NAB KH

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straight line depreciation historical cost / useful life 100,000 / 10 = After first year, what is the book value? 100,000 - 10,000 =

$10,000 per year/$90,000

Under MCR & MCD, an individual who willfully and knowlingly certifies a material and false statement in a resident assessment is subject to a CMP of not more than ____________ for each assessment

$1000

Break even in beds = FC/{Fixed cost rate per bed - Variable Cost Rate per bed} FC is $14,000 Fixed cost rate per bed is $100 VC is $40

$14,000 per week/$100-$40 $14,000 / $60 = 233.33 per week 233.33/7 = 33 beds per day

Amount collected = (Amount of insurance carried / amount of insurance required) x loss Amount of insurance carried is $150,000 Amount of insurance required is $30,000 Loss is $ 5,000 How much will be collected from the loss?

$150,000 / $30,000 = 0.5 0.5 x $5,000= $2,500 collected from insurance company

Amount of insurance required = Value of building x coinsurance percentage Value of building is $150,000 Coinsurance is 20%

$150,000 x .20 = $30,000

Average cost per day = Average cost per resident / # of days in the month Average cost is $2,000 # of days in month is 31

$2,000/31 = $64.52

Break even in beds = FC/{Fixed cost rate per bed - Variable Cost Rate per bed} FC is $20,000 Fixed cost rate per bed is $100 VC is $40

$20,000 per week / $100 - $40 $20,000 / $60 = 333.33 per week 333.33 / 7 = 48 beds per day

Average cost per resident = monthly expense / # of residents Average cost is $200,000 # of residents is 100

$200,000 / 100 = $2,000

SSI resource limit is:

$2000

The Drug-Free Workplace Act of 1988 requires organizations having ___________ or more in federal contracts or grants to make good-faith efforts to maintain a drug-free workplace & to establish drug education & awareness programs for their employees.

$25,000

Profit margin = gross profit / sales Gross profit is $250,000 Sales is $1,000,000 What is the profit margin?

$250,000 / $1,000,000 = 0.25 0.25 is 25%

The Rehabilitation Act of 1973 required employers doing more than ___________ in business with the federal government to apply affirmative action guidelines so as to employ & promote qualified handicapped individuals

$2500

Compute Raw food PPD for the month costs in months / total paint days in month $8,500 / 77 x 31 (days in January) =

$3.56 ppd

Cost per patient day = Total annual operational costs / total patient days for the year Total annual operational costs is $4,000,000 Total patient days for the year is 30,000 days

$4,000,000 / 30,000 = $133.33 cost per patient day

(pay rate x regular hours) + (OT rate x OT hours) Net pay = Gross pay - deductions What is gross pay and what is overtime pay? (10 x 44) + 0 =

$440 (OT rate = 0)

Pay rate = $10 per hour, 44 hours worked, no sick (pay rate x regular hours) + (OT rate x OT hours) What is gross pay and what is overtime pay? OT rate is ($10 x 1.5) = $15 per hours (10 x 40) + (4 x 15) =

$460

Payback period = purchase price/how much will new purchase reduce annual operating costs per year Purchase price is $5,000 How much will new purchase reduce annual operating costs per year is $800

$5,000/$800 = 6.25 years

What are the amounts for deposits to be placed in a interest-bearing account?

$50 MCD $100 MCR skilled

The Rehabilitation Act of 1973 required employers having more than 50 employees & fulfilling a government contract worth ___________ or more were required to have written affirmative actions programs as required by the Office of Federal Contract Compliance Programs.

$50,000

Net profit margin = Net income after tax /Sales NOI after taxes is $500,000 Sales is $1,000,000 What is the net profit margin in % ?

$500,000 / $1,000,000 = 0.5 0.5 = 50%

Under MCR & MCD, an individual who willfully and knowlingly causes another individual to certify a material and false statement in a resident assessment is subject to a CMP of not more than _________ for each assessment

$5000

Break even in units= (TC-TFC)/Variable Rate TC of PT Dept is $6,500 per month TFC is $5,200 Variable cost is $8 How many patient visits are needed per month to break even?

$6,500 -$5,200 / $8 is $1,300/$8 = 162.5 visits

Break even in days = [FC/(Revenue - VC)] x # of patient days in the period FC is $600,000 Revenue is $400,000 VC is $100,000 #of patient days in the period is 9,000 How many days to break even?

$600,000 / $400,000 - $100,000 x 9,000 $600,000/$300,000 x 9,000 2 x 9,000 = 18,000 days

The turnover costs (basic salary, employment taxes and benefits) are typically in the 1.25 to 1.4 times base salary range. The cost range for a $50,000 per year employee might be __________ to _____________

$62,500 to $70,000

The FUTA tax is imposed at a single flat rate on the first ___________ of wages that you pay each employee

$7,000

The FUTA tax rate is fixed at 6%. That is the tax rate that applies to the first ______________ in wages paid to each of your employees during the year

$7,000

Acid test ratio = Quick assets/current liabilities Quick assets is $850,000 Current liabilities is $800,00

$850,000 / $800,000 = 1.06 (If more than 1 company can meet financial obligation)

Wasted cost =

(# of employees) x (days in the month) x (hours per day) x (salary per hour) x (wasted time % given)

Medication error =

(# of errors observed / # of opportunities) x 100

Accountants have determined that uncollectibles are: 5% of accounts 1-30 days overdue 10% of accounts 31-60 days overdue 25% of accounts 61-90 days overdue 50% of accounts 91-120 days overdue 1-30 days is $1,000 31-60 days is $3,000 61-90 days is $1,500 91-120 days is $2,500 What amount is estimated to be uncollectible?

($1,000 x .05) + ($3000 x .10) + ($1,500 x .25) + ($2,500 x .50) $50 + $300 + $375 + $1250 = $1,975 Will see a negative hit on P & L statement as bad debt

Wasted cost = (# of employees) x (days in the month) x (hours per day) x (salary per hour) x (wasted time % given) # of employees is 100 Days in the month is 31 Hours per day is 8 Salary per hour is $9 Wasted time percent is 2% What is the monthly employee wasted cost for January?

(100)(31)(8)($9)(.02) = $4,464 Be sure to change days and hours to 2080 in lieu of days in month and hours in day

Calculation Medication Error Rate. (medication not given + wrong medications given) / (total # of doses given + doses ordered but not given) Medication not given is 2 Wrong medication given is 2 Total # of doses given is 78 Doses ordered but not given is 2

(2 + 2) / (78 + 2) = 0.5 0.5 x 100 =5 % error rate

Amount collected =

(Amount of insurance carried / amount of insurance required) x loss

Break even in units=

(TC-TFC) divided by variable rate It is also where there is NO profit. IT is where Total Cost=Total revenue. TR can be substituted where TC is in equation

% of body weight loss =

(Usual weight-actual weight)(Usual weight) x 100

Calculation Medication Error Rate

(medication not given + wrong medications given) / (total # of doses given + doses ordered but not given)

Gross pay =

(pay rate x regular hours) + (overtime rate x overtime hours)

Compute the average daily absentee rate Lost days / {# of employees x days in the month} 100 / (200 x 31) =

0.02 ~ 2% good

Acid-test ratio=quick assets/current liabilities. Quick assets can be converted to cash quickly, such as AR. If the answer is greater than ______ the company is safe.

1

Current ratio (Current ratio or working capital ratio)=total current assets/total current liabilities; if the answer is greater than _________ the company is able to meet its current obligation or (Solvency) with a surplus of working capital

1

How many accessible routes from the handicapped parking spaces to the building is required?

1

If facility has 1-25 parking spaces, how many must be handicap accessible?

1

Resident's bedrooms must have at least _______ operable window

1

Doors must be at least ___________ fire-rated?

1 1/2 Hour

FTE (full time equivalent) 40 hours worked in 1 week =

1 FTE

Overtime rate =

1 and 1/2 times the base pay

Fire drills required:

1 fire drill per quarter per shift (minimum 12 per year, 8 hour shifts)

Gratings when located on walking surfaces, grating must have spaces no greater than how far in one direction?

1 inch

MSDS or SDS should have how many of each chemical used in the facility?

1 of each chemical

under the Age Discrimination in Employment Act, all employment related records must be retained for how long?

1 year

Short term goals are accomplished in

1-2 years

Adverse event reporting can be completed to MedWatch by fax to what number?

1-800-FDA-0178

Adverse event reporting to MedWatch can be completed by calling what number?

1-800-FDA-1088

To prove fraud, the following facts must be shown:

1. An untrue statement known to be untrue by the party making it and made with the intent to deceive 2. Justifiable reliance by the victim on the truth of the statement 3. Damages as a result of the reliance

The facility must ensure correct installation, use, and maintenance of bed rails, including but not limited to the following elements:

1. Assess the resident for risk of entrapment from bed rails prior to installation 2. Review the risk and benefits of bed rails with the resident or resident's representative and obtain informed consent prior to installation 3. Ensure the bed's dimensions are appropriate for the resident's size & weight 4. Follow the manufacturers recommendations & specifications for installing & maintaining bed rails

When implemented properly, the CAA process should help staff:

1. Consider each resident as a whole, with unique characteristics & strengths that affect his or her capacity to function 2. Identify areas of concern that nay warrant interventions 3. Develop, to the extent possible, interventions to help improve, stabilize, or prevent decline in physical, functional, & psychosocial well-being, in the contexts of the resident's condition, choices, & preferences for interventions 4. Address the need and desire for other important considerations, such as advances care planning & palliative care (ex. symptoms relief & pain management)

Care Area Assessment in the Resident Assessment Instrument, Version 3.0 (20 care areas)

1. Delirium 2. Cognitive loss/Dementia 3. Visual Function 4. Communication 5. ADL functional/ Rehabilitation potential 6. Urinary incontinence & indwelling catheter 7. Psychosocial well-being 8. Mood state 9. Behavorial symptoms 10. Activties 11. Falls 12. Nutritional status 13. Feeding tubes 14. Dehydration/Fluid maintenance 15. Dental care 16. Pressure ulcer 17. Psychotropic medication use 18. Physical restraint 19. Pain 20. Return to community referral

3 objectives of performance evaluation

1. Give employees feedback about their work performance 2. To provide a plan for directing future employee efforts toward organizational goals 3. To provide a basis on which manager will decide on promotions, compensation, & future assignments

MCR A eligibility:

1. Have had a medically necessary hospital stay of 3 days 2. Admitted to the skilled nursing facility within 30 days of hospital discharge 3. Require skilled nursing or skilled rehabilitation services that must be performed by or under supervision of skilled professionals 4. Need these services on a daily basis 5. Require these services on a inpatient basis

Each resident's drug regimen must be free of unnecessary drugs. A unnecessary drug is any drug used when:

1. In excessive dose 2. For excessive duration 3. Without adequate monitoring 4. In the presence of adverse consequences which indicate the dose should be reduced or discontinued 5. Without adequate indications for its use 6. Any combination of above reasons

Common errors made by managers using rating scales:

1. Leniency error (To avoid conflict) 2. Error of Central Tendency (Moderate scores regardless of performance) 3. Halo Effect (One particular good job behavior) 4. Horn Effect (One particular bad job behavior)

Three basic forms of negligence

1. Malfeasance 2. Misfeasance 3. Nonfeasance

Union Labor Rights for employers?

1. Management has the right to restrict union organizers to certain locations in the facility & to avoid certain time periods to avoid interference with facility operations 2. Management has the right to prohibit union activities during employee working hours 3. Management has the right to prohibit supervisors from engaging in union organizational activity

What are the four primary focuses of Fair Labor Standards Act?

1. Minimum wage 2. Overtime 3. Child Labor 4. Equal Rights

Services included in Medicare & Medicaid payment, facilities cannot charge a resident for

1. Nursing Service as required by 483.30 2. Dietary Services as required by 483.35 3. Activities program as required by 483.15 (f) 4. Routine hygiene items and services as required to meet the needs of the resident 5. Medically related Social Services as required by 483.15 (g)

Standard survey consists of 7 tasks these are:

1. Offsite preparation 2. Entrance conference 3. Initial Tour 4. Resident Sample Selection 5. Information Gathering 6. Determination of compliance 7. Exit Conference

3 stages of Alzheimer's

1. Preclinical (lasts 2 to 3 years) 2. Mild (last 1-10 years) 3. Severe (last 1 to 10 years)

Union Labor Rights for employees?

