NAB Practice Questions
A resident is admitted to a nursing home that has been certified as a SNF only. Which of the following is not required to be adhered to by the facility? 1. State medicaid standards for payment 2. SNF regulations 3. State licensing regulations 4. Office of civil rights laws
1
Standard precautions are to be used when providing personal care to: 1. All residents 2. Residents with AIDS 3. Residents with Hepatitis 4. Residents with Tuberculosis
1
Which of the following does not support resident center care concept? 1. Upon admission the resident indicates a preference to bathe at night; the facility policy requires all baths to be given on the day shift 2. Breakfast is served from 630a-800a; the resident chooses to sleep until 900a so the nursing staff makes sure cereal and milk are available at 900a 3. Upon admission the resident was allowed to bring his personal recliner to the facility to furnish his room 4. Prior to living in the nursing facility the resident enjoyed fishing; the activity staff arrange for the resident to attend the annual fishing rodea located 30 miles from the facility
1
Which one of the following statements is true for the medical director? 1. May also serve as an attending physician 2. Must be a member of the facility's QA committee 3. Must be seen by the resident at least every 30 days after the inital required visits 4. Must personally approve each order for each individual to be admitted to the facility
1
a W-4 form shows each employee's 1. number of claimed exemptions for withholding purposes 2. gross earnings 3. number of overtime hours 4. FICA tax withheld
1
A RUG is a? 1. category in a resident classification system 2. standardized resident assessment form 3. cost report form 4. billing form
1. A "RUG" (resource utilizaiton group) is one category in a 53-category resident classification scheme used in the Medicare Prospective Payment System for skilled nursing facilities. The per diem reimbursement rate that the SNF receives depends on which RUG the Medicare beneficiary on Part A covered stay was assigned to for that day. The assignment to a RUG is made on the basis of information from a standardized resident assessment form called the MDS.
If a fcaility has a current ratio greater than 1, which of the following statements is more likely to be true? 1. It will be able to pay its bills on time 2. It should consider raising its rates charged to private-pay residents 3. Its expenses exceed its revenues 4. It will be unable to qualify for a loan
1. A current ratio greater than 1 means that the organization's current assets exceed its current liabilities, and this indicates a good ability to pay short-term liabilities as they come due. Such a favorable liquidity position makes the organization more likely to qualify for a loan, so the answer is not 4. The answer is not 3, as the current ratio does not shed light directly on revenues and expenses. The answer is not 2; raising private-pay rates should be considered if the current ratio were less than 1.
Using the straight-line method, what would be the annual depreciation expense for a piece of equipment having a cost of $6,000, a manufacturer's warranty for 2 years, and an estimated useful life of 6 years? 1. $1,000 2. $3,000 3. $6,000 4. An amount that decreases each year over a six-year period
1. Annual depreciation expense using the straight-line method is calculated by dividing the cost of the asset (less salvage value, if any) by the number of years in the asset's estimated useful life. In this case, the annual depreciation expense is $6,000 divided by 6 years, which equals $1,000. The warranty period is not relevant to this calculation.
