done if a resident chooses to leave AMA?
The next course of action is to contact Adult Protective Services (APS).
The Code of Federal Regulations (CFR) related to medications state that the?
resident may self-administer medication if the interdisciplinary team determines that it is safe for the resident to do so.
What drug administration programs most effectively increases nursing efficiency, saves money, reduces waste, and minimizes preparation errors?
Unit-dose drug distribution system
What is a unit-dose (unit-of-use) drug distribution system?
A unit-dose (unit-of-use) drug distribution system is in place for all dosage forms to provide patient-specific, individually packaged medications, which minimizes caregiver drug product manipulation (e.g., cutting in half) in order to arrive at the correct dose prior to administration. Such manipulation could result in patient harm and consume valuable caregiver resources. These unit doses of medication are also dispensed with individually labeled bar code packaging to enable nurse scanning of the medication at the bedside just prior to medication administration.
The type of emergent treatment a person would or would not receive if their heart or breathing were to stop.
Code status
The appointment of a guardian by a judge to manage the affairs of another person due to old age or physical or mental limitations.
Conservatorship
The ability to use and understand information to decide and communicate any decision made.
Capacity
A legal process utilized when a person can no longer make or communicate decisions.
Guardianship
The process of evaluating and choosing among alternatives in a manner consistent with ethical principles.
Ethical Decision Making
The process of evaluating and choosing among alternatives in a manner consistent with ethical principles.
Ethical Decision Making
A broad term to describe any legal document that addresses your future medical care.
Advanced directive
Pain Assessment in Advanced Dementia Scale (PAINAD)
This scale differs from the others as it is only utilized with those patients diagnosed with dementia. It relies on caregivers or medical personnel observing the individual for approximately five minutes and then rating their behaviors.
Faces Pain Scale
A very popular scale, developed by Dr. Donna Wong, that Uses a horizontal line, illustrated by facial expressions to represent different pain levels.
The Behavioral Pain Scale
This is a scale that is typically utilized by medical professionals to assess nonverbal or critically ill individuals by observing behaviors exhibited in lieu of asking the person to rate their pain.
The Numeric Pain Scale?
This chart measures pain on a scale of 1–10. This scale is used often within the Nursing Home care setting.
What is the recommended duration for washing hands when preparing food?
At least 20 seconds
Washing hands with soap and water helps eliminate germs that cause food poisoning.
What should you do after handling uncooked meat, poultry, seafood, or eggs?
Always wash hands
This practice prevents the spread of germs to other foods.
What is the danger of washing raw chicken before cooking?
It can spread germs
Washing raw chicken can cause cross-contamination, making you sick.
What should be done with utensils, cutting boards, and countertops after preparing food?
Wash with hot, soapy water
This is essential to prevent cross-contamination.
What temperature should whole cuts of beef, veal, lamb, and pork be cooked to?
145°F
Allow the meat to rest for 3 minutes before carving or eating.
What is the safe internal temperature for all poultry, including ground chicken and turkey?
165°F
This ensures that harmful bacteria are killed.
When reheating food in a microwave, what temperature should it reach?
165°F
Using a food thermometer ensures food is heated thoroughly.
What is the ‘Danger Zone’ temperature range where bacteria can multiply rapidly?
Between 40°F and 140°F
Food should not be left out for more than 2 hours in this range.
How should perishable food be stored in the refrigerator?
At 40°F or below
This helps prevent spoilage and bacterial growth.
What is the maximum time perishable food can be left out at room temperature?
2 hours
If the temperature exceeds 90°F, limit to 1 hour.
What can be used to safely thaw frozen food?
In the refrigerator, in cold water, or in the microwave
Never thaw food on the counter to prevent bacteria growth.
Fill in the blank: Food is safely cooked when the internal temperature gets high enough to _______.
kill germs that can make you sick
True or False: You can tell if food is safely cooked by checking its color and texture.
False
The only reliable method is to use a food thermometer.
What should you do with warm or hot food before refrigerating?
Package into several clean, shallow containers
This allows food to chill faster.
What should you do to prevent cross-contamination during grocery shopping?
Keep raw meat, poultry, seafood, and their juices away from other foods
This helps prevent the spread of germs.
What is the recommended cooking temperature for ground meats, such as beef and pork?
160°F
This temperature ensures that harmful bacteria are killed.
Which of the following levels of hospice care consists of providing short-term pain or symptom management in a facility that more suited for higher acuity needs?
General Inpatient
Per Medicare guidance, what are the essential criteria that must be met in order for a medical supply to be deemed “Durable Medical Equipment”?
It must be used for a medical reason in the patient’s home, and it must be able to withstand repeated use for an expected lifetime of at least 3 years.
A homebound individual is interested in using teleconferencing to have a virtual visit with her primary care provider. Which of the following is true regarding payment for these types of visits?
The individual should check with her insurer on coverage for telemedicine as it may change over time or differ based upon plans.
Which of the following is true regarding challenges to providing proper dental hygiene to geriatric populations?
Payment models are provider-centric and generally require in-office visits which can present transportation obstacles.
Type of therapist whose goal is to prevent falls and to assist residents in regaining their memory skills.
Occupational Therapist
Type of therapy that treats issues involving language, communication, voice, swallowing, and fluency.
Speech Therapist
Type of services that focus on improving the resident’s thinking and reasoning skills. Also called cognitive-behavioral therapy.
Rehabilitative
Type of therapy that is important in nursing homes as it lowers the risk of injuries and helps to maintain the resident’s stability.
Physical
Type of therapist that works with residents on breathing and/or airway problems such as Chronic Obstructive Pulmonary disease (COPD), Asthma, and Emphysema.
Respiratory
The Code of Federal Regulations (CFR) requires states to specify that the Medicaid agency will ensure this necessary service for those who qualify?
Transportation Services
A care recipient with traditional Medicare coverage is receiving skilled therapy after a back surgery in a skilled nursing facility. The recipient needs to go to a follow-up appointment with the surgeon. An ambulance transport is medically necessary and reasonable for the recipient. Under consolidated billing, will the nursing facility have to pay for the ambulance transportation?
No, if the ambulance transportation is a medical necessity, the transport may be excluded
For care recipients receiving psychotropic medications, it is important for the facility to perform laboratory testing to check on which of the following metabolic side-effects?
Unstable blood sugars
Nursing facilities operating under a Medicare license must promptly refer care recipients with lost or damaged dentures for dental services within how many days?
The referral must be made within 3 days, or the facility must show documentation to show how they ensured proper intake.
The ______ is a forecast of expected revenues and expenses, based on past experiences and future assumptions. It is used to guide future financial operations.
A budget
This cost is one that does not vary in the total amount due when activity levels or volume of operations change.
Fixed Cost
A ______ cost can vary or change. This is usually in direct proportion to changes in activity levels or when operations volume increases.
Variable
Equity ratio =
Total Stockholder’s Equity/Total Assets
This statement is a record of what an organization owns, what it owes, and what it is worth at a particular point in time.
The Balance Sheet
This statement, also called the Profit & Loss (P&L) Statement or the Operating Statement, reports the inflow of revenue and the outflow of expense over a stated period of time
Statement of Revenue and Expenses
This statement reports the excess of revenue over expenses (or vice versa) for the period as the excess flows into equity (or reduces equity, in the case of a loss for the period).
Statement of Changes in Equity (or Net Worth or Fund Balance)
This statement reports the current period cash flow by taking the accrual basis statements and converting them to an effective cash flow. This is accomplished by a series of reconciling adjustments that account for the noncash amounts.