1. Right to organize & bargain collectively 2. Right to solicit & distribute union information during nonworking hours 3. Right to picket 4. Right to strike

Ethical Decision Making Model:

1. Start with a situation 2. Look at options 3. Choose the best option 4. Act upon the option chosen 5. Evaluate

The Facility Assessment includes the following:

1. The facility's resident population 2. The care required by the resident population 3. Staff competencies 4. Physical environment/equipment 5. Any ethical, cultural, or religious factors that may potentially affect the care provided by the facility

Compute acid test ratio $200,000/195,000=

1.02 (If greater than 1, company is good)

The turnover costs (basic salary, employment taxes and benefits) are typically in the _________ to __________ times base salary range

1.25 to 1.4

Backup batteries must operate entrances & exits, resident call systems, & nurses station for how long?

1.5 hours

Approximately _____________ Americans reside in about 17,000 skilled nursing facilities

1.6 million

Threshold should be how high on entrance & exit doors?

1/2 inch

Business with less than or equal to _______ employees are exempt from completing OSHA 300 log

10

Written notice must be provided by a union to the healthcare institution & the Federal Mediation & Conciliation Service ________ to engaging in any picketing, strike, or other concerted refusal to work. No such notice is required prior to similar actions in other industries.

10 Days Prior

A physician visit is considered timely if it occurs not later than ________ after the date the visit was required

10 days

New employee should be offered the Hep B series within _________ of hire according to OSHA

10 days

The Drug-Free Workplace Act of 1988 requires that the granting or contracting agency must be notified of a drug conviction within how many days?

10 days

Facilities with a DART rate of _________ are subject to OSHA inspections

10 or more

Emergency power generator must come on within how long after power failure?

10 seconds

The emergency generator must start and transfer power under load conditions within ______________ after the interruption of normal power

10 seconds

Nursing homes must report to the Food & Drug Administration or the manufacturer within how many days after the incident or incidents in which the medical devise causes or contributed to a resident's death

10 work days of becoming aware

Nursing homes with _______ employees or more must file an EEO-1 annual report, disclosing the # of employee by race, ethnicity, disability, sex, job category, & salary.

100

S corporations have less than ___________ shareholder

100

Worker Adjustment and Retraining Notification Act (WARN) of 1988 requires employers with ________ or more employees at any individual site to provide advance notice of major reductions in force

100

No room shall be more than how far from an exit in a facility?

100 feet

Compute average daily census & explain Total patient beds / # of days in the month 3100 / 31 =

100 patients

HR department in a contemporary healthcare organization has one staff for every

100 to 150 employees

Safe temp for bathing

100-110 degrees (regulated by automatic control valves)

Medicare Part A skilled services include ________ days of NF and ________ days inpatient hospital

100/150

CNAs are required to have no less than ______ of in-service education per year

12 hours

CNA training requires how many hours of in-service each year?

12 hours & must include dementia management & abuse prevention

Every ___________ dietary workers must be in-serviced on food handling

12 months

To be eligible for FMLA the employee must have worked for at least __________ prior to the leave

12 months (1250 hours) The 12 months doesn't have to be consecutive

FMLA states that covered employers (50 or more employees) must allow up to _________ per year of unpaid leave connected to pregnancy, childbirth, and recovery, or a serious health condition effecting a employee or an employees family member.

12 weeks

7.5 hour shift, Nursing CNAs = 120 hours per day. How many FTEs for the day?

120 / 7.5 = 16 FTEs

8 hour shift administration = 120 hours per day. How many FTEs for the day?

120 / 8 = 15 FTEs

Facility with more than _________ must employ a qualified social worker on a full time basis

120 beds

1200 hours total in nursing LVNs for the week. How many FTEs needed for the week?

1200 / 40 = 30 FTEs

PRN order for psychotropic drugs are limited for _________ days

14

Minors __________ & _________ years of age may be employed in Nonhazardous jobs outside of regular school hours.

14 & 15

MCD and private pay patients comprehensive assessments must be completed within ___________ after admission

14 calendar days

MCD & private pay comprehensive assessments must be completed:

14 calendar days after admission, excluding readmission with no significant change Within 14 days after the facility has determined that there has been a significant change in resident's physical or mental condition Not less than once every 12 months

Within __________ after the facility has determined that there has been a significant change in resident's physical or mental condition a comprehensive assessment must be done

14 days

Facility must electronically transmit MDS to CMS database within

14 days of completion

There must be no more than _________ between a substantial evening meal & breakfast the following day

14 hours

Hypertension blood pressure is usually greater than:

140/90

Final cooking temp for fish and other meats

145 degrees for 15 seconds

Final cooking temp for unpasteurized eggs when cooked to order in response to resident request and to eaten promptly after cooking

145 degrees for 15 seconds, until the white is completely set and the yolk is congealed

A facility must maintain all resident assessments completed within the previous _______ months of the residents' active record.

15

The Americans with Disabilities Act of 1990 applies to employers with ___________ employees working for ________ during a calendar year

15 or more 20 or more weeks

An employer has the right to file a notice of contest with OSHA are director within _________ of receipt of a notice of citation & proposed penalty

15 working days

Total hours for the year in nursing is 15,600. How many FTEs?

15,600 / 2080 = 7.5 FTEs

Minors under _____ may not be employed except under a temporary permit issued by the Department of Labor

16

Up to ________ may lapse between a substantial evening meals & breakfast the following day if a resident group agrees to this meal plan, and a nourishing snack is served

16 hours

Linen wash temp

160 degrees for 25 minutes

Final cooking temp for poultry & stuffed foods

165 degrees

Reheating foods

165 degrees for at least 15 seconds before holding for hot service

Toilet seat must be how far from the floor?

17-19 inches

With COBRA insurance coverage can continue for how long for laid-off employees?

18 months

Daily staffing sheets must be kept on file at a minimum of

18 months or whatever is required by individual state, which ever is greater

Many employment situations are prohibited for those younger than what?

18 years old

Manual washing and sanitizing temp:

180 degrees

Contained MCR & MCD reforms with very stringent requirements

1987 Omnibus Budget Reconciliation Act (OBRA)

MedWatch was founded when?

1993

Maximum slope for ramp is ________, maximum rise is ________

1:12 & 30 inches (For ever 12 in length of ramp, the ramp will rise 1 inch with a maximum rise of 30 in)

______________ are the key persons involved in employee grievances/concerns

1st line supervisor

If facility has 26-50 parking spaces, how many must be handicap accessible?

2

When hiring entry-level personnel, typically between ___ and ___ applicants are interviewed for an open position

2 & 5

Food inventory must include:

2 day supply of perishables 7 day supply of staple goods

Smoke-proof enclosures such as areas in stairwells must be at least how many hours fire rated material?

2 hour

All alleged violations involving abuse, neglect, exploitation, mistreatment, including injuries of unknown source & misappropriation of resident's property must be reported immediately, not more than

2 hours after the allegation is made if involves abuse or results in serious bodily injury. No more than 24 hours of no bodily injury

For facilities that receive approval of construction or reconstruction or newly certified after November 28, 2016 bedrooms must accommodate no more than

2 residents

Each CNA must reregister at least every

2 years

Job evaluations, merit system description & records, & payroll deduction records must be retained for how long?

2 years

Nursing homes must report to the Food & Drug Administration or the manufacturer within 10 work days after the incident or incidents in which the medical devise causes or contributed to a resident's death. How long must these records be maintained?

2 years

The first person to ask someone that is choking is

"Are you choking?"

Break even in units = (TC-TFC)/Variable Rate TC of PT Dept is $10,000 per month TFC is $8,500 Variable cost is $10 How many patient visits are needed per month to break even?

$10,000 - $8,500/10 is $1,500/$10 = 150 visits

Compute Nursing HPPD # of hours worked / # of patients 265 / 130 =

2.038 ~ 2.04 hppd (generally 2.9 and higher depending on acuity)

OWBPA (Older Workers Benefit Protection Act of 1990) covers private employers with ___________ employees, state & local government, employment agencies, & most labor unions

20 or more

Door clearing opening must be _______ & doors must be __________

20" / fire rated

__________ of employees require __________ of supervisory time

20%/80%

The comprehensive assessment must be completed within _______ after admission

21 days

Compute ADSO & explain (AR x # of days) / revenue $70000 x 31 / $100,000 =

21.7~22 days Good within 30-60 days

If, since a CNAs most recent completion of training and competency eval program, there has been a continuous period of ___________ the individual did not provide nursing or nursing related services for monetary compensation, the individual must go through new training & competency eval program or a new competency eval program

24 consecutive months (2 years)

Each facility must provide for or arrange physician services on a

24 hour a basis in case of emergency

Facility must assist residents in obtaining routine ____________ dental care

24 hour emergency

Employers must report any worker's amputation, loss of eye, or hospitalization within how long?

24 hours

Resident or his/her legal rep has the right to upon oral or written request, to access records at all times pertaining to him/herself within

24 hours (excluding weekends & holidays)

Facility must provide for or arrange physician services on a _______________ in case of emergency

24-hour a day basis

Only can garnish employee's earnings the lesser of ________ of disposable earnings or amount which disposable wages are greater than _______ times the federal minimum wage

25 % 30

Patient Protection and Affordable Care Act of 2010 states that young adults can remain on their parents plans until age what?

26

The ALOS for short term care is ________ days

27

Wall unit drinking fountain or coolers should have a clear knee space of how far from the bottom of floor & how many inches deep?

27 inches / 17-19 inches

Stairs handrails must be how high?

28"

With COBRA insurance coverage can continue for how long for disabled employees?

29 months

Each resident must receive at least _________ meals a day

3

Employee records must be kept for ____________ years

3

If facility has 51-75 parking spaces, how many must be handicap accessible?

3

Facility must promptly within ________ refer residents with lost or damaged dentures for dental services

3 days

Facility must have reports with respect to any surveys, certification, and complaint investigations made respecting the facility during the __________________

3 preceding years

Federal guidelines recommend facilities should have enough linen for at least __________

3 sets per bed

Clinical records for a minor must be retained for ___________ after the resident reaches a legal age under state law

3 years

Under the FLSA, payroll records & supporting information such as time cards & time sheets must be retained for how long?

3 years

Ramp must be?

3' deep & 5' wide

Long range goals are accomplished in

3-5 years

Minors 14 & 15 years of age may be employed in Nonhazardous jobs outside of regular school hours. They may work no more than ______ hours on a school day, _______ hours during a school week, & ________ hours on a non school day

3/18/8

Threshold should be how high on sliding doors?

3/4 inch

The Employee Retirement Income Security Act of 1975 requires certification every _____ years of the actuarial soundness of the plan & requires ________ of the employee's equity in the pension fund

3/Vesting

Records of employees exposed to toxic substances must be kept for __________ years

30

The facility must give resident ___________ written notice before resident is transferred or discharged

30 day

Conveyance upon discharge, eviction, or death of a resident with a personal fund deposited with the facility, the facility must convey within ___________ the resident's funds.

30 days

MCD will only pay for the stay if the resident stays in the facility for at least __________

30 days

The Drug-Free Workplace Act of 1988 requires that an employer must take appropriate disciplinary action against the employee, or require the employee to complete an approved drug-abuse assistance or rehabilitation program in a satisfactory manner within how many days?

30 days from receiving notice of an employees criminal drug statue conviction

Restraints must be monitored at least every ____________ removed at least every __________ for ______________ and resident exercised or repositioned at the time

30 minutes 2 hours 10 minutes

Handrails should be how far from ramp or stair tread?

30-34 inches

Average collection period (aka ADSO or Average Daily Sales Outstanding)=365 x AR/Net Operating Revenues. The answer is in days. How many days are okay?

30-60 days

Average payment period=365 x AP/Supplies expense. The answer is in days. How many days is okay?

30-60 days, too many days in AP could result in poor credit relations with vendors

Soiled linen & trash collection containers must be limited to capacity of __________ within any ____________?

32 gallons/64 sq foot area

Wheelchair passage width is _____ inches for doors and ______ inches everywhere else.

32/36

How far do grab bars for toilets have to be from the floor?

