Regulations Flashcards

Question

Rights - description personal funds

Answer 1

Description of manner of protecting personal funds - resident has right to manage their financial affairs, facility may not require resident to deposit personal funds with facility - upon written authorization facility must hold, safeguard, manage and account for personal funds of resident deposited with facility - funds over $50 must be deposited in interest bearing account separate from any facility operating acounts, in pooled accounts there must be separate accounting for each residents share - funds less than $50 in non-interest bearing accounts, interest bearing account, or petty cash fund - exception is Medicare SNF resident minimum is $100 to interest bearing account

Answer 2

Facility must establish and maintain system with full complete and separate accounting of each resident's personal funds entrusted to facility - must preclude any commingling of resident funds with facilitiy funds or funds of any person other than another resident - individual record must be available through quarterly statements and on request to resident or legal representative

Answer 3

Facility must notify each residents that receives Medicaid when amount in account reaches $200 less than SSI resource limit for 1 person - If amount in addition to value of residents other nonexempt resources reaches SSI resource limit for 1 person, the resident may lose eligibility for Medicaid or SSI

Answer 4

Upon death of resident with personal fund deposited with the facility, the facilty must convey within 30 days the resident's funds and final accounting of those funds to individual or probate jurisdiction administering the estate

Answer 5

The facilty must purchase a surety bond or toherwise provide assurance for the security of all personal funds of residents deposited with the facility

Answer 6

Facilty may not charge agains personal funds any item or services which payment is made under Medicaid or Medicare (except applicable deductible and coinsurance) - facility may charge for requested services more expensive than or in excess of covered services

Answer 7

Nursing services, dietary services, activitiy programs, room/bed maintenance, routine personal hygiene items and services (hair, soap, cleansing agents, razor, toothbrush, lotion, deodorant, incontinence, towels, OTC drugs, laundry, ect.), medically related social services

Answer 8

May be charged if requested by resident, if facility informs resident there will be charge and there is no MA or MC payment - telephone, personal TV/radio, personal comfort items (smoking, novelties, confections), cosmetic/grooming in excess of covered items, personal clothing, personal reading matter, gifts, flowers/plants, socal events and entertainment outside scope of activities programs, noncovered special care services (private nurse/aide), private room unless therapeutically required (isolation), specially prepared or alternative food instead of what is offered by facility

Answer 9

Facility must not charge resident for any item or service on requested by resident, facility may not require resident request any item or services as condition of admission or stay, facility must inform resident of charge for any item or service and what charge will be

Answer 10

description of requirements and procedures for establishing eligibility for Medicaid, including right to request and assessment which determines extent of couples non-exempt resources at the time of admission and attributes to the community spouse an equitable share of resources which can't be considered available for payment toward the cost of admitted spouses medical care in his or her process of Medicaid spending down

Answer 11

refers to system established to prtect and advocate the rights of individuals with developmental disabilities, and the prtection and advocacy system established under the protection and advocacy for mentally ill individuals act

Answer 12

posting of names, addresses, phone numbers to all pertinent state client advocacy groups such as State survey and certification agency, licensure office, ombudsman, protection and advocacy network, and Medicaid fraud control, and a statement that the resident my file a complaint with the agency concerting abuse, neglect, misappropriation of resident property and noncompliance with advance directives

Answer 13

Facilty must maintain written policies and procedures regarding advance directives, including provisions to inform and provide written information to all residents concerning the right to accept or refuse medical or surgical treatment and the individuals option, formulate an advance directive, including wirtten descripton of facilities policies to inplement advance directives and applicable State law

Answer 14

Facility must inform each resident of name, specialty and way to contact the physician responsible for their care

Answer 15

Facility must prominently display written information and provide residents and applicants for admission oral and written information about how to apply for and use Medicare and Medicaid benefits, and receive refunds for previous payments covered by such benefits

Answer 16

Facility must immediately inform resident; resident physician;legal representative; interested family member when - an accident involving resident which results in injury and has potential for physician intervention, significan change in physical, mental or psychosocial status, need to alter treatment significantly, decision to transfer or discharge resident from facility, change in room or roommate assignment, change in resident rights

Answer 17

Facility must record and periodically update adress and phone number of resident's legal representative or interested family member

Answer 18

Facility must have written authorization,

Answer 19

does not include dry cleaning, mending, washing by hand or other specialty services resident may be charged for these services

Answer 20

refers to combs, brush, shapmoo, trims, simple hari cuts provided by faciltiy staff as part of routine grooming, hair cuts, ect performed by beauticians not employed by facility may be charged

Answer 21

routine trimming, cleaning, filing and individually care for ingrown or damaged nails but not polishing of undamaged nails

Answer 22

Resident has right to choose peronal physician - however if physician fails to fulfill requirements, facility has the right after informing resident to seek alternate physician participation to assure provision of appropriate and adequate care/treatment, facility may not place barriers to resident choosing own physician, facility may require physician be choosed from ones with practice privileges at facility

Answer 23

Resident has right to privacy and confidentiality of personal and clinical records

Answer 24

includes accommondations, medical treatment, written and phone communications, personal care, visits, meetings of family and resident groups, does not require private rooms

Answer 25

Resident may approve or refuse release of personal and clinical records to any individual outside facility, right to refuse does not apply when resident is transferred to another health institution or release is required by law

Answer 26

Facility must keep all information in resident records regardless of form or storage except when release is required by - transfer to another health care institution, law, thrid party payment contract, the resident

Answer 27

Resident has right to voice grievances without descrimination or reprisal, including respect to treatment, furnished or not furnished

Answer 28

Prompt efforts by facility to resolve grievances including those regarding behavior of other residents

Answer 29

Resident has right to examine results of most recent survey, results placed readily accessible to residents and post notice of their availablility

Answer 30

resident has right to receive information from agencies and have the opportunity to contact these agencies

Answer 31

resident may refuse to perform services for facility, perform services for facility if they choose when - faciliyt documents the need or desire for work in plan of care, plan specifies the nature of services and if voluntary or paid, compensation for paid services are at or above prevailing wages, resident agrees to arrangement in plan of care

Answer 32

Resident has right to privacy in written communications, send and receive mail promptly and unopened, access to stationery, postage, writing implements at residents own expense

Answer 33

Delivery of mail to resident within 24 hours of delivery by postal service, delivery to postal service within 24 hours except when there is no scheduled postal delivery or pick up

Answer 34

Resident has right and facility must provide immediate access to any resident - any representative of the secretary, representative of the state, residents individual physician, ombudsman, agency responsible for protection for develpmentally disabled, agency responsible for protection of mentally ill, immediate family or other relatives, others who are visiting with consent of resident, reasonable access by any entity providing health, social, legal or other services to resident

Answer 35

Facility must allow ombudsman to examine resident's clinical records with permission of resident or representative

Answer 36

Resident has right to reasonable access to phone where calls are not overheard, reasonable access means phones at hright accessible to wheelchairs, adapting phones for impared hearing

Answer 37

Resident has right ot retain and use personal items including furnishing, appropriate clothing, as space permits unless it would infringe upon rights, health or safety of other residents

Answer 38

Resident has right to share room with spouse when in same facility and both consent, payment sources may prevent this, the facility is not required to compel another resident to relocate to accomidate a spouse

Answer 39

Resident may self administer durgs if the interdisciplinary team determines this is safe

Answer 40

Resident has right to refuse transfer to another room if purpose is to relocate - from SNF to non SNF room or NF to SNF room, refusal to transfer does not affect eligibility or entitlement to Medicare or Medicaid benefits

Answer 41

includes movement of resident to a bed outside of the certified facility whether that bed is in the same physical plant or not, transfer and discharge does NOT refer to movement of a resident to a bed within the same certified facility

