Long Term Care Master Study Guide
People who have to care for both their parents and their children are called:
"sandwich generation."
Monthly costs for congregate housing can range from $500 to over:
4000
The current system of long-term care providers has developed largely in response to:
All of these are correct
The ACA makes cuts in Medicare to finance part of the new spending, including:
All of these are correct.
The Community Living Assistance Services and Supports (CLASS) Act:
All of these are correct.
A provider's service community may be defined by:
Any of the above
Hiring and overseeing the organization's CEO is the responsibility of the:
Board
Which of the following is not a reason why long-term care is so heavily regulated?
Consumers of long-term care are politically powerful.
A primary barrier to consumer education is the lack of available information.
False
All home care services must be ordered by a physician.
False
An owner of a long-term care facility may not serve as the CEO.
False
An ownership-based IHS usually consists of a mix of nonprofit and for-profit subsidiaries.
False
Autonomy means that the right of the consumer to make all decisions regarding care is absolute.
False
Because of how long-term care providers are reimbursed, price is not a factor in marketing.
False
Being a change agent refers only to how a manager works within the organization.
False
Communication does not need to be two-way to be effective.
False
Creating an effective quality improvement program for a long-term care facility or agency is best accomplished by copying one developed by an acute care provider.
False
Culture change, if approached properly, can happen quickly.
False
Each provider must find ways to provide all services needed in the service community.
False
Everyday issues such as food, activities, and private space are not of high importance to most residents.
False
HIPAA prohibits sharing clinical data about a consumer with other providers without the consumer's written permission.
False
Long-term care consumers are usually defined by a single disease or condition.
False
Long-term care is defined as care provided in nursing homes.
False
Managed care is not an important factor in the growth of adult day care.
False
Nursing facilities are staffed with only licensed healthcare professionals.
False
Private certification standards measure minimal acceptable levels of performance.
False
Properly assigning blame is one of the characteristics of successful organizational culture change
False
Regulations require that a provider have a quality assurance (QA) committee, but leave the makeup of the committee to the provider to determine.
False
Reward power is s form of personal power.
False
Staff scheduling using information technology is only beneficial to large organizations.
False
Stakeholders are those individuals who have a financial stake in the organization.
False
Strategic planning is the same as strategic thinking.
False
The Affordable Care Act passed with a mix of Republican and Democrats votes.
False
The No Wrong Door system portion of the ACA mandates that long-term care consumers can access any provider's services.
False
The ethical issue of access deals only with whether a person receives services, not the types of services received, or where they are received.
False
The long-term care system has historically been proactive in facing problems.
False
Those who reimburse long-term care are achieving seamlessness faster than are service providers.
False
To qualify for Medicaid coverage, residents must require assistance with all five activities of daily living.
False
Which of the following are not "informal caregivers?
Government agencies
Which of the following is not an accrediting agency?
HCFA
The four basic consolidation strategies are divestment, retrenchment, pruning, and:
Harvesting
Culture change benefits residents. Which of the following is not one of the resident benefits?
It reduces resident care costs.
When compared to public relations, marketing is:
Narrower in scope
The four "Ps" of a marketing mix are product, price, promotion, and:
Place
Public/private partnerships are efforts to reduce:
Public funding of long-term care
Nursing facility administrators are licensed by:
State Governments
Case management is primarily concerned with:
The cost-effectiveness of care received
Which of the following is not a weakness of the long-term care system?
There has been no innovation by providers.
Which of these is not part of the stated aim of the ACA?
To be implemented within two years
A "gatekeeper" is a person or agency that determines how much and what type of care is received by an individual.
True
About three-quarters of residents in nursing facilities are women.
True
Aging in place is a form of single-site care availability.
True
Although we usually think of long-term care as being for the elderly, nearly half of the people using long-term care are non-elderly.
True
An organization may have several quality improvement teams at work at any given time.
True
Any culture can be changed and is probably changing most of the time.
True
Approximately one-third of all nursing facility residents show symptoms of depression.
True
Certified nursing assistants (CNAs) are not licensed.
True
Community relations includes public relations, but goes further.
True
Competency is not the same as rationality.
True
Competition in long-term care comes both from other LTC organizations and from other types of organizations.
True
Culture change reduces employee turnover.
True
Edwards Deming's "total quality management" is based on recognition that individuals can contribute to improving quality and reducing costs.
True
Growing competition is one of the reasons why long-term care organizations need better information technology.
