NHA STUDY PRACTICE QUESTIONS Flashcards
When admitted to the nursing home, which of the following is not required to be given to the resident:
- The resident’s rights and rules and regulations governing resident conduct and responsibilities during the stay in the facility
- Services to be provided and their associated cost
- The federal standards and state licensing rules for nursing facilities
- Information regarding an advance directive
The federal standards and state licensing rules for nursing facilities
A resident is admitted to a curing home that has been certified as a (Medicare) Skilled Nursing Facility only. Which of the following is not required to be adhered to by the facility?
- State Medicaid standards for payment
- NF regulations
- State licensing regulations
- Office of Civil Rights laws
State Medicaid standards for payment
Unless a waiver has been secured, a registered nurse is required to be in the facility:
- At least eight hours within every 24-hour period
- At least eight consecutive hours a day, seven days a week
- At least eight consecutive hours Monday through Friday
- There is no minimum number of hours required
At least eight consecutive hours a day, seven days a week
Which one of the following statements is true?
- Any employee may serve as a feeding assistant when the need arises
- A family member must complete a state-approved training course for feeding assistants before assisting with feeding his/her family member
- Paid feeding assistants must successfully complete a state-approved training course
- A family member is not allowed to feed his/her relative
Paid feeding assistants must successfully complete a state-approved training course
Which one of the following statements is correct about naso-gastric tube feeding while in a facility?
- An individual who needs to be fed may be given a naso-gastric tube to make eating easier for the resident
- The facility must ensure that the resident receives appropriate treatment to restore, if possible, normal eating skills can be restored
- With the family’s permission, the resident may be given a naso-gastric tube
- The initial assessment demonstrates that the resident’s clinical condition indicates he/she can’t eat by himself/herself
The initial assessment demonstrates that the resident’s clinical condition indicates he/she can’t eat by himself/herself
Which level of employees are most at risk for potential personal injury in the nursing home?
- Food preparation workers
- Maintenance personnel
- Certified Nursing Assistants
- Nurses
Certified Nursing Assistants
In a typical facility, staff turnover is greatest among:
- Business office personnel
- CNAs
- Dietary workers
- Maintenance
CNAs
Within the spirit of OBRA and culture change, which one of the following is most descriptive of the movement?
- Resident rights and resident centered care
- Changing the physical structure of the facility to be more homelike
- Having more clearly defined and permanent workloads and assignments
- Protection of residents and employees through an effective infection control program
Resident rights and resident centered care
Which type of employee counseling should not be done between the administrator/department manager and an employee?
- Personal development and career advancement
- Personal non-work problems being experienced by an employee
- Work related problems: scheduling, the work environment, worker performance, etc
- Conflicts between personnel: managers and employees or employee and employee or administrator and employee or manager
Personal non-work problems being experienced by an employee
Regulations related to payment for overtime for nursing staff employed by a skilled nursing facility are guided by the:
- Immigration Reform and Control Act
- Workers Compensation Act
- Medicare Modernization Act
- Fair Labor Standards Act
Fair Labor Standards Act
Why should an administrator get department heads involved in the budget-making process?
- To remain in compliance with federal certification requirement
- To obtain more accurate cost estimates and more control over costs
- To satisfy a generally accepted accounting principle (GAAP)
- To conserve time in developing a budget
To obtain more accurate cost estimates and more control over costs
Medicare Part A coverage of skilled nursing facility (SNF) care entails out-of-pocket payment by the resident of a daily amount for which days of SNF care in a benefit period?
- none
- 1st through 20th
- 21st through 100th
- Each day that the costs exceed a certain level
21st through 100th
Which of the following statements is NOT true regarding the Medicare Prospective Payment System for Skilled Nursing Facilities?
- Facilities located in different urban areas receive different rates that reflect differences in area wage rates
- The system is case-mix-based
- Facilities must submit bills to be reimbursed
- There are separate prospective rates for capital-related costs
There are separate prospective rates for capital-related costs
The process by which an individual becomes eligible for Medicaid by incurring medical expenses until personal resources fall below a specified ceiling is called
- indemnity
- personal needs allowance
- spend down
- swapping
spending down
To obtain maximum reimbursement under the Medicare Prospective Payment System, a skilled nursing facility should do all except which one of the following?