Answer 42

moving the resident from the facility to another leggally responsible institutional setting, including moving resident from FN bed to SNF bed withing facility if they are under separate provider agreements

Answer 43

moving resident to a non-intitutional setting when the releasing facility ceases to be responsible for the residents care

Answer 44

may not transfer or discharge unless - is necessary to meet welfare and the welfare can't be met in facility, appropriate because health has improved services no longer needed, saftey of individuals in facility is endangered or would otherwise be endangered, resident has failed after notice to pay for stay, facility ceases to operate, any of these must be documented in clinical record, notice must be given including right to appeal

Answer 45

Endangerment to health or safety of others, resident's health improved to allow immedicate transfer or discharge, urgent medical needs, has not resided in facility for 30 days

Answer 46

If transfered for welfare or improved health documentation must be made by residents physician

Answer 47

Before transfer or discharge facility must - notify resident and if known family member or legal representative of transfer or discharge and reasons for move in writing and language they understand, record reasons in clinical record

Answer 48

Except in exception notice of transfer or discharge must be made by the facility at least 30 days before transfer or discharge

Answer 49

Written notice must include - reason for transfer or discharge, effective date, location to which resident is being transfered or discharged to, statement that resident has right to appeal to State, contact information for ombudsman, contact information for agency providing advocacy for developmentally disabilities, contact information for agency providing advocacy for mentally ill

Answer 50

Facility must provide sufficient preparation oand orientation to residents to ensure safe and orderly transfer or discharge

Answer 51

2 notieces required, first notice of bed-hold policies provides written infomration of duration of bed-hold policy under State plan may be issued ahead of time but must be reissued if State or facility bed-hold policy changes, second notice specifies duration of the bed-hold policy must be issued at time of transfer, in ER it must be provided with written notification within 24 hours of transfer requirement is met if notice is sent with other papers accompanying the resident to hospital

Answer 52

considered non-covered swervices which resident could use own income to pay ofr bed-hold, Non Medicaid residents may be requested to pay for all days of bed-hold

Answer 53

Facility must establish written policy which resident whose hospitalization or leave exceeds the bed-hold period under State plan, is readmitted to facility immediately upon first availablitliy of bed in semi-private room if resident requires services of facilty and is eligible for Medicaid facility services

Answer 54

facility must establish and maintain identical policies and practices regarding transfer, discharge and services under the State plan for all individuals regardless of source of payment

Answer 55

Facility may charge any amount for services frnished to non-Medicaid residents consistent with notice requirements and describing the charges

Answer 56

Facility must not require residents or potential residents to waive rights to Medicare or Medicaid, require oral or written assurance that they will not apply for Medicare or Medicaid

Answer 57

facility may not require third party guarantee of payment as condition of admission or stay however facility may require individual with legal access to residents income to pay for facility to sign contract with no personal financial liablility to provide payment from residents income

Answer 58

resident has right to be free from any physical or chemical restraints imposed for discipline or convenience and not required to treat the resident's medical symptoms

Answer 59

any manual method, physical or mechanical device, material, equipment attached or adjacent to resident's body that individual conat remove easily which restricts freedom oof movement or normal access to one's body

Answer 60

any drug that is used for disipline of convenience and not required to treat medical symptoms

Answer 61

any action taken by facility for the purose of punishing or penalizing residents

Answer 62

any action taken by the faciltiy to control a residents behavior or manage a residents behavior with a lesser amount of effort by the facility and not in the residents best interest

Answer 63

an indication or characteristic of a physical or psychological condition

Answer 64

resident has right to be free from verbal, sexual, physical, and mental abuse, corporal punishment and involuntary seclusion, from anyone

Answer 65

willful infliction of injury, unreasonable confinement, intimidation, or punishment with resultin gphysical harm, pain or mental anguish, this also includes the deprivation of an individual of goods or services necessary to attain or maintain well-being

Answer 66

useof oral, wirtten or gestured language that willfully includes disparaging and derogatory terms to residents or their families within their hearing distance,m regardless of age, comprehension or disability

Answer 67

sexual harassment, seual coercion, or sexual assault

Answer 68

hitting, slapping, pinching and kicking, controlling behavior thorugh corporal punishment

Answer 69

humiliation, harassment, threats of punishment or deprivation

Answer 70

separation of resident from other residents or from their room or to their room against residnts will, ER or short term selclusion may be permited if limied time and as therapeutic intervention to reduce agitation until plan of care to meet needs is made

Answer 71

facility must develop and implement written polices and procedures that prohibit mistreatment, neglect and abuse of residents and misappropriation of property

Answer 72

failure to provide goods and services necessary to avoid physical harm, mental naguish, or mental illness

Answer 73

deliberage misplacement, exploitation, or wrongful, temporary or permanent use of resident's belongings or money withouth the resident's concent

Answer 74

screening, training, prevention, identification, investigation, protection and reporting/response

Answer 75

screen potential emplloyees for history of abuse, neglect, mistreating residents through references, checking licensure, registires

Answer 76

through orientation, sessions on issues about abuse, appropriate interventions for aggressive or catastrophic reactions of residents, how to report allegations, how to recognize burnout, frustration, stress, what constitutes abuse, neglect, misappropriation

Answer 77

Provide information to reseidents, families and staff on how and whom to report concerns, incidents, grievances and provide feedback regarding concerns expressed, analysis of phsical environment such as secluded areas, deployment of staff in sufficient numbers to meet needs of residents, supervision of staff to identify inappropriate behaviors, assessment, care planning and monitoring of resident swit hneeds and behaviors which might lead to conflict or neglect such as residents with agressive behaviors, self-injurious behaviors, communication disorders, heavy nursing care

Answer 78

Identify events such as bruising of residents, occurrences, patterns and treands

Answer 79

have procedures to investigate different types of incidents, identify staf memeber responsible for inititial reproting, investigation of alleged violations and reporting of results to authorities

Answer 80

Procedures to protect residents from harm during investigation

Answer 81

Procedures to reprot all alleged violations and substantiated incidents to state agency and other agencies as required, and take corrective actions depending on results, reprot to nurse aide registry or licensing authorities any knowledge of any actions by court of law indicating employee unfit for service, determine what changes are needed if any to prevent further occurances

Answer 82

Facility must not employ individuals found guilty o fabuse, neglect or mistreating residents by court of law, or have finding entered into State nurse aide registry concerning abuse, neglect, mistreatment of residents or misappropriation of property

Answer 83

determination made by State that validates allegations of abuse, neglect, mistreatment of residents, or misappropriation o ftheri property

Answer 84

All investigation results must be reported within 5 working days of the incident and if the alleged violation is verified appropriate corrective action must be taken

Answer 85

Facility must have evidence that all alleged violations are throughly investigated and must prevent further potential abuse while investigation is in progress

Answer 86

Both conditions met - source of injury not observed by any person or the source could not be explained by the resident AND injury is suspicious because of extent of injury or the location or number of injuries observed at one particular point in time, or the incidence of injuries over time

Answer 87

As soon as possible but out not exceed 24 hours after discovery of incident

Answer 88

Facility must care for its residents in a manner and environment that promotes maintenance or enhancement of each resident's quality of life

Answer 89

Facility must promote care for residents in manner and environment that maintains or enhances each residents dignity and respect in full recognition of their individuality

Answer 90

grooming as resident wishes, dressing in own clothes, attending activities of choosing, labeling clothing respectfully, avoiding plastic cutlery, paper dishware, bibs instead of napkins, staff standing over residents to help eat, staff talking to each other rather than residents, respecting residnts space and property, speaking respectfully to residents, avoiding labels for residents, addressing residents as individuals when providing care, focusing on residents, maintaining environment with no signs posted in resident rooms or public including personal or confidential information, cover catheter bags, comply with toileting assistance requests, restricting from use of common areas