True
Home health care is based on the concept of taking the services to the consumer.
True
Horizontal integration involves an alliance of two or more organizations providing similar services.
True
Illness prevention is an integral part of the long-term care system
True
Managed care organizations will be customers of long-term care providers.
True
Most hospice organizations are nonprofit.
True
Most problems between the board and administration are unintentional
True
OBRA does not require that the facility's medical director be full-time.
True
Pay-for-performance provides financial incentives to healthcare providers to achieve optimal outcomes for patients.
True
Providers will have to share some of the financial risk of caring for disadvantaged populations.
True
Public relations is primarily a communications tool to influence attitudes.
True
Services provided in subacute care units vary depending on the nature of the specific population served.
True
Subacute care is generally more intensive than nursing facility care, but less intensive than acute care.
True
Telemedicine involves providing care to consumers at remote locations using technology.
True
The ACA requires individuals to have insurance coverage and businesses to provide coverage or pay fines.
True
The U.S. Supreme Court ruled that the individual mandate was, in fact, a tax.
True
The case manager may be "internal" (employed by the subacute unit) or "external" (employed by an MCO or other payer).
True
The difference between cooperation and integration is largely a matter of degree and structure.
True
The final strategic plan may consist of a combination of strategies.
True
The primary role of state government in regulating long-term care quality is as the designated agency administering federal programs.
True
The term "administrator" can be used in reference to any member of the administrative team.
True
The term "culture change" is used in two separate, but closely related, ways.
True
The terms chronic care and long-term care are generally used interchangeably.
True
The long-term care system is made up of providers who are organizationally:
a mix of for-profit, nonprofit, and government-owned.
A living will is a(n):
advance directive
The ACA's employer mandate:
affects only larger long-term care providers.
The term "consumer-driven" means that long-term care consumers are:
allowed to make decisions related to their care and financing as much as possible.
History has shown that increasing the availability of services usually results in:
an increase in usage of services
The Medicare hospital readmissions reduction program (HRRP):
assesses penalties on hospitals with high readmission rates for patients with certain medical conditions.
Baby boomers is a term used to describe people born:
between 1946 and 1964.
Ultimate accountability for an organization rests with:
board
Ensuring the legal and ethical integrity of the organization is the responsibility of:
both of the above
Prominent culture change programs include:
both of the above
The term "governance" may be used in reference to:
both of the above
The term "nursing facility":
came from OBRA legislation.
Rising acuity levels in long-term care facilities refers to:
caring for sicker patients/residents.
Integrated clinical information systems typically address four specific areas: patient management, clinical guidelines, quality improvement, and:
clinical outcomes
Negative feedback is also called:
constructive feedback
Which of the following is not a component of accessibility of long-term care services?
consumer choice
Health information systems are built on the foundation of three processing phases—data input, data output, and:
data management
Care planning begins with:
detailed assessment
Special care units in nursing facilities may be created based on:
disease or condition or age.
Subacute care is generally provided in:
either hospitals or nursing care facilities.
Physician services for hospice patients are provided by:
either of the above
Comparing an organization's strengths and weaknesses with its competitors is part of:
external assesment
"Least restrictive environment" means not using physical or chemical restraints.
false
All assisted living facilities provide the same services.
false
An ideal long-term care system would provide all of the services consumers need or want.
false
Cohousing is age-restricted.
false
Creation of new types of services has reduced overall demand for services.
false
Leadership is only for a chosen few.
false
Less than half of the residents in assisted living facilities need assistance with one or more activities of daily living (ADLs).
false
Location relative to family members is not an important consideration in choosing an assisted living facility.
false
Long-term care today is a competition-driven system
false
Managers of senior housing must be licensed.
false
Medicare does not yet allow electronic transmittal of assessment and outcome information.
false
Nonprofit providers do not need to generate a profit (surplus).
false
Outcomes management ends at discharge.
false
Special care units will be replaced by multilevel, all-inclusive care providers.
false
The CEO does not need to understand or be directly involved in information technology as long as there is a qualified expert on staff.
false
The Patient Self-Determination Act mandates that a patient create a living will.
false
The average age of residents in assisted living facilities is 70.
false
An assisted living facility is staffed with:
fewer nurses than a nursing facility of the same size
The most common type of ownership of independent living communities is:
for profit
Long-term care administrators are subject to professional liability and:
general liability.
The three components of leadership are influencing others, providing direction, and:
getting voluntary acceptance.