33-36 inches

Compute average collection period (365 x AR)/Net operating revenues 365 x $5000 / 52,142.86=

34.99~35 days Good you want it between 30-60 days , harder to collect as days progress

Drinking fountains & water coolers shall be no more than how many inches from floor?

36

Resident's bedroom must have at least 1 operable window and the height of the window sill (opening) must not exceed

36 inches above the floor

With COBRA insurance coverage can continue for how long for dependents following separation, divorce, or death of the previously covered employee?

36 months

Toilet must be how wide?

36"

The ALOS for long term residents is greater than __________ days

365

Average payment period=

365 x AP divided by Supplies expense

Average collection period (aka ADSO or Average Daily Sales Outstanding)=

365 x AR divided by Net Operating Revenues

Compute ALOS and explain Total patient days in the year or month / # of admissions in the year or month 70 x 31 / 55 =

39.45 ~ 39 Good The greater the ALOS the more generated revenue.

Flow of water in drinking fountain & water coolers must be at least how many inches?

4

Medication error = (# of errors observed / # of opportunities) x 100 # of errors observed is 4 (2 given & 2 crushed not suppose to be) # of opportunities is 150 What is the medication error rate? What % will cause the surveyor to write a med error deficiency?

4 / 150 = 0.026 ~ 3% 5% or greater

Nursing homes must be able to provide authorized governmental representative requested OSHA records within _____________

4 business hours

A nurse aide can work in a facility less than ________, without being certified, if the nurse aide has completed a State approved training & competency evaluation program. Registry verification is required

4 months

Resident's bedrooms must accommodate no more than

4 residents

An invoice stating 4/10 - n/30 means

4% discount if payment is made within 10 days. But if discount is not taken, payment in full is due within 30 days

Compute turnover rate in % and also list in the form of a decimal (# of employees terminated x 100) / Total FTEs (5 x 100) / 120=

4.17 % (.0417)

Overtime is paid on a weekly basis for all hours over ________ worked.

40

Mirrors should be how far from the finished floor?

40 inches

As of the summer of 2011, MedWatch has received how many adverse event reports?

40,000

Age Discrimination Employment Act of 1967 protects employees aged __________

40-70

Foods must be maintained at or below ______ and should be the same when serviced

41 degrees

_______ of NH residents suffer from fecal incontinence

46%

The American Health Care Association cites that ________ of persons residing in NH had a primary or secondary dementia diagnosis

47%

Baseline care plans must be developed within ________ hours of a resident's admission

48

Medication orders given to a nurse by physician or physician extender must be countersigned by the ordering physician or physician extender within

48 hours

Public walks (Side Walks) must be how wide?

48" (4' wide)

The facility must ensure that it is free of medication error rates of _____% or greater and residents are free of any significant medications errors

5

Fire alarm pull stations are within _________ of the exit

5 feet

When hiring entry-level personnel, a department manager should be able to select one suitable employee from among ___ or _____ candidates who all meet the published minimum requirements for the position

5 or 6

Intangible assets are amortized to expense over _________ to _________ years with the exception of goodwill

5 to 40

Allegations of abuse must be investigated and results of the investigation must be provided to officials according to State law, including the state survey and certification agencies within

5 working days of the alleged violation

The results of all investigations must be reported to the administrator or his designated rep and to other officials in accordance with state law (including to the state survey and certification agency) within

5 working days of the incident, and if the alleged violation is verified appropriate corrective action must be taken

Clinical medical records must be retained for _________ from the date of discharge when there is no requirement in state law

5 years

OSHA records must be kept how long?

5 years

OSHA requires that all records related to employee injuries & illnesses be retained for how long?

5 years

Records of serious work-related injuries & illnesses must be maintained for how long?

5 years

Accountants have determined that uncollectibles are:

5% of accounts 1-30 days overdue 10% of accounts 31-60 days overdue 25% of accounts 61-90 days overdue 50% of accounts 91-120 days overdue

What % will cause the surveyor to write a med error deficiency?

5% or greater

If toilet door opens inward, the floor space must be how big?

5' x 4 1/2 feet

Average % of Occupancy = Occupied bed days / {# of facility Beds x # of days in the month} Occupied bed days is 5,000 # of facility beds is 200 # of days in the month is 31

5,000 / 200 x 31 5,000 / 6,200 = 0.806 ~ 81%

What is a covered employer?

50 or more employees

The total # of beds in ward rooms with three or more beds must not exceed

50% of the total facility capacity

If ________ of the emplooyees who vote, vote for the union, the union will be established

50% plus 1

Dry food storage should be

50-70 degrees

Wanderers have a ___________ chance of dying if not located in the first 24 hours

54%

The FUTA tax rate is fixed at ________

6%

Administrator must submit to the State Survey Agency, the State LTC Ombudsman, residents of the facility, and legal representatives written notice of impeding closure at least ___________ prior to the date of closure

60 Days

COBRA allows a person how many days to accept the coverage or lose it permanently?

60 days

Some state regulations permit retention of a discontinued drug for _________ when the resident is still in the facility or has been transferred to a hospital

60 days

DON may service at charge nurse only when the facility has an ADC of

60 or fewer residents

Almost _______ of NH residents suffer from urinary incontinence

60%

Almost ________ of NH residents suffer from urinary incontinence

60%

An employer must provide ___________ days notice of an impending layoff of ___________ or more employees, and must notify local government & the appropriate state agency, bureau, or unit responsible for dislocated workers that provides employment & training services

60/50

Standard survey consists of __________ tasks

7

Activities should be offered on a ________ per week basis

7 day

Standard working day

7 day work week or 80 hours in a two week period

The comprehensive care plan must be developed within ________ after completion of the comprehensive assessment

7 days

Age Discrimination Employment Act of 1967. In 1968 the age ____ limitation was removed

70

For low temp washing machine the temp must be between

71-77 degrees plus a 125 part per million (ppm) of chlorine bleach rinse

Facilities initially certified after October 1, 1990 must maintain a temp range of

71-81 degrees

Employment Eligibility Verification Form I-9 must be completed within how many hours of employment?

72

Physician assessments, not performed before resident admission to the nursing home, must occur within ________

72 hours

Compute average payment period & explain (365 x AP) / supplies expense 365 x $5000 / $25,000 =

73 days, not good, should be done within 3-60 days

_________ of training and testing of paraprofessionals (CNA)

75 hours

Facility must use the services of an RN for at least ________ consecutive hours a day, 7 days a week.

8

Paid feeding assistants require ________ hours of training on federal side and ________ hours of training on state side

8 16

Corridors for new facilities must be at least

8 feet & must be equipped with firmly secured handrails on each side

Within _______ after a death of any employee from a work related incident or the inpatient hospitalization of ______ employees as a result of a work-related incident must be reported orally by telephone or in person to the Office of the OSHA, U.S. DOL

8 hours / 3 or more

Handicap parking spaces must be ______ for vehicle & _________ wide for an aisle

8' & 5'

Parking spaces for individuals with physical disabilities must be how wide?

8' wide

FTE for daily is ____________, weekly is ______________, annually is ____________

8, 40, 2080

Using the 8/80 schedule an employee must be paid overtime for any hour over ____ during a 24 hour period & for any hours over _______ in the two week pay period

8/80

Which overtime schedule gives more adequate staff scheduling?

8/80

Resident bedrooms must measure at least

80 sq feet per resident in multiple resident bedrooms 100 sq feet in a single resident room

At least ___ of the total labor workforce in the US is not unionized

80%

Adverse Impact occurs when the selection rate for any racial, ethnic, or sex group is less than ________ of the rate of the group with the highest selection rate

80% If 100 of 1000 white applicants are selected (selection rate of 10%) at least 8% of the minority applicants must be selected

Compute percent of occupancy & explain in relations to revenue Average daily census / # of beds 120 / 150 =

80% increase in percent is equivalent to increase in revenue, not necessarily increase in expense

The food service supervisor is required to have __________ of specialized training from a state approved school

90

_________ of all NF use the ACCRUAL accounting approach

99%

Frozen foods should be stored

<=0 degrees

Hot foods should be served at

>135 degrees

ABC approach

A (Ask questions) B (Behavior that resulted) C (Consequences of behavior)

Means of Egress

A continuous and unobstructed route of exit from any point in a building to a public way.

The facility must furnish a written decription of legal rights which include:

A description of the manner of protecting personal funds A description of the requirements and procedures for establishing eligibility for Medicaid, including the right to request an assessment, and spending down to Medicaid eligibility levels A posting of names, addresses, and telephone numbers of all pertinent State survey and certification agency, the state licensure office, the states ombudsman program, the protection and advocacy network, and the Medicaid fraud control unit A statement that the resident may file a complaint with the State survey and certification agency concerning resident abuse, neglect, misappropriation of resident property in the facility, and non-compliance with the advanced directives requirements

living will

A document that indicates what medical intervention an individual wants if he or she becomes incapable of expressing those wishes.

Is a form of insurance protection that covers policyholders for losses that they incur as a result of fraudulent acts by specified individuals. It usually insures business for losses caused by the dishonest acts of its employees.

A fidelity bond (surety bond)

The universal precaution for choking is

A person grabbing his/her neck & having difficulty breathing

Employers are not required under ERISA or any other law to provide

A private pension fund for their employees (ex. 401K)

BFOQ (Bona Fide Occupational Qualification)

A qualification that is absolutely necessary for the job. It is an allowed and approved reason for discrimination. Approvals are to be sought and granted on a case-by-case basis. (EX. surgeon, pilot, police, & firefighter)

When the facility puts out a notice or amendment,

A receipt of this information must be acknowledged in writing

No information should be released to an outside party without what?

A signed consent from the affected employee or a subpoena or other court order

Antipsychotic drugs should only be used when

A specific clinical condition exists

Social Security's original & sole purpose was to provide

A supplemental retirement for working people & their dependents. Offers Old Age Assistance to needy people aged 65 & older who lived in the community

A warning device that can be securely fastened indicating that the energy-isolating source is not to be used until the tag is removed

A tag

Detail of what is owed to others

A/P Report

99% of all NF use the ______________ accounting approach

ACCRUAL

ADAAG

ADA Accessibility Guidelines

Is a portable electronic device that automatically diagnosis the life threatening cardiac arrhythmias of ventricular fibrillation and pulseless ventricular tachycardia in a patient, and is able to treat them through defibrillation

AED or Automated External Defibrillator

Write offs ___________ a method of depreciation

ARE NOT

Facilities must ensure that residents without pressure sores do not develop them is ____________

AVOIDABLE

The arbitrators decision is final and both management and union must?

Abide by the arbitrator's determination

Employee Assistance Program (EAP) can help control what?

Absenteeism Tardiness Other circumstances that affect job performance

Willfil infliction of injury, unreasonable confinement, intimidation, deprivation, or punishment with resulting physical harm, pain, or mental anguish

Abuse

Before meals

Ac

Unexpected, unintentional damage to an object or injury to a resident, employee, family member, or other person.

Accident

What appears at the top of the "T" structure?

Account name & number

Examples of staff authority

Accountant in business office, RDs, paid consultants, administrative assistant, & secretary

Debit and credit in everyday speech is different from how ______________ use it

Accountants

short-term liabilities (current liabilities)

Accounts Payable (A/P)

Usually reported as net of allowance for uncollectable accounts

Accounts Receivable (A/R)

In healthcare, performance appraisal is mandated by who?

Accrediting & regulatory bodies

Records revenues and expenses when they are incurred rather than when cash is received or is paid out

Accrual Accounting

Revenues are recorded when they are earned and expenses when they are incurred, regardless of the time the cash transaction takes place

Accrual Accounting Approach

Cash budget is prepared on the _____________ of accounting

Accrual basis

______________ is shown in the face of the balance sheet or in the notes

Accumulated depreciation

Medical records belong to the facility and must be

Accurately documented Readily accessible Systematically organized

Demonstrates the facilities ability to pay its bills immediately

Acid-Test Ratio

To set someone or an entity free of accusations

Acquit

Supervisors should earn respect through _________

Actions

In performance appraisal managers compare actual observed performance versus what?