Which one of the following is not a required measure to prevent the spread of infection? 1. Proper handling, storage, and transporting of laundry/linens 2. Use of alcohol-based hand-hygiene rubs 3. Use of personal protective equipemtn 4. Use of isolation in a least restrictive method if needed
2. Alcohol based hand-hygiene rubs are allowable in a facility and are acceptable as a means of hand sanitation, but they are not a required measure for controlling the spread of infection
Which of the following is not a mechanism for overcoming barriers in communication? 1. Use simple language 2. Depend on key persons in each department/unit to interpret the information 3. Connect new ideas with familiar ones 4. Provide an opportunity for feedback on information that is not clear
2. An administrator or supervisor should not depend on other to interpret a message. If someone is unsure about the message communicated, he/she should schedule and appointment with the messenger to discuss what was said or understood to be said
Physician vists are required: 1. Monthly after the initial required visits 2. Quarterly after the initial required visits 3. Every 60 days after the inital required visits 4. Twice a year after the initial required visits
3
The document that describes hazardous chemicals in a product describes the product, and provides precautions for safe handling is the. 1. OSHA 2. MDS 3. MSDS 4. SMDA
3
The facility staff will determine what the needs of the resident are based on: 1. Quality indicator reports 2. Family interviews 3. The MDS assessments 4. Quality measures
3
The process by which an individual becomes eligible for medicaid by incurring medical expenses until personal resources fall below a specified ceiling is called? 1. indemnity 2. personal needs allowance 3. spend down 4. swapping
3
The requirement that all employers, including goverment agencies, must verify that employees hired are either US citizens or authorized to work in the US, is part of the: 1. Social security act 2. Fair labor standards act 3. Immigration reform and control act 4. Health insurance portability and accountability act
3
When admitted to the nursing home, which of the following is not required to be given to the resident? 1. The resident's rights and rules and regulations governing resident conduct and responsibilities during the stay in the facility 2. Services to be provided and their associated cost 3. The federal standards and state licensing rules for nursing facilities 4. information regarding an advance directive
3
Which one of the following is not a correct policy for dietary services? 1. Receiving of food for facility use must be from approved sources 2. Storage of food brought in by staff must be stored separately from facility food 3. Facilities are required to provide a therapeutic diet, prescribed by the dietary consultant, when a nutrition problem exists 4. A specific food temperature level is required at the time of serving
3
Which one of the following is not an employee benefit? 1. Health insurance 2. retirement plans 3. compensation 4. paid vacations and sick leave
3
Which one of the following statements is true? 1. Any employee may serve as a feeding assistant when the need desires 2. A family member must complete a state-approved training course for feeding assistants before assisting with feeding his/her family member 3. Paid feeding assistants must successfully complete a state-approved training course 4. A family member is not allowed to feed his/her relative
3
Written policies and procedures are used by the facility for all of the following except: 1. To communicate what management expects in any situation 2. To prepare staff for dealing with emergency situations 3. To establish the management style for operating the facility 4. To set guidelines for staff to follow in delivery of care
3
Which one of the following is not a step used by management to deal with unexcused absences or excessive abstenteeism by an employee? 1. Interviewing employee upon return to work 2. Stating policies after an infraction 3. Recognizing the worker's positive work performance as a means of encouragement 4. Imposing penalties for unexcused and excessive absences.
3. A worker would not be given praise for their work if they had excessive absenteeism as their work performance would not be positive if they were missing work
Completion of the medicare cost report requires carrying out all except which one of the following tasks? 1. cost finding 2. apportioning the costs for caring for medicare residents from the costs for caring for non-medicare residents 3. aging of accounts receivable 4. determination of allowable costs
3. Aging of accounts receivable is a useful tool for tracking outstanding bills but it is not required to complete the medicare cost report
A check should generally be issued only when which of the following is available and properly signed? 1. lien 2. warranty 3. purchase order 4. general ledger
3. An internal control principle in purchasing is to make sure that a check is issued only when there is a proper purchase order authorizing the purchase.
business interruption insurance covers 1. losses resulting from employee dishonesty 2. repair of wind damage to the building 3. loss of revenue from having to keep beds empty while a unit undergoes repairs due to wind damage to a building 4. claims resulting from negligence in the rendering of care to a resident
3. Business interruption insurance covers loss of income resulting from a reduction or stoppage of operations caused by an insured peril like wind or fire damage
According to the federal certification standards, the QA committee is required to meet? 1. When a problem arises that requires immediate attention 2. At least twice a year 3. At least quarterly 4. When directed by the medical director
3. CMS requires the QA committee to meet quarterly
a nursing home is considering the purchase of a new dish-washing machine that costs $6000 and has a useful life of 10 years. It is estimated that the machine will reduce annual operating costs by $800 over each of the next ten years. What is the payback period? 1. 0.75 years 2. 1.33 years 3. 7.5 years 4. 10 years
3. Calculate the payback period by dividing the $6,000 cost of the item by the expected annual reduction in operating costs of $800. THis gives 7.5 as the payback period in years.
Which one of the following is a critical component of a human resource professional or department? 1. Controlling 2. Organizing 3. Communicating 4. Planning
3. Communication is critical for the transimssion and reception of information; it is an exchange of thoughts and messages. Effective managemtn requres clear and conside communication
What is the discipline that addresses musculoskeletal disorders (MDS) and is directly related to staff that provide resident care? 1. Economics 2. Somatotypes 3. Ergonomics 4. Geometrics
3. Economics focuses on the distribution of goods and services; somatypes is the study of body types; and geometrics examines designs and shapes.