- Record on the MDS all the information about the resident that can determine assignment to a RUG
- Have a physical therapists who serve Part A -covered residents bill Medicare directly
- Track costs by RUG categories
- Collect MDS information more frequently for Part A-covered residents than for other residents
Have a physical therapists who serve Part A -covered residents bill Medicare directly
According to federal certification standards, the square footage for a single resident room is _____ and the square footage for a multiple resident room is ____ square feet per bed.
- 90 / 70
- 100/ 80
- 110/ 90
- 125/ 100
100/ 80
While Title XVIII (Medicare) and Title XIX (Medicaid) both refer to firs safety and construction information, the actual provisions in those areas are specified by the:
- American National Standards Institute (ANSI)
- Occupational Safety and Health Administration (OSHA)
- Life Safety Code (LSC)
- Uniform Building Codes (UBC)
Life Safety Code (LSC)
In order to ensure a comfortable environment, Medicare/Medicaid regulations require that nursing facilities provide:
- air conditioning
- Rooms painted in contrasting colors
- Adequate lighting levels
- Carpeted hallways
Adequate lighting levels
According to the Life Safety Code requirements, a corridor in a new nursing home must be:
- 6-8 feet
- 8 feet
- 8 - 10 feet
- 10 feet
8 feet
Certified facilities must meet the requirements of which edition of the Life Safety Code?
- The latest edition
- The edition that was effect when the facility was built
- The edition determined by the state survey agency
- The 2012 edition
the 2012 edition
When addressing an identified problem with facility policy it is most important for the administrator to first:
- Determine the individual staff member who is at fault
- Discuss with the appropriate department manager
- Gather all of the facts related to the issue
- Conduct staff meeting to discuss the issue and find a resolution
Discuss with the appropriate department manager
Which of the following responsibilities of the governing bogy of a facility is not true?
- Selecting and hiring the administrator
- Selecting and hiring the director of nursing
- Establishing policies to assure resident rights
- Establishing the mission and vision for a facility
Selecting and hiring the director of nursing
Certified facilities are subject to surveys every 9-15 months. The survey process begins with:
- Entrance conference
- Initial tour
- Resident sample selection
- Off-site preparation
Off-site preparation
Which category of the following would best describe the ownership of a Veteran’s Nursing facility?
- Proprietary
- Public
- Private non-profit
- Private for-profit
Public
Which of the following is not true about an extended survey?
- Is conducted based on past survey citations
- Is conducted when surveyors determine substandard care
- Is determined during the course of a survey
- Selects additional policy and procedure reviews
Is conducted based on past survey citations
Legal term meaning that a person with mental capacity or their legal guardian has given permission for medical treatment once the provider has explained the options, risks, and benefits
Informed consent
Prejudicial treatment of the elderly based on stereotypes
Ageism
Licensed facility that provides nursing and personal care to those who are chronically ill or unable to take care of daily living needs. (Also called Nursing Home or Convalescent Care Facility)
Long-Term care Facility
Extent or magnitude of deficient facility practice on care recipient/client/patient outcome. There are three levels (as described in the Federal Enforcement Grid for nursing homes)
Scope
Services or supplies that are needed for the diagnosis or treatment of a medical condition and meet accepted standards of medical practice
Medically necessary
Accommodating the changing needs of older adults while living in familiar surroundings
Aging in place
Statement of the purpose of the organization and its reason for existing. It is usually rather brief (sentence or two) and does not present detailed information about the day to day operations of the organization
Mission statement
Organization operated solely for social welfare, or for any other purpose except for profit; no part of the organization income is payable to, or is otherwise available for the personal benefit of, any proprietor or member
not-for-profit
End points that activities are directed toward. They should be specific, measurable, and attainable
Goals or objectives
Deliberate misplacement, exploitation, or wrongful, temporary, or permanent use of a care recipient’s (patient/client) belongings or money without the care recipient/patient/clients consent
Misappropriation
Sudden emergency occurrence beyond the control of the licensee, whether natural, technological, or man-made, that renders the licensee unable to operate the facility or makes the facility uninhabitable
Disaster
A move from one care setting (hospital, nursing home, or home) to another. Care during the move involves coordination and communication among patient, providers and family caregivers
Transition