Answer 91

Resident has right to - choose activities, schedules, and health care consistant with interests, assessments and plans of care, interact with members of community in and out of facility, make choices about life in facility that are significant to resident

Answer 92

Resident has right to organize and participate in resident groups, family has right to meed in facility with other families, facility must provide private space for these meetings, staff or visitors may attend with invitation, facility must provide staff responsible for assistance and responding to requests from group, facility must lesten to and act upon grievances and recommendations of group

Answer 93

group that meets regularly to discuss and offer suggestions about facility policies and procedures affecting residents care, treatment and quality of life, support each other, plan activities, participate in educational activities, for any other purpose

Answer 94

Not requried, however must be allowed without interferance if desired, facility must listen to recommendations and grievances, facility does not have to accede to recommendations but must seriously consider recomendations and attampt to accomodate to the extent practiable, facility should communicate decisions to group

Answer 95

Resident has right o participate in social, religious, and community activities that do not interfere with right s of other residents in facility

Answer 96

Resident has right to reside and receive services in faciltiy with reasonable accomodations on needs and preferences, except when health or safety of the individual or another would be endangered

Answer 97

Resident has right to receive notice before the residents room or roommate in the facility is changed

Answer 98

Facility must provide ongoing program of activities designed to meet, in accordance wiht assessment the interests, physical, mental and psychosocial well-being of each resident

Answer 99

any endeavor, other than routine ADL's that resident participates in intended to enhance the sense of well-being and promote or enhance physical, cognitive and emotional health

Answer 100

programming provided to residents who will not or cannot plan their own activities pursuits or residents needing specialized or extended programs to enhance their daily routine and activities

Answer 101

idea that each resident has personal identity and history that involves more than just their medical illnessess or functional impairments, Activities should be relevant to specific needs, interests, culture, background o fthe individual whom they are developed

Answer 102

combination of large and small group, one-to-one and self directed activities and a system that supports the development, implementation and evaluation of the activies provided to the residents

Answer 103

involves identification o fresident's interestes, preferences and abilities and any issues concerns, problems or needs affecting resident involvement in activities, information may also be found in separate activity plan , on CNA flow chart, in progress notes

Answer 104

Should be based on measurable objectives and focused on desired outcomes, not merely on attendance at certain number of activies per week

Answer 105

Qualified therapeutic recreation specialist or activities professional who - licensed or registered if applicable by State, eligible for certification as therapeutic recriation specialist or activities professional by accrediting body or has 2 years experience in social or recreational program within last 5 years, 1 of which was full time in patient activities program in health care setting, or qualified occupational therapist or occupational therapy assistant or completed training course approved by State

Answer 106

Facility must provide medically related social services to attain or maintain the highest practicable physical, mental, and psychosocial well being of each resident

Answer 107

services provided by the facilities staff to assest residents in maintaining or improving their ability to manage their everyday physical, mental, and psychosocial needs

Answer 108

arrangements for adaptive equpment, clothing, personal items, reproting changes, encouragement to participate in care planning, assisting to inform about health status and health care choices, referrals and obtaining outside services, assisting with financial and legal matters, discharge planning services, arranging or providing counseling services, support individual needs, enhancing and maintinging resident dignity, providing alternatives to drug herapy or restraints, options to help physical and emotional needs,

Answer 109

facility with more than 120 beds must employ qualified social worker full time

Answer 110

bachelors degree in social work or human services field - sociology, special education, rehabilitation, counseling, psychology and 1 year supervised social work experience in health care setting working directly with individuals

Answer 111

Facility must provide safe, clean, comfortable and homelike environment allwing the resident to use his or her personal belongings to the extent possible

Answer 112

one tha tde-emphasizes the institutional character of the setting to the extent possible and allows the resident to use those personal belongings that support a homeloke environment.

Answer 113

Services are necessary to maintain a nsanitary, orderly, and comfortable interior

Answer 114

includes but not limited to, preventing spread of disease by keeping resident care equipment clean and properly stored

Answer 115

an uncludttered pahysical environment that is neat and well-kept

Answer 116

Clean bed and bath linens that are in good condition

Answer 117

Adequate and comfortable lighting levels in all areas

Answer 118

levels of illumination suitable to tasks the resident chooses to perform or the facilty staff must perform

Answer 119

minimizes glare and provides maximum resident control, where feasible, over th eintensity, location and direction of illumination so tha tvisually impaired residents can maintain or enhance independent functioning

Answer 120

the ambient temperature should be a narrow range that minimizes susceptibity to loss of body heat and risk of hypothermia range between 71 - 81 degrees

Answer 121

levels that do not interfere with resident's hearing and enhance privacy when provacy is desired and encourage interaction when social participation is desired, particular concern is to resident's control over unwanted noise

Answer 122

At time resident is admitted the facility must have physician orders for residents immediate care

Answer 123

Facility must conduct initially and periodically a comprehensive accurate standardized reproducible assessment of each residents functional capacity

Answer 124

written orders faciltiy needs to provide essential care to resident consistent with residents mental and physical stauts upon admission including at leave dietary, drugs, routine care

Answer 125

to provide facility with information to develop care plan to provide appropriate care and services and to modify care plan based on residents status

Answer 126

facility must make comprehensive assessemnt of residents needs using RAI specified by the State