Statement of Cash Flows
What is another name for the operating statement?
Income or profit & loss (P&L) statement
What does the operating statement evaluate?
Profitability over a period of time
What is a balance sheet?
A snapshot of an organization’s financial position for a specified period of time
What are the main components of a balance sheet?
- Assets
- Liabilities
- Service Revenue
- Operating Income
- Interest - income/expense
- Withholding Taxes
- Depreciation
What specific items are included under assets in a balance sheet?
- Accounts Receivable
- Cash on Hand
- Cash Equivalents
- Equipment (value of)
What specific items are included under liabilities in a balance sheet?
- Accounts Payable
- Long-Term Debt
How does management use the operating statement?
To scrutinize the finances of the organization and locate operational or finance issues
What do management and boards use the balance sheet for?
To determine if the organization has appropriate liquidity to meet its payment obligations
What do creditors and lenders evaluate using the balance sheet?
If an organization is generating ample revenue (profits) to pay its liabilities
True or False: The balance sheet helps forecast if additional credits can be paid.
True
Fill in the blank: The operating statement shows revenue, costs, and expenses over a _______.
period of time
What does a high ratio of debt capital to equity indicate?
The organization is over-leveraged
Who uses the operating statement to determine if an organization is generating adequate revenue?
Creditors and lenders
What is the significance of depreciation on the balance sheet?
It reflects the reduction in value of assets over time
What do financial statements show?
They show where a company’s money came from, where it went, and where it is now.
What are the four main financial statements?
- Balance sheets
- Income statements
- Cash flow statements
- Statements of shareholders’ equity
What does a balance sheet show?
It shows what a company owns and what it owes at a fixed point in time.
What information do income statements provide?
They show how much money a company made and spent over a period of time.
What is the purpose of cash flow statements?
They show the exchange of money between a company and the outside world over a period of time.
What does the statement of shareholders’ equity show?
It shows changes in the interests of the company’s shareholders over time.
Define assets.
Things that a company owns that have value.
What are liabilities?
Amounts of money that a company owes to others.
What is shareholders’ equity?
The money left if a company sold all of its assets and paid off all of its liabilities.
What is the basic accounting equation represented in a balance sheet?
ASSETS = LIABILITIES + SHAREHOLDERS’ EQUITY
What are current assets?
Assets that a company expects to convert to cash within one year.
What are fixed assets?
Assets used to operate the business but not available for sale.
What is the difference between current and long-term liabilities?
Current liabilities are obligations expected to be paid off within the year, while long-term liabilities are due more than one year away.
What does an income statement report?
It shows how much revenue a company earned and the costs and expenses associated with earning that revenue.
What is the ‘bottom line’ of an income statement?
It shows the company’s net earnings or losses.
What is earnings per share (EPS)?
It tells how much money shareholders would receive for each share if the company distributed all net earnings.
Fill in the blank: An income statement shows the total amount of money brought in from sales of products or services referred to as ______.
[gross revenues]
What is gross profit?
The subtotal after subtracting costs of sales from net revenues.
What is depreciation?
The process of spreading the cost of long-term assets over their useful periods.
What does a cash flow statement show?
It reports a company’s inflows and outflows of cash.
What are the three main parts of a cash flow statement?
- Operating activities
- Investing activities
- Financing activities
What do operating activities in a cash flow statement analyze?
They analyze a company’s cash flow from net income or losses.
What are investing activities in a cash flow statement?
Cash flow from purchases or sales of long-term assets.
What do financing activities in a cash flow statement include?
Cash raised by selling stocks and bonds or borrowing from banks.
True or False: It is important to read the footnotes in financial statements.
True
What is the purpose of the Management’s Discussion and Analysis (MD&A)?
To provide investors with a narrative explanation of a company’s financial performance.
What is the debt-to-equity ratio?
A comparison of a company’s total debt to its shareholders’ equity.
What does the inventory turnover ratio measure?
It compares a company’s cost of sales to its average inventory for the period.
What is operating margin?
Income from operations divided by net revenues, usually expressed as a percentage.
What is the formula for calculating the P/E ratio?
Price per share / Earnings per share
Fill in the blank: Working capital is calculated as ______.
[Current Assets - Current Liabilities]
What is an internal audit?
An internal audit evaluates a company’s internal controls, corporate governance, and accounting processes.
What are the key objectives of internal audits?
Ensure compliance with laws and regulations, maintain accurate financial reporting, and identify operational inefficiencies.
Who hires internal auditors?
Companies hire internal auditors to work on behalf of their management teams.
What types of internal audits exist?
- Financial audit
- Operational audit
- Compliance audit
- Environmental audit
- IT audit
- Performance audit
- Construction audit
- Special investigations
What is the Sarbanes-Oxley Act of 2002?
An act that holds managers legally responsible for the accuracy of their company’s financial statements and requires documentation of internal controls.
True or False: Internal audits can be scheduled or surprise audits.
True
What is a compliance audit?
An audit to ensure adherence to local laws, government regulations, and other compliance requirements.
What is the purpose of an internal financial audit?
To dive deeper into audit findings and prepare for external audits.
What does an environmental audit assess?
A company’s impact on the environment, including sourcing raw materials and minimizing greenhouse gases.
What is the focus of a performance audit?
It focuses on the outcomes of objectives rather than the processes used to achieve them.
What triggers an operational audit?
Key personnel leaving or new management taking over.
What is the difference between internal and external audits?
Internal audits are conducted by a team selected by the company, while external audits are performed by independent auditors.
What are the main steps in the internal audit process?
- Planning
- Auditing
- Reporting
- Monitoring
What is included in the planning step of an internal audit?
Developing audit requirements, objectives, timeline, and responsibilities.
What is the purpose of the reporting step in internal audits?
To communicate the audit findings and suggestions for improvements.
What are the 5 C’s of internal audit reports?
- Criteria
- Condition
- Cause
- Consequence
- Corrective Action
Fill in the blank: Internal audits may enhance the efficiency of operations and motivate employees to adhere to _______.
[company policy]
How often may internal audits occur?
Daily, weekly, monthly, or annually, depending on the department.
What can management achieve through internal audits?
Identify problems and correct lapses before external audits.
True or False: Internal audit reports are primarily used by external parties.
False
What is a technology/IT audit focused on?
Reviewing controls, hardware, software, security, documentation, and backup/recovery of systems.
What is the role of internal audit?
To identify deficiencies or substantiate proficiencies within company processes.
What factors can enhance a company’s control environment through internal audits?
- Increased awareness of analysis
- Motivation to adhere to policies
- Improvement of processes
What is the goal of monitoring in the internal audit process?
To ensure that recommended changes have been implemented post-audit.
What must an administrator know how to evaluate in a community?
Strengths and weaknesses for profitability and care quality
This evaluation is critical for ensuring the business can be sustained and jobs preserved.
What is the first area to evaluate for financial performance?
Comparing financial statements to the budget
This helps to identify past financial success and changes that may have affected performance.
What should an administrator do if the organization has not been financially successful?
Find out the timeframe of last success and learn what changed and why
Understanding past success can guide future strategies.
What is the significance of census and census mix?
Impact on profitability
If census does not meet budget or is out of order, profitability is seriously affected.
What should be reviewed to assess admission practices?
Marketing efforts and barriers to admissions
This helps understand how the organization is viewed in the community.
What costs should be compared to the budget for labor evaluation?