Mainframe computers:
have been largely replaced by personal computer networks.
Integrated systems will dominate because they:
have the flexibility to survive rough times.
The most common source of admissions to assisted living is from:
home
To date, most integrated health systems have been built around:
hospitals
he first step in solving a problem is:
identifying the problem.
Which of the following types of disclosure of health information is not permitted by HIPAA without the consumer's permission?
information used for marketing purposes
The influence of managed care on the competitiveness of long-term care:
is great
The basic concept behind CQI is that quality:
is not separate from other aspects of the organization's operations
Assisted living is:
largely unregulated, but likely to become more regulated.
The four types of position power are reward power, coercive power, connection power, and:
legitimate power
The four generally agreed-upon categories of subacute care are transitional, general, chronic, and:
long-term transitional.
Studies have shown that informed long-term care consumers:
make better choices
Which of the following is not a function of an institutional ethics committee?
making difficult ethical decisions concerning individual residents
Dividing the market into distinct groups of consumers is:
market segmentation.
Which of the following is not a Medicare-covered home care service?
meals on wheels
The largest single source of financing for most nursing facilities today is:
medicaid
The largest source of reimbursement for subacute care is:
medicare
The primary purpose of the OSCAR computerized national database is:
monitoring compliance with regulations.
The most common destination for people leaving assisted living is:
nursing facilities
Which of the following must be licensed?
nursing facility administrators
Occupancy rates in senior housing are currently:
over 90%
Medicare pays hospice providers on the basis of:
per diem
Denying care that would prevent pain or suffering is a form of what type of abuse?
physical abuse
Planning scenarios are designed to:
prepare for possible future events.
The "Nursing Home Compare" initiative by CMS is designed to raise consumer awareness of the quality of care in nursing facilities, promote consumer use of Medicare's information, and:
pressure facilities to improve quality.
Most residents in long-term care facilities prefer rooms that are:
private
Quality First" is a(n):
private, voluntary initiative by provider associations to improve quality of care.
"Multilevel facilities" refers to facilities that:
provide multiple levels of care.
Two of the most important aspects of improved technology will be integration of system components and:
providing information to consumers.
Which of the following is not a reason for joining an integrated health system?
reduced regulation
Independent living is for:
relatively healthy, active seniors.
Being innovative involves finding creative ways to solve problems and:
replicating them as widely as possible.
The Green House Project breaks the mold of institutional care by creating small homes for 6 to 10 elders who:
require some skilled nursing or assisted living care.
Culture change can also be described as:
resident-centered care.
Adult day care developed from the concept of:
respite
Autonomy, as used in the context of long-term care, means:
self-determination.
The largest source of financing for assisted living facilities is:
self-pay
Most accreditation agencies measure performance against standards that are:
set higher than licensure requirements.
Organizational culture is
something to which employees can relate
Regulators may find it difficult to anticipate and deal with future change because of:
statutory rigidity.
The most commonly used types of quality measures are process, outcomes, and:
structure.
One of the major advantages of a continuing care retirement community is:
the option to move between housing environments
Culture change is particularly important to baby boomers because:
they expect to play a significant role in care decisions.
Developing an organization's ability to work in new and different ways is primarily the responsibility of:
top administration
A team leader must also be a member of the team.
true
Age-restricted retirement communities are oriented toward an active lifestyle, or "younger-thinking" seniors.
true
All boards have a responsibility to assess their own performance.
true
Assisted living developed from both boarding homes and independent living facilities
true
Continuing care retirement communities offer several levels of assistance, usually including independent living, assisted living, and nursing home care commonly all on one campus or site.
true
Educating the governing body is the responsibility of the CEO.
true
Hospice care is provided both at home and in healthcare facilities.
true
Managed care has been a major factor in the growth of subacute care.
true
Many seniors enter into a CCRC contract while they are healthy and active.
true
Technology has already had an impact on education.
true
The first step in measuring quality is determining what is meant by quality.
true
The long-term care system is moving toward becoming more "seamless."
true
In long-term care, family members are:
usually involved.
How important will it be for providers to get involved with an integrated care system?
very important
Externally mandated quality requirements are aimed at:
weeding out poor performers and ensuring that providers meet minimal standards.
When is home health care more cost-effective than nursing facility care?
when used intermittently
The impact of the large number of "baby boomers" on long-term care:
will grow over the next two decades.
The term "legacy" when describing hardware and processing systems refers to systems that:
will not interact with other hardware or systems.