Answer 127

``` identification and demographic info customary routine cognitive patterns communication vision mood and behavior patterns psychological well-being physical functioning and stuctural problems continence disease diagnosis and health conditions dental and nutritional status skin conditions activity pursuit medications special treatments and procedures discharge potential documenation of participation in assessment documentation of summary information regarding the additional assessment on care areas triggered by completion on MDS ```

Answer 128

information regarding residents usual community lifestyle and daily routine in the year prior to date of entry to nursing home

Answer 129

residents ability to problem solve, decide, remember, and be aware of and respond to safety hazards

Answer 130

ability to hear, understand others, make understood

Answer 131

visual acutity, limitations and difficulties and appliances used to enhance vision

Answer 132

residents patterns of mood an dbehavioral symptoms

Answer 133

resident's positive or negative feelings about self or social relationships

Answer 134

residents physical functional status, ability to perform activities of daily living and residents need for staff assistance and assistive devices or equipment to maintain or improve fuctional abilities

Answer 135

residents patterns of bladder and bowel continence pattern of elimination and appliances used

Answer 136

condition of teeth, gums an dother sturctures of oral cavity that may affect residents nutritional status, commuication or quality of life

Answer 137

weight, height, hematologic and biochemical assessments, clinical observations of nutrition, nutritional intake, residents eating habits and preferences, dietary restirctions, supplements and use of applances

Answer 138

residents development or risk of development of pressure sores

Answer 139

resident's ability and desire to take part in activities which maintain or improve, physical, mental and psychosocial well-being

Answer 140

all prescription and over-the-counter medications taken by resident including dosage, frequency of administration and recognition of sidnificant side effects most likely to occur - this does not need to be in assessment but must be in clinical record and care plan

Answer 141

treatments and procedures not part of basic services provided

Answer 142

facilities expectation of dischargeing resident from facility within next 3 months

Answer 143

who participated in assessment process, including direct observation and communcation with resident as well as with licensed and nonlicensed care staff

Answer 144

14 calendar days after admission excluding readmissions in which there is no significant change in physical or mental condition

Answer 145

14 days after determines or should have determined there has been significan change in physical or mental condition

Answer 146

Major decline or improvement in residents status that will not normally resolve itself without further intervention by staff or by implementing standard disease-related clinical interventions that has an impact on more than one area of the residents health status, and requires interdisciplinary review or revision of the care plan

Answer 147

resident elects, and revokes hospice benefit | if decline or improvement is consistently noted in 2 or more areas of decline or improvement

Answer 148

Must be completed within 366 days after the ARD of most recent comprehensive resident assessment

Answer 149

Facility must assess resident using quarterly review instrument specified by State not less than once every 3 months

Answer 150

Assessement reference date

Answer 151

facility must maintain all resident assessments completed within the previous 15 months in the residents active record

Answer 152

after 15 month period RAI information may be thinned from clinical record and stored provided it is easily retrievable if requested

Answer 153

Within 7 days after factility completes residents assessment facility must encode: admission assessment, annual assessment updates, sidnificant change in status assessments, quarterly review assessments, subset of items upon transfer, reentry, discharge and death, background infomration if no admissionm assessment for each resident in facility

Answer 154

7 days after assessment completed facility must be capable of transmitting, must be transmitted withing 14 days after assessment completed

Answer 155

Facility must electronically transmit at least monthly MDS data to state for all assessments conducted during previous month

Answer 156

Facility must transmit data in format specified or approved by CMS

Answer 157

Entering MDS infomration into computer

Answer 158

electronically sending encoded MDS from the facility to teh QIES ASAP system

Answer 159

facility has encoded and edited according to CMS specifications, the record accurately reflects residents overall clinical status

Answer 160

Encoded responses to MDS items are consistent and within range in accordance with CMS standards

Answer 161

Assessment must accurately reflect the residents status

Answer 162

the appropriate, qualified health professional correctly documents the resident's medical, functional, psychosocial problems and identifies resident strengths to maintain or improve medical status, functional and psychosocial problems and identifies resident strengths to maintain or improve status, intitial comprehensive assessment provides baseline data for ongoing assessment

Answer 163

RN must conduct or coordinate each assessment wiht the appropriate participation of health professionals

Answer 164

RN must sign and certify that assessment is completed, each individual who completes portion of assessment must sign and certify the accuracy of that protion of assessment

Answer 165

CMS any person who certifies a material and false statment in assessment is subject to penalty of not more than $1,000 per assessement, or causes another to certify a false statment in assessment is subject to penalty of not more than $5,000 per assessment - Clinical disagreement does not constitute a material and false statement

Answer 166

Facility must develop care plan that includes measureable objectives and timetables to meet residents medical, nursing, mental and psychosocial needs that are identified in comprehensive assessment

Answer 167

services that are to be furnished to attain or maintain highest practicable physical, mental, and psychosocial well being, any services that would be provided but are not provided due to residents right to refuse

Answer 168

care area assessment

Answer 169

should show evidence of residents status triggered in CAA areas, facilities rationale for deciding whether to proceed with care planning, evidence thta facility considered the development of care planning interventions for all CAA's triggered by MDS

Answer 170

Resident has right unless adjudged incompetent or incapacitated under State law to participate in planning care and treatment or changes in care or treatment

Answer 171

Resident is afforded opportunity to select from alternative treatments, this applies to both initial dcisions and changes in care and treatments

Answer 172

developed within 7 days after completion of comprehensive assessment

Answer 173

prepared by interdisciplinary team including: attending physician, RN with resonsibilities for resident, other appropriate staff in disciplines as determined by residents needs, resident, residents family or legal representative as practicable

Answer 174

periodically reviewed and revised by team of qualified persons after each assessment

Answer 175

Meet professional standards of quality and be provided by qualified persons in accordance with each residents plan of care

Answer 176

services that are provided according to accepted standards of clinical practice

Answer 177

when facility anticipates discharge resident must have discharge summary that includes - recapitulation of resident stay, final summary of resident status including items in assessment, post-discharge plan of care

Answer 178

facility must coordinate assessments with pre-admission screening and resident review program under Medicard to avoid duplicative testing and effort

Answer 179

Facility must not admit new residents with Mental illness or mental retardation, unless State authority has determined that physical and mental condition requires level of services in nursing facility and if individual requres specialized services for mental retardation

Answer 180

Services the State is required to provide or arrange for that raise the intensity of services to the level needed by resident, they are an add-on to NF services and are hight intensity than rehabilitation services provided by NF

Answer 181

If they are certified by physician prior to admission to require NF stay less than 30 days and require care at nursing facility for same condition for which they were hospitalized

Answer 182

facility must ensure that resident obtains optimal improvement or does not deteriorate within the limits of residents right to refuse treatment and limits of the normal aging process

Answer 183

ulceration that occurs as the result of arterial occlusive disease when non-pressure related disruption or blockage of the arterial blood flow to an area causes tissue necrosis

Answer 184

open lesion of skin and subcutaneous tissue of lower leg

Answer 185

resident must be diagnosed with diabetes mellitus and have peripheral neuropathy

Answer 186

Activities of daily living - bathe, dress and groom, transfer and ambulate, toilet, eat, use speech, language or other functional communication systems

Answer 187

Based on comprehensive assessment facility must ensure that residents ADL abilities do not diminish unless it is part of the clinical condition that was unavoidable

Answer 188

Resident completed activity with no help or staff oversight, or help/oversight only 1 or 2 times in prior 7 days

Answer 189

Oversight encouragement or cuing provided 3 or more times during last 7 days or supervision + physical assistance provided 1 or 2 times in last 7 days

Answer 190

Resident highly involved in activity and received physical hlep in guided maneuvering of limbs and/or other non-weight bearing assistance 3 or more times in last 7 days