Which one of the following is a most significant factor related to employee retention? 1. Development of master staffing schedules 2. Advisory relationships with consultants 3. Orientation and supervision on employees 4. Strict adherence to policies and procedures
3. Employees who are fully oreinted to their job and well supervised are more likely to remain with the facility. Steps in 1, 2, and 4 would not likely lead as directly to better employee retention.
Which one of the following is a key factor in managing cultural diversity in the workforce? 1. Job roles 2. Job responsibilities 3. Education and training programs 4. an organizational chart
3. Establishment of cultural diversity education and training programs is a key factor in the managemtn of culuture diversity issues in a long-term care facility
Which one of the following is not correct about Material Safety Data Sheets (MSDS)? 1. Facilities are required to post the MSDS at appropriate places with the facility for all shifts 2. The information to be provided on the MSDS is standardized 3. The MSDS relate to hazardous chemicals, isolated residents with contagious infections, and high powered electrical mechanisms. 4. The design of the MSDS may vary
3. MSDS are manufacturers' standardized information about hazardous chemicals and the MSDS are to be postsed in appropriate places to that they are available for all shifts. The design may vary but the information is standardized.
Which term below is descriptive of a third party who makes a decision related to resolving a dispute and that decision is binding on both the union and the facility? 1. Mediation 2. Collective bargaining 3. Arbitration 4. Adverse Impact
3. Mediation is to reach a settlement; collective bargaining is reaching an agreement between labor and the facility; adverse impact relates to a standard for hiring that is discriminatory or not directly related to the job skills, thus preventing qualified presons from being considered for the job
The medicare benefit period ends when a beneficiary 1. has had 100 days of SNF care 2. begins a hospital stay 3. has had 60 straight days with neither any hospital days nor SNF days 4. staps paying the part B premium
3. Medicare defines its benefit period as starting when a beneficiary has been admitted to a hospital and ending when that person has not had any hospital or SNF days for 60 days in a row
Medicare Part A coverage of skilled nursing facility care entails out-of-pocket payment by the patient of a daily amount for which days of SNF care in a benefit period? 1. none 2. 1st through 20th 3. 21st through 100th 4. each day that the costs exceed a certain level
3. Medicare pays for up to 100 days of SNF care per benfit period, but it pays the full amount only for the first 20 days. For each day from the 21st through the 100th, the beneficiary must pay the coinsurance amount that goes up each year.
In order to ensure a comfortable environment, Medicare/Medicaid regulations require that nursing facilities provide: 1. Air conditioning 2. Rooms painted in contrasting colors 3. Adequate lighting levels 4. Carpeted hallways
3. None of the other options are required
Medications not given as intended by the prescriber, as required by the drug manufacturer, or according to acceptable professional standards is: 1. Polypharmacy 2. Drug regimen 3. Medication error 4. Drug therapy
3. Not administering a drug as required is a medication error. Polypharmacy is taking too many medications, drug reimen is the plan to be followed in given drugs, and drug irregularity is giving drug without medical reason
According to federal standards, which one of the following items is NOT required in/for resident rooms? 1. Direct access to exit corridors 2. floor at or above grade level 3. Partial privacy for each resident 4. One window to the outside
3. Rooms must assure full visual privacy for each resident
Which level of employees are most at risk for potential personal injury in the nursing home? 1. food preparation workers. 2. maintenance personnel 3. CNAs 4. Nurses
3. The CNA is most at risk because of the nature of their work- physical effort required, performing the same motions over and over, assuming positions that stress the body.