The process that a manager uses in assigning duties and responsibilities to a subordinate and giving the subordinate the authority necessary to accomplish the assignment
Delegation of Authority
Planned and systematic pattern of all actions necessary to ensure that services conform to established technical requirements or standards
Quality Assurance
Services to help people get back their mental (thinking and feeling) and physical (body) functions lost due to injury or illness. Rehabilitation may be given at the hospital or in a nursing home, special facility, or the patient’s home
Rehabilitation (Rehab)
Type of assisted living facility that provides 24-hour housing and services. In some states, residential care and assisted living facilities are regulated by the same state rules and regulations
Residential Care Homes
Step-by-step guides to action that establish a required method for handling activities
Procedures
Duty to have and to use the degree of knowledge and skill that is usually possessed and used by competent, prudent similar health care providers in like or similar circumstances
Standard of care
Income standard that the federal government issues annually that reflects increases in prices, measured by the Consumer Price Index
Federal Poverty Level
Nurse that works in a homecare environment (includes RNs and LPNs)
Home health Nurse
Physical or mental feature that may indicate a disorder or disease
symptom
Fair market value of property minus any liabilities on the property such as mortgages or loans
Equity value
Statement giving a broad, inspirational image of the future that an organization is aiming to achieve
Vision statement
The act of grieving someone’s death. The total response to death. Includes the process of recovery or healing from the death. Although there are similarities in the ways people respond to grief, there are also marked differences. each person will grieve in their own way and time
Bereavement
Preventative maintenance
Proper maintenance or equipment as designated by the manufacturer to ensure the continuing functioning of equipment, safely and properly
Licensure
Granting of a license to a provider that has been determined to meet a state’s requirements for operations
For Profit
An institution, corporation, or other legal entity that is organized for the profit or benefit of its shareholders or other owners
Telephone Reassurance Program
Purchased service to provide “reassurance calls” that check on the safety and well-being of older adults at home. These calls can also offer reminders (such as when to take medication)
Clinical Information System
Information technology that is designed to be used by various clinicians to support the delivery of patient (resident) care
State Operations Manual (SOM)
Current set of requirements and guidelines to surveyors. Current edition with changes in red can be downloaded from CS website, www.CMS.gov
Guardianship
Process in which the court-appointed guardian is named. The process may take a long time and is often complex and costly
Acuity
Acuteness, as of an illness. The greater the acuity, the more nursing care or other services that are needed
Foster Care Homes
A place where care and services are provided. The number of care recipients served in these homes may vary from state to state but they are usually designed to be a homelike setting
Companion
Serves a non-medical role in a patient’s life. Companion Care Services cater to seniors, new and expectant parents, and other individuals. Companions perform duties such as reminder services (medications, dates , routines) assisting with mobility, providing companionship, preparing meals and feeding, escorting to appointments, organizing and reading mail, entertaining, and more
Agency’s Initial Date of Medicare Certification
The date that Medicare officially determined that an agency meets federal requirements to provide home health care, hospice, or skilled nursing
Certified (Certification)
State government agencies inspect health care providers, including home health agencies, hospitals, nursing homes, and dialysis facilities, as well as other health care providers. These providers are approved or “certified” if they pass inspection. Medicare and Medicaid only cover care given by providers who are certified by Medicare. Being certified isn’t the same as being accredited
Resident Centered Care
Practices that encourage residents to be involved in making decisions about their care and daily activities; examples of resident-centered dietary functions include cook to order eating schedules, resident involved menu planning, and buffet style or family dining meal service
Home and Community Based Services (HCBS)
Services and service settings in the community, such as adult day services, home delivered meals, or transportation services, designed to help people stay in their homes as independently as possible. May serve a variety of targeted population groups, such as persons with mental illnesses, intellectual or developmental disabilities, and/or physical disabilities
Advisory Board
Group generally made up of members of a community to provide direction, feedback, and advice to top management in various advisory capacities as determined by the organization’s by-laws (term has various applications)