Answer 191

While resident performed part of activity over last 7 days help of either was provided 3 or more times - either weight bearing support 3 or more times or full staff performance of activity during part of last 7 days

Answer 192

Full staff performance of an activity with no participation by resident for any aspect of the ADL, resident was unwilling or unable to perform any part of the activity over entire last 7 days

Answer 193

Resident is given appropriate treatement and services to maintian or improve abilitities for ADL's

Answer 194

Resident who is unable to carry out ADL's receives necessary services to maintain good nutrition, grooming and personal and oral hygiene

Answer 195

Resident receives proper treatment and assistive devices to maintain vision and hearing abilities facility must make appointments and arrange for transportation to the appointments

Answer 196

Based on comprehensive assessment facility must ensure that resident who enters facility without pressure sores does not develop pressure sores unless clinical condition demonstrates they were unavoidable

Answer 197

Based on comprehensive assessment facility must ensure resident having pressure sores receives necessary treatment and services to promote healing, prevent infection and prevent new sores from developing

Answer 198

any lesion caused by unrelieved pressure tha tresults in damage to the underlying tissue, although friction and shear are not primary causes they are important contributing factors to development

Answer 199

resident developed pressure ulcer and facility did not do one or more of the following: define and implement interventions consistent with resident needs, goals and recogized standards of practice, monitor and evaluate impact of interventions or revise interventions as appropriate

Answer 200

resident developed pressure ulcer even though facility had evaluated clinical condition and risk factors, defined and implemented interventions consisitent with needs, goals, recognized standards of practice, monitored and evaluated impact of interventions and revised approaches as appropriate

Answer 201

use of appropriate device and solution to clean surfacxe of wound bed and remove foreign debris or contaminants in order to decrease microbial growth

Answer 202

type of mechanical debridement which uses appropriate solution delivered under pressure to the wound bed to remove debris from wound bed

Answer 203

presence of bacteria on the surface or in the tissue of a wound without signs and symptoms of infection

Answer 204

presence of micro-organisms in sufficient quanitity to overwhelm defenses of viable tissues and produce the signs and symptoms of infection

Answer 205

removal of devialized/necrotic tissue and foreign matter from a wound to improve or facilitate the healing process

Answer 206

use of moisture retentive dressings to cover a wound and allow devitalized tissue to self digest by action of enzymes present in wound fluids

Answer 207

topical application of substances to break down devitalized tissue

Answer 208

removal of foreign material and devitalized or contaminated tissue from wound by phyical rather than chemical or autolytic means

Answer 209

removal of foreign material or deviatlized tissue by surgical instrument

Answer 210

sterilie intentional biological debridement using sterile maggots to clean wounds by dissolving the dead and infected tissue and killing bacteria

Answer 211

thick leathery, frequently black or brown in color necortic or deviatlized tissue that has lost its usual physical properties and activity, may be loose or firmly adhered to the wound

Answer 212

necrotic tissue in process of separating from the viable portions of the body usually light colored, soft, moist and stringy

Answer 213

any fluid that has been forced out of the tissues or capillaries because of inflamation or injury, may contain serum, cellular debris, bacteria and leukocytes

Answer 214

any product of inflammation that contains pus

Answer 215

watery, clear or slightly yellow/tan/pink fluid that has separated from teh blood and presents as drainage

Answer 216

mechanical force exerted on skin that is dragged across any surface

Answer 217

indication of both gravity and friction against the surfact of the skin, shearing occurs when layers of skin rub against each other or when the skin remains stationary and the underlying tissue moves and stretches and angulates or tears the underlying capillaries and blood vessels causing tissue damage

Answer 218

pink-red moist tissue that fills an dopen wound when it starts to heal

Answer 219

passageway of tissue destruction under the skin surfact that has an opening at the skin level from the edge of the wound

Answer 220

cavity or channel underlying a wound that involves an area larger than the visible surface of the wound

Answer 221

destruction of tissue or ulceration extending under th eskin edges so that the pressur ulcer is larger at its base than at the skin surgace, often develops from shearing forces and is different from tunneling by the larger extent of the wound edge involved in undermining an the absenceof a channel or tract extending from the pressure ulcer under th adjacent intact skin

Answer 222

observable pressure related alteration of intact skin whose indicators as compared to another area my include changes in skin temp, tissue consistency, sensation, defined area of persistent redness, red, blue, purple hues

Answer 223

Partial thickness loss of dermis presenting as a shallow open ulcer with red pink wound bed without slough, may also present as intact or ruptured blister

Answer 224

Full thickness tissue loss, subcutaneous fat may be visible but bone, tendon, or muscle is not exposed, slough may be present but does not obscure the depth of tissue loss, may include undermining or tunneling

Answer 225

Full thickness tissue loss with exposed bone, tendon or muscle slough or eschar may be present on some parts of the wound bed, often includes undermining and tunneling

Answer 226

Based on comprehensive assessment facility must ensure resident who enters facility without an indwelling catheter is not catheterized unless the residents clinical condition demonstrates that catheterization was necessary

Answer 227

Based on comprehensive assessment facility must ensure resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections and restore as much normal bladder function as possible.

Answer 228

Immediate jeopardy to resident health or safety, facility has caused or is likely to cause serious injury, harm, impairment or death and requires imediate correction

Answer 229

Immediate jeopardy to resident health or safety, facility has caused or is likely to cause serious injury, harm, impairment or death and requires imediate correction

Answer 230

Actual harm that is not immediate jeopardy, noncompliance that results in actual harm and can include clinical compromise, decline, or residents ability to maintain and/or reach hights practicable well being

Answer 231

Actual harm that is not immediate jeopardy, noncompliance that results in actual harm and can include clinical compromise, decline, or residents ability to maintain and/or reach hights practicable well being

Answer 232

No actual harm with potential for more than minimal harm that is not immediate jeopardy, results in resident outcome of no more than minimal discomfort and has potential to compromise hightest practicable level of well being, potential for greater harm if interventions are not provided

Answer 233

No actual harm with potential for more than minimal harm that is not immediate jeopardy, results in resident outcome of no more than minimal discomfort and has potential to compromise hightest practicable level of well being, potential for greater harm if interventions are not provided

Answer 234

No actual harm with potential for minimal harm

Answer 235

No actual harm with potential for minimal harm

Answer 236

Facility must ensure that resident who enters facility without limited range of motion does not experience reduction in range of motion unless clinical condition demonstrates that reduction is unavoidable

Answer 237

Facility must ensure that resident who enters facility without limited range of motion does not experience reduction in range of motion unless clinical condition demonstrates that reduction is unavoidable

Answer 238

Factility must ensure resident with limited range of motion receives appropriate treatment and services to increase range of motion and prevent further decrease

Answer 239

Factility must ensure resident with limited range of motion receives appropriate treatment and services to increase range of motion and prevent further decrease

Answer 240

extent of movement of joint

Answer 241

extent of movement of joint

Answer 242

Based on assessment facility must ensure resident who displays mental or psychosocial adjustment difficulty receives appropriate treatment and services to correct the assesed problem

Answer 243

Based on assessment facility must ensure resident who displays mental or psychosocial adjustment difficulty receives appropriate treatment and services to correct the assesed problem

Answer 244

ensure they do not display a pattern of decreased social interaction and/or decreased social interaction, increased withdrawal, anger, depressive behaviors unless clinical condition demonstrates such pattern is unavoidable

Answer 245

ensure they do not display a pattern of decreased social interaction and/or decreased social interaction, increased withdrawal, anger, depressive behaviors unless clinical condition demonstrates such pattern is unavoidable

Answer 246

refers to problems residents have in adapting to changes in lifes circumstances

Answer 247

refers to problems residents have in adapting to changes in lifes circumstances

Answer 248

Facility must ensure resident who has been able to eat alone or with assistance is not fed by naso gastric tube unless clinical condition demonstrates useof tube was unavoidable

Answer 249

Facility must ensure resident who has been able to eat alone or with assistance is not fed by naso gastric tube unless clinical condition demonstrates useof tube was unavoidable

Answer 250