Current labor costs, including PPD/PRD
This ensures labor is appropriate for the care recipients’ needs.
What additional labor costs should be reviewed?
Overtime and contract labor
Both can significantly impact overall staffing costs.
When evaluating expenses, what should be compared?
Census with budget and PPD/PRD
This helps in understanding the controllable expenses.
What should be ensured regarding expenses in the general ledger?
Proper coding
Accurate coding is crucial for financial reporting.
What must an administrator do after identifying financial performance problems?
Set priorities for improving financial performance
Focus on immediate changes while noting additional issues for future plans.
What should the short-term action plan communicated to the supervisor include?
Problem, solution, responsible individuals, goal dates, final project goal date
Clear communication is essential for organizational accountability.
What does a current ratio greater than 1 indicate?
The organization’s current assets exceed its current liabilities.
What does a favorable liquidity position suggest about a business?
The business will likely have the ability to pay short-term liabilities as they come due.
True or False: A current ratio greater than 1 makes it less likely for an organization to qualify for a loan.
False
Fill in the blank: A current ratio greater than 1 indicates that an organization has a favorable _______.
liquidity position
How is fixed cost per resident calculated?
By dividing total fixed costs by the number of residents
Number of residents is calculated by currently occupied beds.
What happens to fixed cost per resident when occupancy rate increases?
It decreases
Fixed costs are spread over a larger number of residents.
What is accrual accounting?
A financial method that recognizes revenue when earned or expenses when incurred
Revenue and expenses appear on financial statements at the time of earning or purchase.
What does the Objectivity GAAP require regarding market value?
It requires consistency with historical costs
Using current market value would not comply with Objectivity GAAP.
What is a key principle of the Conservatism GAAP?
It mandates the use of conservative estimates
Using optimistic estimates would violate this principle.
What is the purpose of a variance analysis?
To determine the differences between actual and planned numbers
It helps identify trends, issues, opportunities, or threats.
True or False: Fixed costs change with an increase in occupancy rate.
False
Fixed costs remain unchanged by definition.
Fill in the blank: Accrual accounting allows an organization to recognize revenue at the time income is _______.
earned
Which GAAP prohibits the use of optimistic estimates?
Conservatism GAAP
List the benefits of effective variance analysis.
- Spotting trends
- Identifying issues
- Recognizing opportunities
- Detecting threats
What is PDPM?
Patient Driven Payment Model
Mandated by CMS on October 1, 2019.
What type of facilities does PDPM apply to?
Skilled nursing facilities (SNF)
PDPM establishes reimbursement rates for residents in these facilities.
What is the basis for reimbursement rates under PDPM?
Unique needs, characteristics, and goals of residents
Rates are established based on resident assessments.
What type of reimbursement system is PDPM?
Case Mix Reimbursement System
This system evaluates the intensity of care and services required by residents.
How does PDPM differ from former payment models?
It focuses on meeting unique resident needs instead of incentivizing volume of care
Former models were fee-for-service (FFS).
List the five PDPM case-mix adjusted components.
- Physical Therapy
- Occupational Therapy
- Speech Language Pathology
- Non-Therapy Ancillary
- Nursing
These components determine reimbursement rates based on resident care needs.
Fill in the blank: PDPM is a __________ model.
Case Mix Reimbursement System
True or False: PDPM incentivizes the volume of care provided.
False
PDPM incentivizes meeting the unique needs of residents.
What does the term ‘case-mix adjusted’ refer to in PDPM?
Components of reimbursement based on resident assessments
Reflects the care intensity and services required.
Which of the following is NOT a case-mix adjusted component of PDPM? (Select one)
Transportation
Transportation is not included in the case-mix adjusted components.
Fill in the blank: The PDPM model was implemented by __________.
CMS
Can a facility require a resident to deposit their personal funds with them?
No, a facility cannot require a resident to deposit their personal funds with the facility.
What is the fiduciary responsibility of a facility if a resident chooses to deposit their personal funds?
To hold, safeguard, manage, and account for the deposited personal funds.
What must happen to personal funds in excess of $100 deposited with a facility?
They must be deposited in an interest-bearing account that is not co-mingled with the facility’s operating account.
What must be credited to a resident’s account concerning interest earned on their funds?
All interest earned on the resident’s funds must be credited to their account.
If a facility pools residents’ funds into a single account, what must they have?
A system for separate accounting for each resident’s share.
For residents funded by Medicaid, what is the requirement for personal funds in excess of $50?
They must be deposited in an interest-bearing account that is not co-mingled with the facility’s operating account.
What is required for personal funds that do not exceed $50 for Medicaid residents?
They must be maintained in a non-interest bearing account, interest-bearing account, or petty cash fund.
How often must facilities report on the status of resident funds?
Quarterly.
What is the time frame for providing cash requested by a resident?
Requests for less than $100 should be honored within the same day; requests for $100 or more should be honored within three banking days.
What should a facility maintain to meet resident requests for funds?
Amounts of petty cash on hand.
Can a resident request that the facility temporarily hold their funds?
Yes, but the facility is not authorized to manage those funds.
What should be documented when a resident’s funds are held temporarily?
The date, time, amount of funds received, and who the funds were released to.
Can a facility charge a fee for the management of a resident’s personal funds?
No, a resident cannot be charged a fee by the facility for management of their personal funds.
What should all fund transactions include for the resident?
A receipt for the transaction.
What should facilities maintain for their records concerning fund transactions?
A copy of the receipt for the transaction.
What will residents be questioned about during a survey?
Quarterly statements, access to funds, and any limits on withdrawals.
What is cross-referenced with compliance regarding personal funds management?
F583 – Personal Privacy / Confidentiality of Records.
What does PDPM require regarding the assessment reference date (ARD)?
The facility must set an ARD within the first eight days of the beneficiary’s stay.
PDPM stands for Patient Driven Payment Model, which is a Medicare payment system for skilled nursing facilities.
What is the purpose of setting an ARD?
To allow a facility a ‘look back period’ for billing/payment purposes.
This look back period enables facilities to include services provided from day one of admission.
On which day can the ARD be set?
Anywhere from day one of admissions to day eight after admission.
This flexibility helps facilities optimize billing for services rendered.
What is Risk Management?
The process of identifying and overseeing any potential threat that might affect an organization’s capital, earnings, and/or overall reputation.
What does an effective risk management program assist an organization with?
Evaluating the full range of risk types it may face and how to minimize negative impacts.
What are the key components that Risk Management aims to protect?
- Capital
- Earnings
- Overall reputation
True or False: Risk Management only focuses on financial threats.
False
Fill in the blank: Risk Management helps to minimize negative impacts on an organization’s _______.
[strategic goals]
What is the primary goal of Risk Management?
To minimize negative impacts of adverse events on an organization’s strategic goals.
The program where OSHA may inspect those facilities that have a high incident rate and evaluate the facility’s policies and procedures on lifting and transferring residents, is known as:
National Emphasis Program (NEP)
Besides following the specific OSHA standards, all employers must also keep their workplace free of serious recognized hazards to comply with which part of the OSH Act?
General Duty Clause
Which six of the following are among some of the most commonly cited OSHA violations in health care settings in recent years?
Bloodborne Pathogens (1910.1030)
Respiratory Protection, Ladders
Hazard Communication
General PPE
Reporting Fatalities/Injuries
OSHA Recordkeeping Forms
A ____________ leader or manager views laws as a minimum standard of conduct, accepting no deviation from that standard.
