The 5 steps of the grieving process?
Denial – Anger – Bargaining – Depression – Acceptance
An accidental death must be reported to OSHA within what time frame?
Within 8 hours
According to Medical Device Reporting user facilities must keep records for?
2 years
According to OSHA what is the color for safety and first aid?
Green
According to the Life Safety Code no room shall be more than what distance from an exit?
100 Feet
An account that is debited and credited due to the transactions in chronological order?
Journal
The acid test ratio is?
(Cash + Short-Term Securities) / Current Liabilities
Act intended to cover all employment of 15 or more persons and numerous other groups and educational institutions?
Equal Employment Act of 1972 (An amendment to Title 7 of the Civil Rights Act of 1964)
Activities of Daily Living (ADL) include? (5 areas)
Ambulation/Locomotion, Eating, Toileting, Grooming/Personal Hygiene/Bathing, and Communicating
Actual organ loss or failure is termed?
Impairment
An admission assessment is to be complete with how many hours of admission?
8 Hours (RN’s responsibility)
An advisory role not having line authority?
Staff Function
After interruption of normal power the emergency generator must start and transfer power within?
10 seconds
The Age Discrimination Act protects employees in what age group?
40 to 70 years old.
Air temperature should be measured how many feet above the floor in resident rooms and dining areas?
3 Feet
Aisles – must be how wide?
8 feet wide.
All corridor doors must have a solid banded-wood core or an equivalent with what fire protection rating?
1 1/2 hours
All residents must receive a physical exam how often?
At least every 3 months
Annual Net Income / Total Shareholders Equity =
ROE (Return on Equity), a means of assessing a companies profitability.
Anti psychotic drugs (Category 4 drugs) are used for?
Treating organic mental syndromes.
Assets are general classified into what two groups?
Current Assets and Non-Current Assets
Assets can be found in which financial document?
Balance Sheet
Balance sheet is made up off which three items?
Assets, Liabilities, and Owners Equity (all on a particular date)
Bathroom and toilet doors must be how wide?
32 inches
Benzodiazepine or other anxialytic/sedative drugs (Category 4 drugs) are used to?
Control anxiety or agitation
Book which summarizes all the entries in each of the journals for an accounting period, for the purpose of keeping a continuous record of account balances and arriving at a trial balance?
General Ledger
Building additions must be separated by a fire barrier with at least the following rating?
2 hours
Can a pharmacist order that a certain lab be taken?
Yes, the physician is involved but doesn’t necessarily have to agree with the pharmacist.
(Cash + Current Receivables) / Current Liabilities =
Acid Test Ratio
(Cash + Marketable Securities) / ((Total Operating Expenses – Depreciation) / 365) =
Days of Cash
Charged with identifying and eliminating fraud, abuse, and waste in Medicare, Medicaid, and other DHHS programs?
Office of Inspector General
Class A fire extinguishers must be located every?
75 feet of travel distance
C.N.A. must undergo retraining and testing if they have been out of paid aide position for how long?
2 Years
A comprehensive care plan must be completed within how many days once the comprehensive assessment is made?
7 Days
A comprehensive care plan must be developed with how many days of MDS completion?
7 Days (Medicare or 14 days Medicaid)
The Comprehensive Drug Abuse Prevention and Control Act established the?
The 5 Schedules of drugs.
A condition continuing over a long period of time or recurring frequently?
Chronic Condition
A condition that often begins inconspicuously and symptoms are less pronounced than acute conditions?
Chronic Condition
Consistently giving high ratings to all employees in an attempt to avoid conflict?
Leniency Error
A coordinated and aggregated series of work elements used to produce an output?
Task
Current Assets / Current Liabilities
Current Ratio
Current Assets – Current Liabilities =
Working Capital
Current Assets include?
Cash, other assets to be converted to cash, or sold or consumed in business operations, within one year of the balance sheet date.
Current Medicare option for skilled nursing facilities that furnish fewer than 1,500 days of Medicare utilization in the prior year. Such SNFs can elect a predetermined fixed reimbursement for routine service and capital costs and file an abbreviated cost report?
PPS (Prospective Payment System) for skilled nursing facilities
The current ratio is?
Current Assets / Current Liabilities
A current trial balance includes?
Debits, Credits, Names of Accounts (not zero balance)
Days of Cash
(Cash + Marketable Securities) / ((Total Operating Expenses – Depreciation) / 365) =
A declining proration of asset cost is defined as?
Amortization
A decrease in density of bones causing structural weakness throughout the skeleton?
Osteoporosis
The degree to which a test interview procedure or other selection tool measures the skills, knowledge or performance requirements actually needed in the position for which the applicant is considered?
Content Validity
Determination of wage rates by considering the labor market, prevailing wage rates, cost of living, ability to pay, collective bargaining agreements, individual bargaining agreements and value of the job?
Wage Mix
Determining the means of egress requirements based on building use and sq.ft.?
Occupant Load
A disease the happens suddenly and lasts a short time?
Acute Condition
A document that enables a manager to understand what kind of applicant would be best suited for a job?
Job Profile
A document that shows the details of a sale and usually includes (or implies) a request for payment?
Invoice
A drug (ex. Aspirin) that reduces or eliminates pain without affecting consciousness?
Analgesic
Drugs that have a high tendency for abuse and no medical use?
Schedule 1 (ex. Marijuana, Heroin, Ecstasy, LSD, etc.)
Drugs that have a high tendency for abuse, may have an acceptable medical use, and can be available by prescription?
Schedule 2 (ex. Cocaine, Opium, Morphine, Fentanyl, Amphetamines, etc.)
Drugs with less potential for addiction and have a currently accepted medical use?
Schedule 3 (ex. Anabolic Steroids, Codeine, Ketamine, etc.)
Drugs with lowest potential for abuse, current accepted medical use, often don’t require a prescription?
Schedule 5 (ex. Cough suppressants with Codeine)
Drugs with low potential for abuse and limited addictive properties and a current accepted medical use?
Schedule 4 (ex. Valium, Xanax, Phenobarbital, Rohypnol)
DSO (Daily Sales Outstanding)
Outstanding Accounts Receivable / (3 month net revenue / total days in 3 month period) =
During what hours may fire drills be announced by coded message rather than audible alarm?
9pm to 6am
Each resident must have a private closet which includes?
Clothes Racks and Shelves accessible to the resident
EEOC enforces which three acts?
Equal Pay Act, Title 7 of the Civil Rights Act, and the Age Discrimination in Employment Act (not the Fair Labor Standards Act).
Elderly or Elder refer to persons over what age?
60 years old.
Emergency Lighting – May it be battery powered if?
If they meet the candlelight requirements for a period of 1 1/2 hours. Automotive type batteries are not acceptable.
Employees must receive their W-2 no late than what date each year?
January 31 (each year)
Employees pay what percentage of the FICA cost?
50%, the employer pays the other 50%
Employees returning from Military leave must apply to return to work within how many days of discharge?
90 Days
The ERISA (Employee Retirement Income Security Act) is enforced by which agency?
EEOC (Equal Employment Opportunity Commission)
The error by supervisors using rating scales when consistently giving only moderate scores to employees on performance appraisals, regardless of whether the employee is a poor or an outstanding performer?
Error of Central Tendency:
An error made by supervisors using rating scales who value one particular type of job behavior and permit the presence or absence of that one trait to color several or most other trait ratings.
Halo Effect
Establishment of pay grades and rates by employers to both achieve equity and offer some flexibility to supervisors in setting an employee’s wage?
Wage Class
Examples of Schedule 2 drugs?
Morphine, Codeine, Ritalin, and Nembutal, etc.
Exits – What are the minimum letter height and width requirements for exit signs?
Signs must have letters 6 inches high and 3/4 inch wide.
Exits – What are the requirements for illumination of the means of egress?
The illumination must be continuous, have at least 1-foot-candle measured at the floor of the exit access, the exit, and the exit discharge.
Exits – What is the maximum allowable distance between any point in a patient room and an exit access?
200 Feet
Exits – What is the maximum allowable distance between any point in a room and the exit from that room?
50 Feet
Exits – What is the maximum allowable distance between exit signs?
100 Feet
Exits – What is the maximum allowable distance between the entrance door into any room and an exit access?
150 Feet
Expenses that have been incurred but not yet paid?
Accrued Expenses
Explains how the cash balance has changed between the beginning and end of a fiscal period. It reports cash receipts and cash disbursements in three categories of activities: operating, investing and financing?
Statement of Cash Flows
The extent to which a selection tool measures a trait or behavior believed important to performing a job?
Construct Validity
A facility must be free of med errors greater than what percentage?
5% or greater
A facility must give how many days notice to a Union for a desired contract change?
90 Days
The failure to function at a “normal” level is termed?
Disability
The Fair Labor Standards Act requires overtime be computed how and what rate?
OT computed at 1 1/2 times the regular pay rate. Based on 14 day period with any time over 8 hrs daily and over 80 hrs in the 14 day period being overtime.
Favoring one’s family members in hiring practices?
Nepotism
A federal agency that administers Medicare as well as federal guidelines for Medicaid?
HFCA (Health Care Financing Administration)
A financial statement that provides information for planning short-term cash needs?
Cash Flow Statement
A financial statement that shows cash receipts and disbursements leading to a net change in cash in a given period?
Cash Flow Statement
A financial statement that treats hypothetical events as though they had actually happened, and hence includes fictitious data in whole or in part?
Pro Forma Statement
A fire that is out of control is referred to as a?
Flashover
A fixed daily payment?
Per Diem
Food should be served at what temperatures?
140F for hot items and at or below 41F for refrigerated items
A Form 1099-MISC must be issued when an independent contractor is paid more than this amount during a single year?
$600
A form of business that is incorporated under the laws of one of the states. There may be a single stockholder or thousands of holders. It is a separate legal entity from its owners and therefore the owners are not personally responsible for the corporate debts?
Corporation
For Profit Organizations are governed by?
A Board of Directors
Frail Elderly refer to persons over what age?
Healthy persons over 75 years of age.
The freezer should be kept at or below what temperature?
0 F
Fringe Benefits are defined as?
Compensation other than cash wages paid to workers. (ex. Health Insurance)
Fringe benefits are typically outline in?
Personnel Policies
A full time social worker is required if the facility has more than how many beds?
120 Beds
Funds regularly set aside by a firm to redeem its bonds periodically?
Sinking Funds
FUTA refers to?
Federal Unemployment Tax Act (unemployment tax)
Generally, cost reports are due within how many days of the end of the fiscal year?
90 Days
Gerontologists Categories – How is Oldest-Old Defined?
Over 85 + years old
Gerontologists Categories – How is Old-Old Defined?
75 to 84 years old
Gerontologists Categories – How is Young-Old Defined?
65 to 74 years old
The governing board has what two required duties?
1) policy making; 2) appointing the administrator
A group of symptoms that occur together?
A syndrome
A group of two or more jobs that have similar duties?
Job Family
Handicap parking must be at least how wide?
13 Feet
The handrails in stairwells must extend beyond the first and last steps by?
12 inches
Handrails – What clearance is required from the wall?
1 1/2 inches, more if the surface is rough.
Handrails – What is the required height?
34 inches to 38 inches, above the surface of the tread measured vertically to the top of the rail from the leading edge of the tread.
Handrails – Where must they be placed?
On both sides of all sets of stairs.
Has management responsibility for providing comprehensive health care services on a prepayment basis?
HMO (Health Management Organization)
A Hazard posed by medications is a?
Health Hazard (Chemical)
A Hazard posed by surroundings is a?
Physical Hazard
Herzberg’s dissatisfaction factor equates to?
Hygiene Factors (ex. Status, Job security, salary, fringe benefits, work conditions)
Herzberg’s satisfaction factor equates to?
Motivators (ex. Challenging work, recognition, responsibility)
Horizontal Exit – How many doors are required?
A single door may be permitted provided the exits serves one direction, two doors are required if the exit serves both directions (min door width 41.5 inches.)
Horizontal Exit – What is the minimum door width?
41.5 Inches
Horizontal Exit – What is the minimum sq.ft. per patient that must be provided on both sides?
30 sq.ft. per patient
Hot food should be served at what temperature?
140 F
How are ANSI (American National Standards Institute) standards enforced?
Agencies within the individual states
How are Controlled Substances rated?
On a Schedule from 1 to 5. The higher the # the more controlled the substance.
How long can aides work before they become certified?
4 Months (i.e.. They are going through classes or waiting to take a test for certification)
How long must medical records be maintained?
5 years after discharge or 3 years after a discharged resident reaches the age of 18.
How long must vegetables be boiled to kill off the Botulism causing bacteria?
20 Minutes
How many days notice must an employee give to go out on FMLA?
30 Days Notice
How many hours must an employee work to be full time?
35+ hours a week
How many hours of In-Service must C.N.A.’s have each year?
12 hours
How many hours of state approved training are required for a C.N.A.?
75 hours of training
How much space must be between beds in multibed rooms?
3 Feet
How must light must a reading light at the bed yield in illumination?
30 Foot Candles
How often are physicians required to visit their patients?
Once every 30 days for the first 90 day period, then at least every 60 days thereafter
How often must a physician visit a patient after the first 90 days?
At least every 60 days, visits are considered timely is they occur no later than 10 days after the date required.
How often must a physician visit a patient during the first 90 days?
Every 30 days, visits are considered timely if they occur no later than 10 days after the date the visit was required.
How often must dental services be provide?
Annual Inspection
How often must fire drills be performed?
Quarterly (4 times a year for each shift)
How often must form 941 be filed by employers?
Quarterly, Form 941 is the Employers Quarterly Federal Tax Return
How often must individual resident financial reports be given to residents or their designated party?
Quarterly
How often must the QA Committee meet?
Quarterly
An I-9 must be retained for how long?
3 years from the date of hire or until 1 year after termination (whichever is later)
If an applicant isn’t hired how long must their application be kept in file?
1 Year
If marked AC a medication is administered?
Before Meals
If marked AD a medication should be given by which route?
Right Ear
If marked AS a medication should be given by which route?
Left Ear
If marked AU a medication should be given by which route?
Both Ears
If marked BID a medication is administered?
Twice a Day
If marked HS a medication is administered?
At Bedtime
If marked IM a medication should be given by which route?
Intramuscularly
If marked IV a medication should be given by which route?
Intravenously
If marked OD a medication should be given by which route?
Right Eye
If marked OS a medication should be given by which route?
Left Eye
If marked OU a medication should be given by which route?
Both Eyes
If marked PC a medication is administered?
After Meals
If marked PO a medication should be given by which route?
Orally (by mouth)
If marked PRN a medication is administered?
As Needed
If marked QD a medication is administered?
Every Day
If marked QID a medication is administered?
Four Times a Day
If marked QOD a medication is administered?
Every Other Day
If marked R a medication should be given by which route?
Rectally
If marked TID a medication is administered?
Three Times a Day
In civil law a Curator is?
A Guardian
The income of a proprietary corporation remaining after all costs, taxes, and dividends is defined as?
Retained Earnings
An Income Statement shows?
Revenues and Expenses
Information in this statement can be useful in assessing the entity’s ability to generate positive future net cash flows, meet its financial obligations and pay dividends?
Statement of Cash Flows
In T Accounts – decreases in asset accounts are?
Credits
In T Accounts – decreases in capital accounts are?
Debits
In T Accounts – decreases in expense accounts are?
Credits
In T Accounts – decreases in liability accounts are?
Debits
In T Accounts – decreases in revenue accounts are?
Debits
In T Accounts – increases in asset accounts are?
Debits
In T Accounts – increases in capital accounts are?
Credits
In T Accounts – increases in expense accounts are?
Debits
In T Accounts – increases in liability accounts are?
Credits
In T Accounts – increases in revenue accounts are?
Credits
The interdisciplinary team must include?
Attending Physician
Interior Stairs – What are the maximum and minimum riser heights?
Max Height 7 inches, Minimum Height 4 inches
Interior Stairs – What is the maximum height difference between landings?
12 Feet
Interior Stairs – what is the minimum clear width of the stairs?
44 Inches, except for handrails not to exceed 3 1/2 inches at or below handrail height on each side.
Interior Stairs – What is the minimum head room?
6 feet 8 inches
Interior Stairs – What is the minimum tread depth?
11 Inches
Investments that have a maturity of over one year from the balance sheet date?
Long-Term Investments
An invoice is usually a?
List
In what three areas does the Statement of Cash Flows show receipts and disbursements?
Operating, Investing, and Financing
In which type of accounting are revenues recorded when they are earned, and expenses recorded when they are incurred, regardless of when cash is received or paid out?
Accrual Basis of Accounting
Is the administrator typically a primary interdisciplinary team member?
No
It is mandatory that every health care facility offer the HBV (Hepatitis B Vaccine) to whom?
Nursing, Housekeeping, and Laundry Staff (an employees at risk)
A job is defined as?
A collection of tasks assigned to an employee
Journals include the following?
Payroll, investments, cash receipts (not depreciation schedule)
A lease that is recorded by the lessee on the balance sheet as an asset and a corresponding borrowing of funds. Depreciation is treated as an expense and interest payments are deductible. At the end of its term, the lessee becomes the owner of the asset or has the option to purchase it for a nominal amount of money?
Capital Lease
Liabilities that may or may not be incurred by a facility depending on the outcome of a future event?
Contingent Liabilities (ex. Court Case)
Liquid assets include?
Short term notes, cash, and accounts receivable
List the 4 unnecessary drugs in Category 4?
1)Benzodiazepine or other anxialytic/sedative drugs; 2)Long acting benzodiazepines; 3)sedative hypnotic drugs; 4)anti psychotic drugs
List the two types of leases?
Capital Lease and Operating Lease (also a third kind, triple net lease)
List the types of journals a facility may keep?
Cash receipts, cash disbursements, billings, accounts payable, purchases. A general journal is used for entries that do not properly belong in any of the other journals, and for adjusting entries.
Long-acting benzodiazepines (Category 4 drugs) are used only when?
Short acting ones have failed
Managed care organizations are asking for this level of accreditation prior to contracting with the facility?
JCAHO Accreditation (Joint Commission on Accreditation of Health Care Organizations) They are the preeminent accreditation agency for acute care hospital providers.
Means of egress in health care inpatient treatment areas must be adequate for one person per how many square feet?
240 sq.ft.
Means of egress in health care sleeping areas must be adequate for one person per how many square feet?
120 sq.ft.
A method of establishing wage rates for jobs, based on comparing all jobs in the organization to a touchstone job in the facility, such as nursing?
Key Job Comparison
Minimum area in a single (private) resident room?
100 sq.ft..
The minimum square footage calculation in a room excludes the following areas?
Toilet, Closets, and Wardrobe (the area the bed occupies is included in the sq.ft. calculation.