Actual performance

Treats short-stay acutely ill patients

Acute Hospital

Emergency dental services for:

Acute pain in teeth, gums, or palate broken teeth or damaged teeth requiring immediate attention

Nursing facilities must have ___________ of illumination suitable for the tasks of patients and staff

Adequate levels

Facility must ensure that the resident environment remains as free from accident hazards as is possible and each resident receives ____________ and ___________ to prevent accidents

Adequate supervision and Assistance devices

If a court orders a copy of the resident's record be given to someone else, you must

Adhere to the court order regardless of what the resident states (Not a right violation)

Unable to make decisions

Adjudicated incompetent

Decision or disposition of a case by the announcement of a judgement or a decision

Adjudication

Extensive body of public law issued by either state or federal agencies to direct the enactment of laws of the federal and state governments

Administrative Law

Patients with a diagnosis of dementia cannot sign _________

Admission paperwork (same regardless of payer source)

Program whereby a dependent elderly person is institutionalized during the work hours of his/her family

Adult Day Care

Community-based facilities for individuals who need supervised care during the daytime, but who otherwise remain in their homes.

Adult Day Services (MCR does not pay for any types of adult day services)

What does line operations do?

Advance the work of an organization

Resident has the right to refuse treatment or participate in experimental research and formulate an

Advanced Directive

Occurs when the selection rate for any racial, ethnic, or sex group is less than 80% of the rate of the group with the highest selection rate

Adverse Impact

Ways to find candidates for employment:

Advertising Networking Job Fairs Recruiting Trips Search Firms The Internet

HR _______ and ___________

Advises & makes recommendations

Written statement given under oath before an office having authority to administer oaths

Affidavit

AA

Affirmative Action

In hiring a physical exam cannot be conducted until

After a job offer has been extended

ADEA

Age Discrimination Employment Act

Protects employees from being discriminated against on the basis of age. Intended to keep employees from replacing older employees with younger employees.

Age Discrimination Employment Act of 1967

Barriers to communication

Agenda carrying Selective Hearing Difference in knowledge levels Cultural Difference Language

Both psychological and Physiological

Aging process

The aging baby boomers huge impact on society is called:

Aging tsunami

For employers using the 8/80 rule there must be a ________ or __________ in the employee handbook about 8/80

Agreement or Information

Battery power is also required to operate all what?

Alarm systems

The largest number of legal complaints centered on performance appraisal issues involves what?

Alleged violations of individual rights as specified under TITLE VII of the Civil Rights Act of 1964

The second largest number of legal complaints centered on performance appraisal issues involves what?

Alleged violations of the Age Discrimination in Employment Act

Bed hold: Charges to the beneficiary for admission or readmission are not __________

Allowable

A progressive and fatal brain disorder that destroys brain cells and cause memory loss as well as problems with thinking and behaviors that can affect an individual's work and social activities

Alzeheimer's Disease

The most common form of dementia seen in persons over 60 years old

Alzheimer's Disease

ANSI

American National Standards Institute

Prohibits facilities from discriminating against qualified individuals with disabilities in job application procedures, hiring, firing, advancement, compensation, and job training. This act prohibits potential employers from asking about a job applicant's medical condition, if any, and imposing major limitations on pre-employment physical examinations

Americans with Disabilities Act of 1990

A friend of the court. A brief written document that provide the court with information that might otherwise escape attention

Amicus Curiae

Facility must immediately inform the resident, resident's physician, legal rep, or interested family member when:

An accident involving the resident which results in injury & has the potential for requiring physician intervention A significant change in resident's physical, mental, or psychosocial status (deterioration in health, mental, or psychosocial status in either life threatening conditions or clinical complications) A need to alter treatment significantly A decision to transfer or discharge the resident from the facility Change in roommate A change in resident rights under state or federal law or regulations

Instances requiring notifications of change

An accident that results in injury that has the potential for requiring physician intervention A significant change in physical , mental, or psychosocial status such as deterioration in life threatening conditions or clinical complications A decision to alter treatment significantly such as the need to discontinue a present form of treatment due to adverse health reactions or to began a new form of treatment A decision to transfer or discharge resident

PPS (MCR Part A) includes:

An all inclusive per diem rate Routine and ancillary service Capital expenses

team appraisal

An evaluation of how well each member contributes to the team and how well the team accomplishes its goals.

Liabilities include:

An obligation of an entity due to past transactions or events Current liabilities Long-term liabilities

Reduces pain

Analgesic

Nursing homes today are involved in developing _______________ such as its own therapy and pharmacy service

Ancillary Services

Fire drills should be what?

Announced

Routine dental services include an ______________

Annual oral exam

ALL employees must be test for TB ________

Annually

The OSHA form must be submitted when?

Annually

Prohibit offering money or other valuable items in return for referrals

Anti-Kickback

Psychotropic drugs include:

Anti-depressant Anti-anxiety Anti-psychotic Hypnotic

Act on the Central Nervous System (CNS) to enable residents to deal with change in behavior

Antianxiety & Antipsychotic (Psychoactive) Medications

Destroys microorganisms

Antibiotic

What is discussed in infection control committee meeting?

Antibiotic Stewardship Program Influenza Pneumococcal Vaccinations

Tardive Dyskinesia is a neurological disorder most frequently occurs as the result of long-term or high dose of _______________

Antipsychotic Medications

Based on the comprehensive assessment of the resident, the facility must ensure that residents who have not use antipsychotic drugs are not given these drugs unless

Antipsychotic drug therapy is necessary to treat a specific condition as diagnosed & documented in the clinical record Residents who use antipsychotic drugs receive gradual dose reductions Behaviorial interventions, unless clinically contraindicated, in an effort to discontinue these drugs

The facility must not charge a resident for

Any item or service not requested by the resident

In the case of a resident who has not been adjudged as incompetent by the state court, who can exercise the resident's rights?

Any legal-surrogate designated in accordance with state law may exercise the resident's rights to the extent provided by the law

Procedures can be written at _________ of management

Any level

The resident as the right and the facility must provide IMMEDIATE ACCESS to any residents by the following:

Any rep of the secretary Any rep of the state The resident's individual physician The state long term care ombudsman The agency responsible for protection and advocacy system for developmentally disabled individuals The agency responsible for the protection and advocacy system for mentally ill individuals Subject to the resident's right to deny or withdraw consent at any time, immediate family or other relatives of the resident Subject to reasonable restrictions and the resident's right to deny or withdraw consent at any time, others who are visiting with the consent of the resident

Facility must promote the exercise of rights for each resident, including

Any who face barriers (communication, hearing, or cognitive)

Person's ability to communicate is impaired

Aphasia

Surveyors assess the focus of the dietary department based on _________ and ________

Appearance & taste of food

The formal grievance process allows employees to

Approach the next level of management without retaliation

The facility must use _____________ prior to installing a side or bed rail

Appropriate alternatives

Tongue, lips, & vocal cords are unable to work together

Apraxia

Same as mediator but the person makes the decision on the case

Arbitration

Impartial person chosen by the parties to decide the issue between the parties

Arbitrator

What is the only legal question an applicant can be asked about their age?

Are you at least 18 years old?

Pharmalogical treatment/management of cognitive symptoms of Alzheimer's Disease consists of cholinesterase inhibitors such as:

Aricept (donepexil) Exelon (rivastigmine) Razadyne (Galantamine) Cognex (Tacrine-no longer used)

Nonsteriodal Anti-Inflammatory drugs (NSAIDs) such as Ibuprofen are widely used for treating ____________ and ______________

Arthritis & Chronic Pain

It is legal to ask a applicant if they have ever been convicted of a crime and what?

Ask details associated with the conviction

Before conducting a appraisal interview, the supervisor should what?

Ask the employee to sign the appraisal form to acknowledge receipt, signing does not mean employee agrees, if refuse to sign it needs to be noted before filed

Analgesic includes:

Aspirin Acetaminophen (Tylenol) Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) (Ibuprofen)

An attempt to inflict bodily harm on another person

Assault

Intentional, unlawful, offer of corporal injury to another force, or force unlawfully directed toward another person. Intention to harm.

Assault

Regarding training, to implement competency training program, the first step is to _______ your employee needs & not to hire more staff

Assess

Facility must ensure that a resident who enters the facility with an indwelling catheter or subsequently receives one is

Assessed for removal of the catheter as soon as possible unless the resident's clinical condition demonstrates that catherization is necessary

Items owned by the facility. Economic resources that have expected future benefits to the business

Assets

Capital (Net worth) =

Assets - liabilities

Owner's capital=

Assets minus liability

Facilities that help residents with ADLs, coordinate services from outside providers, and monitor activities to help to ensure residents' health, well-being, & safety

Assisted Living Facilities

PACE (Program of All-Inclusive Care for the Elderly). Participant must be:

At least 55 years of age Live in the PACE district Qualify for nursing home services as certified by the appropriate state agency

Civil Rights Act requires all records of personnel transactions to be retained for how long?

At least 6 months unless charges are filed

The Facility Assessment must be reviewed & updated how often?

At least annually

The facility must give resident 30 day written notice before resident is transferred or discharged, unless the resident is

At risk for harming himself/herself or other residents/staff

The facility must inform each resident who is entitled to Medicaid benefits, in writing, when?

At the time of admission to the nursing facility or when the resident becomes eligible for Medicaid

The resident has a right to choose a personal ___________

Attending physician

Therapeutic diets must be prescribed by the ______________

Attending physician

The immediate supervisor should always leave his/her __________ toward an employee out of the objective evaluation

Attitude

Is a person who is authorized to perform business-related transactions on behalf of someone else such as the principal of a company.

Attorney in Fact

Disadvantages of cash accounting include expenses and revenues for a single time period are NOT

Attributed to that same period

ANSI (American National Standards Institute) requires ________ & ________ in facilities

Audible & flashing fire alarms

Concerned with hearing

Audiologist

Threatening, intimidating, decisive, & uncompromising. It motivates by fear and/or attitude. They submit or write policies & procedures & send them to owner for approval without the department heads approval or input

Autocratic leadership

Fire doors are required in corridors & must have what?

Automatic hold-open devices activated by the manual fire-alarm system so they close when the alarm goes off

ALOS

Average Length of Stay

Average cost per day =

Average cost per resident / # of days in the month

ADSO

Average daily sales outstanding

An advantage of the S corporation is that:

Avoids double taxation, it is single taxation

A qualified social worker is one with

Bachelor's degree in social work or Bachelor's degree in human Services including but limited to Sociology, gerontology, special education, rehabilitation counseling, & psychology & 1 year of supervised social work experience in a health care setting working directly with individuals

Uncollectible Accounts Receivable

Bad debt that you more likely will not be able to collect as time increases

Records the entire financial position of the nursing facility at one period in time. It summarizes assets, liabilities, and capital (owner equity) accounts

Balance Sheet (Statement of Financial Condition)

Designed to keep long-term care consumers out of costly institutions. It is aimed at removing barriers to providing long-term care in people's homes & communities

Balancing Incentive Payments Program

Regarding healthcare, caregivers demonstrate beneficence by

Balancing benefits against risks

Perpetual Inventory System is recommended to maintain and accurate count of inventory on hand (an accurate count of supplies used and those remaining in the storeroom). A ______________ is often used for this purpose.

Bar Coding System

Unlawful touching or application of force to another human being without their consent

Battery

Facilities without an on-site generator must have what for alarms, life-safety detection, & security alarm systems

Battery Backups

A resident, even though determined to be incompetent, should

Be able to assert these rights based on his or her degree of capability

OBRA recommends staff devise alternatives to restraints such as

Bed alarms Low beds Chair alarms Use least restrictive devices

Types of transfers include:

Bed to chair Bed to Toilet

When must the facility inform residents of services available in the facility and charges for those services, including any charges for services not covered under Medicare or by the facility's per diem rate?

Before admission, at time of admission, and periodically during resident's stay

Psychological

Behavior, attitude changes, depression, & slow memory retrieval

Which of the alternative HR models is frequently used when designing performance appraisal systems, job evaluations, employee attitude surveys, etc?

Behavioral Science Model

A method of employee appraisal that uses numeric scales to measure various levels of effectiveness

Behaviorally Anchored Rating Scales

Management tool by which an organization seeks to improve its business practices by comparing them with the best practices of other organizations.

Benchmarking

Described the principle of doing good, demonstrating kindness, showing compassion, and helping others.