Moral
Resident rights are founded on both _______ and ethical principles, both of which are accomplished through the CMS regulations.
legal
An individual’s values and beliefs by which they make decisions.
Ethics
These are the values that affect our personality and behavior.
Principles
This is adherence to a defined moral/ethical code with a commitment not to compromise this code. This also involved keeping promises and being honest.
Integrity
This organization developed standards of practice for senior living and health services administrators which have become the basis on which many state licensing boards developed their licensing regulations.
ACHCA
American College of Health Care Administrators
These provide an ethical framework of conduct for the administrator and associates.
Values
What does commercial property insurance cover?
Repair and/or replacement costs for commercial property following covered causes of damage
This includes physical damage to the property itself.
What types of losses does commercial property insurance include?
Lost or damaged inventory, equipment, documents, and employees’ personal belongings
Coverage applies when these items are affected by covered causes.
What additional cost does commercial property insurance cover if the workplace is inoperable?
Lost income due to the workplace becoming inoperable or inaccessible
This is applicable under covered causes.
True or False: Commercial property insurance only covers physical damage to the property.
False
It also covers inventory, equipment, and lost income.
Fill in the blank: Commercial property insurance covers the total cost of lost or damaged _______.
[inventory, equipment, documents, employees’ personal belongings]
This coverage is crucial for businesses to recover from losses.
What is Directors & Officers (D&O) Liability insurance designed to protect against?
Personal losses if sued by the organization’s employees, vendors, customers, or other parties.
Who does D&O Liability insurance protect?
Directors and officers of a company.
True or False: D&O Liability insurance covers personal losses for company shareholders.
False
Fill in the blank: D&O Liability insurance protects against lawsuits from _______.
[employees, vendors, customers, other parties]
What is another name for fidelity bond insurance?
Commercial crime insurance or employee dishonesty bond
What does fidelity bond insurance coverage protect against?
Employee theft including:
* Fraudulent activities
* Property theft
* Embezzlement
* Theft of employee benefits
The primary instrument used to provide clues identifying a potential risk situation in a health care organization is the:
Incident Report
The type of insurance that would cover the health care organization if it were sued by a care recipient who was injured as the result of a medication error by a nurse employee is:
Professional Liability
General liability insurance for a healthcare organization provides the owner with protection against:
Claims resulting from negligence not related to rendering professional services.
What should organizational leaders analyze to decrease workplace injuries?
The root causes of prior workplace injuries, illnesses, and/or incidents.
Analyzing root causes helps in understanding the factors that led to injuries.
What is the first step of any effective safety and health program?
Identify or recognize where the failure occurred.
This involves understanding what hazards were present or could have been anticipated.
What must leaders ask themselves to improve workplace safety?
What hazards were present, or could have been anticipated, that contributed to the emergency and injury?
This reflective questioning is essential for identifying risks.
True or False: The process of identifying hazards is a one-time event.
False.
It is a proactive, ongoing process.
Fill in the blank: To decrease injuries and emergencies in the workplace, leaders must engage in a _______ process to identify and assess hazards.
proactive ongoing
Continuous assessment is key to workplace safety.
What is one of the root causes of workplace injuries, illnesses, and incidents?
Failure to identify or recognize hazards that are present or could have been anticipated
What is a critical element of any effective safety and health program?
A proactive, ongoing process to identify and assess hazards
What are the steps employers and workers should take to identify and assess hazards? List them.
- Collect and review information about hazards
- Conduct initial and periodic workplace inspections
- Investigate injuries, illnesses, incidents, and close calls
- Group similar incidents and identify trends
- Consider hazards associated with emergency or nonroutine situations
- Determine severity and likelihood of incidents
True or False: Hazards such as housekeeping and tripping hazards should be fixed as they are found.
True
What is Action Item 1 in identifying workplace hazards?
Collect existing information about workplace hazards
What types of existing information about workplace hazards should be collected?
- Equipment and machinery operating manuals
- Safety Data Sheets (SDS)
- Self-inspection reports
- Records of previous injuries and illnesses
- Workers’ compensation records
- Exposure monitoring results
- Existing safety and health programs
- Input from workers
What are some external sources of information about workplace hazards?
- OSHA
- NIOSH
- CDC
- Trade associations
- Labor unions
- Safety and health consultants
What is the purpose of conducting regular workplace inspections?
To identify shortcomings and address them before an incident occurs
What should be included in workplace inspections?
- All operations
- Equipment
- Work areas
- Facilities
- On-site contractors and temporary employees
What are the major categories of hazards to look for during inspections?
- General housekeeping
- Slip, trip, and fall hazards
- Electrical hazards
- Equipment operation
- Fire protection
- Ergonomic problems
- Lack of emergency procedures
What is Action Item 3 in identifying workplace hazards?
Identify health hazards
What types of health hazards should be identified?
- Chemical hazards
- Physical hazards
- Biological hazards
- Ergonomic risk factors
What is the goal of conducting incident investigations?
To identify the root causes of incidents to prevent future occurrences
What should a plan for conducting incident investigations include?
- Who will be involved
- Lines of communication
- Materials and supplies needed
- Reporting forms and templates
What types of scenarios should be identified for emergency and nonroutine situations?
- Fires and explosions
- Chemical releases
- Hazardous material spills
- Structural collapse
- Weather emergencies
What should be evaluated when characterizing the nature of identified hazards?
- Severity of potential outcomes
- Likelihood of occurrence
- Number of workers exposed
Fill in the blank: ‘Risk’ is the product of _______ and _______.
[hazard] and [exposure]
The building must be evacuated once the sprinklers have been shut down for __ hours.
10
A long-term care facility may install alcohol-based hand rub dispensers in its facility if:
The dispensers are installed in a manner that adequately protects against inappropriate access.
What is the primary purpose of a formal orientation for new employees?
To welcome and introduce new employees to the organization.
What type of paperwork should be completed during new employee orientation?
New hire paperwork such as Form I-9, Form W-4, state tax withholding forms.
What documents should new employees be reminded to bring before their start date?
Verification documents such as social security cards, driver’s licenses, passports.
What organizational policies should be covered in an employee orientation?
Attendance expectations, leave policies, expected hours of work, employee conduct.
What are some examples of employee conduct topics to discuss during orientation?
Dress code, telephone/computer use.
What compensation and benefits information should be addressed in orientation?
Pay periods, direct deposit options, health insurance coverage, 401(K) offerings, EAP.
Why is it important to provide a benefits package in advance during orientation?
To clarify any confusion regarding compensation and benefits offerings.
What is the significance of the employee handbook?
It outlines the organization’s expectations, policies, and procedures.
What should new employees do with the employee handbook after receiving it?
Sign and return an attestation page indicating they have received and reviewed it.
What is the purpose of an organizational tour for new employees?
To help them attain comfort in their new position and highlight important locations.
What types of training should be specified for new employees?
Informal training, formal training, or a combination of both.
What might an effective training plan for a new employee include?
Mentorship, formal classes, instructional models.
What should be provided to new employees at the completion of orientation?
A checklist of forms to return and skills to master.
Fill in the blank: An important aspect of orientation is to remind new employees that they are responsible for all the information contained in the _______.
[employee handbook]
What does a right-to-work (RTW) law provide to workers?
The freedom to choose whether they join a labor union or not
RTW laws are seen as granting workplace freedom or allowing workplace choice.
How many states and territories have passed right-to-work laws?
27 states and Guam
In unionized workplaces under RTW laws, can workers be compelled to pay union dues?