Minimum wage, overtime, standard workweek definitions, equal pay, child labor, and record keeping requirements are set by?
Fair Labor Standards Act
A modality is a?
Specific Treatment
The morning meal must be served within how many hours after the previous meal?
14 Hours, if the required evening snack is substantial and the resident approves 16 hours may elapse
The most common form of arthritis?
Osteoarthritis
Must a totally Private Pay Health Care Facility be licensed?
Yes
Net Resident Accounts Receivable from all Sources / (Net Patient Revenue / 356) =
Days in Resident Accounts Receivable
Non-Current assets include?
Long-term investments, property, plant, and equipment (PPE), etc.
Non-Profit Organizations are governed by?
A Board of Trustees
One who dies leaving a will?
Testator
The operating budget is composed of what two categories?
Revenue and Expense Categories
The organization created by the Civil Rights Act of 1964 to carry out the provisions of the act?
Equal Employment Opportunities Commission (EEOC)
Organization providing accreditation for medical rehabilitation programs?
CARF (Commission on Accreditation of Rehab Facilities)
The organizations expected financial condition if the budgeted amounts are realized?
Pro Forma Statement
OSHA is under the?
U.S. Department of Labor
OT?
Occupational Therapy
Outstanding Accounts Receivable / (3 month net revenue / total days in 3 month period) =
DSO (Daily Sales Outstanding)
Palliative Care is defined as?
Management and support provided for reduction or abatement of pain. Doesn’t include treatment to cure medical condition or to artificially prolong life.
PASARR (preadmission screening and an annual review) determines whether what type of patients may be admitted?
Patients with active diagnoses of Mental Illness or Mental Retardation. Patients must have a primary diagnose requiring skilled nursing care to be admitted. Exceptions are made for organic disorders (ex. Alzheimer’s, multi-infarct dementia, and similar senile dementias). Second exception made for persons who have lived in the facility for 30 months or more.
The percentage of accounts outstanding for more than 60 days should never exceed?
5%
The person responsible for performing most the personnel functions, who is delegated authority by the administrator to make decisions on his/her behalf and authority to commit facility resources. Often defined as the lowest level of management which has only workers under its direction?
Line Manager
A phrase meaning let the employer answer for the acts of his/her employees?
Respondeat Superior
Physical restraints must be monitored?
Every 30 minutes
Portable Heating devices are prohibited except for use in?
Nonsleeping staff areas where the heating elements do not exceed 212 F
Practice by health care providers of charging private-pay patients more than the actual costs of their care in order to compensate for shortfalls in reimbursement for patients covered by Medicaid and other government programs when those programs pay less than actual costs?
Cost Shifting
The practice of posting available jobs on bulletin boards and encouraging employees to apply for openings?
Job Bidding
The Pregnancy Discrimination Act is an amendment to what other act?
The Civil Rights Act
A principle that teaches anytime a higher paid employee makes a decision a lower paid employee can make out as well or better?
The Principle of the Economy of Action (facility pays more than it should)(she got a raise why shouldn’t I)
The process of defining a position in term of the tasks or behaviors required, specifying the qualifications of the employee assigned those duties?
Job Analysis
Process of selling a/r, as a means of short-term financing. When this is done “without recourse” the seller transfers not only the receivables, but also the risk of default?
Factoring of Receivables
Progressive stiffening in the muscles, tendons, and ligaments that surround the joints?
Contracture
PT?
Physical Therapy
The QA Committee meeting must include whom?
DON, a Physician, and Three other Staff Members
Quality control relates to policies and procedures designed to?
Maintain quality care.
Quality improvement is defined as?
The development and maintenance of quality care programs.
Quality Indicator sentinel health event signified by QI 11?
Prevalence of Fecal Impaction
Quality Indicator sentinel health event signified by QI 15?
Prevalence of Dehydration
Quality Indicator sentinel health event signified by QI 24?
Prevalence of Stage 1-4 Pressure Ulcers
Quality Indicators (QI) will be flagged at what percentage?
90% Percentile (the higher the % the worse the flag)
The quick ratio is?
(Current Assets – Inventories) / Current Liabilities
Ramp – a ramp with a slope of 7-20 degrees is a?
Stairway and Landing
Ramp – a ramp with a slope of 20-50 degrees is a?
Stairway
Ramp – a ramp with a slope of under 7 degrees is a?
Ramp
Ramp – what are the minimum requirements/dimensions for a ramp?
Slip resistant, clear width of at least 44 inches, maximum rise of 30 feet per ramp run.
Reasons for adjusting Journals include?
Entries for depreciation, prepaid expenses, and inventory usage, etc.
The Refrigerator should be kept below what temperature?
41 F
A report from the state surveyors which shows recent survey deficiency trending for that facility?
OSCAR (an administrator may request a copy of the most recent OSCAR)
(required staff / provided staff) * 100 =
Employee Productivity
A resident centered outcome oriented inspection?
OBRA Survey
Residents funds in excess of what amount must be kept in an interest bearing account?
Medicaid- $50; Medicare-$100
Residents must be notified when their account rises to within what amount of the resource limit the state has established?
Within $200 of the limit
Residents paying in this manner may be billed in advance?
Self pay residents (third party programs may not be billed in advance)
A resident’s room must have at least how much useable space?
80 sq.ft..
A resident who dies with leaving a will is said to have died how?
Intestate
Revenues that have been earned but not yet billed?
Accrued Revenues
Review of job descriptions and activities essential for performing each job?
Task Analysis
The Safety Medical Devices Act requires that a serious injury or death be reported to whom and when?
Incidents resulting from medical devices causing death or serious injury must be reported to SMD within 24 hours and to the FDA within 10 days.
The second most common type of arthritis?
Rheumatoid Arthritis
Sedative hypnotic drugs (Category 4 drugs) are used for?
For sleep induction.
Services which are not generally provided to most residents and which may be separately billable?
Ancillary Services (ex. Labs, Radiology, Pharmacy Services, and Rehab Therapies)
Shipping arrangement under which the buyer of the goods pays a separate charge for the transportation costs. The goods while in transit are the property of the buyer, who thus bears financial liability for the goods if they are lost in transit?
F.O.B. (Freight on Board) Shipping Point
Shipping arrangement under which the seller of the goods bears the costs of transportation to the buyer’s location?
F.O.B. (Freight on Board) Destination
The simplest account structure in accounting is the?
T Account (account name on top of the T, debits on the left side, and credits on the right side.
Smoke detectors should be located no more than how many feet apart?
30 Feet
Smoke detectors should not be more than how many feet from any wall?
15 Feet
Soiled linen and trash collection containers must be limited to a capacity of?
32 gallons within an 64 square foot area.
Soiled Linen carts should be decontaminated how often?
Weekly (minimum) or ASAP when visibly contaminated.
ST?
Speech Therapy
Stairwells – What fire protection rating is required for doors entering or exiting stairwells?
1 1/2 Hours Fire Rating
Stairwells – What fire resistance is required?
2 Hour Fire Rating
A statement of the tasks to be done based on the job analysis, usually including a list of duties and responsibilities of the position in order of importance?
Job Description
Sub acute care is a comprehensive inpatient program designed for individuals with three attributes?
1) Has an acute event as a result of an illness, injury, or exacerbation of a disease process; 2) Has a determined course of treatment; 3) does not require intensive diagnostic and/or invasive procedures.
Sub acute medical and rehabilitative programs in nursing facilities may include specialty programs for?
Post-Operative Recovery, Extensive Wound Care, Ventilator Support, Brain Injury Care, Rehabilitation, Complex Medical Care, and Respiratory or Pulmonary Management.
The sum of all the activities which create the desired and needed changes in quality care are?
Quality Improvement
Survey – Issued when a facility is found to be in substantial compliance; a POC (plan of correction) is not required, but a facility is expected to correct the deficiencies?
Notice of Isolated Deficiencies
Survey – Issued when a facility is found to be noncompliant?
HFCA – 2567 (requires a POC / plan of correction)
Survey – Must be completed to reply to 2567?
POC (Plan of Correction)
Survey – Remedy Category 1 includes?
Directed plan of correction, state monitoring, and directed in service training
Survey – Remedy Category 2 includes?
Denial of payment for new admissions, denial of payments for all residents, civil monetary penalties of $50 to $3,000 per day.
Survey – Remedy Category 3 includes?
Temporary management, immediate termination from Medicare and Medicaid programs, and civil monetary penalties of $3,050 to $10,000 per day
Survey – Severity Level 1Tags?
Letters A,B,C – deficiencies in this range are not serious. No actual harm or potential to cause harm, just a minor negative impact on residents.
Survey – Severity Level 2 tags?
Letters D,E,F – These tags are cited when there is noncompliance with no actual harm to residents but possibility of minimal harm to residents.
Survey – Severity Level 3 tags?
Letters G,H,I – Actual harm has occurred. Harm can include, bruise, skin tear, or making a resident upset.
Survey – Severity Level 4 tags?
Letters J,K,L – Worst tags possible. Immediate jeopardy is possible.
Survey – the effect on resident outcomes?
Severity Level
Survey – the number of residents potentially or actually affected?
Scope Level
A system of accounting in which revenues are recorded when cash is received, and expenses are recorded when cash is paid out?
Cash Basis of Accounting (not allowable with Medicare and Medicaid)
A temporary disorder?
Acute Condition
Theory X advocates?
The use of Fear of Punishment to motivate (assumes employees are inherently lazy and dislike work)
Theory Y advocates?
Rewards employees for accomplishing goals (assumes employees like work as much as play)
Theory Z advocates?
Participation in Nature. Employees have input into how their work is done and how decisions are made.
There must be at least how many windows in a resident room?
At least One, may not have more than 4 windows.
They give advice that does not have to be taken. They do not have the power or the liability of law behind them?
Advisory Boards
The three ratios that measure the liquidity of a business entity? (its ability to pay off its short term obligations)
Current Ratio, Quick Ratio, and Acid Test Ratio
Thresholds may not rise over?
1/4 Inch
Title 14 or Medicaid recipients must meet the following eligibility requirements?
Recipients must meet the eligibility requirements for either Aid To Families With Dependent Children (AFDC), or Supplemental Security Income (SSI). AFDC covers primarily dependent children living with one parent only; and the parent. SSI covers the aged and disabled.
Title 15 of the Social Security Act is a?
Assistance Program (based on need)
Title 18 of the Social Security Act is basically an?
Insurance Program
Title 18 of the Social Security Act (Medicare) is a social insurance program administered by?
HFCA (Health Care Financing Administration)
To avoid retraining and a competency evaluation program a C.N.A. must work continuously for how long?
24 Consecutive Months
To become certified a facility must?
Complete a Life Safety Code Survey and a Standard Survey
To be disadvantaged for fulfilling customary roles is termed?
Handicap
To be eligible for FMLA (Family Leave Act) and employee must have worked how many hours in the last 12 months?
1250 Hours
To decrease unemployment costs what must an administrator do?
Documentation of progressive discipline steps taken to terminate the employee
A toilet seat for the disabled must be how high?
17 to 19 inches from the floor
To what does a chart of accounts compare?
Table of Contents
To what does the physicians desk reference relate?
Drugs
Transferring entries from a journal to an account in a ledger at the end of an accounting period?
Posting
The travel distance between Class B or C fire extinguishers may not be more than how many feet?
50 Feet
Two entities that have established regulations relative to requirements for emergency electrical power?
NFPA (National Fire Protection Association) and OBRA (Omnibus Budget Reconciliation Act)
Type of authority characterized by advisory capacity?
Staff Authority
Type of authority characterized by direct supervision over a subordinate?
Line Authority
The type of budget that projects cash inflows and outflows?
Cash Budget
The type of budget that reflects long-term capital decisions?
Capital Budget
Type of business where partners are personally liable for all of the business debt?
Partnership
Type of leadership known as Top down leadership?
Autocratic
A type of lease that is a rental or usage agreement which is not shown on the balance sheet. Rentals are treated as an expense, and ownership does not transfer to the lessee?
Operating Lease
Under COBRA an employee has how many days to elect to continue coverage?
60 Days
Under COBRA how long may coverage be extended?
18 months
Under COBRA when does coverage begin?
Coverage begins on the date coverage would otherwise have ended
Under double entry rules decreases in assets and expenses are recorded as?
Credits
Under double entry rules decreases in Liability, Revenue and Capital accounts are recorded as?
Debits
Under double entry rules increases in assets and expenses are recorded as?
Debits
Under double entry rules increases in Liability, Revenue and Capital accounts are recorded as?
Credits
Under OBRA (Omnibus Budget Reconciliation Act) the medical director is responsible for the implementation of?
Dietary, Admission, and Infection Control Policies
Under OSHA what is the maximum penalty for each “serious violation”?
$7,000
Under OSHA what is the maximum penalty for falsifying records?
$70,000
Under the ADA (Americans with Disabilities Act) what item is not a disability?
Illiteracy – Not having learned to read
Under the Civil Rights Act this occurs when the selection rate for any protected group is less than 80% of the rate of the non-protected group?
Adverse Impact
Unemployment is paid to laid off workers for how many weeks?
26 Weeks (Now 99 weeks???)
An unincorporated business owned by an individual. The owner is responsible for both personal and business debts?
Sole Proprietorship
A Union must give how many days notice before a strike?
10 Days
The use of 9 or more medications for a given resident?
Polypharmacy
Use of a/r as security or collateral for a loan. When this is done “with recourse”, the borrower remains responsible for collecting the receivables but promises to use the proceeds for repaying the debt?
Pledging of Receivables
Vertical openings must have a minimum fire protection rating at least?
1 Hour, 2 Hours if the building is more than 3 stories.
Walks must be how wide?
36 Inches
What act established the position of long term care ombudspersons?
The Older Americans Act of 1965
What agency prepared “standard precautions” procedures?
CDC (Centers for Disease Control and Prevention)
What are the 5 functions of management?
Planning, Organization, Staffing, Leading (directing), and Controlling
What are the 5 levels of needs in Maslow’s Hierarchy?
1) Food (physiological); 2) Safety; 3) Love; 4) Power (esteem); 5) Self-Actuating Needs (ex. Fulfilling ones potential)
What are the maximum forward and side reaches for switches and controls?
Forward Reach – 48 inches and Side Reach – 54 inches
What are the qualifications of an Activities Director?
Meet state regulations, be eligible for certification by accrediting body. To direct activities, have 2 years of experience within the past 5 years, or be an occupational therapist or occupational therapy assistant.
What are the two most important risk management tools?
Education and Quality Control
What are three typical types of ledgers?
Accounts Payable (ap), Accounts Receivable (ar), and General
What benefits does FMLA provide?
12 Weeks unpaid leave
What controls are necessary for #2 scheduled substance?
Must have Separate Locked Storage. Must be Accounted for Each Shift.
What document establishes the fire rating of building materials?
The Life Safety Code
What does FMLA stand for?
Family and Medical Leave Act
What does Herzberg’s Two Factor Theory teach regarding employees negative feelings about work?
Generally associated with the environment in which they are working.
What does Herzberg’s Two Factor Theory teach regarding employees positive feelings about work?
When employees feel good about work they associate it with the work itself.
What does QAC stand for?
Quality Assurance Committee
What does the Wagner Act guarantee?
Bargaining rights for employees
What entity establishes the resident to bathroom/toilet ratio?
The State
What entity must decide questions involving the mission, organizational structure, personnel, budget and future direction of the facility. They have the power and the liability of the law behind them?
Governing Board
What information is included in Form 941?
Amount witheld for federal income taxes and the employer’s & employee’s share of FICA and Medicare taxes.
What is a drug holiday?
A break from the drug to see how the patient responds
What is a substantial weight loss or gain?
5% gain/loss in one month or a 10% gain/loss in a 6 month period
What is significant weight loss?
5% in a month; 7.5% in 3 months; or 10% in 6 months
What is the acceptable air temperature range in a facility?
71 – 81 Degrees Fahrenheit
What is the maximum allowable sill height of a window?
36 inches above the floor.
What is the Medicare definition of Hospice Care?
Supportive care provided to terminally ill patients and their families in the final 6 months of a patients life.
What is the minimum number of exits?
2 Exits
What is the minimum travel distance to class A, B, and C extinguishers?
Class A – 75 feet, Class B – 50 feet, Class C – 50 feet
What is the minimum width of egress doors?
32 Inches
What is the national standard for budgeting the time required for cleaning a facility?
One hour per day per housekeeping employee per 1,000 sq.ft.
What is the primary source of payment in a nursing facility?
Medicaid
What is the typical cost of fringe benefits for a an employee?
15-30% of wages
What items must be provided to Medicare and Medicaid residents without cost?
Shaving cream, dental floss, deodorant, and combs
What may an administrator ask if employees attempt to organize a labor union?
If the employee has signed a union card
What must be done after entering a transaction in the journal and posting it to the ledger?
Periodically balance each account
What must be provided to a resident prior to transfer?
A written notice detailing right to refuse transfer, the transfer location, a written statement letting the resident know they can appeal the transfer to the state.
What qualifications are required of a full time social worker?
BS (Bachelors of Science) in Social work, psychology or rehabilitation counseling. Also, 1 year of supervised social work experience in a health-care setting
What space must be provided below automatic sprinkler heads?
18 inches (items may not be stored above 18 inches below the sprinkler heads)
What temperature should dishwasher rinse water be?
180F
What terms are used to refer to inventory?
LIFO, FIFO, Physical, & Perpetual (Posting is Not)
What type of fires involve electrical equipment?
Class C Fires
What water temperature is required when rinsing dishes?
180 F, if washing manually hot immersion for at least 30 seconds at 170 F is OK
What water temperature is required when washing dishes?
140 F
When are locks permitted on patient sleeping room doors?
Locks are not permitted on patient sleeping room doors except for a lock that would prevent patients from accidentally wandering into an isolation room, but the patient in the isolation room would be able to exit the room w/o use of a key or tool.
When a resident has been in bed all of the time during a 7 days period, other than for treatment, they are deemed to be?
Bedfast
When a surveyor demands a list of all residents/room numbers indicating each resident’s case mix category and special care needs, the facility must supply this information within what time frame?
4 Hours
When calculating staffing requirements what is the general guide for C.N.A’s and Licensed nurses?
70% C.N.A.’s and 30% Licensed Nurses
When can the DON act as charge nurse?
When ADC (Average Daily Census) is 60 or lower
When is recordkeeping of Occupational Illness and Injuries required?
For facilities with 11 or more employees. General keep records on problems that require more than just first aid.
When meat is cooked too high it can shrink by what factor?
35%
When must a continuation of employee insurance be offered under COBRA?
Employee retirement, marriage dissolved, employee fired (not if the employee’s work hours are reduced)
When must all investigations of abuse be reported to the proper state authorities?
Within 5 working days
When must a resident’s account balance be turned over upon their death?