White Title XVIII (Medicare) and TItle XIX (Medicaid) both refer to fire safety and construction information, the actual provisions in those areas are specified by the: 1. American National Standards Instititue (ANSI) 2. Occupational Safety and Health Administration (OSHA) 3. Life Safety Code (LSC) 4. Uniform BUilding Codes (UBC)
3. The Life Safety Code contains these provisions
A valid court order directing that medical records be made available to a given third party, or revealed in a given circumstance, must be honored: 1. Only if the resident has raised the issue of his/her medical care in a law suit 2. But the resident's consent is required if the third party is an insurance company 3. Only with the resident's consent 4. The resident's consent is not required
4. A resident's medical record must be kept confidential and free from any unauthorized disclosure without the resident's consent except when release is required by law, transfer to another facility, or the resident requests his/her chart
______ communication occurs between peers or persons of equal rank or status 1. Downward 2. Formal 3. Upward 4. Horizontal
4. Downward refers to supervisors to staff or administrators to supervisors; formal is along the lines of the organizational chart; and upward is from the employee to the supervisor/manager or administrator
Regulations related to pyament for overtime for nursing staff employed by a skilled nursing facility are guided by the: 1. Immigration reform and control act 2. workers compensation act 3. medicare modernization act 4. fair labor standards act
4. Fair labor standards act, which sets minimum wage, overtime, standard workweek definitions, equal pay, child labor, and record keeping requirements for over 50 million employees, including those in nursing facilities
Facility employees are allowed to serve as feeding assistants during meal time as long as they meet certain requirements. Which of the following statements is NOT true? 1. Feeding assistants must work under the supervision of a RN or LPN 2. Feeding assistants can only assist resident who have no difficulty swallowing 3. Feeding assistants must complete a state-approved training program 4. Feeding assistants can assist residents who are at rish for aspiration
4. Feeding assistants are not allowed to feed residents who have complicated feeding problems such as difficulty swallowing, aspiration risk, and feeding tube
Which of the following is most likely to be part of the responsibilities of a compliance officer? 1. rendering assistance to the residents' advisory council 2. coordinating the resident admission process and ensuring the exchange of all required information 3. representing management in implementation of the grievance procedures under the facility's contract with a labor union 4. investigation and acting on certain kinds of problems that employee report regarding claims submissions to third-party payers
4. Having a compliance officer with this as part of his/her role is one of the OIG's recommendations in its 'Compliance Program Guidance for Nursing Facilities'
Which of the following statements is correct about naso-gastric tube feeding while in a facility? 1. An individual who needs to be fed may be given a naso-gastric tube to make eating easier for the resident 2. The facility must ensure that the resident receives appropriate treatment to restore, if possible, normal eating skills. 3. With the family's permission, the resident may be given a naso-gastric tube. 4. The initial assessment demonstrates that the resident's clinical condition indicates he/she can't eat by himself/herseal
4. If the "comprehensive assessment" of a resident's clinical condition demonstrates that use of a tube was unavoidable, the facility must ensure that the resident receives the appropriate treatment to restore, if possible, normal eating skills.
Nurses chatting casually about nursing matter in the nurses' lounge is an example of: 1. Formal communication 2. Upward communication 3. Downward communication 4. Informal communication
4. Itis communication between professionals, but the one clearly correct answer is informal communication
Which of the following statments is not true regarding the Medicare prospective payment system for skilled nursing facilities? 1. Facilities located in different urban areas receive different rates that reflect differences in area wage rates 2. The system is case-mix-based 3. Facilities must submit bills to be reimbursed 4. There are seperate prospective rates for capital-related costs
4. Medicare does not make separate reimbursement to SNF's for capital-related costs. The RUG rate that the facility receives is expected to cover all types of costs.
The type of insurance that would cover the facility if it were sued by a resident who was injured as the result of a medication error by a nurse employee is 1. patients compensation 2. health insurance 3. general liability 4. professional liability
4. Professional liability (or malpractice) insurance covers losses due to negligence by an employed nurse. (note that there is no such thing as option 1 "patients insurance".
Death in building fires is mainly caused by: 1. Induced panic 2. Faulty evacuation 3. Burns 4. Smoke inhalation
4. Smoke inhalation is known to be the main cause of death in fires according to the National Fire Protection Association statistics
An abnormal condition or disorder caused by exposure (inhalation, absorption, ingestion, or direct contact) to environmental factors associated with employment is: 1. An occupational injury 2. a musculaskeletal disorder (MDS) 3. a violation of the hazardous communication standard (HCS) 4. An occupational illness
4. That is the definition of occupational illness. An occupational injury is a cut, fracture, sprain or amputation that results from a work accident and requires more than basic first aid
In public buildings, signage that depcits a human figure in a wheelchair is an international symbol that indicates entry into: 1. An area that includes a change in floor level 2. A hazardous area 3. An area of accessibility for the handicapped 4. An emergency area
3
Nurse aids must have a minimum of ___ hours of in-service training annually? 1. 6 2. 10 3. 12 4. 16
3
One specified reason for a "significant change" comprehensive reassessment is an unplanned wight loss of either ___% over 30 days or ___ over 180 days? 1. 5%, 7% 2. 7% 10% 3. 5%, 10% 4. 10%, 29%
3
All of the following are barriers regarding the recognition of chronic pain except for: 1. Cognitive impairment and communication barriers hinder a resident's ability to report pain or respond to caregiver's questions regarding pain 2. Staff who are utilizing valid tools to screen for pain 3. Elderly may not show verbal or non-verbal symptoms of pain 4. Staff may not have knowledge of or be skilled in assessing pain
2 The instrument the staff utilizes to screen for pain doesn't create any type of barrier for them to determine if the resident is experiencing pain. All of the other are related to the ability of the resident to express pain or the staff to evaluate the presence of pain.