Facility must ensure resident fed by tube receives appropriate treatment and services to prevent aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal pharyngeal ulcers and to restore if possible normal eating skills

Answer 251

Facility must ensure resident fed by tube receives appropriate treatment and services to prevent aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal pharyngeal ulcers and to restore if possible normal eating skills

Answer 252

any unexpected or unintentional incident which may result in illness or injury to resident

Answer 253

any unexpected or unintentional incident which may result in illness or injury to resident

Answer 254

accident occurred because facility failed to: identify hazard, evaluate hazard, implement interventions, monitor effectivness of interventions

Answer 255

accident occurred because facility failed to: identify hazard, evaluate hazard, implement interventions, monitor effectivness of interventions

Answer 256

accident occurs despite facility efforts to identify hazards, evaluate hazards, implement interventions, monitor effectiveness of interventions

Answer 257

accident occurs despite facility efforts to identify hazards, evaluate hazards, implement interventions, monitor effectiveness of interventions

Answer 258

Facility must ensure that resident environment remains as free of accident hazards as possible and that each resident receives adequate supervision and assistance devices to prevent accidents

Answer 259

Facility must ensure that resident environment remains as free of accident hazards as possible and that each resident receives adequate supervision and assistance devices to prevent accidents

Answer 260

top layer of skin (minor sunburn), red and painful to touch skin will show mild swelling

Answer 261

top layer of skin (minor sunburn), red and painful to touch skin will show mild swelling

Answer 262

first two layers of skin, deep reddening of skin, pain, blisters, glossy appearance from leaking fluid possible loss of skin

Answer 263

first two layers of skin, deep reddening of skin, pain, blisters, glossy appearance from leaking fluid possible loss of skin

Answer 264

penetrate the entire thickness of the skin permanently destroy tissue, loss of skin layers, often painless, may appear charred or patches that appear white, brown or black

Answer 265

penetrate the entire thickness of the skin permanently destroy tissue, loss of skin layers, often painless, may appear charred or patches that appear white, brown or black

Answer 266

100F or 37C

Answer 267

100F or 37C

Answer 268

Life Safety Code prohibits use in resident areas

Answer 269

Life Safety Code prohibits use in resident areas

Answer 270

Should not take place of adequate wiring, should be properly secured, not placed overhead, under carpets or rugs, anywhere it can cause trips, falls, or overheat, connected to only one device, not have grounding device removed

Answer 271

Should not take place of adequate wiring, should be properly secured, not placed overhead, under carpets or rugs, anywhere it can cause trips, falls, or overheat, connected to only one device, not have grounding device removed

Answer 272

may be used for computer, monitor and printer, not used with medical devices, placed to prevent tripping

Answer 273

may be used for computer, monitor and printer, not used with medical devices, placed to prevent tripping

Answer 274

Facility must ensure that resident maintains acceptable parameters of nurtitional status such as body weight and protein levels, unless the residents clinical condition demonstrates that this is not possible adn receives a therapeutic diet when there is a nutritional problem

Answer 275

Facility must ensure that resident maintains acceptable parameters of nurtitional status such as body weight and protein levels, unless the residents clinical condition demonstrates that this is not possible adn receives a therapeutic diet when there is a nutritional problem

Answer 276

Facility must provide each resident with sufficient fluid intake to maintain proper hydration and health

Answer 277

Facility must provide each resident with sufficient fluid intake to maintain proper hydration and health

Answer 278

Injections, Parenteral and enteral fluids, colostomy, ureterostomy, illeostomy care, tracheostomy care, tracheal suctioning, respiratory care, foot care, prostheses

Answer 279

Injections, Parenteral and enteral fluids, colostomy, ureterostomy, illeostomy care, tracheostomy care, tracheal suctioning, respiratory care, foot care, prostheses

Answer 280

Each resident drug regimen must be free from unnecessary drugs: excessive dose, excessive duration, without adequate monitoring, without adequate indications for its use, presence of adverse consequences, combination of any above

Answer 281

Each resident drug regimen must be free from unnecessary drugs: excessive dose, excessive duration, without adequate monitoring, without adequate indications for its use, presence of adverse consequences, combination of any above

Answer 282

Preparation or administration of drugs or biologicals which is not in accordance with physicians orders, manufacturers specifications, accepted professional standards and principles

Answer 283

Preparation or administration of drugs or biologicals which is not in accordance with physicians orders, manufacturers specifications, accepted professional standards and principles

Answer 284

One which causes the resident discomfort or jeopardizes health or safety

Answer 285

One which causes the resident discomfort or jeopardizes health or safety

Answer 286

Facility must ensure that the medication error rate is 5% or less and that residents are free of any significant medication errors

Answer 287

Facility must ensure that the medication error rate is 5% or less and that residents are free of any significant medication errors

Answer 288

Immediate jeopardy to resident health or safety, facility has caused or is likely to cause serious injury, harm, impairment or death and requires imediate correction

Answer 289

Actual harm that is not immediate jeopardy, noncompliance that results in actual harm and can include clinical compromise, decline, or residents ability to maintain and/or reach hights practicable well being

Answer 290

No actual harm with potential for more than minimal harm that is not immediate jeopardy, results in resident outcome of no more than minimal discomfort and has potential to compromise hightest practicable level of well being, potential for greater harm if interventions are not provided

Answer 291

No actual harm with potential for minimal harm

Answer 292

Facility must ensure that resident who enters facility without limited range of motion does not experience reduction in range of motion unless clinical condition demonstrates that reduction is unavoidable

Answer 293

Factility must ensure resident with limited range of motion receives appropriate treatment and services to increase range of motion and prevent further decrease

Answer 294

extent of movement of joint

Answer 295

Based on assessment facility must ensure resident who displays mental or psychosocial adjustment difficulty receives appropriate treatment and services to correct the assesed problem

Answer 296

ensure they do not display a pattern of decreased social interaction and/or decreased social interaction, increased withdrawal, anger, depressive behaviors unless clinical condition demonstrates such pattern is unavoidable

Answer 297

refers to problems residents have in adapting to changes in lifes circumstances

Answer 298

Facility must ensure resident who has been able to eat alone or with assistance is not fed by naso gastric tube unless clinical condition demonstrates useof tube was unavoidable

Answer 299

Facility must ensure resident fed by tube receives appropriate treatment and services to prevent aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal pharyngeal ulcers and to restore if possible normal eating skills

Answer 300

any unexpected or unintentional incident which may result in illness or injury to resident

Answer 301

accident occurred because facility failed to: identify hazard, evaluate hazard, implement interventions, monitor effectivness of interventions

Answer 302

accident occurs despite facility efforts to identify hazards, evaluate hazards, implement interventions, monitor effectiveness of interventions

Answer 303

Facility must ensure that resident environment remains as free of accident hazards as possible and that each resident receives adequate supervision and assistance devices to prevent accidents

Answer 304

top layer of skin (minor sunburn), red and painful to touch skin will show mild swelling

Answer 305

first two layers of skin, deep reddening of skin, pain, blisters, glossy appearance from leaking fluid possible loss of skin

Answer 306

penetrate the entire thickness of the skin permanently destroy tissue, loss of skin layers, often painless, may appear charred or patches that appear white, brown or black

Answer 307

100F or 37C

Answer 308

Life Safety Code prohibits use in resident areas

Answer 309

Should not take place of adequate wiring, should be properly secured, not placed overhead, under carpets or rugs, anywhere it can cause trips, falls, or overheat, connected to only one device, not have grounding device removed

Answer 310

may be used for computer, monitor and printer, not used with medical devices, placed to prevent tripping

Answer 311

Facility must ensure that resident maintains acceptable parameters of nurtitional status such as body weight and protein levels, unless the residents clinical condition demonstrates that this is not possible adn receives a therapeutic diet when there is a nutritional problem

Answer 312

Facility must provide each resident with sufficient fluid intake to maintain proper hydration and health

Answer 313

Injections, Parenteral and enteral fluids, colostomy, ureterostomy, illeostomy care, tracheostomy care, tracheal suctioning, respiratory care, foot care, prostheses

Answer 314

Each resident drug regimen must be free from unnecessary drugs: excessive dose, excessive duration, without adequate monitoring, without adequate indications for its use, presence of adverse consequences, combination of any above