Within 30 days after the death
When must emergency power come on and how long must it last should a power failure occur?
Must come on in 10 seconds and last for a minimum of 1 1/2 hours.
When must I-9 forms be completed for new employees?
Within 3 business days of start of employment
When must OSHA accident reports be posted?
The entire month of February (every year)
When must the admission medical evaluation (physical examination) be performed?
Within 48 hours of admission unless such examination was performed within 5 days prior to the admission.
Where must Sharps containers be provided?
in the Laundry Room and Every Med Cart
Which federal agency mandated the RAI (Resident Assessment Instrument)?
HCFA (Health Care Financing Administration) preferred term in now CMS (Centers for Medicare and Medicaid Services)
Who determines if it is safe/unsafe for a resident to self-administer drugs?
Interdisciplinary Team
Who is eligible for Medicare?
Automatic eligibility is limited to persons over 65 years of age who are eligible for Social Security cash benefits and are enrolled in the program and to persons under 65 after they are eligible for Medicare Part B without paying premiums if they have received Social Security Disability or Railroad Retirement Board benefits for 24 consecutive months (any person over the age of 65 may purchase Medicare Part B regardless of whether or not they have paid into Social Security System. Persons of any age may receive Medicare A without paying premiums automatically if they have had a kidney transplant or are on kidney dialysis. All enrollees are entitled to Part A but Part B is voluntary and requires a monthly premium as well as an annual deductible.
Whom is most affected by Title 1 of the ADA?
The health care facility administrator
Who regulates Medicaid benefits and eligibility requirements?
They are established by a combination of federal and state legislation, regulations, and programs.
Who regulates the retention period of the medical records at a nursing facility?
The state in which the facility is located.
Will Medicare pay for adult day care?
No, Medicare does not pay for adult day care
65 percent of residents accidents occur in
the resident bedroom
The accrual method of accountin is required by
Medicare and Medicaid
Activities shoudl focus on
resident enjoyment and participation
Adaptive feeding equipment must be prescribed by who?
Physician or occupational therapist
The administrator of a facility is considered what type of employee if they can not be paid overtime?
Exempt or salaried.
Affirmative action relates to
hiring practices
The air in a nursing home must be changed every
6 minutes
Air temperature is measured from the???
Just above the floor or 3 ft above the floor.
All cost reports to medical are due within how many days of the end of the fiscal year
90 days
All doors in a facility except for bathroom and toilet must be _ inches wide.
44
All personal appliances brought into a facility must be inspected by the __ ensure it is safe before it can be plugged in.
Maintenance
Ambulate means to
walk
An amortization is a schedule showing
interest and principal owed to a creditor
Analgesic provides
pain relief
Annual audits done by _(who) are needed to verify the information in financial statements.
CPA Certified Public Accountants
Anti-coagulant is used to
prevent the cells in the blood from clotting.
Aphasia is
difficulty speaking. Inability to interpret or formulate language
Are facilities able to manage a resident with AIDS?
A facility is abl eto care for a resident with AIDS using universal precautions
Are you required to have glass panels in the double doors of a fire compartment?
Yes
Assessment of a resident’s condition produces a description of
their current status. A physical exam every 3 months documented in MDS.
Assets appear on the what?
balance sheet
An attending physician must visit residents days for the first three months and then _ thereafter.
Once every thirty days for the first 90 days and then once every 60 days thereafter.
Attracting customers to buy the facility’s services and fill empty beds is called what?
Marketing
Autism is or is not a developmental illness
Is a developmental illness
Bathroom and toilet doors must be at least___inches wide?
32
Becoming incontinent is a psychological or physiological change?
Physiological
Becoming neurotic is a psychological or physiological change
psychological
Bedfast means being confined to a bed all the time within the past ___days.
Bedfast means being confined to a bed all of the time within the past 7 days
Benin means a cell mass is
non-malignant
Best indicator of new hires ability to suceed in a job is
prior job performance
The best source of new hires is
a current employee
The best way to evaluate a job applicant is the
interview process
Blind residents must be provided a copy of their resident rights in
Braille
A bruising of the skin is called
contusion
Budgets are based on what?
Future expectations and past experience
The budget should be reviewed how often
Every 30 days and prepared annually
Buying a computer or repaving the parking lot are
capital costs
Calculate percentage of occupancy where you have 120 beds and 87 are occupied
87/120 is 72.5
Can a facility require a resident to sign advanced directive?
No
Can an exempt employee be given overtime wages?
No
Can a non-profit issue stock?
No
Can internal and external meds be kept in the same drawer or area?
No. They must be kept in separate areas and stored in different drawers on med cart.
Cannot hire a non-certified aide
for more than 4 months without them passing the exam.
Cannot store any object above _ inches from the ceiling
18 inches from the ceiling
Can state and federal agencies impose civil or criminal penalties
no. Only a civil court or a criminal court can impose
Can you charge a resident for the time to locate records?
No
Can you charge for the time to type a bill?
NO
Can you require a medical exam before someone is hired?
No, only after hire
Can you use extension cords in a facility?
No
Carcinoma is
cancer
A care plan must be completed within how many days of the completion of the MDS
within 7 days of completion of MDS
A care plan must be signed by a
Registered Nurse
Care plans address activities appropriate for each resident based on the
comprehensive assessment
CARF stands for the
Commission on Accreditation of Rehab Facilities
A carpet cannot have a pile higher than how many inches?
1/2 inches
Cash flow is the cash receipts minus
Cash disbursements
The CEO is sued by shareholders for mismanaging the company and losing money. Which policy will cover you?
Officers and Directors insurance will cover the facility
A change in ownership, DON or management could trigger a _ survey
extended
A charge nurse has what authority
Line Authority
The Civil Rights Act of 1964 prohibits discrimination on the basis of what?
Race, religion, gender, color, or national origin.
A civil wrong is a
tort
A Class A fire extinguisher is used for what type of flammable material(s)?
Paper or wood fire
Class B fire extinguisher would be used to put out what kind of fire?
Flammable Liquid Fire
Class C Fire Extinguisher would be used for what type of fire?
Electrical Fire
Class D Fire Extinguisher would be used for what type of fire?
Flammable Metals
COBRA provides workers the right to keep their insurance for how many months after termination?
18 months
A collection of tasks that can be performed by an employee
job
The complaint survey is an ____survey.
Abbreviated Standard
A comprehensive assessment must be completed within how many days of admission to a facility?
14 days
A comprehensive assessment must be reviewed every _ and completely updated .
reviewed every 3 months and completed annually.
A comprehensive assessment must be reviewed every _ and completely updated .
reviewed every 3 months and completed annually.
The consultant dietician is responsible for
The review of the residents’ nutritional intake and weight loss and recording of their food preferences.
A ___corporation can choose any 12 month period as its fiscal year.
C corporation
A court order to deduct monies from a worker’s paycheck to repay a debt is called a
garnishment
The current ratio should be no less than 2.0 to 1.0? True or False
True. Less than 1, indicates you have more liabilities than assets.
A dark area under the skin containing fluid is called
Hematoma
Dealing with press releases and news conferences is called
public relations
A debt to equity ratio should be less than
1.
The debt to equity ratio should be less than
1 to 1
Demographic information relates to
Age, family, sex, educational level, occupation, and religion.
Department managers have what authority?
Line Authority
Depreciation is correctly defined as the decrease in value due to
wear and tear and obsolescence
Discharge planning is started
upon admission
Disclosure of ownership requires facilities to
Notify the state licensing agency of changes in corporate offices, administrator, and Director of nursing.
The distance from inside a resident room to the fire exit corridor cannot exceed how many feet?
50 ft
The distance from inside a resident’s room to the outside fire exit cannot exceed how many feet?
200 ft
A doctor involved with causes of disease is called
pathologist
Do employers have to provide an employee paid leave while on FMLA?
No. Employees may also be required to use any vacation or sick leave before going to unpaid status.
Does a resident have a right to a bath? (per OBRA)
Not specified, just that it is assumed you will keep the resident clean.
Does a resident have a right to a shower?
Not specified, just that it is assumed you will keep the resident clean.
Does OSHA require an employee to have a physical?
Yes
DON can serve as a charge nurse with how many beds?
60 beds or less
The DON is responsible for supervising
the nursing staff
A door on the fire exit corridor must be how many inches thick with a solid wood core and have how many minutes of fire rating.
Must be at least 1 3/4 inches thick with a 20 minute fire rating.
The door that leads from a resident room to the main hallway must be a minimum of how many inches wide?
44 inches wide
Do seniors lose interest in intimacy and sex as they age?
The aging continue to have a strong interest and need for intimacy and sex.
Doxidan is a
laxitive
Drugs should be administered how long after they are prepared?
Within one hour after they are prepared.
A durable power of attorney covers
both financial and health care
Dysphagia is
difficulty swallowing
Each facility must have a _ with one or more hospitals approved for participation under Medicare and Medicaid. This also allows to exchange medical information per HIPAA
Transfer Agreement
E-coli comes from
Beef
An effective maintenance program emphasizes
preventative maintenance
Egress is
Outward
An electrical power transformer blows up down the block and the facility loses power for a week and you lose 100,000 dollars in income, which policy covers you?
Business interruption insurance.
The emergency electrical generator must be inspected how often?
Weekly
The emergency generator must be tested under full load for how many minutes and how often?
30 minutes each month
The emergency generator must switch on within how long?
10seconds
Employees must be trained in safety procedures )lock out, Tag out, Universal Precautions, Hazard Communication) within what time frame?
immediately after hire and before they actually start working
Employees not formally evaluated by their supervisor _ be expected to make good progress.
Can not
Employees on medical leave __ be given their job back when they return.
Must
Employees pay ——of their FICA tax
50%
An employee wage evaluation program should be based primarily on
Merit/performance based
An employee who punches in on a time clock is considered to be
non-exempt or hourly.
Employers must provide employees training in any changes in OSHA laws within how many days?
90 days
Employment at will allows an employer to
fire an employee without cause
Employment at will means employer can
Terminate a worker without cause.
The _ enforces the FLSA
The Department of Labor
Every facility must be divided into a minimum of how many smoke compartments?
2
Every resident should have a physical exam at least
quarterly
Expenses appear on the what?
profit and loss statement or income statement
Explain class 1-4 deficiencies per OBRA
- no harm, no potential for harm. 2. no harm, but potential for harm. 3. harm, but no immediate jeopardy. 4. harm and immediate jeopardy.
Facilities are constructed of what material?
Non-combustible material
A facility must inform the resident of their rights both verbally and
in written format to meet legal obligations.
A facility must keep blank months of resident assessments in the resident chart
15 months
The facility must make dental services available. Who is responsible for paying for these services?
The resident or the resident’s family.
The facility needs to provide adequate space in the dining room and spacing between tables to
maneuver around a room
A facility that has no deficiencies would have a
Standard License
A facility that takes only private pay residents would be subject to a____ survey.
A state survey
A facility with 60 parking spaces must have how many handicapped spaces?
3 spaces. One space for each 25
A facility with outstanding deficiencies would have a
conditional license
A federal law that provides union members a bill of rights is called?
Landrum Griffin Act
Federal regulations are published in the
Federal regulations are published in the Federal Register
Filing a bowl with standing warm water to wash hands is
not an acceptable practice
A fire exit corridors cannot be longer than how many feet?
150 ft.
The fire exit doors should swing which way?
Swing outward
Fire exits must be located how far from each other
As far away as practical from each other.
The fire rating of a building material is determined by the
life safety code
A fire rating of how many hours for the walls of a smoke compartment?
2hrs
The fiscal intermediary is an——-who processes Medicare and Medicaid claims
Insurance company
Food must be stored how many inches off the floor?
6 inches off the floor
The formula to determine body weight loss is
loss is divided by (the usual weight minus the actual weight) / usual weight X 100.
GAAP means
Generally accepted accounting principles
A group of symptoms which occur together is called a
syndrome
A Hallway or ramp must have a minimum width of how many feet wide?
8 feet wide
A handicapped parking spot must be at least how many feet wide?
13 ft wide
A handrail on a staircase must extend how many inches beyond the bottom and top step?
12 inches beyond the bottom and top step.
Handrails must be how many inches from the floor on ramps and stairways?
30-34 inches
A hazard area needs how many hours of fire protection of automatic extinguishing system.
one hour fire protection
High forward reach from a wheelchair is how many inches?
48
HIPAA limits the exclusion period for pre-existing conditions to how many months
12
Housekeeping does not clean the kitchen. Why?
To prevent cross contamination and infection from resident rooms
How does a business pay it’s payroll taxes?
Employers pay payroll taxes quarterly on form 941
How do you calculate adequate required living space in a resident room
Living space less the bathroom, vestuble, closet, and hallway.
How do you calculate the current ratio?
Dividing current assets by current liabilities.
How do you calculate working capital
Working capital is current assets minus current liabilities
How do you report injuries OSHA?
Into the summary log and supplemental log of injuries and illnesses within 6 days. If several workers are hospitalized or killed you must report within 8 hrs.
How is Current Ratio calculated
by dividing current assets by current liabilities
How is the fire alarm activated?
Manually
How long do you have to work for an employer to be eligible for FMLA?
12 months or 1250 hrs
How many compensatory hours can you accrue each year?
Not more than 240 comp hours.
How many days do you have to report a non-fatal accident to OSHA?
7 days
How many days do you have to report any injuries from a medical device?
10 days
How many days in advance must you prepare the menu
30 days
How many days notice must be given for an intent to change an existing union contract?
90 days
How many employees does an employer need to have to be subject to the Age in Discrimination Act.
20 employees
How many employees do you need to be subject to EEOA
15 working: more than 20 per year
How many employees do you need to be subject to the OSHA injury reporting requirement?
11 employees
How many fire drills do you need each year?
12 per year, or all three shifts per quarter.
How many years do you have to keep the OSHA medical records?
for the course of employment plus 30 years
How often do businesses file taxes
Businesses (publicly traded) must file quarterly while an individual business files only annually.
How often do workers have to have a physical exam?
Annual TB Test and offer Hep B Exam
How often is the Balance Sheet prepared?
Annually at the year end
How often must a facility be surveyed?
Every 15 months
How often must all facility policies be reviewed?
Annually
How often must the quality assurance committee meet?
Quarterly
How often must the safety committee meet?
Monthly
How often must your emergency plan be approved and by whom?
The facility emergency plan must be approved by the emergency management plan by the county.
How soon should supplies just delivered to the facility be secured behind locked doors
Immediately
Identify and solving problems before they get out of hand is called what?
Risk management is identifying and solving problems before they get out of hand. Purchasing insurance decrease your risks.
If 3 or more workers are hospitalized or killed, how must you notify OSHA and within what time frame?
Must notify OSHA within 8 hrs by Telephone
If a facility had any life safety violations, which type of tag would they receive?
K tag
If a facility is subject only to a state survey, which type of tag would they receive?
N tag or Non-Federal Tag
If a facility is subject to a federal survey, what type of tag would they recieve?
F or Federal Tag
If a medication has a stop order- when must the nurse notify th ephysician?
The nurse must notify the physician before the last dose is administered
If an administrator notices a resident is deteriorating he should
ask the nurse to evaluate the patients overall condition ad report it to the physician
If an employee damages the facility van resulting in costly repairs, which insurance policy would cover you?
Auto Insurance
If an employee worked 11 months and 1300hrs, would they be eligible for FMLA?
Yes, they worked more than 1250hrs.
If a nursing aide punches a visiting family member, causing serious injury, which insurance policy will cover you?
General liability insurance will cover the facility
If a person were declared not competent by a court, who would make the decisions for that individual?
A guardian
If a resident cannot afford emergency dental care (Medicaid) does the facility have to provide emergency dental care?
yes
If a resident has vision problems, a copy of resident rights must be provided in
large print
If a resident is given an anti-psychotic, the physician must document _ in the chart per OBRA
A rationale or reason for the use of the anti-psychotic
If a resident is harmed because a nurse gage a resident the wrong medication, which insurance policy would cover you?
Malpractice or Professional Liability insurance will cover you.
If a resident suffered a myocardial infarction, which therapy would be best for them?
A cardiac recovery program
If a wind storm blows the roof of the facility, which insurance policy would cover you?
Property insurance
If contacted by a union representative for collective bargaining, the administrator should
call a lawyer who specializes in labor relations
If I hire 10 white people (the majority group), then how many minority people do I have to hire per EEOA?
8 minorities
If I need to hire additional minorities, because I did not meet the minimum required by the EEOA, this is called _
Ratio Hiring
If I wanted to know how much I was worth, I would look at the
Balance Sheet
If I wanted to know the financial well being of a company I would look at the
Balance Sheet
If resident does not speak predominate language, then the facility must provide___
an interpreter or a written translation in their own language.
If you wanted to know how much money I made Last month, I would look at the
Profit and loss statement
If you wanted to know how much your business was worth, you would look at?
Balance Sheet
I have 120 residents and need 2 hours of nursing care for that day. My nurses work 8 hour shifts. How many nurses do I need to staff that day?
30 nurses-120 x2 hours is equal to 240 hours divided by 8 equals 30 nurses.
In accrual system, income and expenses are recorded when
Incurred (The date of the Invoice).
An incline of less than .5 inches requires what?
Beveled Edge
An incline or slope of more than 1/2 inch requires
ramp treatment
Income and expenses are recorded in accrual method when
incurred
An individual who executes or carries out a will is called
an executor
Infections in residents that develop after a resident is admitted to the facility is called?
Nosocomial or (within)
In GAAP, what is the conservatism principle?
Play conservatism principle states that you must use the lower valuation when deciding which depreciation schedule to use calculating the value of your assets.
In GAAP, What is the objective evidence principle?
The objective evidence principle states that you must use source documents to evidence your transactions.
Ingress is
Inward
In multi-bed rooms, the minimum distance between each bed is how many feet?
3 ft.
Intentionally not providing a prescribed dose to lower concentration of drug in body is called a
Drug holiday
In the cash system, transactions are recorded when
cash changes hands
Involuntary movement of the head, lips, tongue, face, and extremities, including lip smacking movement is called
Tardives Dyskinesia
IRS records must be saved for how many years?
4
Is an hourly employee an overtime eligible employee?
Yes
Is communication with family between administrator privileged?
It is not privileged, or protected by law. Attorneys, doctors, and clergy do have confidential privilege and cannot be forced to disclose what you reveal to them.
Is it true, the administrator must implement all recommendations of the Resident Council
No, the administrator must respond to recommendations, not required to implement them
An isolation room does or does not need a private bath or shower?
Does not need
I spend $7100 in June on maintenance supplies. I have 100 beds with 90% occupied on average each day. Approximately how much did I spend per resident per day?
$3
I spent $15,000 on food in June. I had an average of 100 residents each day that month. How much did I spend on per resident per day in June?
$5 per resident per day.