Beneficence

Monetary compensation such as _______ & ________, are not enough to motivate good employees

Benefits & Pay

Hypothermia is usually treated with

Blankets

Ultimate authority in private corp nursing facility is

Board of Directors

2 major categories of insurance

Bodily and property damage

BFOQ

Bona Fide Occupational Qualification

Pressure sores occur in a

Bony prominence area

Considers all income recorded in the financial records. This includes both earned and unearned revenue. When the company makes a sale to a customer, it records, or books, the earned revenue into the financial records.

Booked Revenue

Occurs when there is a violation of one or more of the terms of a contract

Breach of contract

BE

Break even

A projection of fiscal data usually 1 year

Budget

Planning & controlling device

Budget

With

C

Most nursing homes are organized as a?

C Corporation

Class B fire extinguishers are _______ based

C02 or dry chemical

Schedule I drugs __________ be administered in nursing home

CANNOT

Complete blood count

CBC

Title 42 sets minimum standards for participation in the MCR & MCD programs that must be met by all facilities regardless of location

CFR (Code of Federal Regulations)

Established quality standards for all laboratory testing to ensure the accuracy, reliability, & timeliness of patient test results regardless of where the test was performed.

CLIA (Clinical Laboratory Improvement Act)

HCFA is now

CMS

Is the governmental agency that oversees the Long-Term Care Regulatory process & LTC State agencies

CMS

Paid feeding assistant is a __________ approved position

CMS

The institution must request approval from _________ for all proposed changes in the number of bed in the approved distinct part

CMS

Who mandates that facilities maintain an effective pest control program?

CMS

Which position has the highest turnovers?

CNA

Anyone who completes a part of the MDS should be part of the IDT meeting to include:

CNA (takes care of resident) MDS Coordinator (LVN or RN) Could include (Hospice, PASARR level 2 coordinator, Rehab Director, Physician

When employee is discharged don't forget to send what for insurance?

COBRA letter

Isolation rooms should include at least a

Call light Bed Sink Restroom (Shower not required)

Employers ________ take any adverse action against an employer or applicant for refusing to take a polygraph test

Can Not

The second leading cause of death of people aged 65 and over

Cancer (Malignant)

After the owner pays all the bills, the residual money is owned by the owner, which is known as

Capital

Moved invested into the facility (investors), also known as owner's equity, shareholder's equity, fund balance, or retained earnings

Capital

Large equipment purchases or repairs to building (Generally over $500)

Capital Asset

A summarization of all anticipated capital (Items with a useful life of more than 12 months)

Capital Budget

Covers 1 year plus more futuristic views. May cover a 5 or 10 year period

Capital expenditure budget or capital spending plan

A the aging process advances, the residents need fewer ___________

Carbohydrates

Can be broken down quickly into readily available fuel for the body

Carbohydrates

Physician that specializes in diagnosis and treatment of Heart disease

Cardiologist

What type of drug is Nitroglycerin?

Cardiovascular

The resident has the right to be fully informed in advance about __________ and ___________ and of any changes that may effect the resident's well being

Care and Treatment

Paths along which employees can hope to progress, a major source of employee incentive & satisfaction

Career Ladder

Involves preparing several candidates for a single position

Career planning

________ or __________ should never be left in corridors (hallways)

Carts or equipment

Prepared based on cash basis of accounting and is based on revenue and expenses from the operating budget.

Cash Budget

Details including cash receipts, cash on hand, and cash disbursement

Cash Report

Expenses are recorded when when cash is actual disbursed and revenues are recorded when when the money is received when services are rendered.

Cash accounting

It is a common eye problem which involves clouding of the eye lens. Major symptom ia increasingly blurred vision with perception of shadows

Cataract

Laxative

Cathartic

Decision occurs at the top

Centralization

CMCN

Certified Managed Care Nurse

Line authority that runs downward from the department manager

Chain of Command

In binding arbitration, the decision of the arbitrator cannot be what?

Challenged

The purpose of progressive discipline is to

Change employee behavior from unacceptable to acceptable & to help improve work performance

CNA must report abuse to

Charge Nurse

List of every operating account in the facility

Chart of accounts

Angina or Angina Pectoris

Chest Pain

Asking applicants "are you at least 18 years old" is permissible & allowed because employment of workers under the age of 18 is governed by what?

Child Labor Laws

Foot doctor

Chiropodist same as Podiatrist

A long-lasting or recurrent illness that needs to be managed on a long-term basis

Chronic illness

The Immigration Reform & Control Act of 1986 prohibits employers from discriminating against job applicants on the basis of what?

Citizenship status or national origin

A tort is a ___________ for _____________

Civil Case/Money Damages

Conduct between private parties

Civil Law

Was the pivotal event in dramatically changing the activities of the personnel department

Civil Rights Act of 1964

A voluntary employment based public long-term care insurance program intended to provide a private financial base for disability related services & supports during working years & in old age

Class Act (Community Living Assistance Services & Support)

Which HR Model of organization process & file paper, maintain records, track statistics & key dates, & administer employee benefits plan

Clerical Model

5 Models of HR Organization

Clerical Model Counseling Model Industrial Relations Model Control Model Consulting Model

What are the alternative HR Models?

Clerical Model Legal Model Managerial Model Humanistic Model Behavioral Science Model

CLIA

Clinical Laboratory Improvement Act

CNS

Clinical Nurse Specialist

QAPI program must address all systems of care & management practices including;

Clinical care Q of Life Resident choice Utilize best available evidence to define & measure quality indicators & facility goals Reflect complexities Unique Care Services that the facility provides

The facility must allow representatives of the State Ombudsman to examine a resident's

Clinical records with the permission of the residents or the resident's legal representative, and consistent with state law

Feedback & advice given to employees by an immediate supervisor or HR professionals

Coaching

Urinary incontinence is curable to those whose __________ are adequate

Cognitive capabilities

Connective tissue that loses elasticity over time and appears to account for sagging of the skin often observed in the aging person

Collagen

What defines steps for processing grievances?

Collective bargaining agreement

There can be no _________ of resident's funds with facility funds

Comingling

Performing or doing something wrong that causes neglect

Commission of an act

Person is involuntarily admitted to a facility (psych hospital) per the judge

Committed to facility

Law passed down as a result of a court decision

Common Law

SNF or NF must be operated under _____________ and _____________ by the institution of which it is a distinct part

Common ownership and Control (Common Goverance)

Exchange of information & the transmission of meaning

Communication

Provides a 6% increase in federal MDC matching funds to states for providing community-based attendance services & support within their MCD program. It is intended to allow people to more easily receive services in the community rather than being in an hospital or nursing home

Community First Choice Options

Jury decides how much of the injury to a person should be blamed on the facility's negligence and how much the patient is to blame. Each party involved is responsible

Comparative negligence

How do you assess employee performance?

Compare actual performance with company expectations.

Nursing facilities are designed & built the walls & floors _____________ the building to prevent the spread of smoke & fire from one part of the building to another.

Compartmentalize

A facility must maintain clinical records on each resident that are

Complete Accurately documented systematically organized readily accessible

Everything is based on

Comprehensive Assessment Comprehensive Care Plan Resident Choices (person centered care)

Plan taking into consideration the total needs of the resident

Comprehensive Care Plan

Controlled drugs in participating NF are subject to this act

Comprehensive Drug Act of 1976

The facility must conduct, initially and periodically a

Comprehensive, accurate, standardized, reproduciable assessment of each resident's functional capacity

The facility must not require resident or Rep to request any item or service as a _____________ or ____________

Condition of admission or Continued stay

In termination, discharge is related to what?

Conduct & behavior

Personnel records are ______________

Confidential

Role is conflicting with the purpose and goals of the organization

Conflict of Interest

Facilities typically designed for those aged 75-82 that offer social activities & homemaker services such as meals, housekeeping services, & transportation

Congregate care facilities

The primary reason for the use of accounting procedures is to establish __________ and ___________ management control procedures

Consistent and effective

A work environment where an employee is pushed to quit a job because the employer has made working conditions intolerable

Constructive Discharge

Notification of change: Except in an emergency or when the resident is incompetent, the facility MUST within 24 hours

Consult with resident immediately Notify the resident's physician Notify the family member or legal rep

NHA must ensure that drug regimens in the facility are monitored by the

Consultant Pharmacist aka Registered Pharmacist (Rph)

Which HR Model of organization is HR expert resources?

Consulting Model

Title III of this act limits the amount of employee's earnings that may be garnished & protects employees from being discharged for any one indebtedness

Consumer Credit Protection Act of 1968

Fire safety plan must include:

Containment procedures Evacuation chart or floor plan How to use alarm devices

Residential complexes for seniors that offer comprehensive nursing care & housing options to residents as they age & their needs change. Usually has ALF, SNF, & independent living all on one campus

Continuing Care Retirement Communities

A promissory agreement between two or more persons that creates legally enforceable rights and remedies.

Contract

Area of law involved in a breach by one party relating to a purchase order

Contract law

The employee handbook is not a what?

Contract of employment

Medical Director, Dietary Consultant, PT Consultant is considered what type of services?

Contractual Services

A deformity that result when the muscle has shortened and pulls the adjacent into a flexed position

Contractures

Victim is partly responsible for their own injury. Person does not exercise reasonable care for his or her own safety

Contributory Negligence

Which HR Model of organization has substantial power & managerial decisions may be made only following clearance by HR?

Control Model

Payroll is the largest expense in nursing facility and is considered a _______________ cost

Controllable

Most important tool available to administrators in process of keeping the organization on course

Controlling

Instrumental ADLs

Cooking Cleaning Buying groceries Administering medication Handling money or finances Using the phone

Nursing facilities and skilled nursing facilities must have in operation a compliance and ethics program that is effective in preventing and detecting criminal, civil, and administrative violations

Corporate Compliance Program

Made up of shared basic assumptions & beliefs developed by an organization over time

Corporate Culture

The overall style or atmosphere of a facility. Governs how people relate to each other in the organization

Corporate Culture

With a LLP or limited liability partnership there are no ______________

Corporate taxes

A _____________ is a form of business owned by a few persons or by thousands of people

Corporation

The support cost must be spread over all revenue producing departments that support costs in a very systematic way. This is called?

Cost Finding or cost allocation

Sets up a cost unit center in each department

Cost accounting

Medicare defines a capital expenditure as an item

Cost more than $5,000 with a life expectancy of more than one year.

Which HR Model of organization is a resource to managers for people problems, resolving disputes, and disciplinary issues?

Counseling Model

What is listed on the left side of the "T" structure?

Credit Side

Using resident's funds for personal use is ____________ law

Criminal

Recklessness or carelessness resulting in injury or death punishable as a crime

Criminal Negligence

Penalties in anti-fraud and abuse measures under the PPS system can include:

Criminal/civil penalties Denial of participation in the Medicare Program Suspension of provider participation in federal care programs for 10 years

The main function of risk management is to prevent __________ before they occur, and protect ____________

Crisis/employees

CPM

Critical Path Method

Also known as person centered care or resident-directed care

Culture change

Cash and other assets that are expected to be converted to cash or sold or consumed within one year or in the operating cycle (whichever is shorter) without disturbing the normal operations of the business are called

Current Assets

Records of serious work-related injuries & illnesses, if requested, copies of the records must be provided to who?

Current employees Former employees Employee Representatives

Expected to be liquidated in a year. Included payables such as wages, accounts taxes, accounts payable, and short-term obligations such as purchase of equipment

Current liabilities

Cash, AR, and equipment (All assets that can be converted to cash in 1 year)

Current or short-term assets

Lips and nails turn blue

Cyanosis

Is a safety metric used by OSHA to show how many workplace injuries & illnesses caused the affected employees to remain away from work, restricted their work activities or resulted in a transfer to another job as they were

DART (days away, restricted, & transfers)

Types of advance directives include

DNR, living will, power of attorney

Human resource management _____________ manage employees except for those who work under them in HR dept

DO NOT

Residents have the right to manage his/her own financial affairs and _________ have to deposit their personal funds with the facility

DO NOT

OBRA ____________ require any minimum qualifications for the dietary manager

DOES NOT

Current ratio (Current ratio or working capital ratio)=total current assets/total current liabilities; if the answer is greater than 1 the company is able to meet its current obligation or (Solvency) with a surplus of working capital. It can be deceiving because it ________ reflect the _________ of the assets

DOES NOT/Liquidity

Effective November 28, 2016 QAPI committee must consist of

DON Medical Director (or designee) 3 other members (1 of the 3 must be administrator, owner, board member, or other individual in a leadership role) Infection control & prevention officer

MedWatch system included publicly available _______ & _______ for professionals

Databases & Online Analysis Tools

The effective date of approval of a distinct part is the

Date that CMS determines all requirements (including enrollment with the fiscal intermediary (FI)) are met for approval, and cannot be retroactive

DART

Days Away Restricted Transferred

OSHA reportables include what?