No, workers cannot be compelled to pay union dues or other membership fees
As of early 2021, at what level do right-to-work laws exist?
State level
What is the definition of At-Will employment?
Allows an employer to change and/or terminate the terms of an employment agreement without reasoning
Under At-Will employment, when can employees leave their position?
At any time with no reason given
In At-Will employment, when can an employer incur legal liability?
If the change/termination is related to an illegal reason
Which state does not follow the At-Will employment doctrine?
Montana
True or False: All employment relationships in the United States are considered ‘at-will’.
True
What is the ownership status of personnel files?
Personnel files are the property of the employer.
True or False: Employees have no access to their personnel records.
False
What do some states provide regarding employee access to personnel records?
Laws that give employees access to all or part of their personnel records.
In addition to access, what rights do some states grant employees concerning their personnel files?
Rights to have certain files copied.
What should employers understand regarding personnel file laws?
The laws in any and all states where their employees live and/or work.
A negotiation of wages and other conditions of employment by an organized body of employees through their unions (two words).
Collective Bargaining
An organized and intentional stoppage or slowdown of work by employees, intending to make the employer comply with the demands of the employees.
Strike
A document signed by an employee that authorizes a union to negotiate employment terms and conditions on behalf of the employee (two words).
Authorization Card
The relationship between the management of an organization and its workforce. (two words)
Labor relations
A form of protest in which people congregate outside a place of work or location in an attempt to dissuade others from going in or to draw public attention to a cause.
Picketing
This form of alternative dispute resolution is a way to resolve disputes outside the judiciary courts.
Arbitration
A written or spoken agreement, especially one concerning employment, sales, or tenancy, that is intended to be enforceable by law.
Contract
The group of employees represented by a union, or the employees the union is proposing to represent when it applies for certification (two words).
Bargaining Unit
What are the key factors to determine whether discipline is appropriate?
- Establishment of facts regarding employee’s actions
- Violation of an established rule, regulation, or requirement
- Employee’s knowledge of the rule, regulation, or requirement
- Consistent enforcement of the rule
These factors ensure fairness and clarity in disciplinary actions.
What must be established for discipline to be appropriate?
The employee did - or failed to do - the things claimed
This means there should be clear evidence of the employee’s actions or inactions.
What constitutes a violation for disciplinary action?
The employee’s behavior, if proven, violated an established rule, regulation, or requirement
Without a violation, disciplinary action is not justified.
What must an employee know regarding rules and regulations?
The employee knew - or should have known - of the rule, regulation, or requirement
Adequate communication of rules is essential for accountability.
What should be signed off by employees upon hire and revision?
Policies, procedures, and practices
This ensures that employees are aware of the expectations and regulations.
What happens if the rule has not been adequately communicated to employees?
The employee cannot be held accountable for compliance with them
Clear communication is vital for enforcing rules fairly.
What is required for consistency in disciplinary actions?
The rule has been enforced consistently
Inconsistent enforcement can lead to perceptions of arbitrary or discriminatory discipline.
What can disciplinary actions be considered if not enforced consistently?
Arbitrary or discriminatory
Consistency in enforcement is crucial to uphold fairness in discipline.
What does PBJ stand for?
Payroll Based Journal
What does the Fair Labor Standards Act regulate?
Minimum wage, overtime, standard workweek definitions, equal pay, child labor, and record keeping requirements
It applies to over 50 million employees, including those in nursing home organizations.
What is the primary reason for high turnover among CNAs in nursing homes?
Low pay and lack of benefits
CNAs play a crucial role in the success of the organization and the quality of life for residents.
What rights does the National Labor Relations Act (NLRA) grant to employees?
The right to organize and join unions without fear of retribution
Employers must adhere to specific guidelines regarding union activities.
Is it lawful for management to ask employees about their interest in joining a union?
No, it is unlawful
Management cannot threaten or intimidate employees regarding their right to organize.
What is the process of progressive discipline?
Using increasingly severe steps when an employee fails to correct a problem
It includes counseling, oral warnings, written warnings, suspension, and termination.
List the typical steps in the progressive disciplinary process.
- Counseling
- One or more oral warnings
- One or more written warnings
- Suspension with or without pay
- Termination
The final step is termination of employment.
What should performance goals be like?
Measurable and specific to tasks and skills
They should align with job requirements and standards.
The administrator recently discovered that the housing manager ordered new cleaning supplies for the community. When asked about the reasoning behind the decision for the change, they replied “these are organic so I felt they would be healthier for our residents.” What would be the best source to verify if these would be appropriate for sanitizing the community?
Environmental Protection Agency (EPA)
During a review of the infection log at the monthly Quality Assurance (QA) meeting, an analysis revealed that there was an increase in urinary tract infections in those care recipients with Foley catheters. The team has decided to set a process improvement project (PIP) goal to reduce these infections, which would be part of their overall QAPI plan. Which code/resource would they seek for more information?
Centers for MCR and MCD Services (CMS)
This is the agency responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices, and by ensuring the safety of our nation’s food supply, cosmetics, and products that emit radiation.
Food and Drug Administration (FDA)
This organization coordinates development and use of voluntary consensus measures in the United States and represents the needs and views of U.S. stakeholders in standardization forums around the globe.
American National Standards Institute (ANSI)
This agency was established in 1970 when Congress established laws that ensured safe and healthful working conditions for workers by setting and enforcing standards in addition to providing training, outreach, education, and assistance.
Occupational Health and Safety Administration (OSHA)
As the new administrator of record, you are reviewing the physical environment of your community to determine if updates are needed for compliance. While walking through the building, you noticed a fire barrier door that seems older than the rest. While the door still latches, you have some questions about the smoke barrier. What agency would be the best to consult on issues such as this?
National Fire Protection Association (NFPA)
What does preventative and/or routine maintenance mean?
Regular inspections to evaluate the performance of certain tasks to prevent unexpected equipment failures
This includes assessing equipment to ensure it operates efficiently and effectively.
What are the benefits of implementing a preventative maintenance program?
Benefits include:
* Preventing costly breakdowns
* Delaying the need to replace equipment
* Reducing disruption time of vital services
A well-implemented program can lead to significant cost savings and increased efficiency.
True or False: Preventative maintenance can help reduce the amount of disruption time of vital services.
True
This is crucial for maintaining operational continuity in various sectors.
Fill in the blank: Preventative maintenance helps to _______ the need to replace equipment that may otherwise wear out earlier than expected.
delay
This aspect is critical for managing budgets and resource allocation.
The Life Safety Code requires at least ______ testing of certain emergency systems, such as fire doors, automatic doors, smoke detectors, and emergency generators.
Monthly
The major purpose of preventive maintenance is to:
Ensure that all equipment is safe and operable for use by the care recipient.
Which of the following documents must be kept on file for all chemicals and includes emergency procedures to take when exposed to the chemical?
Safety Data Sheet
What must extension cords be approved by?
Underwriters Laboratories (UL) or comply with other recognized electrical appliance approval standards
Compliance ensures safety and reliability of the cords.
Where should extension cords not be placed?
Under rugs, through doorways, or in locations subject to physical damage
These placements pose tripping hazards and risks of damage.
What are the Life Safety Code Standards regarding extension cords?
Facilities must comply with National Electric Code Section 400-7
This includes restrictions on using flexible cords and cables.
What uses are prohibited for flexible cords and cables according to Life Safety Code K147?