The ___is required to develop a written hazard communication policy.
employer
The ___is responsible to check resident drug regimens monthly
The pharmacist consultant is responsible to verify drug records
Is the employer required to pay for health insurance premiums while an employee is on FMLA?
The employer is required to pay for health insurance premiums.
___is the main cause of death from a fire.
Smoke.
Is where fluid in the eye builds up pressure in the optic nerve causing intense pain and blindness.
Glaucoma
It cannot take more than how many lbs of pressure to operate a faucet, water fountain, or flush a toilet?
5lbs of pressure
The key to inventory control is to
Standardize supplies, organize a central purchasing department, and control number of people authorized to purchase.
Knee clearance is how many inches?
at least 27 inches high, 30 inches wide, 19 inches deep under the sink.
Labor costs total between _
50 and 60%.
The landing on a staircase must be a minimum of how many square ft?
60
A law passed by an agency is called a
regulation.
A law passed by a town or city is called an
ordinance
A law passed by the state legislature is called
A Statue
A law requires an employer to pay for injuries to third parties caused by employees is called
Respondent Superior
A legal document that spells out a person’s preferences concerning life sustaining treatment is a __.
living will.
A Levin tube is a
naso-gastric tube
Liabilities appear on the what?
Balance Sheet
Life safety code sets fire rating of buildings and was developed and published by
ANSI or American National Standards Institute
Lighting of the means of egress must be continuous with exit floor surfaces illuminated at a level of ______ foot candle from the ______.
1 ft from the floor.
Listening intently, connecting with the speaker and acknowledging you hear their concern is called___.
Active listening.
The _ lists all accounts in the General Ledger
The chart of accounts lists all accounts in the General Ledger
The livable space in a resident room would not include
bathroom, closet, hallway
Long term goals are for
three or more years
Long term residents are surveyed
annually
A loss of appetite is called
Anorexia
Low sodium diets are for
high blood pressure
The main function of personnel management is
staffing
Main goal of physical therapy is to
help residents live life to the fullest.
Main job of activity director is to
identify interests and complete assessments
Main job of the local ombudsman is to
investigate and resolve complaints
The main purpose for a resident council is
to give residents a sense of control over their lives
The maintenance cost of aging capital equipment justifies replacement in how many years?
10 years
Major causes of overtime is
Absenteeism
Management by objectives is where the
supervisor and worker jointly set the workers performance goals.
Management by walking around would not involve______.
Taking Corrective Action
Marketing is concerned with
Filling your beds.
The maximum corridor length allowed without a smoke stop is _ feet
150 ft
The maximum in assets you can have and qualify or Medicaid is how much?
$2000
The maximum number of residents who can be in a room?
4
The MDS has how many triggers
18
An MDS must be signed by a
Registered Nurse
The medical director coordinates the___ in the facility
physician services
Medicare fraud is reported to
the office of inspector general, OIG
Medicare is an insurance program for
Americans over 65
Medicare residents funds totaling less than $100 do or do not need to be placed in an interest bearing account?
Do
Minimum daily nursing hours are set by who?
the states with federal approval
The minimum width of a resident bedroom is determined by _.
the state
Mirrors and towel racks are mounted no more than _ inches from floor
40 inches
The most common cause of infection in nursing home is
Exposure to visitors and employees is most common cause for infections.
The most common psychological problem of elderly is
depression.
The most effective form of communication is
face to face
The most effective way to prevent the spread of germs in a nursing home is
hand washing
The most you can earn each month and still be eligible for Medicaid (2012) is
2094
MSDS material sheets are required by?
OSHA
Must close doors in a fire to contain what?
Smoke
Must complete a form _ for employees receiving compensation other than regular salary
1099
Must have a charge nurse on what shifts?
All three shifts (7-3,3-11,11-7)
Must have a registered nurse _ hours per day, 7 days a week.
8 hrs per day
Must have battery power to power the emergency lighting for how many hrs?
1.5 hrs
Must have one fire extinguisher every __ square feet
2,500
Must inform residents of their rights
before and during admission.
Must keep the resident chart for how many years?
5 years
Must keep the resident contract for how many years?
5 years
Must make records available for inspection within how many hours of request
24 hrs
Must monitory physical restraints how often?
30 minutes
Must notify the _ if management changes the administrator changes of officers of the company change
State Licensing Authority
Must offer therapeutic activities based on a resident’s _
interests and hobbies
Must provide copies of a resident’s records within how many hrs
48
Must provide resident __ days notice of any changes in charges or policies.
14 days advance notice of any changes
Name 2 inventory valuing methods valuing methods
FIFO and LIFO
Name 2 revenue centers in a nursing home
Nursing, physical tehrapy, dietary (sells meals)
Name 3 expenses in a nursing home
social services, nursing, physical therapy, maintenance
Name 3 ways food can be prepared and stored that destroys its nutritive value.
Over boil in water, add baking soda, leave uncovered in the fridge.
Name the 6 legal reasons to involuntarily discharge a resident against their will.
- Resident’s needs can not be met by facility. 2. Health has improved to no longer need care. 3. The safety of others in the facility is in danger. 4. The health of others in the facility is endangered by resident. 5. The resident has failed to pay after notice. 6. The facility is closed.
Name three types of liquid thickeners?
Nectar, pudding, and honey
The national standard is to staff one hour per day of housekeeper time per
1000 square feet
Need a _ day qualifying stay in a hospital to be admitted to a skilled nursing facility.
3 day qualifying stay
Need a vote of ___of all workers to vote in a union
50 percent plus one
The need for physical restraint should be re-evaluated
every 2 hours
Nonprofits can or cannot pay dividends?
cannot
NPO means
nothing by mouth
The number of accounts outstanding for more than 50 days should not exceed
5%
The number of required fire drills is determined by
The Life Safety Code
A nurse aide must have _ hours of in-service per year.
12
The nursing home bargaining units may only represent which employees?
2 units, professional and non-professional
A nursing home may have how many bargaining units?
2
Nursing home placement causes anxiety because of what?
The fear of the unknown.
OBRA requires how many hours of nursing aide in service each year.
12 hours
The ombudsman program is funded by
the Administration on Aging
The open market ruling in 1977 relates to
advertising health services
An ophthalmologist is a medical doctor that treats?
Visual disorders and is a medical doctor.
An organizational chart does not show _ relationships.
Informal
OSHA’s color is
green
An ostomy bag is connected to the body through
Connected to the colon through the stomach wall.
Other than an mergency, you must give residents how many days advance notice of transfer or discharge?
30 days
An otologist deals with___
Hearing Loss
Outdated, deteriorated, or discontinued drugs
should not be stored in the drug room.
Overtime is an
operating expense
The owner’s assets of a business are called?
Equities
Per OBRA 1987, the comfortable air temperature range in a facility is between _ and degrees?
71-81 degrees
Per resident per day standard to launder sheets, blankets etc is _ pounds
8-10 lbs
Personnel policies are found in the
employee handbook.
Persons over 65 use an average of how many drugs?
7.2
A person who died without a will is said to have died __.
intestate
Ñ
A person who makes a will is called
a testator
A person who studies the aging process?
Gerontologist
Per Theory X, employees do or do not want to work?
Do not want to work.
Pest control programs can or cannot use open traps, sticky fly paper, poison bait?
Cannot use open traps
The pharmacist consultant does or does not dispense or dispose of drugs
The pharmacist consultant does not administer, dispense or dispose of drugs. The pharmacy under contract does that
Physical restraints should be evaluated how often in the first hr?
Every 15 minutes
Physicians must write, date, and sign progress notes at
each visit.
A physician who specializes in mental disorders?
Psychiatrist
A physician who works with the musculoskeletal system.
physiatrist
Play residence and work for the facility provided it is recorded in the
Plan of care
PO means
By mouth
A power of attorney covers
deals only with financial affairs
The president may halt a union strike for how many days?
80 days
The primary purpose of a safety program is to
prevent or minimize accidents and injuries
Primary purpose of financial information is to
enable administrators to make decisions
The primary reason residents should be encouraged to eat in the main dining room is
encourage them to socialize with other residents and get out of their room
The principal difference between Medicare and Medicaid is that Medicare is _ and Medicaid is an insurance for _.
Medicare is an insurance program based on age where insured pay premiums and co pays and Medicaid is an insurance for the poor and elderly based on income.
Prior to hiring a nurses aide, the administrator must check the
state nurse aide registry
Privacy considerations include privacy curtains, knocking on doors, and understanding each individuals needs for
privacy.
Privacy curtains and all other obstacles must hang or sit how many inches from the ceiling to avoid blocking the water sprinklers?
18
A private room must have a minimum of how many square ft?
100
A private room, television, and phone are or are not covered by Medicare or Medicaid
Not Covered
PRN means
as requested
The process of determining job tasks, employee behavior and skills necessary for a job is called __.
Job analysis
A professional who grinds lenses for glasses is called
Optician
An _ provides training in adaptive feeding devices.
OT, occupational therapist
The purpose of a transfer agreement between facilities is to provide
an interchange of medical information
A railing or grab bar must support a minimum of how many lbs?
250
Ramps and corridors must be a minimum of __ feet wide
8 feet
Reaching out to the community and strengthening your relation ship with community organizations is called
Public relations
Reality orientation involves
calendars, clocks, and signs
Recreational therapist is or is not a specialized therapist
Not
Referrals from who are the best source for new hires
current employees
Regulations are published in the
Code of Federal Regulations or CFR
Requests by a resident to see their medical records can be submitted
Orally or in writing by resident
The resident chart belongs to the
Facility
Resident funds held in trust must be funded to his or her estate within how many days of death with a final accounting?
30 days
A resident is prohibited from being forced to sign a _ as a term of admission.
Advanced directive
A resident must be given a physical exam at least how often?
Every 3 months
A resident must have a medical evaluation within how many days unless examined within how many days prior to admission from the hospital?
Within 2 days unless it was done within 5 days when at the hospital.
Residents are encouraged to participate in activities________.
personally satisfying to them and give them a sense of belonging.
Residents can take home medications if approved in writing by __
their attending physician
Residents have the right to self administer drugs approved by the
inter disciplinary team
Residents that are both _ and _ are most at risk for injuries because they are able to move around but pose poor risk awareness.
Ambulatory and incompetent
A resident who is to be admitted to a nursing home must have a physical evaluation or exam done how many days prior to admission or how many hours after admission?
5 days prior to admission or 48 hours after admission
A resident who was approved to self-administer drugs overdoses by mistake and is hospitalized. When the resident is ready to be released, and returned to the facility, the facility should?
Re-admit them and then re-assess their ability to self-administer.
A resident with audiological problems would be referred to an
an otologist
Restorative nursing is provided by
Nursing aides
The results of all abuse investigations by facility staff must be reported to the state within how many days?
5
ROM means
Range of Motion
Rookie managers make the mistake of
over managin
A salaried employee would or would not be entitled to overtime pay?
Would not
Salary increases should be based on
Merit/performance
Salmonella comes from
Chicken
Schedule 1 drugs are
illegal narcotics and are not allowed in nursing homes
Schedule II drugs can or cannot be refilled without a physicians new prescription
Cannot
A semi private room must have a minimum of how many square feet of living space per person?
80 square ft.
A semi private room with 4 residents would require how man y square feet
320 square ft
A sensory experience that is independent of stimulation from the environment is called
a hallucination
Shareholders of a ___corporation are taxed as a partnership or a salary
“S” corporation
Sharps must be discarded
immediately after use.
Short term residents should be surveyed
30 days after discharge
Side reach from a wheelchair is how many inches?
9-54 inches
A sidewalk must be a minimum of how many ft wide
3 ft wide
A significant change must be processed within how many days
14 days (completely new MDS)
Significant weight loss for 1 month is what percent?
5
Significant weight loss for 3 months is what percent?
7.5
Significant weight loss for 6 months is what percent?
10
Sitters and private duty nurses are
not employees of the facility if they are hired by family members or residents. They must follow the rules of the facility.
Skilled therapy that focuses on the lower body and strengthening weight bearing muscles is called
physical therapy
Slowed reflexes is a psychological or physiological change?
Physiological
Social security is a __tax
payroll
Solid lines show what on an organizational chart?
Authority
Some one breaks into your facility and steals 1,000 dollars, what insurance would cover you?
Burglary insurance
A sphygmomanometer is used to measure
blood pressure
A stage 4 pressure sore that developed from a stage 1 or stage 2 while in your facility would warrant.
immediate jepardy or a level 4 citation.
Standard Precautions deal with handling
body fluids by total body protection.
State survey process is ____based?
Outcome
STAT means
immediately
STAT means
immediately
The study of the aging process
Gerontology
A subpoena requires
personal appearance at a hearing or trial
Substituting one person for another in regard to a lawful claim is called___.
Subrogation is substituting one person for another in regards to a lawful claim
The __ summarizes the debts and credits
The Ledger or General Ledger
The sum of all activities to create desired changes in quality care is the definition of ______.
Quality Improvement
A telephone cord must be how long?
A minimum of 29 inches long.
The term “lock out and tag out” refers to preventing staff and residents from what?
Electrocution
There must be a wheelchair passing lane every how many feet?
200ft
The____ specifies time limit to bring a lawsuit.
Statue of Limitations
To determine the capability of a facility to meet short term cash needs, you would look at the __.
The cash flow statement
Toe clearance for a wheelchair is how many inches?
9 inches
Toilet seat for disabled must be between _ and _ inches high
17 and 19
Topical drugs are administered
for external use only
The travel distance between a class be or class c fire extinguisher can not be more than how many feet?
50 ft
Trial subpoena requires attending at
a trial to testify
Two wheelchairs require how many inches to pass?
60 inches
Ultimate mission of a nursing home is:
to provide quality resident care
Under GAAP what is the entity principle?
The owner of a public corporation is separate from the company and cannot take cash from the cash register and not record the transaction.
Under OBRA, the quality improvement committee must meet at least how often?
Quarterly.
Under respondent superior, both the employer and the employee are liable for wrongful acts of employees to third parties such as who?
residents and visitors
Under the ADA, employees can be required to submit to a __ exam relevant to their job after being hired.
fitness for duty
Under the Family and Medical Leave Act, an employee can take up to _____weeks of paid leave each year for certain personal and family illness situations.
12
A union must give employers how many days notice before they can strike?
10 days notice
Using labor pools can substantially
decrease continuity of care.
A violation with an “N” tag means the violation was _.
state tag or Non-Federal
A walkway must be at least how many feet wide
3 ft wide
Weekend overtime wages are an operating
expense. Such as electricity bills, payroll, medical supplies, and food costs
What are examples of mechanically altered food?
Puree, mechanically softened
What are general statements that guide thinking?
Policies
What are some examples of a therapeutic diet?
Soft, liquid, diabetic
What are source documents under GAAP?
Source documents include invoices, receipts, and cancel checks. Source documents are objective evidence of the transaction and include receipts for bills that have been paid, bills or invoices for money owed by the facility, bank statements indicating interest earned periodically.Receipt for money received by the facility each day or designated period.
What are the 4 stages of a decubitis sore?
The stages of a decubitis sore 1. redness/warm to touch 2. a blister that opens with possible puss. 3. tissue loss of the upper and lower layers of the epidermis. 4. tissue loss down to the bone.
What are the main symptoms of Tardives Dyskinesia?
Lip Smacking and Uncontrolled facial gestures
What are the minimum requirements for a social worker?
Must have a bachelors degree in social work and one year of experience.
What are the requirements for a closet in a resident room?
The closet must have 30 x48 inch clear floor space, a clothes rack and a shelf no higher than 54 inches
What are two major reasons for the increased stress nurses are experiencing in long term care?
Increased acuity and shorter resident stay
What can you specifically charge a resident when providing photocopies of their records?
a per page copy charge and the actual time required to copy the records.
What depreciation depreciates evenly over a set period of years?
Straight line depreciation
What did HIPAA require when it first passed?
HIPAA makes a workers insurance portable by limiting the period of time a workers new insurance company can refuse to cover a pre-existing condition to 6 months.
What direction do the double doors of a fire compartment swing?
In opposite directions.
What document summarizes the assets, liabilities, and capital (or net worth equity) on a certain date?
The balance sheet
What does a citation or deficiency with a “K” denote
The facility was not in compliance with the life safety code.
What does ANSI do?
Develops and publishes the American with Disabilities Act
What does ANSI stand for?
American National Standards Institute
What does CASPER stand for?
Certification and survey provider enhanced reports
What does CMS stand for?
Center for Medicare and Medicaid Services
What does CVA stand for?
Cerebral Vascular Accident
What does DHHS stand fro?
Department of Health and Human Services
What does FMLA stand for?
Family and Medical Leave Act
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
What does MSDS stand for?
Material Safety Data Sheet
What does NFPA stand for?
NFPA stands for National Fire Protection Association.
What does OIG stand for
Office of Inspector General
What does OSHA do?
Protects American workers by ensuring a safe workplce
What does OSHA stand for?
Occupational Safety and Health Act or Administration
What does palatable mean?
Pleasant to taste
What does RACE stand for?
Remove, Alert, Confine, Evacuate/Extinguish
What does SMDA stand for?
Safe Medical Devices Act
What does the NFPA do?
researches and publishes the life safety code. It does not enforce the code.
What does the OIG do?
Investigates Medicare and Medicaid Fraud
What does the OSHA Bloodborne Pathogen Program require an employer to do?
Requires a written plan in case of exposure.
What does the PSDA require a facility to do?
PSDA requires a facility to inform a resident they have the right to make an advanced directive but cannot require them to do so .
What does the PSDA stand for?
PSDA stands for the Patient Self Determination Act
What does TIA stand for?
Trans Ischemic Attack
What do the initials COPD stand for?
Chronic Obstructive Pulmonary Disease
What do we mean by an employee’s right to know?
Relates to MSDS
What do we mean by substandard care?
A resident was harmed and is a class 3 or 4 violation
What entity enforces the Civil Rights Act
EEOC
What establishes the standards for the width of a parking space for handicapped?
ANSI
What furniture are you required to provide residents in their bedroom per OBRA
Bed, Mattress, side table, dresser with drawers, chair, bed pan, and window or door with a window to the outside.
What information do you need on a drug label?
Resident name, drug name, dosage, mode of administration, and how often to take
What information do you not need on a drug label?
manufacturer’s name
What information is on the OSHA year end summary?
Essentially the summary log but you may need to redact employee names with confidential medical conditions.
What information is recorded on the OSHA Summary Log of Injuries?
Must record the date of injury, employee name, and type of injury, and any restrictions: this is only a summary.
What information is recorded on the OSHA Supplemental Log?
The supplemental Log is your accident investigation form and contains all of the detailed information about the incident.
What inventory keeps count of inventory supplies throughout the year?
Perpetual
What is a CVA?
Stroke
What is a facility policy?