Answer 315

Preparation or administration of drugs or biologicals which is not in accordance with physicians orders, manufacturers specifications, accepted professional standards and principles

Answer 316

One which causes the resident discomfort or jeopardizes health or safety

Answer 317

Facility must ensure that the medication error rate is 5% or less and that residents are free of any significant medication errors

Answer 318

Ensure resident receives education regarding benefits and side effects, offered between Oct 1 and March 31 unless contraindicated or already immunized, has the opportunity to refuse, that medical record documents education, and immunization received, contraidicated, refused

Answer 319

Ensure resident receives education regarding benefits and side effects, offered unless contraindicated or already immunized, has the opportunity to refuse, that medical record documents education, and immunization received, contraidicated, refused

Answer 320

Facility must have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well being of each resident

Answer 321

Facility must designate a licensed nurse to serve as charge nurse on each tour of duty

Answer 322

Facility must designate a registered nurse as director of nursing on a full time basis, DON may serve as change nurse only when the facility has an average daily occupancy of 60 or fewer residents

Answer 323

Facility must use services of registered nurse for at lease 8 consecutive hours a day, 7 days a week

Answer 324

State may waive if: facility demonstrates that it is unable, despite diligent efforts to recruit, waiver will not endanger health or safety of residents, an RN or physician is obligated to respond immediately to calls from facility. Waiver granted subject to annual Stte review, may require other qualified licensed personnel be used, notice of waiver provided to Obudsman, residents notified of waiver

Answer 325

State may waive if: facility is located in rural area and supply of SNF in area not sufficient to meet needs in area, facility has one full time RN regularly on duty 40 hours, only has patients whos Dr have indicated in writing they do not require services of RN or MD for more than 48 hours, or has made arrangements for RN or MD to spend time at facility as necessary to provide SN on days when RN not on duty, notice given to ombudsman, residents notificed, subject to annual renewal

Answer 326

Facility must post daily - facility name, current date, total number and actual hours worked by RN, LPN, CNA's, resident census, it must be in clear readable format, in prominent place accessible to residents and visitors, must maintain posted data for minimum of 18 months

Answer 327

Facility must provide resident with nourishing, palatable, well balanced diet that meets daily nutritional and special dietary needs of each resident

Answer 328

Facility must employ a qualified dietitian either full, part time or as a consultant

Answer 329

If qualified dietitian is not employed full time faclity must designate a person to serve as director of food service who receives frequently sceduled consultation from qualified dietitian

Answer 330

Qualified based upon either registration by the Commission on Dietetic Registration of the American Deitetic Association or on the basis of education, training, or experience in identification of dietary needs, planning and implementation of dietary programs

Answer 331

enough staff to preparte and serve palatable, attractive, nutritionally adequate meals at proper temperatures and appropriate times and support proper sanitary techniques being utilized

Answer 332

Must meet the needs of the residents in accorddance with recommended deitary allowances, menues and nutritional adequacy, be prepared in advance and be followed

Answer 333

prepared by methods that conserve nutritive value, flavor, appearance, palatable, attractive and at the proper temperature

Answer 334

designed to meet individual needs

Answer 335

ofered of simular nutritive value to resident who refuse food served

Answer 336

diet ordered by physician as part of treatment for a disease or clinical condition or to eliminate or decrease specific nutrients in the dient or increase specific nutrients in the died or provide food the resident is able to eat

Answer 337

the texture of a diet is altered, when texture is modified the type of texture modification must be specific and part of the physicians order

Answer 338

Resident receives and facility provides at least 3 meals daily at regular times comparable to normal mealtimes in the community

Answer 339

There must be no more than 14 hours between substantial evening meal and breakfast the following day

Answer 340

Facility must offer snacks at bedtime daily

Answer 341

When nourishing snack is provided at bedtime, up to 16 hours may elapse between evening meal and breakfast if resident group agrees to the span

Answer 342

offering of 3 or more menu items at one time, one of which includes a high quality protein such as meat, fish, eggs or cheese, meal should represent not less than 20% of days total nutritional requirements

Answer 343

verbal offering of items, single or combination from the basic food groups

Answer 344

Facility must provide special eating equipment and utensils for residents who need them

Answer 345

Facility may use if completed state approed course, use is approved by state, under supervision of RN or LPN, in ER must call nurse, no residents with complicated feeding problems

Answer 346

dfficulty swallowing, recurrent lung aspirations, tube feeding

Answer 347

sources approved or considered satisfactory by Federal, State of local authorities

Answer 348

santitary conditions and dispose of garbage and refuse properly

Answer 349

transfer of harmful substances or disease causing microorganisms to food by hands, contact surfaces, sponges, cloth towels or utensils which are not cleaned after touching raw food

Answer 350

refers to temperature above 41 degrees and below 135 degrees that allow rapid growth of microoganisms that cause foodborne illnedss

Answer 351

Food held in danger zone for more than 4hours being prepared or 6 hours if cooked and cooled by cause illness if consumed

Answer 352

storing/maintaining dry foods

Answer 353

unintended presence of potentially harmful substances including microorganisms, chemicals, or physical objects in food

Answer 354

series of operational processes involved in getting foods ready for serving such as washing, thawing, mixing ingredients, cutting, slicing, diluting, cooking, ect

Answer 355

process involved in gettign food to the resident, including steam table or refregeration, dispensing food portions, family styal and dining room service

Answer 356

illness caused by ingestion of contaminate food or beverage

Answer 357

Potentially hazardous food, time/temperature control for safety - food that requires time temperature control for safety

Answer 358

can not be used in place of proper hand washing in a food service setting

Answer 359

gloves are single use item and shold be discarded after each use to prevent cross contanination

Answer 360

dietary staff must wear hair restrants

Answer 361

clean and neat

Answer 362

reommended keep to minimum and cover with gloves when handling food

Answer 363

designated for storage, keep in clean, dry area free from contaminants, controlling temp, humidity, infestation

Answer 364

keep off floor, clear of sprinklers, sewer pipes, vents, manage receipt and storage, remove foods not safe, keep in closed containers and rotating supplies

Answer 365

at or below 41 degrees

Answer 366

must keep food frozen solid

Answer 367

montitor fredgeration daily and at routine intervals during all hours

Answer 368

in shallow containers to allow to cool quickly

Answer 369

separate from each other, store bleow fruits, vegs so meat does not drip on these foods

Answer 370

dating and monitoring so it is used by use by date or frozen or discarded

Answer 371

refrigerator in drip proof container, or part of ontinuous cooking process

Answer 372

completely submerged 70 degrees or less, water running fast enough to agitate and float off loose ice particles

Answer 373

then cooking and serving immediately

Answer 374

Monitoring internal temp for 15 seconds

Answer 375

165 degrees

Answer 376

at least 155 degrees

Answer 377

145 degrees

Answer 378

eaten proptly after cooking 145 degrees for 15 secons, white completely set youk congealed

Answer 379

rotated and stirred during process so all parts are heated to at least 165 degrees and allowed to stand covered for at least 2 minutes after cooking

Answer 380

135 degrees

Answer 381

16r5 degrees

Answer 382

best taken directly from sealed container or intact package 135 degrees

Answer 383

is not acceptable to reheat foods as it does not bring to the proper temerature within accepatble time

Answer 384

colled within 2 hours from 135 to 70 degrees, 4 hours to 41 degrees, total time should not exceed 6 hours

Answer 385

if temperature drops below 135 degrees in must be reaheated to 165 for 15 seconds

Answer 386

waivers for undercooked unparteurized eggs are not acceptable even for preference

Answer 387

damaged shells are unsafe

Answer 388

once to 165 degrees descard if not eaten within 2 hours

Answer 389

keep foods at or bleow 41 degrees

Answer 390

must keep frozen foods frozen solid

Answer 391

wash 150 - 165 degrees

Answer 392

180 degrees or 165 for stationary rack

Answer 393

wash 120 degrees

Answer 394

50 ppm hypochlorite on dish surface

Answer 395

1. wash thorough using hot water, 2. rinsing with hot water 3. sanitizing with either hot water or chemical soltion in correct concentration

Answer 396

hot water at least 170 degrees for 30 seconds

Answer 397

according to manufactuers instructions, or if not provided: Chlorine 50-100 ppm 10 sec contact time Iodine 12.5 ppm minimum 30 sec contact time QAC Quaternary 150-200 ppm contact time per manufacturer

Answer 398

may increase risk for cross contamination

Answer 399

cold at or below 41 degrees | hot at or above 135 degrees when served

Answer 400

policies and procedures, foot temp records from tray line, fridge, dishwasher, maintenance records, infection control records