If the facility's occupancy increases from 94% to 98%, the fixed cost per resident: 1. decreases slightly 2. remains the same 3. increases slightly 4. increases slightly
1. Fixed cost per resident is calculated by dividing total fixed costs by number of residents (currently-occupided beds). If the occupancy rate increases slightly, fixed costs do not change (by definition), and number of residents increase, resulting in a decreased fixed cost per resident. Another way of saying this is that the fixed costs are spread over a larger number of residents.
The practice of giving verbal warnings, followed by written warnings is known as: 1. Progressive discipline 2. Mandatory discipline 3. Enlightened discipline 4. Regressive discipline
1. Progressive discipline. Before sever action can be taken, such as a suspension, there must be a paper trail of warning that are documented.
"Assets are always equal to the sum of liabilities plus owners' equity" is the basic concept in the organization of the: 1. balance sheet 2. income statement 3. general journal 4. statement of operations
1. The balance sheet is based on the "accounting equation" present in this question.
Within the spirit of OBRA and culture change, which one of the following is most descriptive of the movement? 1. Resident rights and resident centered care 2. Changing the physical structure of the facility to be more homelike 3. Having more clearly defined and permanent workloads and assignments 4. Protection of residents and employees through an affective infection control program
1. The spirit of OBRA and the cultural change movement is to accord more dignity to residents, creat ea more resident centered care that allows the resident to determine when they want to do things
In the event of an error in administration of medication, which of the following should be notified first? 1. Report to the attending physician 2. Report the error to the DON 3. Report to administrator 4. Report to the family
1. When a medication error has occurred the resident's condition at the time is the most important consideration. The resident must be assessed and the physician must be immediately notified of the physical findings and the details of the medication error so the appropriate medical intervention can be initiated
According to federal certification standards, the square footage for a single resident room is ______ and the square footage for a multiple resident room is ______ square feet per bed 1. 90/70 2. 100/80 3. 110/90 4. 125/100
2
In the case of non-Medicare Part A residents, the initial resident assessment must be completed: 1. Within 10 days of admission 2. Within 14 days of admission 3. Within the first week of admission 4. Prior to formally admitting the resident
2
In the typical facility, staff turnover is greatest among: 1. Business office 2. CNAs 3. Dietary workers 4. Maintenance
2
The term for unintentional improper or excessive use of benefits of a health insurance program is? 1. fraud 2. abuse 3. kickback 4. grossing up
2
Under the accrual basis of accounting, revenues are recorded when __________ and expenses are recorded when __________. 1. cash is received and - cash is paid out 2. revenues are earned - expenses are incurred 3. revenues exceed expenses - expenses exceed revenues 4. the fiscal year ends - expenses are incurred
2
Unless a waiver has been secured, a registered nurse is required to be in the facility? 1. At least eight hours within every 24 hour period 2. At least eight consecutive hours a day, seven days a week 3. At least eight consecutive hours Monday through Friday 4. There is no minimum number of hours required
2
Which changes in the dietary department would most closely reflect the principles behind culture change? 1. Providing set meal service times with little flexibility to maintain a daily routing for the residents 2. LIberalizing therapeutic diets to provide more food choices to resients 3. Increasing the number of pureed or soft diet orders to make feeding easier for the staff 4. Structuring meal times to the benefit of staff schedules
2
Which of the following is a current asset? 1. gross earnings 2. accounts receivable 3. company car 4. retained earnings
2
Which one of the following is not a function of the activities director? 1. To ensure that the culture, functional ability, cognitive level, and background of the individuals contribute to enhanving personal identity, self-esteem and dignity of the resident 2. Develops the restorative therapy program for each resident 3. He/she is a part of the comprehensive assessment team within the facility 4. May form small groups (clubs) to include resident of like interests
2
Which one of the following statements is NOT required with respect to fire safety. The facility must have: 1. An audible and visual communication and alarm system 2. A coded word or phrase as a means of notifying staff of a fire event. 3. The illuminated exit signes with battery or generator backup 4. At least two exits on each floor or fire sections
2
Why should an administrator get department heads involved in the budget-making process? 1. To remain in compliance with federal certification requirements 2. To obtain more accurate cost estimates and more control over costs. 3. To satisfy a generally accepted accounting principle (GAAP) 4. To conserve time in developing a budget
2. Input from persons responsible for making key decisions about resource consumption should result in more realistic cost projections. Also, when individuals participate in the making of policy, they are more likely to consider it legitimate. Department heads are more likely to comply with a budget that they hepled develop. The answer is not 1 or 3: GAAP or federal regulations for a participatory budget making process. The anser is not 4: a participatory approach is likely to be more, rather than less, time-consuming.