Broad statement of a goal.
What is a living will?
Specifies weather a person wants artificial life prolonging measures if they cannot sustain bodily functions on their own.
What is a LVN?
licensed vocational nurse
What is a mission statement?
A mission statement is simply the purpose of a corporation
What is an IDR
Informal Dispute Resolution (Send letter to survey team leader)
What is an LPN
Licensed practical nurse
What is an MDS
Minimum Data Set
What is another word for a TIA?
Stroke
What is a resident classification system used by nursing homes to determine reimbursement from Medicare?
RUG Resources Utilization Group
What is
Arthritis
inflammation of the joints
What is a therapeutic diet?
A diet that deviates from the regular menu
What is a transaction recorded in the cash accounting system?
In the cash basis of accounting, and transaction is recorded when a bill is actually paid or cash is actually received. And the accrual system the transaction incurred on the date of the invoice.
What is blockage of the arteries called?
arteriosclerosis
What is CHF?
congestive heart failure
What is class 1 deficiency
No harm or potential for harm
What is class 2 deficiency
No harm and no potential for harm
What is class 3 deficiency
Harm but not immediate jeopardy
What is class 4 deficiency
Harm and immediate jeopardy
What is communication between the facility and the public and includes managing the facility’s image?
Public relations
What is continuing concern principle under GAAP?
The company will still be in business next year and the year after that
What is FDR?
Formal Dispute Resolution (within 20 days of receipt of 2567)
What is FUTA?
Federal Unemployment Tax Act
What is hardening of the artery walls?
Atherosclerosis
What is hemiplegia
paralyzed on one side
What is Hepatitis
inflammation of the liver
What is in each compartment of a 3 compartment sink?
Compartment 1- Warm Sudsy Water 2. Clear water to rinse 3. sanitizing solution.
What is it called when older inventory is used first?
FIFO is first in and first out
What is it called when the inventory is only counted once per year?
Periodic inventory
What is loss of urine and bowel control called?
Incontinence
What is Maslow’s most basic need in the hierarchy of needs?
Self realization
What is MBMA
Management by Walking Around or Leadership that starts with Visability
What is MBWA and why is it important?
Management by Walking Around is a management style and is the best way to communicate with staff.
What is myocardial infarct?
Heart Attack
What is Nephritis
Inflammation of the kidneys
What is paraplegia
paralysis from the waist down
What is plegia?
Paralysis
What is preparation for future eventualities and uncertainties called?
Strategic Planning
What is procedure?
A step by step description on how to implement a policy.
What is quadraplegia?
Paralyzed from the neck down.
What is Respondeat Superior
means, hold the employer responsible for the acts of the employee
What is Respondent Superior?
Respondent Superior means the supervisor must respond for the inferior or servant. Or, the employer must pay for injury or damage to third person caused by employees.
What is responsible for categorizing resident rights?
OBRA
What is the accounting equation
assets equal liabilities plus shareholders equity. Assets equal liabilities plus capital
What is the best recovery program for a resident who suffered a cerebrovascular accident
Stroke Recovery Program
What is the Consistency Principle under GAAP?
States you must use the same accounting system year from year.
What is the correct order of steps of annual survey?
Offsite Preparation, entrance conference, sample selection, information gathering, information analysis, exit interview
What is the decibel range for a hearing aide compatible telephone?
12-18
What is the difference between a leader and a manager?
Manager maintains the status quo and resists change whereas a leader is forward thinking and understands the need to innovate, adapt, and change.
What is the difference between a power of attorney and a durable power of attorney?
POA is for financial matters only, Durable POA is for financial and healthcare decisions.
What is the difference between universal precautions and standard precautions?
Universal are gloves, gown, and handwashing. Standard are total body protection and include gown, face mask, gloves, and head covering.
What is the Federal Employer Liability Act?
Says the employee must pay for medical bills and lost time for a worker injured on the job.
What is the first stage of annual survey?
Offsite preparation
What is the focus of the OSHA Hazard Communication standard?
focuses on the MSDS
What is the last in and first out inventory?
Newer inventory is used first
What is the least effective way to market a facility?
Advertising in print media and TV ads
What is the main cause of decubitus sore
Blood supply cut off to the tissue in the skin and muscle
What is the main objective of the Equal Pay Act?
To ensure that females’ re paid the same wages as males in same work.
What is the most common accident in a nursing home to employees?
Lacerations/cuts
What is the most costly fringed
Vacation is most costly
What is the most effective way for an administrator to verify what is actually going on in a facilitity?
Management by Walking Around
What is the most effective way to market a facility?
Word of mouth
What is the number of hours between an evening meal and breakfast without a snack?
14
What is the number of the form that you will receive detailing any deficiencies found during an annual or complaint survey
form 2567
What is the number one reason for employee Longevity
Employee relationships with residents and co-workers.
What is the only thing an employer or manager may tell workers about the benefits of a union?
A manager may tell workers how they feel about a union, but they cannot say anything else or ask any questions about union participation of meetings or donate money to the union.
What is the OSHA general duty clause?
OSHA general duty clause requires employers to provide a safe work place.
What is the primary reason you would invite the fire department to provide staff training in fire emergency measures at your facility?
Have them get familiar with your building and its layout.
What is the principle cause of odor in a nursing home?
Incontinence
What is the procedure to wash hands?
Apply soap fingertips to forearms, scrub under fingernails, wash under hot running water for a minimum of 20 seconds
What is the purpose for the COBRA and how would it help your employees if you had to consel them upon termination of their employment and insurance benefits.
COBRA was designed to allow workers with pre-existing conditions to move from one employer to another without losing insurance coverage for pre-existing conditions.
What is the purpose of life safety?
The life safety code is designed to prevent death due to structural fires
What is the purpose of the MDS?
Required to maintain a continuing evaluation of each residents physical, mental, and psychosocial well-being throughout the year.
What is the RAI and what is it comprised of?
Resident Assessment Instrument and it consists of the MDS, RAPS, and instructions on how to use the RAI
What is the standard of care a facility must provide to each resident per Obra 1987?
Must maintain each resident’s highest practical physical, mental, and psycho-social well being and minimize decline.
What is the standard we use today to determine if discrimination in hiring employees has occurred per the EEOC
Adverse Impact
What is the standard you must provide residents with respect to the facility environment per OBRA?
You must provide residents with an environment that is home-like and de-emphasize the institutional look of nursing homes.
What is the temperature of the final rince cycle of a hot water dishwasher
180 degrees
What is TIA?
Stroke
What is Time Period Principle under GAAP?
You must use the same time period from year to year. Either calendar or Fiscal.
What is type 1 Diabitis?
Insulin dependent and treated with Injections
What is type 2 diabetes?
Adult onset and treated with diet, exercise, and pills.
What is your business plan?
Your budget is your business plan
What kind of questions are best for eliciting info during a job interview?
Open ended
What letter would indicate the existence of a substandard care? (A-L?)
F?
What mandates that the governing body approve all facility policies?
OBRA
What percentage of residents selected to be interviewed during survey must be interviewable?
50%
What physical exam does OSHA require employees to have post hire, but before they work with any residents?
TB test and vaccination against Hepatitis B
What question can you ask a job applicant about their health?
Can they do the job in the job description.
What question can you ask a job application about their criminal background?
Can ask if they have been convicted, not if they have been arrested.
What stage of survey involves a sit down with staff and discloses the results of the annual survey?
Exit Conference
What three things must the facility’s written fire plan address?
The use of an alarm, transmission of an alarm, a procedure to isolate an extinguish a fire, a plan to remove any person in proximity to a fire and a fire evacuation plan. Just remember RACE
What type of depreciation claims most of the depreciation deduction in the first year of an assets life?
Accelerated depreciation.
What would be the basis for a resident to file a tort against a nursing home?
If the resident were injured by staff
A wheelchair is how many inches wide?
30 inches
A wheelchair needs __ inches in diameter to make a 180 degree turn
60 inches
When all nursing staff report directly to the director of nursing, this is called
unity of command
When an agitated resident is given a drug to calm them down, this is an example of a _
A chemical restraint
When bacteria or cells (cancer) move from one part of the body to another, this is called.
Metastasis
When decisions are made at lowest level authorized to make them this is called?
Effective delegation
When do you have to post the OSHA year end summary?
Must be submitted annually and posted where employees can easily see it at least during January and February of each year.
When inventory is increased, cash is
decreased
When is the earliest the survey team can return to verify the facility corrected all cited deficiencies.
30 days from the date the survey team exited the facility.
When supplies are delivered to a facility, what is the correct procedure to verify the items delivered
Check each item delivered against the invoice and manifest and confirm receipt. Items are almost always missing and require a demand of refund.
When surveyors review a resident chart, they want to see primarily
Quality over quantity
When the DON requests a meeting with the administrator, this is
upward communication.
When two or more drugs are taken at the same time and produce unwanted side effects this is called
drug interaction
When urine is accidently released when an individual sneezes or laughs, this is called…
stress incontinence.
When your assets are able to meet your current liabilites this is called?
Liquidity
Where a facility has an outside provider provide in-house dialysis, the facility must a __ to protect resident rights?
Must have a transfer agreement with each dialysis center to allow for sharing of medical information. Surveyors will demand to see that contract during survey.
Where oxygen is in use in a room you are required to __ as required by rule not law
A no smoking sign outside of the room
Where would corrective mistakes be made in the journals?
The general journal
Where would you record prepaid expenses?
The general journal
Which accident accounts for most resident injureis?
Falls
Which document contains rules and regulations that detail purpose and mission, corporate membership and overall financial management?
Bylaws
Which document contains rules, regulations, and a mission statement?
Bylaws
Which document details the name of a corporation, the officers and directors, the number and amount of stock to be issued, and how th corporation will be run?
The By-Laws
Which document is filed with the state to form a corporation?
The certification of incorporation is filed with the state to form a corporation.
Which document is the governance of a corporation?
By -Laws
Which document or documents would include revenues, expenses, assets, liabilities, and capital?
The financial statements collectively would include these.
Which document outlines job duties
Job Description
Which document specifies an individuals preference for use of life prolonging measures such as a tube feeding or ventilators?
Living will
Which entity certifies nursing homes for Medicaid and Medicare?
CMS
Which entity enforces the ADA with respect to access to public buildings by the handicapped?
The Architectural Barriers Compliance Board enforces the ADA with respect to access to public buildings by the handicapped.
Which entity enforces the Discrimination in pregnancy act?
The EEOC
Which entity enforces the Equal Employment Opportunity Act?
The EEOC enforces the Equal Employment Opportunity Act
Which entity enforces the Fair Labor Standards Act?
The Department of Labor
Which entity enforces the Life SAfety Code?
NFPA enforces the Life Safety Code
Which entity enforces the provisions of the Americans with Disability Act?
Architectural Barriers Compliance Board
Which entity enforces the SMDA
FDA
Which entity licenses nursing homes?
The state licenses each nursing home.
Which expense is the largest expense in a nursing home
labor
Which federal agency administers Medicare and Medicaid contracts
The CMS
Which federal agency regulates minimum wage?
Fair Labor Standard Act
Which federal labor law required employers to bargain collectively with unions?
The Wagner Act
Which federal law created the National Labor Relations Board
The TAft Hartley Act
Which federal law limits how much creditors can garnish from your paycheck?
The Consumer Credit Protection Act
Which federal law prohibits discrimination against workers 40 and older.
The Age Discrimination in Employment Act
Which federal law prohibits federal courts from issuing an order preventing unions from striking?
The Norris LaGuardia Act
Which federal law prohibits paying for Medicare referrals?
Ethics in Patient Referrals Act
Which federal law prohibits providers from entering into agreements with one another to set Medicare rates or to self refer to their own facilities?
The Robinson Patman Act
Which federal law recognized workers’ rights to bargain collectively.
Wagner Act recognized workers right to bargain collectively.
Which federal law recognized workers right to strike?
Norris LaGuardia Act
Which federal law requires a Director of Nursing, Medical Director, Registered Dietitian and Consultant Pharmacist
OBRA 1987
Which federal law requires a poster?
OSHA, ADA, and FSLA require a poster
Which Federal law requires employees to provide vacation and sick leave to employees?
None
Which federal law requires employers to notify a job applicant if a consumer credit check is required?
Federal Fair Credit Act
Which federal law requires employers to pay their employees a minimum wage?
The Fair Labor Standards Act
Which federal law requires employers to provide health insurance?
none
Which federal law requires employers to provide terminated employees a certificate of coverage upon termination or seperation
COBRA
Which federal law requires overtime?
The Fair Labor Standard Act
Which federal law requires overtime to be paid to employees?
Fair Labor Standards Act
Which federal law requires the employer to pay for worker on the job injuries?
Federal Employer Liability Act
Which federal law requires written policies and procedures to protect patient info
HIPAA
Which federal law specifies the requirements for handicap access to public buildings?
The Americans with Disabilities Act
Which form of doing business provides the most limited liability?
Corporations provide the most limited liability
Which form of therapy uses the environment as treatment?
Milieu therapy uses the environment as treatment, so does occupational and speech therapy.
Which is more popular, for profit or not for profit nursing homes?
For-profit corporation own most nursing homes
Which law requires a Quality Assurance Committee
OBRA 1987
Which law requires workers to complete an I-9?
The immigration law
Which life safety code do we follow?
Safety Code of 2000
Which manager should be the first to resolve a worker grievance?
The immediate supervisor
Which manager should do an employee’s performance appraisal?
Immediate supervisor
Which national organization represents for profit nursing homes?
AHCA
Which national organization represents healthcare administrators?
American College of Health Care Administrators
Which national organization represents non-profit long term care facilities?
AAHSA
Which organization develops and publishes the life safety code?
NFPA
Which organization provides research to OSHA
NIOSH provides research to OSHA
Which organization sets the standard for the American with Disabilities Act
ANSI (American National Standards Institute)
Which phase of survey involves identifying which deficiencies the facility is sited for?
Information Analysis
Which phase of survey involves team identifying which people they want to talk to and records they want to review.
Sample Selection
Which phase of survey involves the team observing residents and staff, taking notes, interviewing the resident council and other residents?
Information Gathering
Which program must have an active volunteer program
Activities program
Which skilled therapist can work as a therapeutic activities director or assistant?
The occupational therapist since they are familiar with ADL’s
Which staff members have the least training?
housekeeping
Which stage of the annual survey involves the team leader sitting down with the facility staff discuss the survey about to take place and what records they need to see.
Entrance Conference
Which stage of the survey involves survey team walking around the facility to identify layout?
Facility Tour
Which survey type is a complaint survey?
An abbreviated standard survey
Which survey type is the annual survey
Standard Survey
Which survey type is used to verify a facility corrected any cited deficiencies where the facility was cited for more than one F?
A re-survey is done to verify a facility corrected any cited deficiencies
Which survey type would you be subject to if the surveyor finds substandard care during a complaint survey?
A partial extended survey
Which survey type would you be subject to if the surveyors find substandard care during an annual survey?
An extended Survey
Which tax form do businesses use to file FICA and workers compensation taxes?
Form 941
Which tax form do employers provide employees at the end of the year?
W-2
Which tax form do you fill out to declare your tax individual exemptions?
W-4
Which therapists are concerned with the upper body and ADLs?
Occupational therapists
Which therapists evaluate residents for speech and swallowing problems?
Speech therapists
Which therapy uses heating pads?
Occupational and physical therapy
Which therapy uses the social environment?
Milieu therapy uses the social environment
Which type of corporation can choose any 12 month period as its fiscal year
A “C” type corporation
Which types of injuries must be reported to OSHA?
Any injuries that require medical attention or lost time.
Who can act in place of an attending physician in an emergency?
The Medical Director
Who can dispense medication?
Only a pharmacist
Who can prescribe a therapeutic diet?
Only a p
Who can prescribe skilled therapy?
Only a physician can
Who can supervise feeding assistants in a nursing home?
A licensed nurse (RN or LPN)
Who determines the hazards of a product and prints the MSDS?
The manufacturer
Who do you report injuries to in relation to a medical device?
The FDA and the manufacturer
Who enforces HIPAA violations?
OCR Office of Civil Rights
Who enforces OSHA?
Occupational Safety and Health Administration
Who enforces the rehabilitation act of 1973?
EEOC
Who has responsibility for the day to day operations of a nursing home?
Governing Body
Who has ultimate legal responsibility for the operation of a nursing home?
Governing Body
Who hires the staff in a nursing home?
The governing body does not hire staff, most of the time it is done by department heads.
Who is responsible to ensure drug records are in order and accounted for?
Consultant pharmacist
Who is responsible to ensure residents rights are respected?
The administrator
Who is responsible to implement resident care policies in a SNF?
The medical director is responsible to implement resident care policies.
Who is the corporate compliance officer in a nursing home?
The administrator
Who must approve and implement resident care policies?
Medical director must implement resident care policies.
Who must approve bargaining units?
The National Labor Relations Board
Who must approve resident care policies?
The medical director
Who must approve the budget for a nursing home?
Governing Body
Who must approve your fire plan and how often?
The local fire department must approve your fire plan annually.
Who must attend the quality assurance committee meeting?
The DON, a physician, three staff members, NHA does not have to attend.
Who must be notified in the event of a significant change in a resident’s condition?
The attending physician, resident and legal rep
Who must determine if a job applicant requires special accommodation under th eADA?
A physician must determine if a job applicant requires special accommodation under the ADA.
Who must develop the mission statement for a nursing home?
Governing Body
Who must implement facility policies in a nursing home?
Governing Body
Who must make the critical decision for a nursing home?
Governing Body
Who must prepare the menu?
A registered dietician
Who must store and record drugs self administered by residents?
Nursing staff
Who must supervise union elections?
National Labor RElations Board
Who requires a safety committee
OSHA
Who requires nursing home staff to use universal precautions?
OSHA
Who requires overtime to be paid?
The Fair Labor Standards Act
Who would exercise the rights of a person declared incompetent by a court?
A legally responsible person, or guardian
Why do we have policies for everything we do in a nursing home?
To provide guidance to staff to allow the facility to run 24hrs a day even when managers are not physially present in th ebuildign.
The width of an interior staircase must be a minimum of how many inches?
44 inches
The width of the bathroom door in a resident bedroom is a minimum of how many inches wide?
32
The window in a residents room is not required to
open
A window sill can not be higher than how many inches
36 inches
With a snack, how many hours can pass between snack and breakfast?
16 hrs
Within how many days does the I-9 need to be completed from the date of hire?
3 days
Within how many days must a facility submit a plan of correction in response to any allegations of deficiencies?
10 days from the receipt of the report of deficiencies.
Within how many days of the survey team exiting a facility and completing a survey must the facility receive a report of the results of compliance survey?