- Substitute for fixed wiring
- Run through walls, ceilings, or floors
- Run through doorways or windows
- Concealed behind walls or ceilings
- Installed in raceways
Exceptions allow attachment to building surfaces under specific provisions.
What should be ensured when using extension cords?
- Properly secured
- Not placed overhead or under carpets
- Connected to only one device
- Correct size and type for electrical load
- Proper grounding if required
These precautions help prevent overheating and tripping hazards.
Can power strips be used as a substitute for adequate electrical outlets in a facility?
No
Power strips are not a replacement for proper electrical outlets.
What devices may power strips be used with?
- Computer
- Monitor
- Printer
They are not designed for use with medical devices in patient care areas.
What precautions are needed when using power strips?
- Install internal ground fault and over-current protection
- Prevent cords from becoming tripping hazards
- Use adequate strips for the number and types of devices
These precautions help ensure safety and prevent overload.
What can overload on any circuit potentially cause?
Overheating and fire
This highlights the importance of proper usage and monitoring of electrical devices.
What may be required in locations near water sources to prevent electrocution?
Ground fault circuit interruption (GFCIs)
GFCIs enhance safety in potentially hazardous environments.
Certified facilities must meet the requirements of which edition of the Life Safety Code?
The 2012 edition
What do Standard Precautions refer to?
The basics of infection control used for all patient care situations
They involve common-sense practices and personal protective equipment to protect healthcare providers and prevent infection spread.
What are Transmission-based Precautions?
A tier above Standard Precautions, used in addition to them for patients with known or suspected infections
Includes use of gowns, face shields, cleaning priority for patient care areas, and disposable or patient-specific care equipment.
According to the CDC, what is the most important measure for reducing the spread of infection in healthcare facilities?
Proper hand hygiene
Routine use of alcohol-based hand rubs is recommended as the primary method for cleaning hands.
What should be done if hands are visibly soiled or contaminated?
Wash hands with soap and water
This is the recommended action when alcohol-based hand rubs are insufficient.
Who is eligible for Medicare?
People aged 65 and older, people with certain disabilities, and people with end-stage renal disease
Medicare serves individuals across different age groups based on specific criteria.
What does Part A of Medicare generally cover?
Inpatient care in hospitals and non-custodial long-term care in skilled nursing facilities
This part focuses on hospital stays and certain types of care.
What does Part B of Medicare generally cover?
Doctors’ services and outpatient care
This part addresses outpatient services and visits to healthcare providers.
What does Part D of Medicare generally cover?
Prescription drug costs
This part helps with the expenses associated with prescription medications.
What is the Home and Community-Based Services Waiver?
Allows states to develop programs offering alternatives to institutional placement for Medicaid eligible people
This waiver provides services like home care and adult day care, aiming to keep individuals in community settings.
What types of services can states offer under the Home and Community-Based Services Waiver?
- Home care
- Adult day care
- Respite care
- Case management
These services are alternatives to traditional institutional care.
True or False: Transmission-based Precautions are used for all patient care situations.
False
Transmission-based Precautions are specifically for patients with known or suspected infections.
You must provide written notification and a plan for relocation at least how many days prior to the closure of a facility?
60
The administrator must notify FOUR entities of the closure of the facility, in writing. Who must you notify?
Medical Director, Residents Primary Care physician, CMS, The state
Can new residents may be admitted after written notice is provided of the closure of the facility.
No
What is a Standard Survey?
A resident-centered, outcome-oriented inspection to gather information about the facility’s compliance with participation requirements, including residents’ rights, safety, quality of life, care, and services.
What triggers an Extended Survey?
A survey conducted after substandard resident-centered quality of care is determined during a standard survey.
What is the focus of an Abbreviated Standard Survey?
A survey concentrating on a particular area of concern(s), such as substantiating a complaint or changes in ownership, management, or Director of Nursing.
What is a Partial Extended Survey?
A survey conducted after substandard quality of care is found during an abbreviated standard survey or during a revisit, when substandard quality of care was not previously identified.
What is the purpose of a Post-Survey Revisit?
An onsite visit intended to verify correction of deficiencies cited in a prior survey.
What does the Initial Certification Survey accomplish?
It performs the tasks of both the Standard and Extended Surveys, focusing on residents and structural requirements related to qualification standards and resident rights notification.
True or False: An Initial Certification Survey only focuses on residents without considering structural requirements.
False
Fill in the blank: An Extended Survey is conducted after _______ is determined during a standard survey.
[substandard resident-centered quality of care]
What are the main aspects assessed in a Standard Survey?
Residents’ rights, safety, quality of life, care, and services.
What conditions may lead to an Abbreviated Standard Survey?
A complaint substantiation or change of ownership, management, or Director of Nursing.
What is the relationship between Partial Extended Surveys and Abbreviated Standard Surveys?
Partial Extended Surveys occur after substandard quality of care is found during Abbreviated Standard Surveys.
What are the seven tasks required when completing a survey in long-term care communities?
- Offsite Survey Preparation
- Entrance Conference/Onsite Preparatory Activities
- Initial Tour
- Sample Selection
- Information Gathering
- Information Analysis for Deficiency Determination
- Exit Conference
Which tasks require modifications when surveying communities predominantly serving short stay residents?
Task 1 and Task 4
What is Task 1 in the survey process for long-term care facilities?
Offsite Survey Preparation
What is the focus of Task 2 in the survey process?
Entrance Conference/Onsite Preparatory Activities
What does Task 3 entail in the context of the survey process?
Initial Tour
What is the purpose of Task 4 in the survey procedures?
Sample Selection
What does Task 5 involve during the survey process?
Information Gathering
What is the goal of Task 6 in the survey process?
Information Analysis for Deficiency Determination
What is the final task in the survey process for long-term care facilities?
Exit Conference
Fill in the blank: Task 1 is known as _______.
Offsite Survey Preparation
Fill in the blank: Task 4 is focused on _______.
Sample Selection
What does PoC stand for?
Plan of Correction
A Plan of Correction is often abbreviated as PoC.
What is the purpose of a Plan of Correction?
To describe actions that will be taken to correct deficiencies identified during the survey process.
Who must approve a Plan of Correction?
CMS or other survey agency.
What scope and severity levels of deficiencies must a PoC address?
Levels B through L.
How many calendar days does a community have to submit a PoC after receiving the Statement of Deficiencies?
Ten (10) calendar days.
What is a PoC considered in a legal context?
A formal statement from the community.
List the five elements that a Plan of Correction must address.
- How corrective action will be accomplished for affected residents
- How the facility will identify other affected residents
- Measures to ensure the deficient practice will not recur
- How the facility plans to monitor performance
- Dates when corrective action will be completed.
What happens if a PoC is unacceptable?
The State will notify the facility in writing.
What happens if a PoC is acceptable?
The State will notify the facility by phone, e-mail, etc.
True or False: The responsibility of compliance with the PoC lies with the facility’s leadership.
True.
What document serves as the facility’s allegation of compliance?
The Plan of Correction.
What is a Quality Measure?
Quality measures are standards for measuring the performance of healthcare providers to care for patients and populations.
What aspects of care do Quality Measures identify?
Quality measures identify important aspects of care like:
* safety
* effectiveness
* timeliness
* fairness
What do quality measures focus on?
Each quality measure focuses on a different aspect of healthcare delivery.
What is the purpose of quality measurement?
Quality measurement provides a more comprehensive picture of the quality of healthcare.
What parts of healthcare do Quality Measures address?