Deaths & accidents requiring medical treatment for employees

What is listed on the left side of the "T" structure?

Debit Side

The tendency to disperse decision making authority (delegations) in an organization structure. Delegating decision-making authority down to the lower levels in an organization

Decentralization

______________ is a more common outcome of reengineering than centralization

Decentralization

Manager makes choices among available alternatives

Decision Making

Aging population has a _______ in bowel function control

Decrease

Injurious cmcn to the reputation or good name of the victim

Defamation

The party being brought to court

Defendant

The application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish and effective rhythm

Defibrillation

A retirement plan, typically funded by an employer, that pays a retiree a set amount of money on a predictable schedule

Defined benefit plan

A retirement plan to which an employer contributes money, such as 401 K while the person is employed there. When the employee leaves there the employers obligation is over

Defined contribution plan

Atrophy

Degeneration of an organ due to diuse

Can occur quickly in the elderly when a fever exists

Dehydration

Permitting decisions to be made at the lowest possible level

Delegation

Condition associated with aging that involved hallucinations and confusion

Dementia

The loss or decline in memory and other cognitive abilities. It is caused when the brain cells are damaged from various diseases or conditions

Dementia

Allows considerable employee input & is a true participative management style

Democratic leadership

Patient with loss or damaged dentures must be referred to whom?

Dentist

Amount of cost allotted to a department taking into consideration salary and other indirect costs

Department Cost Allocation

A ______________ should have no active role in administering employee benefits

Department Manager

DHS

Department of Homeland Security

DOL

Department of Labor

Promotes an efficient operation

Departments (Departmentalization)

Statement given under oath, in writing, and authenticated by a notary public

Deposition

Testimony of a witness taken upon interrogatories (questioning)

Deposition

An expense associated with an asset; also known as contra-asset?

Depreciation (Buildings depreciate, land does not)

The most common mental illness in the elderly

Depression

Historical cost of the asset is the cost of acquiring the asset

Determining Depreciation Expense

is a US law providing federal funds to Councils on Developmental Disabilities, Protection and Advocacy Systems, as well as University Centers.

Developmental Disabilities Assistance & Bill of Rights Act

Types of leadership

Dictatorial Paternal Democratic Laissez-faire

Threatening, intimidating, decisive, & uncompromising. It motivates by fear and/or attitude.

Dictatorial leadership

The usage of antimicrobial gel recommended by CDC for all other employees does not apply to what department?

Dietary employees

_____________ must approve all menus and any changes made to them

Dietitian

Residents have the right to:

Dignified existence Self-determination Communication & access to persons and services inside and outside the facility

___________ directly impacts a revenue center

Direct Costs

It is the process of communicating to employees what is to be done by each of them & helping them to accomplish it.

Directing (leading)

Who has line authority of employees in finance?

Director of finance (but does not extend beyond the boundaries of the department)

Detailed written plan that includes procedures to meet all potential emergencies & disasters, such as fire, severe weather, & missing residents

Disaster Plan

Should begin at admission and facility must assist resident with discharge

Discharge planning

A ______________ must be completed at discharge

Discharge summary

A recapitulation of the resident's stay that includes, but not limited to, diagnoses, course of illness/treatment or therapy, and pertinent lab, radiology, & consultation results

Discharge summary

The resident has the right to voice grievances without _______ or _________

Discrimination or Reprisal

Hepatitis

Disease of the liver

Destroys pathogenic Organisms

Disinfectant

What happens to the interest earned in the RTF account?

Divided among Trust Fund residents, not all residents

Minor injuries requiring first aid only ____________ need to be recorded

Do Not

Exempt employees

Do not clock in and out & are exempt from FLSA overtime

Prior to hiring it is unlawful to ask questions such as

Do you need a reasonable accommodation to perform essential functions of the job?

What is critical for any disciplinary action?

Documentation

When an employee is terminated for cause, all disciplinary actions must be what?

Documented

A resident may work in and for the facility when the desire to work is

Documented in the resident's care plan and paid at least minimum wage

Residents have the right to choose visitors and choose the time to see visitors in a manner that

Does not impose on the rights of other residents

A disadvantage of C corporations is that they are subject to ________, which means that a corporation is taxed on its net income and when the same income is distributed to shareholders in the form of dividends it is taxed again on shareholders' personal income tax returns.

Double taxation

Theorist who first discussed Theory X & Theory Y

Douglas McGregor

Position 1 (Autocratic) manager simply makes the decision & it emphasizes a scalar chain system & centralization of authority

Douglas McGregor Theory X Manager Center Leadership

Employees are involved in the decision-making process, decentralization of authority.

Douglas McGregor Theory Y

The MedWatch system collects reports of adverse reactions & quality problems, primary with __________ & ____________ and also for ______________

Drugs & Medical Devices Also FDA regulated products (dietary supplements, cosmetics, & infant formulas)

Used to coordinate care of individuals who are eligible for both MCR & MCD

Duel Eligible Initiative

A person appoints another individual to make decision on his or her behalf after the person becomes incompetent

Durable Power of Attorney (DPOA)

A legal obligation of care, performance, or observance imposed on one to safeguard the rights of others

Duty of Care

Speech is slurred or unintelligible because of muscle weakness

Dysarthria

Inability to swallow

Dysphagia

Has the authority to bring lawsuits against employers in the federal court

EEOC

Limit their beneficiaries to participating providers for any healthcare providers.

EPO (Exclusive Provider Organizations)

The facility must establish and maintain a system that assures a full, complete, and separate accounting, according to GAAP, of

Each resident's personal funds entrusted to the facility on the resident's behalf.

Assets include:

Economic Resources Represent ownership of value that can be converted into cash Tangible or Intangible

_______________ and ______________ have led many of todays retirees to return to the workforce

Economic downturns Increasing cost of healthcare

The __________ focuses on CARE instead of treatment utilizing the "homelike" atmosphere promoted by CMS

Eden Alternative

Philosophy of providing long-term care services in an environment that promotes quality of life for all involved, as opposed to the traditional institutional model

Eden alternative

Includes birds, cats, dogs, fish, rabbits, chickens, children, plants, and gardens

Edenized Home

The best way to control worker's compensation cost is to have a what?

Effective Accident Prevention program

Power or ability to bring about the desired results

Effectiveness

Ability to produce the desired effect with a minimum of effort, expense, or waste. Getting the maximum output with minimum input

Efficiency

Class C fire extinguishers are used for what?

Electrical fires

LBWA & MBWA are ___________ centered

Employee

When the employee evaluation is completed it should be signed by ______________ and ______________

Employee & Immediate supervisor

Performance evaluations should be signed by __________ and _________

Employee & immediate supervisor

Douglas McGregor's Theory Y is ______________ leadership

Employee - Centered (democratic)

EAP

Employee Assistance Program

Intended to assist employees in addressing particular personal problems that can affect their work performance. It is an employee benefit.

Employee Assistance Program

What Act prevents most private-sector employers from requiring job applicants or current employees to take polygraph tests?

Employee Polygraph Protection Act of 1988

The importance of compensation benefits in retaining employees is embodied in the need to keep them competitive so that valued employees will be encouraged to remain loyal to the organization

Employee Rentention

ERISA

Employee Retirement Income Security Act

Used to help the employee to understand his/her weaknesses & strengths as well as develop guidelines to improve his/her work.

Employee evaluation

You DO NOT withhold the FUTA tax from ____________

Employee's wages

The Immigration Reform & Control Act of 1986 applies to all employers regardless of the number of what?

Employees

Employee records are the property of the _____________

Employer

A doctrine of employment in which the employer is free to discharge individuals without cause & the employee is free to quit, strike, or cease working at any time

Employment at will

Employment in the second half of life, often in positions of greater meaning and social impact in not for profit or public interest fields

Encore career

Chronic renal failure that has progressed to the state where little or no urine is produced.

End Stage Renal Disease (ESRD)

Physician specializing in disorders affecting the endocrine system which secretes hormones into the blood stream

Endocrinologist

Grievance procedures are designed to

Ensure that employees have the opportunity for due process when they believe management ha not acted fairly

Business is recognized as a whole, and is separate from the affairs of the owners, managers, or employees

Entity Concept

Backup batteries must operate what?

Entrances & Exits Resident Call System Nurses Station

EPA

Environmental Protection Agency

EEO

Equal Employment Opportunity

Amendment to Title 7 of the Civil Rights Act of 1964 & intended to cover all employees of 15 or more persons

Equal Employment Opportunity Act 1972

EEOC

Equal Employment Opportunity Commission

Requires men & women performing equal jobs receive equal pay & is enforced by EEOC. No employer shall discriminate between employees on the basis of sex by paying wages to employees less than the rate at which he pays wages to employees of the opposite sex for equal work on jobs which require equal skill, effort, responsibility, & similar working condition

Equal Pay Act of 1963

Charleston has $805.35 in his trust fund, he expired and has no responsible party/family, what needs to happen and in what time frame?

Escheat to state within 30 days

Need to be respected, self esteem, self respect, feel of self value

Esteem Needs

Universal rules of conduct, derived from ethical theories that provide a practical basis for identifying what kinds of actions, intentions, and motives are valued

Ethical Principles

Branch of philosophy that seeks to under the nature, purpose, justification, and the founding principles of moral rules and the system they compromise

Ethics

Edema

Excessive amount of fluid between cells

Administer and enforce the law

Executive Branch of Government

The starting point in resolving turnover problems?

Exit Interview

Each departing employee should complete an ____________

Exit interview

What did the Patient Protection and Affordable Care Act do?

Expanded MCD to cover more lower-income people Subsidizing insurance premiums for persons of certain income level Providing incentives for businesses to provide healthcare benefits Prohibiting denial of claims of coverage because of preexisting conditions Other fixes aimed at expanding coverage to include greater numbers of people, controlling costs, & reducing the deficit

Costs such as salaries, supplies, repairs

Expense also known as outflow

What lists anticipated expenses of the facility for the coming year and is prepared largely by department heads

Expense budget

The COBRA premium is very ________

Expensive

Power based on skillfulness, knowledge, & training

Expert Power

Services delivered outside a patient's home. They require that the patient come & receive the services at a community based location

Extramural Services

Does not vary or change according to volume (# of patients) such as utility bill

FC (Fixed Cost)

Break even in beds=

FC/{Fixed cost rate per bed - Variable Cost Rate per bed}

Voluntary reporting by healthcare professionals, consumers, & patients id conducted on what single, one page form?

FDA 3500

Administrators should secure a copy of what for reporting problems with drugs?

FDA's Medwatch Packet

A method that assumes older supplies in stock are used first. If inflation occurs, the value of the remaining goods in stock is higher than goods already used. It is a method often used in operations as a means of using up certain inventories to prevent spoilage. It is often used in kitchen as well as pharmacy where a item may have a short shelf life.

FIFO (First in first out)

federal regulations mandate certain benefits be available to employees such as :

FML Worker's Comp Social Security Medicare Unemployment tax

An example of a required employee benefit is _______ & _____

FML & Overtime pay

What do staff departments

Facilitate the work, striving to enable overall efficiency & effectiveness

OSHA targets who?

Facilities with high incident rate (Work-related illness or injury)

If Basel has -2.50 in his trust fund, what is the problem?

Facility gave him money that he doesn't have

Daily staffing at the beginning of the shift must be posted in a prominent place that is accessible to visitors and well as residents. It must include:

Facility name Current date Total hours and actual hours worked # of RNs # of LVNs # of CNAs Census

What act governs payment of wages?