10 days
The word _ means mandatory in laws and regulations
Shall
The word __ means optional in laws and regulations
May
Worker’s Compensation premiums are based on
How many employees are collecting Worker’s Compensation benefits
Working capital is calculated by
Working capital equals current assets minus current liabilities
Work orders must include what?
Location, problem. and authorized signature
Work should be assigned to staff based on
individual abilities
You have how many days to file a request for an administrative hearing to dispute a citation?
10 days
You must enter all recordable injured into the OSHA summary log of occupational injuries and illnesses within how many days?
7 days
You must have how many days of emergency food
7
You must keep the menu for how many days?
30 days
A line authority position is characterized by
Decision making vested in the supervisor
An example of line authority is
Administrator
Major schools of thought regarding source of authority are
formal and subordinate acceptance
The scope of authority in the operation of the nursing facility is greatest at which level
Ownership
Ultimate authority in a private corporate nursing facility is with the
Board of directors
Managerial authority is power
to command, issue orders or exact action by subordinates
Decentralized authority is characterized by
process of delegating authority
Centralized authority is
vesting decision making in top managment
Authority vested in a supervisory nurse is
middle management authority
Decision making authority is when a supervisor
hires, fires and makes judgmental decisions
Concepts of modern management recommend that an effective administrator will delegate
operational authority
Unity of command refers to
reporting to one supervisor
Which of the following forms of business is considered the oldest form of business
sole proprietorship
The term proprietorship as it relates to the nursing facility industry means
privately owned
The majority of nursing facility beds in the united states are owned by
corporations
Which of the following forms of ownership must have articles drawn up and reduced to writing?
corporation
Under which form of ownership would the administrator have the greatest latitude of authority and decision making?
Sole proprietorship
All but one are considered advantages of sole proprietorship
Unlimited liability
All but one are considered disadvantages of a partnership
Retention of valuable employees
A corporation is
a legal entity created by law to carry on a business or profession
Which one of the following forms of business ownership is considered the most important?
Corporation
A nonprofit corporation is one which
makes a profit but returns it to the operation of business
Pursuant to the Code of Federal Regulations, 42 CFR part 483, a facility wishing to participate in medicare must have
a governing body
The role of the governing body pursuant to the Code of Federal Regulation 42 CFR Part 483 is to
establish and implement policies regarding management and operation of the facility
The Code of Federal Regulations 42 CFR part 483 requires that the facility disclose
officers, directors, agents, or management employees
The role of the administrator in a modern nursing facility is to
advise the governing body and carry out their decisions
According to the Code of Federal Regulations 42 CFR Part 483 the administrator appointed by the governing body must be
licensed by the state and responsible for the management of the facility
An objective may be defined as
organizing
The first step in planning is
setting the objectives of the organization
Effective management is best carried out by following which method?
management by objectives
Management by objectives involves
plurality of objectives
Which of the following objectives would be considered first in establishing a new nursing facility?
Type of facility
An administrator of a proprietary nursing facility should be primarily concerned with which one of the following objectives?
Quality of care
Which one of the functions of management would be accomplished first?
planning
Relative to setting objectives, which task listed below would be of primary importance for the administrator to accomplish?
constantly review and reassess objectives of the nursing facility
Which one of the following statements is true?
Every department in the nursing facility should have goals or objectives
Since there is a plurality of objectives in a nursing facility, the facility should concern itself with
long and short term goals
Planning is primarily concerned with
use of facts to determine course of action for the future
Strategic planning
helps the facility to re evaluate its mission and identify its long term goals.
Planning on a broad scale is carried on primarily by a
administrator
Planning involves all but one of the following
personnel decisions
Which of the following is not a function of the administrator?
ultimate approval of all policies (governing board does that)
Planning at the top level of management is best characterized as
broad, far-reaching, and basic
In the process of planning, which guideline should be followed?
involve as many managers as possible
Considering the functions of management such as: directing, organizing, coordination, controlling and planning, which of these functions would be first?
planning
The technique of forecasting is important in the modern nursing facility. The accuracy of the administrator’s forecasts will affect the success of planning. Forecasts are expected to be
a reasonable estimate of what reality will be in the future
In the process of planning, the administrator should
constantly check, recheck, and modify the plan if necessarry
A short range plan covers which time period?
1-2 years
A long range plan covers
3-5 years
The function of management called organizing is best described as
the process of grouping various activities of a similar nature and establishing authority relationships
At which operational level in a nursing facility does organizing take place?
at all dept levels within the organized structure
The mission statement of a nursing facility
explains the goals and objectives to the facility
Span on management is the
number of employees a supervisor can effectively handle
The schematic drawing representing the functional operation of a nursing facility structure is called the
organizational chart
Service departments of a nursing facility can best be described as
departments that facilitate, aid and assist other departments
An example of a service department in a nursing facility is the
personnel office
Line authority structure is best described as a situation in which
a superior delegates authority to a subordinate who, in turn, delegates his or her authority forming a line from the top to the bottom level of the organization
A line authority position exists when the executive
makes final decisions regarding departmental functioning
An example of a line authority position in a nursing facility is the
administrator
An example of a staff authority position in a nursing facility is the
administrative assistant
The primary function of a staff authority position is
aid, assist, and advise the department heads
All but one of the following would be considered contractual services in a nursing facility
Nursing director
A standing committee is one which
permanent in nature
A task force is another term used for
ad hoc committee
A policy is a
a broad guideline for thinking and setting boundaries
Who establishes policy in a nonprofit nursing facility corporation?
Board of directors
When a subordinate asks his or her superior to set a policy regarding an operational problem, this is called
appealed policy
A procedure is a
detailed statment to accomplish a task
Which of the following is a procedure?
a statement explaining the steps to be taken to put money in safekeeping
A resident checks into a nursing facility without following the steps described relating to safekeeping of personal belongings. By what procedure should the business office be guided?
procedure for safekeeping
Which of the following statements is not a part of a procedure relating to the death of a resident?
ask the mortician to declare the resident dead (only an RN or physician can do this)
Procedures should not be developed by the administration in which area?
establishing rules of conduct of board members
The purpose of a procedure manual is to
assist in the implementation of a policy
Controlling is
setting goals or objectives, checking performance, and taking corrective action.
An acceptable method of checking on the performance of an employee is to
written and oral reports and direct observation
Percentage of occupancy is what kind of control mechanism?
Quantity
A budget is
a planning and controlling device
For effective control, which element is not necessary?
Configuration
Meeting with the DON and nursing supervisors is what kind of control?
Quality
In order to have effective controlling which item is not required?
on the spot discipline
The principle of Economy of Action states that
any time a higher paid employee makes a decision that a lower paid employee can make as well or better, the facility is wasting money.
Discipline is a part of controlling. Which item is not considered good management practice?
public reprimand of employee
Which item listed below is not a function of management?
comparing
An intangible standard of control in a nursing facility is
quality of care
PERT is a planning and controlling device. The term PERT refers to
program evaluation and review techniques
Coordination is best defined as
orderly synchronization of efforts to accomplish a stated objective
The administrator needs to consider all but one of the following items before making a decision
Gut feeling about the problem
The modern day administrator of a nursing facility must
confer on a daily basis with a variety of individuals, such as :residents, their families, dept heads, suppliers, and community representatives.
The decision making process involves all but one of the following
Delegation
An important tool in management is communication. Communication is best defined as
process of exchanging information in which there is a mutual understanding between the sender and the receiver
Formal communication is all but one of the following
grapevine communication
All but one of the following is considered to be a roadblock to communication
Feedback
Physical resource management is
establishing a preventative maintenance program
Leadership can be defied as
process by which an executive directs, guides and influences the work of others in attaining specified goals by mediating between the individual and organization in such a way that both obtain maximum satisfaction.
S0me of the qualities that a leader must possess include all except what?
Authoritative image
Consultative leadership technique is best defined as wen the executive
consults with subordinates before making a final decision
Free rein technique of leadership occurs when the administrator
consults with subordinates and allows them to reach a final decision
Autocratic leadership may be best defined as when the administrator
does not consult and makes the final decision
All but one of the following are advantages of the consultative approach of leadership
Increases the time spent with the employees
An example of free rein leadership in a nursing facility is when the administrator
allows the attending physician to make medical decisions
All but one of the following are advantages of autocratic leadership
precludes initiative to develop management skills
Some factors that should be considered when using the consultative leadership technique include all but one of the following.
Age of the executive
The best reason health care providers get together to form a consortium is
to experience greater economy in the facility by sharing services and projects
It has been estimated that the administrator spends what percentage of time sending or receiving information?
90 percent
All but one are considered to be roadblocks for effective communication
feedback
The most effective means of communication is
face to face oral communication
An example of informal communication is
grapevine
All but one of the following are considered to be a form of written communication
Nonverbal communication
All but one of the following are considered good techniques of communicating
Over or under communication
One of the goals of a nursing facility is to provide maximum care and services to its residents. Surveyors can best access a facilities success by?
reviewing residents’ assessments, plans of care, and actual care outcomes of a specific sampling of residents
Common law may be defined as
law passed down as a result of court decisions
Statutory law is
law enacted by the legislature
Public law is
law involving a party and a governmental subdivision
Civil law
is concerned with conduct between private parties
A tort is a
civil wrong between private parties
A nursing facility administrator is licensed by the
State licensure board
All but one would be considered an intentional tort
Negligence
Defamation is
making an untrue statement, thereby holding another out to ridicule or contempt
An administrator uses resident trust funds for personal use. What area of law has he or she breached?
criminal law
An administrator forgets to give information to the Board of directors and damages occur as a result. Under what law may he or she be liable?
Negligence
Libel
written defamation
An intentional breach of the Medicare law may result in what kind of action?
criminal action
Releasing information to a third party without a resident’s consent may result in what kind of action?
Invasion of privacy
When a corporation is chartered, the effect of the charter is to
allow the corporation to carry out the purpose of the corporation as indicated in the Articles of Incorporation
What area of law would be involved in a breach by one party relating to a purchase order?
Contract law
A claim on the assets of a resident filed by a nursing facility is called
lien
A civil action in negligence is started legally by filing a
summons and complaint
The moving party in the filing of a negligence action is called the
plaintiff
An action for a violation of law concerning the Medicare Act would be brought in which court?
U.S district court
If a health care facility employee performs a negligent act and thereby a resident is injured, the facility may be held liable under which theory?
Vicarious Liability
A private duty nurse in a health care facility may be held personally liable for his or her negligent acts because his or her legal status is
independent contractor
The attending physician in a health care facility ordinarily has the legal status of
independent contractor
To enact a law, a legislature must
vote on a bill recommended by a committee
Active euthanasia is
homicide
A person who dies without a will is
intestate
A person who dies with a will is
testate
A legacy is a
bequest of real or personal property by means of a will
A will is a
bequest of a real or personal property effective at the death of the testator
Conflict of interest in regards to the role of the administrator as it relates to the facility means that his or her role is
conflicting with the purpose and goals of the organization
Charitable immunity as it relates to a health care facility means the facility cannot be sued for torts because
its purpose is of a charitable nature
Vicarious liability means that if an employee is negligent, that negligence will be transferred
to the facility
Corporate negligence means a duty owed to the resident is breached by
the facility itself
An informed consent is one in which the individual receiving treatment is informed
about the nature and the consequences of the procedure
A subpoena duces tecum is
an order to bring certain documents to court
A pension trustee is a person who may be responsible for financial matters of
Medicaid resident
Which of the following does not have state jurisdiction?
Medicare approval of a facility
Institutional licensure refers to the licensing of the
facility
A volunteer worker working outside the scope of his or her assignment may be held
personally liable
Estate planning has to do with which aspect of the law
Probate
An act concerned with the donation of one’s body or parts of one’s body at the time of death is the
Uniform Anatomical Act
A commitment procedure is a
involuntary commitment to a facility
An individual, who has not been adjudicated incompetent, objects to being admitted to a nursing facility. Other family members want him to be admitted anyway. What should the facility do?
Disallow the admission
The performance of an autopsy on a resident without the consent of the next of kin may be ordered by
medical examiner
A power of attorney is
an instrument authorizing another to act as one’s agent
Release of information in medical records may be given only by the
resident
The PSDA Act of 1990 concerns
advance directives
To comply with PSDA written information must be provided to the resident
upon admission to the facility
The advance directive in which a resident gives instructions to a provider as to whether or not he or she wants life-sustaining equipment is a
living will
After a person executes a living will, he or she should give a copy to all but who
Funeral director
The advance directive appointing an agent to designate what care you want or desire as to life-sustaining equipment in an emergency or terminal condition is a
durable power of attorney for health care
One of the most important concepts the administration should keep in mind regarding public relations is that the facility must
meet the needs and expectations of the residents and their families
One of the first steps to take in developing a marketing program is to
define the facility’s goals and objectives
A primary marketing concept, according to Harvard professor Theodore Levitt, is to produce goods
and services that people want and value at prices and under conditions that are reasonably attractive
Which of the following would be considered of primary importance to quality care in a facility?
attitude of management and staff toward the resident and the resident’s family
In nursing facility administration, marketing means
reaching persons who need the facility services
A market audit is
a process for analyzing the environment in which a program is to function
In a marketing sense, it is important that employees be trained to
have a greater awareness of and participation in customer relations.
Administration should do which of the following to achieve maximum customer satisfaction?
be innovative and responsive to staff
From the marketing viewpoint, advertising means
a presentation of a product in a non personal manner
Which of the following skills is of primary importance in nursing facility employees?
Service orientation of the employee
In a marketing sense, selling is
interaction between a representative of a facility and a prospective customer
Which f the following would be the most effective means of bridging the gap between the community and the nursing facility residents?
having an open house
Which of the following are the most influential in the marketing of nursing facilities?
Increasing number of elderly
All but one of the following are important in developing an effective marketing program
create expectations that may be illusionial or unrealistic to the resident
All but one of the following are necessary for the development of a successful marketing program
name of the administrator
Essentially, marketing is
selling a facility to targeted audiences
Marketing segmentation is
recognizing and pinpointing various groups and their unique needs
One of the most regularly used public relations tools in a facility is
newsletter or magazine
An effective marketing program will
help identify shortcomings in the operation of the facility
The concept of foster care as it relates to the elderly involves a person living in a
private home with people not related to him or her
A home health agency as it relates to the elderly provides
part time skilled nursing services
A program in which elderly individuals belonging to a special group enter into custodial living arrangements by life care contracts is best described as
fraternal custodial care
A custodial living arrangement for elderly veterans would most likely be financed by
the veterans administration
A program whereby the elderly meet their recreational and social needs
senior citizens center
A program whereby a dependent elderly person is institutionalized during the working hours of his family is called
Day care
Assistance for the disabled elderly would most likely be financed under
the social security administration
Meals on wheels is a program for the elderly which is best described as serving meals to
individuals in their home environment
A facility which treats short-term acutely ill patients is called a
individuals in their home environment
A facility which treats short term acutely ill patients is called
acute hospital
Generally an organized medical staff is found in which facility?
acute hospital
A facility which has elderly patients for an average stay of over 60 days with formal ancillary departments such as xray, laboratory, and pharmacy, is called
chronic hospital
A transfer agreement is usually made between a skilled nursing facility and a
hospital
Approximately what percent of the hospitals in the U.S are non-profit
20 percent
Approximately what percent of nursing facilities in the U.S are proprietary?
68 percent
A chief of the medical staff would most likely be found in which facility
Hospital
A retained Medical Consultant would most likely be found in which facility?
Nursing facility
Which one of the following is the most important step in developing good job descriptions
A careful analysis of job content
An employee in the maintenance department comes to work in an intoxicated condition. The administration should?
go to the department head involved and handle the situation through him or her.
A nurse’s aide uses foul language when addressing a resident in the dining room during lunch hour with the Director of Nurses present. The DON should
have a supervisory conference concerning this action, in private, as soon as possible
In disciplining employees, the effective supervisor should take all but one of the following items into consideration
Age of the employee
One of the most important principles an effective supervisor should realize concerning employee discipline is that he or she should try to
establish a reputation of impartiality
The most common employee problem is likely to be
tardiness for work
An effective way to control employee absenteeism is to
interview the employee upon his or her return to work
In order to establish respect among the employees, a supervisor should
earn respect through actions
If employee morale is low the administrator should
attempt to discover the the reason and take appropriate action to remedy the situation
One of the best indications of low employee morale is
employee turnover
The primary purpose of evaluating personnel in the nursing facility is to
help the employee to understand his or her weaknesses and strengths as well as develop guidelines to improve their work
Which of the following is an important factor affecting employee retention?
Orientation and supervision of employees
Verbal warnings followed by written warning is best described as
progressive discipline
An employee wage evaluation program should be based primarily on
merit wages, depending upon the quality of work the employee performs
One of the primary reasons for employee dismissal is
misconduct
A worker’s compensation insurance policy covers all but one of the following
Benefit for injury at home
A group accident and sickness insurance policy issued to an employee on a noncontributory basis requires
that the employer pay for all the cost of the insurance
The primary reason for using incident reports is to
prevent future accidents
If an employee with willful intent does not follow the instructions of his or her employer and is thereby injured, the employer
is likely to be held responsible
One of the best ways for an administrator to be informed as to the number and type of positions to be filled is to
have each department head report weekly on vacancies and types of positions open
There is a dispute between department heads over the interpretation of certain written policies. As administrator, the most effective way to end the dispute is to
talk out the dispute with the dept heads using a team approach
Who should complete an evaluation form on an employee
Immediate supervisor
All but one of the items below should be included in an objective evaluation of an employee
Attitude of the supervisor toward the employee
Discussion of food service in the cafeteria among food service employees is
informal communication
When an evaluation of an employee is competed, it should be
signed by the supervisor and the employee
If an employee refuses to sign an evaluation form, which of the following should take place?
the refusal should be noted on the evaluations and signed by the employee supervisor
The two major categories of liability insurance risks are
bodily injury and property damage
Fidelity insurance covers
loss resulting from a dishonest act of an employee
Employee recruitment is considered the function of which department in the nursing facility
Personnel
All but which of the following are an effective way to recruit employees?
Off the street
In the typical nursing facility, the highest rate of staff turnover is among which of the following employees?
CNA
The application blank is a valuable tool for recruiting personnel. A good application black should have all but one of the following
Form should require that the prospective employee waive worker’s compensation rights
All but one of the following would be considered good interviewing techniques
The applicant should not be encouraged to talk but listen (the exact opposite is true, we want the applicant to do all the talking)
Some important items to observe during an interview include all but
Ethnic background
The purpose of pre-employment testing is to
determine whether or not the applicant is specifically qualified for the position he or she is seeking.