Quality measures address many parts of healthcare, including:
* Health outcomes
* Clinical processes
* Patient safety
* Efficient use of healthcare resources
* Care coordination
* Patient engagement in their own care
* Patient perceptions of their care
* Population and public health
What is the measure for hospitalizations in long-stay residents?
Number of hospitalizations per 1,000 long-stay resident days
What is the measure for outpatient emergency department visits in long-stay residents?
Number of outpatient emergency department visits per 1,000 long-stay resident days
What percentage of high-risk residents should not have pressure ulcers?
Percent of high-risk residents with pressure ulcers
What percentage of low-risk residents should not lose control of their bowels or bladder?
Percent of low-risk residents who lose control of their bowels or bladder
Percent of residents who received an antipsychotic medication?
Percent of residents who received an antipsychotic medication
What is the measure for falls with major injury in residents?
Percent of residents who have experienced one or more falls with major injury
What is the measure for urinary tract infections in residents?
Percent of residents who have a urinary tract infection
What is the measure for catheter use in residents?
Percent of residents who have or had a catheter inserted and left in their bladder
What is the measure for physical restraint in residents?
Percent of residents who were physically restrained
What is the measure for weight loss in residents?
Percent of residents who lose too much weight
What is the measure for depression symptoms in residents?
Percent of residents who have symptoms of depression
What is the measure for antianxiety or hypnotic medication use in residents?
Percent of residents who used antianxiety or hypnotic medication
Residents assessed and appropriately given the seasonal influenza vaccine?
Percent of residents assessed and appropriately given the seasonal influenza vaccine
Percent of residents who received the seasonal influenza vaccine?
Percent of residents received the seasonal influenza vaccine
Percent of residents who were offered and declined the seasonal influenza vaccine?
Percent of residents who were offered and declined the seasonal influenza vaccine
Percent of residents who did not receive the seasonal influenza vaccine due to medical contraindication?
Percent of residents who did not receive, due to medical contraindication, the seasonal influenza vaccine
Residents assessed and appropriately given the pneumococcal vaccine?
Percent of residents assessed and appropriately given the pneumococcal vaccine
Percent of residents who received the pneumococcal vaccine?
Percent of residents who received the pneumococcal vaccine
Percent of residents who were offered and declined the pneumococcal vaccine?
Percent of residents who were offered and declined the pneumococcal vaccine
Percent of residents who did not receive the pneumococcal vaccine due to medical contraindication?
Percent of residents who did not receive, due to medical contraindication, the pneumococcal vaccine
What is the measure for a decrease in ability to move independently?
Percent of residents who had a decrease in their ability to move independently
What is the measure for increased need for help with Activities of Daily Living?
Percent of residents who had an increased need for help with Activities of Daily Living
What percentage of short-stay residents were re-hospitalized after a nursing home admission?
Percent of short-stay residents who were re-hospitalized after a nursing home admission
Specific percentage not provided in the text.
What percentage of short-stay residents have had an outpatient emergency department visit?
Percent of short-stay residents who have had an outpatient emergency department visit
Specific percentage not provided in the text.
What percentage of residents newly received an antipsychotic medication?
Percent of residents who newly received an antipsychotic medication
Specific percentage not provided in the text.
What percentage of residents had changes in skin integrity post-acute care?
Percent of residents who had changes in skin integrity post-acute care: pressure ulcer/injury
Specific percentage not provided in the text.
What percentage of residents made improvements in function?
Percent of residents who made improvements in function
Specific percentage not provided in the text.
What percentage of residents were assessed and appropriately given the seasonal influenza vaccine?
Percent of residents who were assessed and appropriately given the seasonal influenza vaccine
Specific percentage not provided in the text.
What percentage of residents received the seasonal influenza vaccine?
Percent of residents who received the seasonal influenza vaccine
Specific percentage not provided in the text.
What percentage of residents were offered and declined the seasonal influenza vaccine?
Percent of residents who were offered and declined the seasonal influenza vaccine
Specific percentage not provided in the text.
What percentage of residents did not receive the seasonal influenza vaccine due to medical contraindication?
Percent of residents who did not receive, due to medical contraindication, the seasonal influenza vaccine
Specific percentage not provided in the text.
What percentage of residents were assessed and appropriately given the pneumococcal vaccine?
Percent of residents who were assessed and appropriately given the pneumococcal vaccine
Specific percentage not provided in the text.
What percentage of residents received the pneumococcal vaccine?
Percent of residents who received the pneumococcal vaccine
Specific percentage not provided in the text.
What percentage of residents were offered and declined the pneumococcal vaccine?
Percent of residents who were offered and declined the pneumococcal vaccine
Specific percentage not provided in the text.
What percentage of residents did not receive the pneumococcal vaccine due to medical contraindication?
Percent of residents who did not receive, due to medical contraindication, the pneumococcal vaccine
Specific percentage not provided in the text.
A resident is admitted to a nursing home that has been certified as a (Medicare) Skilled Nursing Facility only. What is NOT required to be adhered to by the facility?
State Medicaid Standards for payment
What is required for a paid employee or feeding assistant to serve as a feeding assistant?
Completion of a state-approved training course for feeding assistants
Family members are not required to complete this course before feeding their family member.
Are extended surveys based on past citations?
No
Extended surveys are not conducted based on past citations.
What is the purpose of the Plan of Correction?
To remedy deficient practices found during a health inspection
It includes corrective actions, identification of at-risk residents, systemic changes, ongoing compliance monitoring, and a date of credible compliance.
What must states allow providers to do regarding deficiencies cited on a survey?
Challenge deficiencies
However, the IDR process cannot be used to delay remedies or challenge other aspects of the survey.
What aspects cannot be challenged through the IDR process?
Scope and severity of a deficiency, remedies imposed by the enforcing agency, inconsistencies of the survey process
This includes substandard care or Immediate Jeopardy.
What are the three sets of information that a facility’s 5-Star Rating is based upon?
Health Inspection score, Quality Measure 5-Star rating, Staffing 5-Star rating
The Health Inspection score is compiled from the last three years’ annual and compliant surveys.
What does QAPI stand for?
Quality Assurance and Performance Improvement
It combines traditional Quality Assurance processes with forward-looking Performance Improvement processes.
What is the goal of the Performance Improvement process in QAPI?
To prevent future failures in the delivery of care
It aims to identify areas of risk before failures occur.
What must a facility complete annually to determine resources for patient care?
A facility-wide assessment
This assessment must address patient population, available resources, and a facility-based/community-based risk assessment.
What three broad categories must the facility-wide assessment address?
- Examination of the facility’s patient population
- Resources, including equipment and personnel
- Facility-based and community-based risk assessment
This assessment uses an all-hazards approach to examine potential environmental or societal disasters.
What is governance?
The overall process of providing strategic direction and leadership within an organization.
This includes developing policy, monitoring organizational performance, and managing organizational risk.
What is a governing body?
A group of people with the authority to exercise oversight and leadership over organizations, political entities, and corporations.
Governing bodies can vary in size but share similar objectives.
What is the Duty of Care?
To be reasonably informed about the mission/vision of the entity and use sound judgment in organizational decisions.
This includes ensuring proper financial reporting and mechanisms to minimize fraud.
What is the Duty of Obedience?
To validate that decisions follow the organization’s bylaws, policies, and regulatory/legal requirements.
This duty ensures compliance with internal and external standards.
What is the Duty of Loyalty?
To ensure decisions are made in the best interest of the organization and avoid conflicts of interest.
This duty emphasizes the importance of integrity in leadership.