Fair Labor Standards Act (FSLA)

This act states that employer must advise applicants if credit reports will be requested

Fair credit reporting act

Supervisors should be _________, _________, & ______________

Fair, firm, & consistent

A MAJOR cause of disability and death in the elderly

Falls

Confining another person within fixed boundaries against their will

False Imprisonment

Who authorized the imposition of damages up to three times the amount of the fraud and civil monetary penalties per false claim? Intentionally submitting false claims for reimbursement

False claims act

FMLA

Family & Medical Leave Act of 1993

NSAIDs provide ______ and _______ pain relief

Fast & effective

The body's source of energy reserve

Fats

Each __________ through ____________, employers must post a summary of the injuries & illnesses recorded the previous year

February through April

OSHA 300A must be displayed in the facility each __________ through __________

February through April

QAPI plan must be submitted to ___________ upon request as well as CMS

Federal & state surveyors

Act which may require compulsory arbitration

Federal Mediation & Conciliation Act

FUTA

Federal Unemployment Tax Act

Employers must pay _______________________ in order to fund the unemployment tax system

Federal and state unemployment taxes

The benefits paid to jobless workers are financed through

Federal and state unemployment taxes paid by employers

OSHA requirements do not have to followed if?

Federal standards are exceeded (more stringent)

A crime of a graver or more atrocious nature than those designated as misdemeanors

Felony

A crime that is punishable by a term of imprisonment of more than 1 year

Felony

Hemodialysis

Filtering of the blood

What can be imposed for missing or incomplete I-9 forms?

Financial Penalties

Financial Accounting vs. Managerial Accounting

Financial accounting is usually for outside or third party use Managerial accounting is usually for inside or internal use

Administrator compares ultimate financial results with the ex[ected

Financial results

Building materials must all be what dependent on the number of stories in the building?

Fire-rated

Washer & dryer filters must be cleaned. Dry traps must be cleaned to prevent what?

Fires

Attending physician must be notified ___________ immediately in the event of a medication error

First

Accidents & Incidents that do not have to be reported are those that require only __________ & do not result in _____________

First aid/Time lost

Refers to an entity or private company that has a contract with the center for Medicare & Medicaid services to determine and to pay part A and some part B bills such as bills from hospitals, on a cost basis and to perform other related functions

Fiscal Intermediary

FC

Fixed Cost

Capital assets is also

Fixed assets

Capital Budget is prepared for ___________ such as real estate, buildings, and equipment

Fixed assets (AKA long-term assets)

Decorations & curtains must be what?

Flame retardant & record of fire-rating kept by facility

Middle managers are often eliminated & responsibilities of remaining managers, usually first line supervisors, are increased

Flattened Organization

Policies allow considerable _______________ in decision making

Flexibility

Provides recommendations for nutritional menu planning

Food & Nutrition Board of the National Research Council

FANS

Food & Nutrition Service Staff

FSS

Food Services Supervisor

A mediator advises or counsels and does not what?

Force a settlement

What form do user facilities report device-related death or device-related serious injury?

Form FDA 3500A

Memos

Formal communication

Regarding public relations (marketing), the primary focus is to

Foster community relations & not to attract new patients

The menus for nursing faiclities are based upon the ________ and __________

Four food groups Recommended Dietary allowance

Idea that post retirement employment provides additional income when the traditional three sources are insufficient

Four pillars of retirement income

The father of scientific management

Frederick W. Taylor

Employee benefit that is not required by law such as sick time, leave/vacation time, or worker's compensation

Fringe benefit

upward communication

From subordinates to upper mgmt

downward communication

From upper mgmt to lower level

OBRA mandates that a facility employ a qualified dietitian either _________, __________, or __________

Full-time Part-time Consultant

Working capitals is

Funds available to facility

A series of accounting rules which books and financial statements are prepared. Standardized for all businesses.

GAAP (Generally Accepted Accounting Principles)

Physician who treats and diagnosis diseases of the digestive tract

Gastroenterologist

EPO (Exclusive Provider Organizations) it uses a __________________ to authorize non-primary care services

Gatekeeper approach

Records of transactions that do not properly fit into any other journal such as A/P journal, cash disbursement journal, and sales journal

General Journal

Summary of all debits and credits contained in the journal for a period of a time.

General Ledger

Addresses the organization's structure leadership, employee parking, facility security, infection control, universal precautions, EAP, work rules, & health benefits

General Orientation

____________ are not useful and should be avoided in any element of an performance appraisal

Generalizations

GAAP

Generally Accepted Accounting Principles

One of the first management theorists that emphasized the importance of human & social behavior in management

George Mayo

Physician who specializes in treatment of diseases of the elderly

Geriatrician

Professionals who study the problems of the aging population in society and they are NOT physicians

Gerontologist

Symptoms usually do not appear until irreversible damage is done. Fluid pressure builds up in the eye causing loss of sight. Untreated, it can cause total blindness.

Glaucoma

Example of medical devices include:

Glucometer Pace makers Infusion Pump Restraints Scales Thermometers

Examples of devises that indirect transmission can happen

Glucose monitoring devises Scrubs Lab coats Electronic thermometers

Every dept in the nursing facility should have _____________ and _______________

Goals & objectives

To participate in Medicare facility must have a ____________________.

Governing Board

Affirmative Action & Equal Employment Opportunity are no longer mandated for organizations which they formerly applied. AA required organizations holding ____________ to demonstrate that positive efforts were being made to align the composition of organization's workforce

Government Contracts

Pension Guarantee Corporation is?

Government agency established to guarantee benefit payments to participants of legally qualified defined-benefit pension plans. It also reduces or eliminates the deduction of contributions by employers for better funded plans

An example of informal organization

Grapevine

Example of informal organizations. Employees act as "center of information"

Grapevine

Class B fire extinguishers are used for what type of material?

Grease & flammable liquid

A deinstitutionalization movement for long term care in which individuals who require care live in small homes and have access to clinical & personal care services on the level of those provided in high-quality nursing homes

Green houses

Examples of involuntary movements include:

Grimacing Tongue Movements Excessive eye blinking

Gross profit aka

Gross Income

Profit margin =

Gross profit / sales

Profit Margin (Contribution Margin)=

Gross profit divided by sales

Appointment by a probate court of a substitute decision maker for a person a judge declares incompetent

Guardianship/conservatorship

Never make decisions based on ________ feeling

Gut

Agency within the US Dept of Health & Human Services that states deal with regarding MCR & MCD.

HCFA or CMS

5 ADLS

HMEDC Hygiene Mobility Elimination Dining Communication

Organized healthcare systems that are responsible for both the financing and delivery of a broad range of comprehensive health services to an enrolled population

HMO (Health Maintenance Organizations)

All offers of employment are ordinary processed through what department?

HR

_________ staff are not affected by reengineering

HR

What are staff areas in healthcare?

HR Finance Housekeeping (ESS) Maintenance (Engineering)

_________ and _________ can be outsourced

HR & payroll

Staff Function & no line authority

HR Management

Who should check references of applicants?

HR or Central Office

Where recruitment occurs

HR/Personnel Management

An antipsychotic drug

Haldol

Is the primary means of preventing the spread of infections

Hand Hygiene

A lack of ________ remains a MAJOR source of the spread of infections in the healthcare setting

Handwashing

What is a key procedure in standard precautions (universal precautions)

Handwashing

Battery operated smoke detectors must be installed in resident's sleeping rooms and public areas by May 24, 2006, exceptions include

Hard wired AC smoke detection system in patient rooms and public areas that is installed, tested, and maintained in accordance with NFPA 72 Sprinkler system maintained in accordance with NFPA 13

The facility must provide reasonable access to any resident by an entity or individual that provides

Health Social Legal Other services to the resident, subject to the resident's rights to deny or withdraw consent at any time

HCFA

Health Care Finance Administration

Privacy standards that facilities must ensure their residents in order to continue to be eligible for Medicare funds. Privacy of resident information. The intent was to enable workers to change jobs without losing coverage.

Health Insurance Portability & Accountability Act of 1996 (HIPAA)

Intended to reduce costs by eliminating regulatory barriers to HMO development & encouraging the proliferation of what was seen as a more cost-effective healthcare delivery system

Health Maintenance Organization Act of 1973

A legal document that allows a person to appoint a healthcare agent to make treatment decisions in the event he or she becomes incapacitated and is unable to make decisions for him or herself

Healthcare Proxy

While on FMLA employees must continue to receive

Healthcare benefits but are not entitles to accrue vacation, sick time, or seniority

involves an unlawful act, generally deception for personal gain

Healthcare fraud

A majority of labor relations activities consist of ______ and ______ complaints

Hearing & Resolving

Acute Myocardial Infarction (AMI)

Heart attack

The _______________ is used for first aide in choking

Heimlich Maneuver

Kidney dialysis is also called

Hemodialysis

Heat sanitization comes from

High temp dishwasher

Motivation factors for Douglas McGregor Theory Y are the ___________ of Maslow Hierarchy of Needs

Higher order

The most common serious injury in the elderly is ?

Hip fracture

The resident has the right to be fully informed in language that he or she can understand of his or her total health status, including but not limited to,

His or her medical condition

After the first year, the book value of the asset =

Historical cost - annual depreciation expense

Annual depreciation expense =

Historical cost divided by useful life

The overall resident-care management system should use a _____________ approach, since it must address the total needs of an indiviual

Holistic

Provides part time skilled services

Home Health

Active euthanasia is

Homicide

Treatment that provides support and comprehensive care for the dying and focuses on maintaining quality of life by relieving the patient's physical, emotional, or spiritual suffering

Hospice

After washing and rinsing, dishes & utensils are sanitized by immersion in either:

Hot water sanitizing at least 171 degrees for 30 seconds (wash cycle must be 140 degrees & rinse cycle 180 degrees) Chemical sanitizing solution

Indirect nursing costs include

Housekeeping Maintenance Interest expense Administration Payroll Utility Depreciation Taxes

The facility must inform the resident or rep requesting a item or service for which a charge will be made that there will be a charge and ___________

How much it will be

The most valuable asset in any organization

Human Capital (people)

Recordkeeping, employee recruitment & selection, training & development, compensation management, performance evaluations, & labor relations

Human Resource Functions

Personnel is now called what?

Human Resources

Which of the alternative HR models foster human values & potential within an organization?

Humanistic Model

Used to higher blood pressure

Hypertensive

Employers must verify the employment eligibility status of newly hired employees as part of the hiring process, who might audit this?

ICE DOL DHS

Are to participate in the care plan meeting and other appropriate staff or professionals in disciplines as determined by resident's needs or as requested by the resident

IDT

The ________ should be involved in discharge planning

IDT

The CAA is part of the care plan and should be brought to the

IDT/Care Plan Meeting

The resident has the right to self administer medications if first the ________ has determined that the practice is safe and a _______________ is obtained.

IDT/Physician's order

It is __________ for anyone other than the pharmacy to re-label medication

ILLEGAL

Model HMO that provides medical care to its subscribers through contracts it establishes with independent physicians

IPA (Independent Practice Association)

The goal of the ABC approach is to

Identify the activator that caused the bahavior

The QAPI committee is responsible for

Identifying issues that necessitate action by the committee

Difference in line operations and staff operations?

If a line operation is ignored or omitted, the physical product or services remains incomplete. Staff operations do not advance the work of the organization or hasten its completion. Staff positions may be removed and the productive work of the organization will usually continue.

Loss of weight is generally caused by __________ and ___________ in the elderly

Ill fitting dentures and Decreased sense of small

Exchanging pay scale information with professional colleagues in different organizations is essentially ____________

Illegal (organizations should use healthcare association, hospital association, or neutral third party)

Only the ______ should complete an evaluation form on an employee

Immediate Supervisor

The employee evaluation should be completed by the ______________.

Immediate supervisor

What Act requires employers to review, and, as necessary, modify their hiring practices?

Immigration Reform & Control Act of 1986

ICE

Immigration and Customs Enforcement

Residents that are high risk of infection include:

Immobilized Residents Residents with pressure sores Altered Immune System Recently discharged from hospital

Housekeeping materials and all chemicals should be stored where?

In locked room away from residents

Many people fail at assessing employee performance because they are what?