Which one of the following is the most important step in developing clearly defined job descriptions? 1. Having all job descriptions written by line supervisors? 2. Careful analysis of the job content 3. Obtaining sample job descriptions from allied professions 4. Updating the job description to reflect changes in compensation policies
2. None of the stapes suggested in 1, 3, and 4 would lead to a clearly defined job description
The financial success or failure of a nursing facility is usually measured by its: 1. company earnings 2. return on equity 3. gross earnings 4. capital
2. One of the performance ratios (also called profitability ratios) is the return on equity. This takes net income and divides it by owners' equity. The answers are not 1 or 3 because, instead of looking only at earnings, it is better to look at earnings per dollar of equity investment. The answer is not 4; the amount of the entity's capital by itself does not indicate recent profitability.
Which type of employee counseling should not be done between the administrator/department manager and an employee? 1. Personal development and career advancement 2. Personal non-work problems being experienced by an employee 3. Work related problems: scheduling, the work environment, worker performance, etc. 4. Conflicts between personnel: managers and employees or employee and employee or administrator and employee or manager
2. Only trained professionals should assist an employee on problems outside the work area. Getting involved in personal problems outside the work area has the potential to cause additional problems down the road
All certified nursing home facilities must have a sprinkler system by the year: 1. 2011 2. 2013 3. 2012 4. 2010
2. THis requirement is specified in section 483.70(a)(8)(1) of the Code of Federal Regulations
To obtain maximum reimbursement under the medicare prospective payment system, a skilled nursing facility should do all except which one of the following? 1. record on the MDS all the information about the resident that can determine assignment to a RUG 2. Have physical therapists who serve part A covered residents bill medicare directly 3. track costs by RUG categories 4. collect MDS information more frequently part A covered residents than for other residents
2. The consolidated billing rules prohibit separate billing for physical therapy (and occupational and speech therapy) provided to a medicare beneficiary on a part A covered stay
An example of a variable cost is 1. real estate taxes 2. nursing supplies 3. rent 4. mortgage loan payments
2. The cost of nursing supplies can be expected to increase in direct proportion to the number of resident-days, census, occupancy rate or other measure of the facility's business activity. THe answer is not 1, 3, or 4; taxes, rent, and mortgage loan payments are fixed costs. THis is true even of payments for variable-rate mortage loans. Such loans may vary over time with changes in the wider economy, but not with any measure of the facility's activity.