Who is the Chief Executive Officer (CEO)?
The top administrative individual responsible for leading long-term strategies and overseeing staff.
The CEO typically reports directly to the governing body.
What is administration?
The process of managing people, information, and resources to achieve organizational objectives.
It involves operational oversight and resource allocation.
What is an administrative team?
Employees responsible for managing day-to-day operations and implementing policies.
They carry out directives from the governing body.
What does the term ‘administrator’ refer to?
A staff member who plans, organizes, and directs operations within a senior living and health service community.
Administrators play a key role in operational management.
What is management?
The process of planning, organizing, and directing systems to accomplish short-term goals.
Management focuses on execution and operational efficiency.
What is leadership?
The process of establishing an overarching vision and inspiring staff to drive change initiatives.
Leadership involves innovation and strategic guidance.
What is the first step in Kotter’s 8 step change model?
Create Urgency
Leaders can accomplish this by identifying the organization’s internal strengths/weaknesses and external opportunities/threats (SWOT) and engaging in honest discussions about the need for change.
What is the second step in Kotter’s 8 step change model?
Form a Powerful Coalition
The coalition should have diverse representation from staff leaders and key stakeholders, including cross-functional teams with demonstrated leadership skills.
What is the third step in Kotter’s 8 step change model?
Create a Vision for Change
The vision should align with the organization’s core values and be easily understood by both internal staff and external stakeholders.
What is the fourth step in Kotter’s 8 step change model?
Communicate the Vision
To gain buy-in, the vision must be communicated enthusiastically and frequently, connecting it to real-life applications.
What is the fifth step in Kotter’s 8 step change model?
Remove Obstacles
Continually assess and implement proactive measures to remove barriers, whether they are people or processes.
What is the sixth step in Kotter’s 8 step change model?
Create Short-Term Wins
Achieving small victories early in the change process helps maintain momentum and makes goals seem more achievable.
What is the seventh step in Kotter’s 8 step change model?
Build on the Change
Analyze short-term wins individually and seek additional small improvements, reaching continuous quality improvement.
What is the eighth step in Kotter’s 8 step change model?
Anchor the Changes in Corporate Culture
Change initiatives should be kept at the forefront of communications, making them integral to the organizational culture.
True or False: The coalition formed in Kotter’s model should consist only of top leadership.
False
The coalition should include diverse representation from staff leaders and key stakeholders, not just top leadership.
Fill in the blank: The vision in Kotter’s change model should align with the organization’s _______.
[core values]
The vision should be something that both internal staff and external stakeholders can easily understand.
What is Transformational Leadership?
A leadership style seen as the ‘selling’ style, exemplified by leaders who involve their teams and adapt products based on customer feedback.
Reed Hastings of Netflix is a key example, providing a safe environment that encourages innovative change.
What is Transactional Leadership?
A ‘telling’ leadership style where leaders focus on rewards and performance, exemplified by leaders like Nick Saban.
It emphasizes structure and compliance to achieve results.
What defines Strategic Leadership?
Leadership that maintains a singular vision and focuses on team strategy, exemplified by figures like Wayne Gretzky.
This style often leads to sustained success and record-breaking achievements.
What is Participative Leadership?
Also known as democratic leadership, it involves organizational-wide decision-making and prioritizes employee involvement.
Jim Parker of Southwest Airlines is a notable example.
What characterizes Collaborative Leadership?
A leadership style focused on teamwork and leveraging individual strengths within a group, exemplified by Richard Branson.
Branson emphasizes listening, learning, and passion for work.
What is Servant Leadership?
A leadership approach that prioritizes serving others, exemplified by leaders like Jim Senegal of Costco.
Servant leaders often have low employee turnover and engage directly with their teams.
What is Situational Leadership?
A flexible leadership style that adapts to changing circumstances, exemplified by Jim Lentz during a PR crisis at Toyota.
It involves real-time communication and transparency.
Fill in the blank: Transformational Leadership is often referred to as the _______ leadership style.
selling
Fill in the blank: Transactional Leadership is often referred to as the _______ leadership style.
telling
Fill in the blank: Participative Leadership is also known as _______ leadership.
democratic
True or False: Servant Leaders typically have a high salary compared to their peers.
False
True or False: Situational Leaders do not adapt their strategies based on changing circumstances.
False
What does an organizational chart show?
Authority relationships, responsibilities, and communication lines
Who shares the responsibilities for ensuring a plan for senior leadership turnover?
The organization’s governing board and administrative leadership
What is the governing board ultimately accountable for in an organization?
The organization’s leadership succession plan
What should the leadership succession plan be part of?
The strategic planning process
How often should the leadership succession plan be updated?
On a routine basis
What is Management by Objectives?
A participative evaluation approach used with higher-level employees and managers
In Management by Objectives, who develops the specific objectives?
The employee in collaboration with management
What must both the employee and management understand in the Management by Objectives process?
How the performance evaluation process will work
What is the main characteristic of a corporation regarding its stockholders and debts?
Stockholders are not personally responsible for the debts of the organization
What type of taxes do sole proprietorships pay?
No corporate taxes
A type of planning tool that, when addressing from a senior living and health services administration context, would include fundraising approaches, grant opportunities, as well as any other funding sources to support the organization’s overall strategic initiatives.
Developmental
A type of planning that focuses on the execution of specific projects and/or any logistical and administrative tasks. It is not designed to shape future organizational strategy.
Operational
This type of scan is a process of systematically gathering, analyzing, and interpreting data from your organization’s internal and external environment(s) regarding key factors and trends that could pose threats or opportunities (either potential or actual) to your long-term viability of your organization.
Environmental
An acronym to represent the four categories of information that is evaluated as part of an environmental scan: political, economic, social, and technological.
PEST
A planning process where action plans are developed to encourage performance improvement and progress is evaluated on a daily basis: __ range.
This type of operational planning document outlines how the organization plans to use advertising and outreach to target a specific market.MR
This type of operational planning document outlines how the organization plans to use advertising and outreach to target a specific market.
Marketing
A comprehensive planning framework that encompasses goals that are set to be accomplished over a time period over 4-5 years: __ range.
Long
A type of planning by which an organization defines goals, objectives, and tactics to guide and shape its future strategy or direction making decisions. Plans tend to be broad and outline goals over a period of year(s).
Strategic
What defines an organization’s basic purpose for existence?
An organization’s mission
The mission statement identifies what the organization is, the services it provides, and the core stakeholders it serves.
What is the primary goal of an organizational strategic plan?
To develop a collaborative strategy among all stakeholders
This strategy helps the community thrive and prosper.
What needs to be assessed to develop an effective strategic plan?
Where the organization presently is and where it wants to be in the future
Strategic goals should aim for accomplishment over a longer time period.
What is the main reason for market segmentation?
To identify distinct market sections that constitute the target market
This target market is where most customers of the senior living and health services profession will come from.
What is the first step in developing any type of marketing strategy?
Conduct a feasibility study
Feasibility studies provide essential information, including demographic reviews, necessary for developing a marketing strategy.
What can a feasibility study sometimes lead to in the context of marketing?
Identification of a niche market
This niche market is specific to that community.
What is the main objective of any public relations tool or campaign?
To build and maintain a positive image of the organization
This is achieved through effective communication directed towards would-be customers and stakeholders.
Who are the stakeholders targeted by public relations tools and campaigns?
- Organizational associates
- Community healthcare agencies
- Physicians
- Local media
- Legislators
- The community at large
These stakeholders are essential for effective communication.