Quality Improvement
Method of evaluating and improving processes of care recipient care that emphasizes a multidisciplinary approach to problem solving and focuses not on individual’s but systems of care recipient care that might be the cause of variations
Exception
When a facility or agency requests a written variance to be granted/allowed from the local, state, or federal authority from a regulation or provision of rules. Examples of this could be: and exemption to a physical plant that does not meet new construction standards, and exemption to property taxes for a not for profit organization, and an exemption to receive a higher rate for medically complex care recipients
Charitable Remainder Trust
Special tax-exempt irrevocable trust written to comply with federal tax laws and regulations. You transfer cash or assets into the trust and may receive some income from it for life or a specified number of years(not to exceed 20). The minimum payout rate is 5 % and the maximum is 50% At your death, the remaining amount in the trust goes to the charity that you designated as part of the trust arrangement
Statement of Deficiency (SOD)
Written summary of noncompliance with regulations found during a provider survey or complaint investigation
General Medicaid Eligibility Requirements
There are many pathways to being eligible for Medicaid. For example, most states provide Medicaid to anyone who is receiving benefits under the Supplemental Security Income (SSI) Program, administered by the Social Security Administration. The SSI disability or aged 65 or older. A number of states provide Medicaid to older adults or persons with a disability with an income that is below 100 percent of the federal poverty level. However, in general you must be; a care recipient of the state in which you are applying, either a United States citizen or a legally admitted alien age 65 or over, or meet Medicaid’s rule for disability, or blind
Intermediate Care
(Also known as transitional care) Often takes place after a hospital visit but before an individual has recovered enough to take care of his or her self. It is meant to provide a measure of independence to the individual while he or she is still relatively dependent on someone else for care
Code of Federal Regulations (CFR)
The federal Congress passes laws for which implementing rules are written and enforced. These are The Federal Requirements and Guidelines to Surveyor; guidelines issued by the federal government interpreting how a given law is to be administered
Reverse Mortage
Type of loan based on home equity that enables older homeowners ( age 62 or older) to convert part of the equity in their homes into tax-free income without having to sell the home, give up title, or take on a new monthly mortgage payment. Instead of making monthly payments to a lender, as you do with a regular mortgage, a lender makes payments to you. The loan, along with financing costs and interest on the loan, does not need to be repaid until the homeowner dies or no longer lives in the home
Home-Delivered Meals (Meals on Wheels)
Meals brought to people who cannot prepare their own meals or are homebound (cannot leave their homes)
AAA
Area Agency on Aging
ADLs
activities of daily living
ADR
Adverse Drug Reaction
ADRCs
Aging and Disability Resource Centers
APS
Adult Protective Services
ADA
Americans with Disabilities Act
ALF
Assisted Living Facility
CAA
Care Assessment Area
CMS
Centers for Medicare and Medicaid Services
CNA
certified nursing assistant
CFR
Code of Federal Regulations
CCRC
Continuing Care Retirement Communities
CQI
Continuous Quality Improvement
DAVE
Data Assessment and Verification
DON
director of nursing
DNS
Director of Nursing Services
DNI
Do Not Intubate
DNR
Do Not resuscitate
DME
Durable Medical Equipment
DPOA
Durable Power of Attorney
EEOC
Equal Employment Opportunity Commission
FCSP
Family Caregiver Support Program
FMLA
Family Medical Leave Act
FDA
Food and Drug Administration
HIPAA
Health Insurance Portability and Accountability Act
HCBS
home and Community Based Services
HHA
Home Health Aide
ICF/IDD
Intermediate Care Facilities for Individuals with Intellectual Disabilities
LPN
Licensed Practical Nurse
LSC
Life Safety Code
LTC
Long-Term Care
MDS
Minimum Data Set
NFPA
National Fire Protection Association
NSAIDs
nonsteroidal Anti-Inflammatory Drugs
NP
Nurse Practitioner
SNF
Skilled Nursing Facilities
OSHA
Occupational Safety and Health Administration
OT
Occupational therapy
OBRA
Omnibus Budget Reconciliation Act of 1987
PEG
Percutaneouse Endoscopic Gastrotomy
PERS
Personal Emergency Response System
PIF
Personal Incidental Funds
PA
Physician Assistant
POLST
Physician Orders for Life-Sustaining Treatment
POC
plan of correction
PASRR
Preadmission Screening and resident Review
PCP
Primary Care Provider
QAPI
Quality Assurance Performance Improvement
RAI
Resident Assessment Instrument
RD
Registered Dietician
RN
registered Nurse
RPH
Registered Pharmacist
RPT
Registered Physical Therapist
RUGs
Resource Utilization groups
SDS
Safety Data Sheets
SHIP
State Health Insurance Program
SOM
State operations Manual
Supplemental Security Income
SSi