The age discrimination act as amended: 1. Protected persons up to age 70 2. Prohibited mandatory retirement in most lines of work 3. Protected persons 40-70 from being laid off and replaced by younger workers. 4. Prohibited hiring younger workers and releasing workers once they were eligible for social security
2. The original act sought to protect persons aged 40-70 from being replaced by the employer with younger persons, but the amendment addressed prohibiting mandatory retirement
TO establish job descriptions, the work the facility seeks to accomplish must be broken down into sets of activities that can be: 1. Evaluated by supervisors 2. Performed by one person 3. Effectively analyzed 4. Grouped in job families
2. The point being tested is whether the respondent knows that all the work of a facility must be broken down into a set of activites that one person can perform
Which of the following statements is correct regarding activities provided through the activities department of a facility? 1. Spiritual activities are not permitted in a facility that receives federal funding 2. Manicures/pedicures, hair styling, and makeovers may be considered part of the activities program 3. Trips to casinos and other gaming type facilities, museums, fishing events, etc. are not permitted because of the liability for facilities 4. Most activities, which are scheduled by the activity director, should be of a physical nature in order to help residents increase or maintain their mobility
2. These activities are defined as acceptable activities in the Survey Operations Manual - Tag F248
According to the Life Safety Code requirements, a corridor in a new nursing home must be: 1. 6-8 feet 2. 8 feet 3. 8-10 feet 4. 10 feet
2. This is a requirement of the Life Safety Code
According to federal certification standards, when a nourishing snack is provided at bedtime, up to _____ may elapse between a substantial evening meal and breakfast the following day if a resident group agrees to this meal plan. 1. 12 hours 2. 16 hours 3. 14 hours 4. 15 hours
3
For interviewing a potential employee, a good technique is to: 1. Spend half the time putting the interviewee at ease 2. Keep the interviewee on guard by asking a succession of rapid questions 3. Let the interviewee do most of the talking in order to gain as much information as possible 4. Spend most of the time giving the interviewee information about the job.
3
If a resident refuses to consume all of a meal initially given to him/her the nursing staff should? 1. Do nothing; it is the resident's right to refuse meals 2. Document that the resident was being uncooperative for that particular meal 3. Offer a suitable meal replacement or nutrition supplement to provide adequate calories 4. Force-feed the resident the meal as served
3
Which of the following statements regarding budgeting procedure is correct? 1. An operating budget projects only revenues from providing resident services? 2. the operating budget includes planned expenditures for major building renovations 3. a cash budget may provide advance warning of months when cash outlays fall short of cash receipts 4. the capital budget includes epxenses for all routine maintenance of equipment
3. The anser is not 1: the revenue budget part of an operating budget will include operating revenues in addition to patient-service revenues. The answer is not 2: plans for major capital expenditures go into the capital budget, not the operating budget. The answer is not 4: routine maintenance expense and repairs that do not increase the value of an asset or extend its useful life are expense items that go in the operating budget.
Which act is directly related to questions that the administrator or HR representative can ask in an interview with a client? 1. fair labor standards act 2. uniform service employment and reemployment act 3. civil rights act 4. the health insurance portability and accountability act
3. The civil rights act seeks to protect applicants for a position from discrimination in being considered for a position
Last year's food costs for 100-bed facility were $146,820. The facility had an average occupancy rate of 85% that year. What was this facility's food cost per patient day (PPD)? 1. $3.80 2. $4.02 3. $4.73 4. $5.18
3. The first step is to calculate the total number of patient-days (or resident-days). If every bed in this facility were filled every day of the year, that number would be 100 beds x 365 days of the (non-leap) year. However, on average, only 85% of the beds were filled. So the total number of resident days was: 100 beds x 365 days x.85 = 31,025 resident days. Then divide this figure into the food cost of $146,820 and this gives $4.73 as the food cost PPD.
The importance of matching revenue with the expenses incurred in generating those revenues is the reason for recording which one of the following? 1. working capital 2. current ratio 3. deprectiation 4. payback period
3. The purpose of recognizing depreciation is to satisfy the Matching Principle (GAAP) state in this question
_____Contracts are those established each time a need arises, then terminated upon completion 1. Non-routine activities 2. routine activities 3. job-unit 4. temporary
3. These contracts are for such things as roof repair, minor repairs, equipments installation, painting (if not done by in-house personnel), etc.