Answer 401

for transport not out of temp control for more than 4 hours from time it is plated

Answer 402

good condition (no leaks), lids or covered, storage area maintained in sanitary condition, covered when being removed from kitchen to dumpster,

Answer 403

clean, free from debris, free of foul odors and waste fat

Answer 404

physician must personally approve in writing a recommendation that individual be admitted to facility, resident must remain under care of physician

Answer 405

medical care of each resident is supervised by physician and another physician supervisies when their attending is unavailable

Answer 406

Physician must review residents total program of care incuding medications, tratments at each visit

Answer 407

physician must write, sign and date progress notes at each visit, sign and date all orders

Answer 408

residents must be seen by physician at least once every 30 days for the first 90 days after admission and at least once every 60 days after that

Answer 409

visit considered timely if it occurs not later than 10 days after the date the visit was required

Answer 410

at option of physician required visits after the intitial visit may alternate between personal visits by the physician and visits by a PA, APRN, or clinical nurse specialist

Answer 411

facilty must provide or arrange or provision of physician services 24 hours a day in case of emergency

Answer 412

Not allowed to be facility employee

Answer 413

defferentiated from restorative services which are provided by nursing staff, they are provided by or coordinated by qualified personnel

Answer 414

services provided by State which can only be delivered by peronnel or programs other than those of the NF because the overal level of NF is not as intense as necessary to meet the individual needs

Answer 415

Services of lesser frequency or intensity to be implemented by all levels of nursing facility staff

Answer 416

provided under the written order of a physician by qualified personnel

Answer 417

Facility must assist resident in obtaining routine and 24 hour emergency dental care

Answer 418

Facility must provide or obtain routine and ER dental services, may charge resident additional amount for services

Answer 419

Facility must provide or obtain routine and ER dental services, without charge to resident for services covered under State plan

Answer 420

Must assist if needed making appts, arranging transportation, refer residents with lost or damaged dentures

Answer 421

facility must provide routine and ER drugs and biologicals to residents or obtain them under an agreement

Answer 422

Facility may permit unlicensed personnel to administre drugs if State law permits if under general supervision of licensed nurse

Answer 423

Facility must employ pharmacist to consult all aspects of provision of pharmacy services, establish system of records of receipt and dispostion of drugs to allow accurate reconciliation, determine drug records are in order and account of all controlled drugs in maintained and reconciled

Answer 424

must be reviewed at least once a month by licensed pharmacist

Answer 425

Pharmacist must report any irrecgularities to attending physician and DON and reports must be acted upon

Answer 426

Facility must lable in accordance with currently accepted professional principles and include accessory and cautionary instructions and expiration date

Answer 427

Facility must store in locked compartments under proper tem controls and permit only authorized personnel to have access to keys

Answer 428

Facility must provide separately locked permanently affixed compartments for storage of controlled drugs and other durgs subject to abuse, except when facility uses single unit package drug where quantity is minimal and missing dose can be readily detected

Answer 429

Facility must establish and maintain an infection control program designed to provide a safe, sanitary and comfortable environment and to help prevent th development and transmission of disease and infection

Answer 430

Investigates, controls, and prevents infections, decides what procedures should be applied to situation, maintains record of incidents and corrective actions related to infections

Answer 431

Facility must isolate the resident

Answer 432

Facility must prohibit direct contact with residents or their food, if direct contact will transmit disease

Answer 433

Facility must require staff to wash hands after direct resident contact where indicated by professional practice

Answer 434

Personnel must handle, store, process and transport linens as to prevent the spread of infection

Answer 435

facility must meet provisions for 2000 edition of the life safety code of the national fire protection association

Answer 436

State law adequately protectis patients, residents and personnel in logn term care facilities

Answer 437

3/16/2006 long term care facility must be in compliance

Answer 438

may be bloaced if it does not conflict with any State or local codes prohibiting or otherwise restricting placement of dispensers

Answer 439

installed in manner that minimizes leaks and spills that could lead to falls, adequately prtects against access by vulnerable populations

Answer 440

resident sleeping rooms and public areas by 3/24/2006

Answer 441

facility must have program for testing, maintenance, battery replacement to insure reliability of dectectors

Answer 442

if facility has hard wired AC smoke dectection system in same areas same checks, or has sprinkler system throughout that is installed, tested, and maintained

Answer 443

at least lighting all entrances and exits, fire dectection equipment, alarm, extinquishing systems, life support systems

Answer 444

facilty must provide sufficient space and equipment in dining, health services and recreation areas to enable staff to provide residents with needed services ans required and in plan of care

Answer 445

no more than 4 residents

Answer 446

at least 80 square feet per resident in multiple resident rooms at least 100 square feet in single resident room

Answer 447

direct access to exit corridor

Answer 448

be designed or equipped to assure full visual privacy for each resident

Answer 449

After 3/31/1992 semi private rooms must have ceiling suspended curtains which extend around the bed to provide total visual privacy in combination with adjacent walls and curtains

Answer 450

must have one window to the outside, sill height shall not exceed 36 inches, must be operable

Answer 451

must be at or above grade level, above surrounding exterior ground level

Answer 452

Each resident must have separate bed of proper size and height for convenience of resident, clean comfortable mattress, bedding appropriate to weather and climate

Answer 453

Functional funtiture appropriate to residents needs and individual private closet space in bedroom with rachs and shelves accessible to resident

Answer 454

Each room must be equipped with or located near toilet facilities

Answer 455

Nurse station must be equipped to receive residents calls through communication system from resident rooms and toilet, bathing facilities

Answer 456

One or more rooms desinated for resident dining and activities, well lighted, well ventilated with nonsmoking areas identified, adequately furnished, sufficient space to accomidate

Answer 457

procedures in place in ensure water available to essential areas in loss of normal water supply

Answer 458

adequate outside ventilation by means of windows, or mechanical ventilation or combination

Answer 459

equip corridors with firmly secured handrails on each side

Answer 460

facility must have governing body legally responsible for establishing and implementing policies regarding management and operation

Answer 461

appointed by governing body, licensed by state, responisble for management of facility

Answer 462

facility must not use person more than 4 months unless competent to provide services, completed training and competency evaluation program approved by state

Answer 463

faciltiy must receive registry verification aide has met competency evaluation from every state believed to have information on person

Answer 464

if moren than 24 consectutive months providing no nursing related services must complete new training and competency evaluation

Answer 465

must complete performatnce review every 12 months and proved at least 12 hours coninuing competence per year, must address weakness from reviews, address care of cognitively impaired, demential management, patient abuse prevention

Answer 466

facility must designate physician to medical director to implement resident care policies, coordinate medical care in facility

Answer 467

must provide or obtain to meet the needs of residents, facility is responsible for quality and timeliness of services

Answer 468

ordered by attending physician only, attending physician promptly notified of results

Answer 469

facilty must maintain records on each resident, complete, accurate, readily accessible, organized

Answer 470

identify resident, assessments, plan of care and services provided, preadmission screening results, progress notes

Answer 471

period of time required by state, 5 years from date of discharge when no requirement by state, 3 years after residetn reaches legal age if minor under state law

Answer 472

must have detailed written plans and procedures to meet all potential emergencies and disasters such as fire, severe weather, missing residents

Answer 473

must train all employees in er procedures when begin to work in facility and review procdures with existing staff, carry out unannounced staff drills using procedures

Answer 474

must have written transfer agreement with one or more hospital participating under Medicare programs

Answer 475

residents will be transferred from facility to hospital timely admission when appropriate, medical information for care will be exchanged, considered in effect if good faith effort has been made

Answer 476

quality assessment and assurance committe - DON, physician, 3 other members of staff, meets at least quarterly, identify issues to which quality assessment and assurance activities are necessary, develops and implements plans of action to correct quality deficiences