Using a nurse’s salary as a basis for determining salaries of other employees is
key job comparison
The ultimate decision of hiring a new employee should be made by the
appropriate dept head
One of the primary purposes for a pre-employment physical is
to keep down worker’s comp claims
The purpose of a reference check on all employees is to
protect the facility from undesirable employees
A reference check should always be
reduced to writing
In establishing job descriptions, the workload is broken down into sets of activities that can be
performed by one person
In an interview with a job applicant, all but one of the following may be asked
Arrests
A job description is best defined as
a written summary of the duties and responsibilities of a job
An exit interview occurs when an employee is
asked the reason he/she is leaving the position
Personnel policies are a set of guidelines primarily with
policies of all employees
The person in the nursing facility most likely to administer and implement policies is the
Administrator
The personnel director is best characterized as
staff authority position
The autocratic approach is establishing personnel policies is when the administrator
writes the policies and submits them to ownership for approval
The personnel function in a nursing facility is responsible for all but one of the following
Presenting the completed personnel policies to ownership for approval
Establishment and ratification of personnel policies in a nursing facility is accomplished by
ownership
The consultative approach in establishing personnel activities would involve the administrator
receiving input from dept heads and staff and then submitting completed policies to ownership for approval
Which item would most likely be part of the personnel policies
fringe benefits, vacations, and retirement
The best guideline to follow in writing personnel policies is to:
hold staff meetings and get personnel policies from the neighboring facility
Which item should be included in a good set of personnel policies
Description of the disciplinary procedure
Large fringe benefit programs
may be potentially disadvantageous
All but one of the following are considered to be effective sources of employee recruitment
Walk in’s
All but one of the following are considered to be part of the selection process of an employee
on the job training
A disaster program should include
orientation, on going training and drills for all personnel
A formalized mechanism for expressing dissatisfaction with conditions in workplace is called a
grievance procedure
The national labor law concerned with unfair practices of employers is
NLRA (National Labor Relations Act)
The national labor law concerned with unfair union practices is the
Taft-Harley Act
All non-public health care facilities are now covered under which federal act?
National Labor Relations Act
The Fair Labor Standards Act concerns itself primarily with
wages and hours of employment
Under the 1976 amendment to the National Labor Relations Act, it is mandatory for health care facilities to participate in
collective bargaining
The Age Discrimination Act passed in 1987 protects employees aged
40-70
Title VII concerned with
discrimination in hiring and firing practices and other employment practices
The process of mediation primarily concerns
facilitating an agreement between parties by the acts of a third person
Collective bargaining as contemplated in the National Labor Relations Act is
making collective arguments between employers and accredited representatives
Arbitration is
submission of disputed matters to private unofficial persons selected as provided by law
If a health care facility is approached by a union for collective bargaining, the administrator should immediately
seek the assistance of an attorney conversant with labor relations
If a health care facility is approached with a view toward collective bargaining, which one of the following actions should not be taken?
Fire the employee involved in trying to organize the facility
The primary argument used by nursing facilities in combating efforts to unionize a facility is that
unionization may be in conflict with the objectives of high quality resident care
The first labor law concerning practices of management and unions is the
Wagner Act
The National Labor Relations Board considers control of a labor union in the facility by the administrator to be
unfair labor practice
In a labor dispute concerning a collective bargaining effort, the administrator of the facility may not
urge employees to persuade others to oppose the union
What percentage vote is required to get a collective bargaining agreement in effect?
50% plus one vote
What is a bargaining unit?
Employees performing work for a similar nature
Which one of following is considered to be a formal training program?
In-service training program
An orientation program in the nursing facility is primarily for
the employees and staff of the facility
An administrator in training program can best be described as a
program to train individuals who have no prior nursing facility experience for administrative positions
An example of an informal training program is
on the job training program
A new employee is hired in the nursing facility. The type of training program most appropriate would be a
orientation program
A dietary aide wo has been employed by the nursing facility for several years is in need of training to upgrade their skills. The kind of training most appropriate would be?
in-service training
An administrator needs to upgrade his or her skills. The most appropriate training program is
attendance at an approved continuing education program
A nurse continually makes errors in drug administration. What kind of training program should the administrator compel him or her to attend?
continuing education
The trend in the U.S relative to retaining a license for nursing facility administrators is to have mandatory training in
continuing education
What type of program is the least expensive but most effective?
In-service training
A nurse’s aide continues to come into work lat. An effective supervisory method is
bring the matter to the attention of the employee in private during a supervisory conference
As the administrator of Pleasant view Nursing Facility, you receive a complaint about nursing care rendered by a staff nurse. The course of action should be to
gather the facts from the DON and then evaluate the course of action with the DON
An effective department head working as a nursing staff committee member should
discuss their role and responsibility as a member of the committee
During a regular department head meeting a department head who is extremely aggressive attempts to monopolize the meeting by asking irrelevant questions. As administrator the best way to handle the situation is to
discuss the problem with him or her in private at a supervisory meeting
Departmentalization is the
process of grouping various activities into separate units
Patterns most commonly found in departmentalization are groupings
by functions, products, territory, process, and time.
An example of grouping by function in a nursing facility is
the nursing department
Select the department of the nursing facility grouped by the customer that serves
Nursing
All but one of the following are advantages of functional departmentalization
Excessive centeralization
Departmentalization should be considered a part of which one of the functions of management
organizing
All but one of the following are disadvantages of functional departmentalization
occupational specialization
An example of product departmentalization is
dividing a large company into smaller administrative units
For a small nursing facility the best kind of departmentalization is by
function
The most effective type of departmentalization for a large nursing facility is by
function
Some of the concepts which accounting is based are all but one of the following
Inconsistency of accounting methods
Cash accounting is revenues recognized
when cash is received
Accrual account is recognition of
revenues when actually earned and of expenses when actually incurred
An asset is
an item of value owned by the nursing facility
A fixed asset is an
item of value owned by the nursing facility which has value over an extended period of time
An example of a fixed asset is
land and buildings
A current asset is
cash
Which one of the following is not a liquid asset?
Inventory
Working capital is
Current assets minus current liabilities
A liability is
debt of the nursing facility
a fixed liability is
a debt which becomes due in a period of over one year
An example of a fixed liability is
mortgage
Owner’s equity or net worth is the
total of assets minus total liabilites
The first step in the accounting cycle is to record transactions on a daily or chronological basis. This is called
journalizing
A long term indebtedness collateralized by real estate is called a(an)
mortgage
When a nonprofit nursing facility makes a profit, this profit is referred to as
excess of income over expense
A third party payor situation exists when
an intermediary pays for the legal obligations incurred by the resident
All but one of the following are examples of third party payors in the nursing facility industry.
Resident
The excess of total income over total expenses is referred to as
net profit
A correct statement concerning the social security tax is that it
cannot exceed a certain percentage of an employees wages
In a proprietary nursing facility the profits distributed to shareholders are called
dividends
The primary function of depreciation is to
better determine the actual costs of operation
Depreciation may be defined by
devaluation of an asset based upon wear and tear over a specific period of time
An invoice which says 4/10-n/30, means a discount may be taken if payment is made within
10 days
A stale check refers to a
outstanding check for over 60 days
In order to determine the percentage of occupancy in a health care facility
divide the beds occupied by the bed complement
A W-4 form is a form indicating
the number of claimed exemptions by an employee
The social security tax
is a percentage of up to a certain amount of an employee wage.
Determine the percentage of occupancy. On a certain date in a 150 bed facility there were 68 patients. Occupancy was
45 percent take #of patients and divide by number of beds in facility
F.I.C.A, taxes concern
employees wages
Under the Medicare program, skilled nursing facilities are reimbursed on a
price basis
In the double entry bookkeeping system of accounting, when recording each transaction, which of the following two entries should be made in two different accounts?
A credit and debit
In double entry accounting, the term “debit” includes
decrease in liability account
Fixed cost is best defined as
an operating or capital expense that does not vary with business volume
If the facility occupancy increases from 90% to 98%, the fixed cost per resident
decrease somewhat
Variable cost is best defined as
operating costs that vary in direct proportion to changes in volume
A variable cost is one that
changes according to occupancy
An example of a fixed cost is
depreciation
An example of a variable cost is
supplies
All but one of the following are examples of property damage insurance
consequential loss
A department head wishes to purchase a motorized wheelchair costing $510 during the coming fiscal year. Which of the following budgets would be affected by such a purchase?
Operating
A budget may be defined as a
a projection of fiscal data for a specified period of time, usually one year
An operating budget is considered a
planning and controlling device of a fiscal nature, usually for one year period
In compiling an operating revenue budget, all but one of the following would be taken into consideration
Title VI
The plant and equipment budget should include consideration of
anticipated purchase of equipment and repairs needed by departments
The financial success or failure of a proprietary nursing facility is usually measured by its
return on equity
On the balance sheet, assets must equal the sum of liabilities plus
owners equity
The primary use of accounting procedures in a nursing facility is to
establish consistent and effective management control procedures
All but one of the following items are necessary to implement an adequate accounting system
a peg board system
The profit and loss statement is a
statement of income vs expenses
The purpose of the profit and loss statement is
to portray the fiscal operation of the facility
The balance sheet is a statement of
assets, liabilities, and capital as of a given date
The purpose of the balance sheet is to
portray the entire financial operation of a facility as of a given date
All but one of the following items would be included in a balance sheet
current operating expenses
During the purchasing process, checks should be issued when which of the following is properly signed?
Purchase Order
All but which one of the following are considered to be acceptable accounting methods of depreciation?
total write off
The term E.D.P as related to the business office operation means
electronic data processing
A report detailing on a monthly basis the cash receipts, cash on hand and cash disbursements is called a
cash report
A report prepared on a monthly basis recording what is owed to others is called a
accounts payable
Cost per patient day is obtained by
dividing total expenses by total patient days
Cash flow may be best described as the
amount of cash generated by the operation of the nursing facility
Short term financial commitments are normally met by the nursing facility’s
net working capital
The primary source of capital for financing nursing facilities is
long term bonds
A nursing facility has been notified that its reimbursement lag will increase by ten days, which administrative act is most appropriate?
Working capital should be increased
If the nursing facility loses $20,000, which accounts are affected?
cash and notes payable
Current ratio or working capital ratio is computed by
dividing the current assets by the current liabilities
The acid test ratio is computed by dividing
the quick assets by the current liabilities
Cost accounting is
setting up a cost unit center in each department
Departmental cost allocation refers to
amount of cost allotted to a department taking into consideration salary and other indirect costs
Which of the following deductions from revenue is an allowable expense under current Medicare law?
Coinsurance bad debts
All but which of the following factors are considered regarding premiums on a worker’s compensation policy?
The current salary of the administrator
The primary purpose for maintaining inventory control is to
maintain supplies at optimum level and discourage theft and embezzlement
One of the following is considered essential in establishing an effective inventory control system.
A requisitioning system and centralized storeroom
A perpetual inventory system involves keeping a
daily record of supplies received, issued, and left in inventory
A perpetual inventory system is most likely used on a regular basis in which department of a nursing facility?
Pharmacy
The Budget Reconciliation Act of 1997 established a prospective payment system (PPS). A PPS is a
price based system
Under a PPS, the facility will be required to
manage costs within the reimbursement rate
Which of the following services is not excluded by the Budget Reconciliation Act of 1997?
Routine and ancillary services
Under the PPS system, Medicare guidelines will
stay the same
To become a resident in a nursing facility, a person must be admitted by
a physician
If a resident decides to leave a facility or is transferred, the facility
must assist and coordinate the transfer
The OBRA Act of 1987 requires the services of a full-time, qualified social worker for
any nursing facility with more than 120 beds
According to the Code of Federal Regulations, 42 CFR Part 483, a SNF resident must be seen by a physician during the first 90 days once every
30 days
How many hours per day must the facility provide a resident with access to physician services?
24 hours
Under the Code of Federal Regulations, 42 CFR Part 483, the term “licensed health professional” includes all of the following except
Nurse assistant
To comply with the Code of Federal Regulations 42 CFR Part 483, the director of an activities program must be a qualified professional who
is a registered or licensed therapeutic specialist eligible for certification, a qualified OT or OTA, or has completed a training course approved by the state
A nursing facility must use the services of a RN at least
8 consecutive hours a day, 7 days a week , except when waived
A nurse practitioner is a
RN meeting state requirements governing qualifications of a nurse practitioner
A requirement of OBRA, relative to the nursing staff in a nursing facility is that there is
sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical mental and psychosocial well being of the resident
The Code of Federal Regulations, 42 CFR Part 483, requires that the DON services be
an RN on a full time basis except when waived
A waiver of the RN requirement pursuant to the Code of Federal Regulations 42 CFR Part 483, is subject to review by the Secretary
annually
The Code of Federal Regulations, 42 CFR Part 483, states that the DON can serve as a charge nurse and perform his or her duties as a DON at the same time in a nursing facility with an average daily occupancy of
60 or fewer residents
One of the following has the most direct resident contact during the work day
Nurse Assistant (CNA)
Under the Code of Federal Regulations, 42 CFR Part 483, a nurse assistant is any individual who
provides nursing and nursing related services to residents in a facility
Nurse assistants have which of the following educational requirments
75 hours of initial training and a competency exam, inservice education thereafter
A nurse assistant may perform all but one of the following
Administer IV solution under supervision
A residents assessment must be conducted no later than a stay of
14 days
A comprehensive care plan must be developed within
7 days after the completion of the comprehensive assessment
A resident assessment must take place
quarterly, and after any significant changes in condition
A resident (comprehensive) care plan is a
planned course of action taking into consideration the total needs of the resident
Resident rehabilitation is a process that
is an interdisciplinary responsibility
The physical therapy department should
have a goal of prevention as well as treatment
The primary purpose of rehabilitation is to
restore the resident to his or her maximum functional capacity
Restorative nursing is geared to
restoring to normal function from a diseased or impaired physical disability
One important way to evaluate the outcome of rehabilitative services is
the extent to which a function is restored or improved
Specialized physical, occupational, or rehabilitative services must be provided under the Code of Federal Regulations, 42 CFR part 483 by a written order of the
physician
The rehabilitation plan of care for a resident should be completed
as soon as the condition of the resident warrants it
A physical therapist in a nursing facility is responsible for
helping the resident regain use of limbs
An occupational therapist is primarily concerned with
assisting the resident to learn constructive skills
Enhancing upper extremity mobility and improving fine motor coordination are areas of emphasis of the
occupational therapist
Which person may serve as an occupational therapy assistant in a nursing facility
COTA
An audiologist in a nursing facility is concerned with
hearing aids
A speech therapist in a nursing facility is responsible for assisting the resident to
regain the ability to speak
The primary function of the dietary department is to
provide adequate nutritional needs of the residents
Which of the following statements should be a nursing facility policy?
Self help devices should be available for the physically impaired
It is required that the length of time between the evening meal and breakfast meal does not exceed
14 hours
A decentralized dietary department means
trays are served from a floor kitchen directly to the resident
Food exchanges as used in diet planning concern
modified diets
A centralized food system is best defined as
trays served from a main kitchen to the resident directly
A state approved food service supervisor generally is required to have how many hours of specialized training
90 hours
Calcium as found in food is a
mineral
A professionally trained dietary consultant would have what initials after her name
R.D
A primary reason older persons may lose their appetite is
decreased sense of smell
The primary reason for serving standardized portions of food is
portion control
Nutritional menu planning would best be based upon the recommendations of which group
Food and Nutrition Board of the National Research Council
As the aging process advances, the resident needs fewer
carbohydrates
In the process of digestion, carbohydrates are
broken down to glucose
Federal and state regulations require that health records be kept
on each resident in the facility
The legal right to information included in a health record is that of the
resident
In the absence of a state statute, the general rule for retention of health records in terms of years after a resident dies is
five years
A physician’s verbal order must be signed by the
physician and the nurse taking the order
The portion of the health record dealing with personal data of the resident is called the
identification station
The chronological recording of nursing care in the health record is in the
nurses progress
An attending physician prescribes valium for a resident. In which part of the medical record would this be recorded?
physician’s order section
The acknowledgement form for the Resident’s Bill of Rights would be kept in which part of the medical record?
Reports and rehabilitation section
The results of physical therapy treatment are recorded in the health record
physical therapist
The consents for surgery or other elective medical procedures are found in which part of the medical record?
Reports and forms
A valid court order directing that medical records be made available to a given third party must be honored
and the residents consent is not required
Which person may serve as a medical record consultant in a nursing facility?
R.R.A
Dispensing drugs to individual residents from bulk containers is done by a
pharmacist
Administration of a drug is best defined as an act
in which a single dose of a prescribed drug or biological is given a resident by a duly authorized person according to law
A subcutaneous injection is placed
under the skin
Sodium pentathol is a
barbiturate (sleep inducing drug)
Which of the following can receive oral orders regarding the prescription of medication?
Licensed nurse, pharmacist, or another physician
Medication orders given to a nurse must be countersigned by the ordering physician within
48 hours
The best way to dispose of noncontrolled drugs is by
water disposal
Medications requiring refrigeration should be stored in a refrigerator with a temperature range of
35-50 degrees
Nonprescription drugs are commonly purchased
over the counter
The Controlled Substance Act of 1976 classifies a Schedule II substance as a drug
that has a high potential for abuse
Nitroglycerin is a drug commonly classified as a
cardiovascular
The Physicians Desk Reference (PDR) is a textual resource for
use of drugs and side effects
The nutrients that are adversely affected by over the counter or prescription drugs are
vitamins B-6, B-12, folate and zinc
A prescription drug
is ordered only by a physician
According to the Code of Federal Regulation, 42 CFR part 483, the drug regime of each resident must be reviewed by a licensed pharmacist at least
monthly
In the event of a medication error, the first action to take is to report to the
attending physician
Residents in a facility may take medications home upon approval of the
attending physician
In a nursing facility, the primary goal of a good medication administration procedure is
Resident safety
Which of the following may serve as a consultant pharmacist in a nursing facility
Rph
Controlled drugs in a participating nursing facility are subject to which act?
Comprehensive Drug Act of 1976
Geriatrics is best defined as
branch of medicine concerned with the problems of aging
A physician specializing in treatment of diseases of the aging is a
geriatrician
A resident who manifests constant depression is said to be in a state of
melancholia
All but one are a function of the Social Service Department
Assisting with review of the physical condition of the resident
A prognosis of the time a person has to live is called
life expectancy
Gerontology is best described as
patterns and trends in the aging population
Those 65 or over in the United States consist of what percentage of the total population?
12 percent
The most important concept to consider in housing for the aging is that the housing should
be adapted to peculiar problems of the elderly
The express purpose of preadmission screening and annual resident review (PASARR) is to
ensure that the mentally ill and mentally retarded receive appropriate care.
Approximately what percentage of those 65 or over are in nursing facilities?
5.5 percent
Retirement as it applies to the aging population is
relatively new in American cultural patterns
Aging is common to all. What statement best describes the aging pattern?