____________ refer to any endeavor in which a resident participates that is intended to enhance his/her sense of well-being and to promote or enhanve physical, affective, spiritual, cognitive, and emotional health. 1. Activities of dialy living 2. instrumental activities of daily living 3. activies 4. occupational therapies
3. This is the definition of activities in the Survey Operations Manual under tage F248
Which one of the following is the best approach for a supervisor to use with an employee who is clearly distracted and upset by a personal problem? 1. Issue a written warning 2. Ask the administrator to reprimand the employee 3. Discuss the problem with the employee as it relates to his/her job performance 4. Suspend the employee until the problem is resolved
3. Warning, reprimand, suspension are inappropriate responses to an employee upset by a personal problem. The employee needs to understand how the personal problem is impacting his/her work performance and seek help outside the facility to resolve the problem
Facilities are expected to provide a pleasant dining experience for all residents. This includes all except: 1. Provideing well-lit, well ventilated dining room 2. Provideing adequate space and seating accomodations 3. Maintaining a level of dignity when serving all residents 4. Serving residents without attempting to honor resident food preferences
4
How many hours a day must the facility provide a resident with access to physical services or with transportation to a hospital emergency room? 1. 8 2. 12 3. 18 4. 24
4
Restorative care must be provided: 1. Only with the order of the facility's physical therapist 2. By specialized qualified staff for which the facility has contracted services 3. Only if the resident can't provide his/her own care 4. By nursing staff based on a comprehensive assessment
4
Which one below is an exception to when a facility may release resident identifiable information under the HIPAA Privacy Standard without the residents permission? 1. For a research study conducted by CMS 2. When any immediate family member requests it 3. To consumer groups 4. When a resident is transferred to another health care institution
4
Which one of the following is most descriptive of the personnel policy handbook (HR handbook)? 1. A collation of job descriptions of all jobs in the facility 2. A compilation of federal and state regulations that directly relate to each department in the facility 3. A compilation of culture change criteria that needs to be implemented to ensure quality resident centered care 4. A compilation of facility policies and procedures that directly relate to work conditions
4
Which one of the following statements is true regarding a facility providing medically related social services to the facility? 1. A facility must have a full-time qualified social worker on staff for each work shift except weekends 2. A facility's qualified social worker must have a BA degree in social work and one year of supervised experience in a health care setting working with individuals 3. A facility must have one qualified social worker for each 75 residents 4. A facility's qualified socail worker's bachelor's degree can be in a human services field or in another degree with one year of supervised social work experience in a health care setting working directly with individuals
4
A change in which one of the following is not likely to be the cause of a budget variance? 1. Case mix 2. Staff efficiency 3. rates paid by third-party payers 4. the personal needs allowance
4. A change by the state medicaid program in the personal needs allowance will affect how much of the social security that certain medicaid recipients will be allowed to keep, but the amount that the facility can expect to receive as its medicaid rate (in the form of payments from both the state and covered resident with income) should remain the same. In contrast, changes in 1, 2, or 3 could result in a budget variance. A change in case mix could result in changes in the types or amounts of services provided, and this could undermine cost projections (as well as revenue projections under a case mix based reimbursement system).
Which of the following practices is illegal for a medicaid certified facility? 1. Offering a resident staff assistance in applying for medicaid 2. billing the resident for certain services or items when medicaid is paying for that residents care 3. asking a medicaid recipient to help pay for care by turning over any private pension amounts that the resident may be receiving 4. requiring the payment of the facility's private pay rate for a certain number of months as a condition for admission
4. The federal certification standard [483.12(d)(3)] prohibits charging a medicaid eligible resident any amount of money as a precondition for admission. The interpretive guidelines specify that the certified facility may not accept "any promise to pay private rates for a specified period of time" as a prerequisite to admission or continued stay in the facility. The anser is not 1: the federal standard at [483.10(b)(10)] requires the facility "provide to residents and to applicants oral and written information about how to apply for Medicare and medicaid benefits. (The facility should consider assisting with medicaid applications to an extent further than the regulatory minimum) The anser is not 2. a nursing facility may bill a medicaid-eligble resident for items and services if (a) the items and services are not covered under the state program; (b)the resident has requested and received them; and (3) the facility gives proper notice of their cost. The anser is not 3: the facility may be required to do this and to collect the private income as partial payment for care.
Certified facilities must meet the requirements of which edition of the Life Safety Code? 1. The latest edition 2. The edition that was in effect when the facility was built 3. The edition determined by the state survey agency 4. The 2000 edition
4. The federal rules continue to be based on the 2000 edition of the Life Safety Codes
A generally accepted accounting principle (GAAP) would be violated if a company 1. used a fiscal year that did not correspond to the calendar year 2. records as revenue amounts that have been earned but not yet received 3. counts as assests its accounts receivable with a deduction for the proportion expected to be uncollectible 4. used in its balance sheet an optimistic estimate of the current market value of its building
4. The use of current market value rather than historical costs would not be consistent with the Objectivity GAAP, and the use of an optimistic rather than conservative estimate would violate the Conservatism GAAP. The practices in options 1 and 3 are acceptable, and the practice in option 2 is a requirement of the accrual basis of accounting