It varies with individuals
A tertiary care facility is a
hospital
P.R.O.S try to regulate
overutilization of institutional facilites
One of the most prevalent chronic diseases among the elderly is
arteriosclerosis
A readily treatable condition of the eye occurring in old age is
cataracts
The word supine means
lying on the back, face upward
Some of the factors contributing to the aging process include all but one of the following
drug interactions
Which of the following is not a consequence of normal aging?
Dementia
Anemia is best defined as
decrease in number of red blood cells
Arteriosclerotic heart disease is a
hardening of the arteries of the heart
Phlebitis is a
inflammation of the walls of the veins
Arthritis is
inflammation of the joints
Hepatitis is a disease of the
liver
Cerebral vascular accident is commonly referred to as
stroke
Hemorrhage is a condition in which the blood vessels
break
Parkinson’s disease is a
slowly progressive disease of the brain
Carcinoma is
a malignant growth
The term benign means
nonmalignant
Diabetes is a
chronic disorder involving carbohydrate system
Myocarditis is an inflammation of the
heart muscles
Atrophy is
degeneration of an organ due to disuse
Nephritis is inflammation of the
kidney
Gastritis is a disease of the
stomach
Chronic constipation is
abnormal infrequency of defecation
Varicose veins are a condition in which the
veins become enlarged through distension
Epilepsy is a
chronic disease of the nervous system
Congenital heart disease means
a heart disease caused by hereditary factors
Neuritis is a
degenerative lesion of a nerve fiber
Bronchitis is the inflammation of the
membranes of bronchial tubes
Parkinson’s disease is characterized by
tremors
Osteoarthritis is commonly referred to as
degenerative joint disease
A fractured patella refers to
knee
Acute brain syndrome is an organic brain disorder which is
sometimes reversable
All of the following are suggestions of cardiac disorder with the exception of
tremors of extremities
An acute illness may be best defined as one which
is sharp, has a rapid onset, and is of short duration
Preventative medicine concerns itself with
taking steps to prevent a disease from occuring
Which one of the following is considered to be a mental illness
schizophrenia
Oral hygiene has to do with the
mouth
Social dislocation means
removing oneself from the environment
EKG is an abbreviation for
electrocardiogram
B.I.D means
2 times a day
P.R.N means
as needed
Q.H means
every hour
The prefix “anti” means
against
URI is wat kind of disease
upper respiratory infection
C means
with
Stat means
immediately
A.C means
before meals
C.V.A means
stroke
S.O.S means
if necessary
The ability to cope with stress helps increase
self-confidence
One of these is considered a part of senscence
Grief
Senile regression may be defined as
withdrawing from reality and living in one’s memories
When a resident enters a nursing facility for the first time she/he experiences
trauma
Which factor is of primary importance in helping a new resident adapt to the nursing facility environment?
Personality and habits acquired during the resident’s earlier years
The two predominant emotions a resident experiences upon admission to a nursing facility are
helplessness and hoplessness
One of the objectives an older person seeks in a nursing facility is
stable environment
Trauma in a nursing facility resident is best defined as a
emotional shock
Reality orientation is most appropriate for which kind of resident?
Confused and disoriented
The simplest level of reality orientation is
remotivation
If a nursing facility resident experiences a debilitating stroke, what technique is used to help him or her to emotionally readjust to her environment?
remotivation
When a resident experiences senile regression, what technique is used to assist him or her?
reality orientation
One of the typical reactions a visually disabled person experiences is
withdrawal
The role of the volunteer worker in relation to working with the elderly resident is to
give the resident psychological and emotional support
The primary purpose of using volunteers to encourage one to one relationships, is to
provide a sense of self worth and dignity
One of the most important considerations in assigning roommates in a nursing facility is
compatability
Often, relatives who place a loved one in the nursing facility feel
guilt
The majority of residents are admitted to a nursing facility from a
hospital
Developing interpersonal relationships with the residents should be a primary concern of the
administrator
At the time of the residents admission, the administrator should
establish an image as a supervisor of a professional organization
The phases of death behavior as described by Kubler-Ross includes all of the following except
relief
Separation reaction results from
being torn loose from family and friends
Depression may be described as
a natural response to loss and disappointment
Tri-cyclic drugs may be used to treat
depression
Which agency promulgated the Resident’s Bill of Rights making them mandatory in nursing facilities under state and federal law?
Health and human services
In the case a resident is legally adjudicated incompetent, who will make decisions for the resident?
a guardian appointed by a court law
One of the most difficult items to enforce in a nursing facility is
the spirit of OBRA resident rights
The most appropriate statement regarding residents’ rights is
OBRA is placing a greater emphasis on resident rights
Under the Residents’ Bill of Rights, a facility is required to inform the resident of his or her rights and in addition, must
have a written acknowledgment of the receipt of such information concerning the rights and signed by the resident or his or her legal representative
Under the Residents’ Bill of Rights, a resident must be given a full explanation of
the charges for services available in the facility including any charges not covered under Medicare or in the facility per diem rate
The Residents’ Bill of Rights requires that before experimental research can be conducted on a resident, the facility must advice the
resident that experimental research is being done and obtain a written statement accepting or refusing participation in such research
If a resident refuses a prescribed treatment, what appropriate action should a nursing facility take?
clarify to the resident the consequences of the refusal
Before a resident is transferred or discharged from a facility, the Residents’ Bill of Rights requires that the facility beforehand must
notify the resident and (if known) a family member or legal representative of the resident of the transfer or discharge and the reasons
The Residents’ Bill of Rights provides that the resident may
voice grievances with respect to treatment and care without discrimination
If a resident consents to keep money in a resident trust fund, the facility must
establish and maintain a system of complete and systematic accounting of each resident’s personal funds and must convey information about the account to the resident upon his or her request or that of his or her legal representative
OBRA 1987 requires which of the following?
That there be evidence of multidisciplinary assessment and plans for reduction of restraints
Under the Residents’ Bill of Rights, physical restraints may be imposed for the
treatment of the resident’s medical symptoms
A resident is restrained without a physician order by an aide and the resident has not been given a bath. How many residents rights have been violated?
1
Release of information under Residents’ Bill of Rights may be authorized or refused by the
resident or their legal representative
The resident’s right to refuse release of medical records does not apply when the
resident is transferred to another health care facility
Under the Residents’ Bill of Rights, the resident is entitled to
personal privacy and confidentiality of clinical records only
The resident right most frequently violated by personnel is which one of the following?
failure to knock before entering the resident’s room
According to the Code of Federal Regulation 42 CFR part 483, a single resident room must contain.
100 square feet
In public buildings, a sign depicting a person in a wheelchair is an international symbol indicating entry into a
area of accessibility for the disabled
A fire alarm system that does not meet the multiple type criteria is
mechanical and electric
Who would be in charge in the case of a fire occurring in the facility until the fire department arrives?
Highest ranking employee in the facility at the time of the fire
What is the preferred lighting system for residents of the nursing facility?
Florescent and metal halide
Which of the following are required to meet federal rules concerning quality of life?
glare free surfaces
Perishable foods in a refrigerator should be kept at a temperature between
34-45 degrees
Water temperatures in the facility must be
controlled by an automatic control device
One of the major reasons for a grease film remaining on the dishes after washing is that
not enough detergent was used
The administrator can best judge the effectiveness of an odor control program by
making regular tours of the facility
Who performs general cleaning duties in a nursing facility?
General housekeeping employees only
One of the disadvantages of contracting housekeeping services is
loss of flexibility in assignments
The majority of employee accidents occur because of
unsafe employee behavior
The primary purpose of keeping a clean facility is
infection control
The use of microbiological sampling in surveillance of the nursing facility is
helpful, but not widely accepted standard exists for this procedure
The primary way to control rodents is through
preventative measures
The reason waste containers stored outside the facility should be placed on racks that are one foot above the ground is to
discourage infestation of pests
When can soiled linen be stored in the same room as clean linen
if there is effective segregation of storage areas
If a resident is known to have a communicable disease, which of the following procedures must be followed?
isolate the resident
From an infection control viewpoint, a nursing facility practicing universal precautions with residents who have infections diseases, would be
fully prepared to accept residents with AIDS
The primary element of universal precautions is
use of gloves and proper handling techniques
Bacteria is caused by
pathogens
A communicable disease which is widespread is
pandemic
Which committee in a participating facility would promulgate policies to aseptic techniques?
Quality Assessment and Assurance Comittee
The responsibility for writing and enforcing policies to control communicable disease under OBRA 1992 and thereafter, is with the
facility infection control program
In order to have effective infection control in a facility, which one of the following should not be adhered to?
Nursing personnel are assigned to housekeeping duties
One of the most important aseptic techniques used by nursing personnel is
proper handwashing
Which of the following procedures would most effectively control odors in a nursing facility?
quick cleanup and attentive nursing care
When a facility wide emergency occurs at a nursing facility, who should be in charge and responsible for making decisions?
The highest level staff member on duty at the time of the incident
Regarding fire and disaster preparedness, the Code of Federal Regulation 42 CFR part 483, says that a facility must have a
detailed written plan and procedures to meet all potential emergencies and disasters
A facility participating in Medicare must comply with which standards regarding safety from fire?
NFPA
Fire safety and construction information is found in which code?
LSC
The most common cause of death in fires is
smoke inhalation
How often must fire drills be conducted according to the LSC?
one per shift per quarter
The routine checking of mechanical, electrical and resident care equipment is called
preventative maintenance program
Scheduling an item for repair, replacement, or maintenance on a pre set basis is best described as
preventative maintenance
An effective preventative maintenance program will
allow less time for scheduled maintenance
What is the most important factor to consider in including a piece of equipment in a preventative maintenance program?
Safety to residents
The best time to acquire schematics and parts lists is
when the purchase of equipment is being discussed
Medicare and Medicaid were established in 1965 as
an amendment to the social security act
Medicare is commonly referred to as
XVIII
Requirements that nursing facilities must meet to provide services to Medicare and Medicaid residents are called
requirements or conditions of participation
Title XIX is best described as
a public assistance program for the medically indigent
Medicare is a health insurance plan for
those aged 65 and over and some disabled
Medicare is a program run by the
Federal government
Medicare’s hospital insurance plan is referred to as
Part A
Medicare’s medical insurance plan is referred to as
Part B
Part A of Medicare covers hospital
and skilled nursing facility inpatient care, home health care, and hospice care.
Part B of Medicare covers
physicians services, outpatient hospital care, outpatient physical therapy, and speech pathology services
Organizations handling claims for hospitals, SNF’s and home health agencies are called
intermediaries
Organizations handling claims from physicians and other suppliers of services is called
carriers
Organizations giving services to the elderly are called
providers
Medicare is paid for under which government group
Social Security Act
The mandatory age for those participating in Medicare, with exception of the disabled and those on dialysis is
65 and over
Under Part A, Medicare can help pay for inpatient hospital care for a benefit period up to
150 days
The amount of money the Medicare recipient must pay for hospital services is called
deductible
Under Part A of Medicare, inpatient hospital care is paid according to the following formula
Prospective Payment System (PPS)
Under Part A of Medicare, inpatient care in a certified SNF may be paid up to
100 days in a benefit period
Under Part A of Medicare, Medicare will pay hospice care up to
Beyond 210 days when recertified as terminally ill
Effective in 1990, Medicare will pay
some prescription drug cost
Under Part A of Medicare, if certain conditions are met, a resident in a skilled nursing facility may be covered for
100 days
A Medicare-eligible resident who transfers from the hospital to the nursing facility, may receive Medicare benefits while in the facility if
the resident’s diagnosis qualifies him for skilled bed Medicare benefits while in the nursing facility
Part B of the Medicare Act refers to coverage for
physician’s services
Final requirements relating to Medicare are the
requirements a provider must meet to be certified as a Medicare approved facility
Under part B of the Medicare program, a certain amount that varies from year to year for covered medical expenses must be met by the recipient. this is called the
deductible
Under Part B of Medicare, the physician is paid based upon
approved charges
Under Part B of Medicare, the physician is paid
80 percent of the approved charge
Home Health services may be defined as
intermittent services for those confined to their homes because f illness or injury
Home health services are provided under which federal program
Title XVIII
Under Part B of the Medicare Act a C.O.R.F refers to a
comprehensive outpatient rehabilitation facility
The assignment method of Medicare payment means the
physician or supplier receives the medical insurance payment directly from Medicare
In order to be eligible for hospice under Part A of Medicare, which of the following conditions must be met?
Physician certification that patient is terminally ill, patient chooses to receive hospice care, care is provided by a Medicare-Certified hospice program
A Hospice is a public or private organization that is primarily engaged in providing to the terminally ill
symptom relief, pain relief and supportive services
Which agency is primarily responsible for making sure that buildings are accessible to the physically handicapped?
ANSI
The American Standards for the Physically Handicapped apply to all buildings and facilities
used by the public
According to these standards, administrative authorities may grant exceptions from the literal requirements when
practical difficulty, unnecessary hardship, or extreme differences are shown
According to the ASPH Standards, individuals 5’6 tall require the following space between crutch tips
31″
According to the standards, public walks should be
48″ wide
Parking spaces for individuals with physical disabilities, when placed between conventional spaces, should be
13″ wide
A ramp shall have a level platform of
3′ deep and 5′ wide
If it is determined that a nursing facility wheelchair ramp rises too steeply, the facility is in violation of which of the following?
American Standards for the physically handicapped
Doors shall have a clear opening of no less than
32″
Stairs should have handrails
32″ high
Toilet rooms for men shall have a wall mounted urinal with the opening of the basin
17″ high
Toilet rooms shall have at least one toilet that is
36″ wide
Raised letters or numbers used for identification shall be placed on the wall at a height of between
4’6″ and 5’6″
Audible warning signals shall be accompanied by
visual signals
When manholes are open and in use barricades shall be placed on all sides at least
8′ from the hazard
Low hanging signs that protrude into regular corridors shall be at a minimum height of
7′
The primary purpose of OSHA is to
assure safe and healthful working conditions for men and women
Standards concerning the use of chemicals and the notification of employees chemicals in the workplace are promulgated by
OSHA
The Material Data Safety sheets on hazardous chemicals for a nursing facility are required by what agency?
OSHA
As part of the OSHA requirements, the Chemical Hazard communication Materials Study Data Sheets (MSDS) must be available to affected employees
at all times
If an employee is exposed to a bloodborne pathogen, how should the test results of the source individual be handled according to OSHA?
The test results should be made available of the HBV/HIV status
The National Institute for Occupational Safety and Health is established within HHS to
conduct training and research carried on under the act
Waste management by nursing facilities is monitored by
OSHA, EPA, DNR, and the local health department
The most important record relating to occupational injuries and illness is the
log
Who is primarily responsible for safety under the OSHA program?
Employer and Employee alone
Citations are issued for violations of OSHA
standards
A nonserious violation under OSHA is where there is no
death or serious physical harm
A citation is a statement including a description of the
violation, standard, how the standard was violated, means to abate, and penalty
The penalty for willful or repeated violations OSHA is a maximum of
$70,000
Serious multiple accidents of a fatal nature (5 or more employees) must be reported to the regional director within
48 hours
The Life Safety Code is
published by the NFPA
The life safety code is a standard that covers
fire safety and prevention
Enclosure walls in two story buildings of a nursing facility must have a fire resistance rating of
2 hours
If there is an approved automatic extinguishing system, construction of protected noncombustible type of enclosure walls may have fire resistance ratings of
1 hour
Existing nursing facilities without automatic sprinklers must have
an automatic smoke detector system
The minimum height of handrails in nursing facilities must be
30 inches
The travel distance between any resident room door intended as an exit access and an exit shall be a maximum of
100 ft
Doors opening to the exterior of a building must be at least
36 inches wide
The minimum width of a corridor in a nursing facility of new construction is
8 feet
Under what conditions may the Life Safety Code be waived
The local code exceeds the requirements of the LSC
The maximum travel distance between any point in a room and an exit is
150 feet
The maximum allowable distance in an exit access corridor which is deadend is
30 feet
Exiting externally- luminated exit signs shall have plainly visible letters not less than
4.5 inches high
The minimum number of exits allowable in a fire area of a nursing facility is
two
The bonded solid core bedroom doors of a nursing facility must be a minimum thickness of
1 3/4 inches
Firestop partitions must have fire resistance of
1 hour
Manual fire alarm boxes must be located no further away in all directions on the same floor
200 feet
Minimum width required for private bedroom doors in new construction is
44 inches
Portable fire extinguishers of a Class A nature must be located so that a person will have to travel no more than
75 feet
Portable fire extinguishers of Class B and C natures must be located so that a person will have to travel no more than
50 feet
The most appropriate fire extinguisher to use for a Class B fire is a
Carbon Dioxide extinguisher
Smoke partitions shall have a fire resistance rating of at least
1 hour
Fire extinguishers should be checked by the fire department
quarterly
Shafts for elevators must be of a noncombustible construction for fire resistance of
2 hours
Window sill height in a residents room must be a maximum of
36 inches
If an existing facility of two or more stores does not have at least two hours fire resistant construction, the blind, bedridden, and physical disabled cant be housed above the
street level
According to Title XVIII, there must be available equipment to maintain
detection, alarm and extinguishing system
During a fire, which of the following is the most life threatening to a resident?
Smoke
Quality Assessment and assurance programs in a nursing facility are
mandated as part of nursing facility program
The PRO is an organization consisting of physicians whose primary purpose is to
review resident charts to determine whether the resident is in the proper facility
The JCAHO is a nonprofit corporation whose primary purpose os to
establish standards for hospitals and long term care facilities
The primary purpose of the ombudsman program is to
mediate and negotiate problems on behalf of the resident
The NFPA concerns itself with
reduction of fire waste in lives and property
In order to participate in the Medicare or Medicaid program, a nursing facility must
comply with the Code of Federal Regulation, 42 CFR Part 483
The health care financing administration (HCPA) is
the federal agency administering Medicare and federal guidelines for medicaid
The function of the resident council is to
give the residents more control over their lives
In evaluating the quality of nursing facility resident care, which of the following is used as an indicator?
Activities of Daily Living
The quality assessment and assurance committee must have at least
a physician designated by the facility
The quality assessment and assurance committee must meet at least
quarterly
The results of monitoring by a quality assessment and assurance committee
are not subject to discovery by the state survey team
The survey process under OBRA is
intends to focus on the outcome of resident
All nursing facilities must be
licensed
Training and educating employees about the rules and regulations of the facility are the responsibilities of the
administrator
The facility administrators responsibility relating to new legislation affecting the facility, is to
ensure facility compliance
The survey agency conducting a valid survey may impose all but one of the following sanctions
Official notification of the state Ombudsman
The review of facility hiring practices to determine adherence to Civil Rights Laws, is referred to as
affirmative action
Nursing home administrators are licensed by
a state licensure board
Which one of the following is considered to be a mental illness