Inappropriately trained Insufficiently oriented Inadequately supported

____________ are necessary if resident, employee or visitor is injured

Incident report

Performance Evaluation

Includes establishing goals for the employee to achieve until next scheduled performance evaluation. The main purpose is to focus the energies of the employee on the performance level expected of them

SNF or NF is financially integrated with the institution of which it is a distinct part, as evidence by the sharing of

Income & expenses with that institution, and the reporting of the costs on that institution's cost report

Projected revenues are based on the _____________, not on the amount of cash received for services during the month. It is an estimate of cash coming in and going out for the next 12 months

Income earned in the time period

Inability to control or restrain natural discharges

Incontinence

The ability to control the timing of elimination and it is involuntary

Incontinence

Category of housing options for individuals who are able to live without assistance

Independent Living

The QAPI committee focuses on

Indicators of the outcomes of care & quality of life

Transfer of an infectious agent through a contaminated intermediate object such as resident care devise shared without disinfecting & cleaning between each resident

Indirect Transmission

Costs that can't be directly associated with a revenue center.

Indirect costs

A ledger consists of

Individual accounts (Payable & Receivable)

Conveyance upon discharge, eviction, or death of a resident with a personal fund deposited with the facility, the facility must convey within 30 days the resident's funds and a final accounting of those funds, to the

Individual or probate jurisdiction administering the resident's estate

Worker's Compensation standards _______ by the state, some states have a self-insured program, this program is not worker's compensation but a _________ benefit

Individualized/Fringe

Which HR Model of organization workforce is unionized & there are periodic contract negotiations; grievances; arbitrations; confrontations?

Industrial Relations Model

Improper handling of soiled linens is the major cause of exposure to what by residents & staff?

Infection

IC Committee

Infection Control Committee

TITLE VII of Civil Rights Act

Influenced affirmative Action & Americans with Disabilities Act. Prohibits discrimination in employment practices on the basis of age, sex, race, martial status, religion, national origin, or handicap. 1964 Uses the Equal Employment Opportunity Commission to implement the provisions of the civil rights act Prohibits discrimination with regard to any employment condition including hiring, firing, promotion, transfer, & admission to training programs.

Long term care continuum has 3 major subsystems The informal system The community based system The Institutional System Which is the largest?

Informal Care

As a rule of thumb, an ___________________ is acceptable only of the manager can stay in close contact with all aspects of the operation

Informal Management Control System

Chatting in lounge, casual conversation

Informal communication

LTC facilities must electronically submit to CMS complete & accurate direct care staffing information including

Information for agency & contract staff, based on payroll & other verifiable & auditable data

horizontal communication

Information that flows between peers or persons of equal rank or status

Social Services Role

Informational Case Manager Coordination Enabler/Facilitator Intervention Advocacy

Individual receiving treatment is informed about the nature & consequences of a procedure

Informed Consent

The relationship between the patient and physician is considered an ____________

Informed consent (patient agrees)

Injury not observed by anyone and can not be explained by the resident and the injury is suspicious because of the extent of the injury or the location of the injury

Injury of unknown origin

Process of bringing new ideas into the way an organization accomplishes its purposes

Innovation

Capital (net worth) is less than

Insider claims

Sleep disorder which is common among the elderly

Insomnia

A facility may install alcohol-based hand rub dispenser in its facility if the dispensers are what?

Installed in a manner that adequately protects against inappropriate access

A common example of prepaid expense is

Insurance

Nonphysical resources and rights that have a value to the firm because they give the firm some kind of advantage in the marketplace.

Intangible Assets

_________________ lack of physical substance and usually are very hard to elevate.

Intangible assets

If it is _____________, it is not an accident

Intentional

Comprehensive care plan is a ____________ communication tool

Interdisciplinary

Residents whose care is funded by Medicaid the facility must deposit resident's personal funds in excess of $50 in an

Interest bearing account

In a MCR facility funds in excess to $100 must be deposited into an:

Interest bearing account separate from the facility's operating account

The resident have the right to be free of

Interference Coercion Discrimination Reprisal from the facility in exercising his or her right

Physician who specializes in diagnostic procedures and treatment of nonsurgical cases

Internist

Person who dies without a will

Intestate

Community based systems include

Intramural & Extramural Services

Taken to patients who live in their own home

Intramural system (ex. Meals on Wheels)

Current assets include:

Inventory

Trading these assets is a normal business of a company.

Inventory

The ____________ reported on the balance sheet is usually the historical cost or fair market value, whichever is lower. This is known as the "lower of cost or market" rule

Inventory Value

Locked central storeroom

Inventory control (supplies & equipment)

All grievances/complaints must be

Investigated & educate staff on grievance process

Each facility should have a infection control committee. The infection control committee is responsible for

Investigation Control Prevention of infections in facility

Result of a negligent act (reckless driving)

Involuntary manslaughter

Separation of a resident from other residents or from his or her room against the resident's will or will of the legal rep

Involuntary seclusion

Toilet doors may open ______ or ___________

Inward or Outward

Short term disability _________ a universal legal requirement

Is Not

Goal of TQM (Total Quality Management)

Is that HR in every unit arrive at a level of daily performance reflecting a passion for quality

A Resident can be moved to another room without consent if

It is due to the protection of other residents

If the patient can release the restraint

It is not a restraint

Fixed asset include:

Items such as building and equipment

Decertification of a union: Employees can remove a union when?

Its leaders fail to meet members expectations

The OSHA form must be posted where employees can see it during ____ & ______ of every year

January & February

Group of positions that are similar in their duties?

Job

One way to defend job against unemployment charges of unfair employment practices is to conduct ______________ and prepare _______________

Job Analysis / Job Description

Includes job identification information Job summary Principle duties performed Job specifications

Job Description

Should be flexible & should allow room for innovations & employee participation & input. These are the most obvious & visible output of a job analysis

Job Description

Information at a job that results in a statement of the job to be done, usually a list of duties?

Job Description (Position Description)

The most obvious & visible output of a job analysis

Job Description (Position Description)

Position description elements:

Job ID information Job Summary Principal duties performed Job specification

Provides purpose, nature, & extent of the tasks performed by the person in the position.

Job Summary

Position Description Components:

Job Title Status: Exempt vs. Non-exempt Summary of duties Salary Range Knowledge required Skills required Effort required: Mental or Physical Responsibility: consequences of error Working conditions General Statement: Other duties as assigned

Distinguishes one job from another

Job Titles (Job Classifications)

Process of defining a job in terms of tasks or behaviors Process of grouping a series of related tasks into a position

Job analysis

What precedes the preparation of a position description?

Job analysis

The purpose of conducting a job analysis is to prepare a?

Job description

A statement of skills, education and experience required to do a job is called a __________.

Job specification

Outlines the minimum specific skills, efforts, & responsibilities required of an incumbent in the job

Job specification

The FIRST step in the accounting cycle which consists of recording transactions on a daily or chronological basis

Journalizing

Treatments for End State Renal Disease includes:

Kidney Transplant and dialysis

Class K fires are ___________ fires

Kitchen

The Immigration Reform & Control Act of 1986 established civil & criminal penalties for what?

Knowlingly hiring, recruiting, referring, or retaining in employment persons designated as unauthorized aliens.

_______________ or ________________ allows administrator to assure him/herself that facility resources & finances are successfully being used to best meet the needs of the residents

LBWA & MBWA

What is used to handle resident & family concerns?

LIFE Listen Investigate Feedback Evaluate

Two methods of inventory costing used to account for effects of inflation or deflation on the price of inventory

LIFO & FIFO

A method that assumes that "newer" inventory will be used 1st. The goods remaining in inventory is lower than the the value of the goods already used to provide services

LIFO (Last in first out)

Items owed by the facility. Outsider claims such as bills

LIabilities

Taxed as a partnership. A form of business owned by a few persons or by thousands of people

LLC (Limited liability Company or corporation)

Limits a partner's liability; no individual liability (unless fraud occurs) for malpractice of other partners. A business owned by two or more persons.

LLP (Limited liability Partnership)

Under no circumstance can the _______ or ________ service in the capacity of the DON

LPN or LVN

Every container in a facility must be ___________ according to the Hazard Communication Program

Labeled

Landrum-Griffin Act of 1959 is also known as

Labor Management Reporting & Disclosure Act

The most common associated causes of UTI include:

Lack of hand washing between patient contacts Close proximity of residents with catheters Prevalence of residents who have indwelling catheters

Easy going, supportive style which the leader tells his staff what he wants accomplished & leaves them alone

Laissez-faire leadership

Seeks to protect the interests of the individual union member against possible union abuses

Landrum-Griffin Act of 1959

Dementia is an acquired persistent impairment of intellectual function that compromises at least 3 of the following spheres of mental activity:

Language Memory Visual/spatial skills Emotion or personality Cognition

A distinct part SNF or NF is physically distinguishable from _______________ or ____________ that houses it

Large institution / Institutional Complex

Each facility toilet must have a

Lavatory with mirror and a toilet

Process of influencing employees to work willingly & enthusiastically toward common goals whether managers are present or not

Leadership

LBWA

Leading by walking around

Which of the alternative HR models is part of workforce is unionized?

Legal Model

HR provides services that are essential to the __________________ of an organization

Legal Survival

If the past employer had relevant & documented knowledge of a serious problem & did not reveal that info upon request, the former employer could be at rick for what?

Legal action brought on by the new employer

A patient with dementia will need either a ______ or ________ to make decisions for him or her

Legal guardian or responsible party

Employers must verify if applicants are __________ to work in the USA

Legally Eligible

This landmark federal legislation comes by its common name "OBRA" through the

Legislative process

Power according to position

Legitimate Power

Assets =

Liabilities + Capital

Assets=

Liabilities + Owner's Equity

Written defamation is ______________

Libel

Nursing facility administrators must be ______________ in every state that they work

Licensed

Depending on the state law, the physician can delegate the prescribing of diet/therapeutic diets to the ____________

Licensed dietitian Other than that dietitian can make only recommendations

Dumpster requirements include:

Lid closed due to pests Located far from dietary service as possible

A claim or charge on a particular property for payment of a debt or obligation

Lien

LSC

Life Safety Code

NFPA (National Fire Protection Association), 2000 edition is used regarding what?

Life Safety Code inspections/regulations

NFPA requires generator supply power to at least:

Life Support System Nurses Station Medication Prep area Alarm system Boiler room (power room) Communication System

Allows payment to relatives to give care to family members regardless of the age pf the one being care for

Lifespan Respite Care Act of 2006

An emergency electrical power system must supply power adequate at least for

Lighting all entrances & exits Equipment to maintain the fire detection alarm extinguishing systems Life support systems in the event the normal electrical supply is interrupted

Emergency power must supply power adequate for at least to run what?

Lighting all entrances / exits Equipment to maintain the fire detection, alarm, & extinguishing systems Life support system in the event the normal electrical supply is interrupted

Closing the doors during a fire will what?

Limit the spread of fire & smoke & limiting & eliminating any loss of life

Assistant Administrator has ___________ authority

Line

Dietary service have __________ activities & ___________ activities

Line & staff (Line=feed residents & staff=prepare the cafeteria)

Person who is empowered by the administrator to make decisions for the organization. Decision-making vested in the supervisor

Line authority

solid line in organizational chart

Line authority

Manager of staff activity. They supervise & coordinate people

Line manager

If an activity or position is abandoned & the workflow is immediately disrupted, then it is what?

Line operation

When an error is made in medical record;

Line should be drawn through error Correct info is written Person must initial & date

Assets that can be converted to cash quickly without appreciable loss (limit impact on its value for ex. cash, stocks, bonds)

Liquid Assets

Arbitration is an alternative to what?

Litigation

Advance directive which resident gives instructions on if he/she wants life-sustaining equipment to be used

Living Will

Upon admission, it is strongly recommended that the residents have a ________________ and ________________

Living will / advance directive POA

Work orders to repair equipment should include at a minimum what?

Location Date Problem

Some type of lock, either key or combination, that will hold an energy isolated device in a safe position that prevents energizing the machine or equipment

Lockout Device

A type of lock, either key or combination type, that will hold an emergency isolating device in a safe position that prevents energizing the machine or equipment.

Logout Device

Assets that can not be converted to cash within 12 months

Long-term asset

Expected not to be liquidated within 1 year. Includes issued long-term bonds, notes payables, long-term leases, pension obligations, and long-term product warranties

Long-term liabilities

OSHA mandates what?

Loss prevention

Chemical sanitization comes from

Low temp dishwasher

Physical therapy is done on what part of the body?

Lower

Nurse supervisor, charge nurse, ADON, are considered ______________ management

Lower level

Guide employees according to established policies of the facility

Lower level management

Motivation factors for Douglas McGregor Theory X are the ___________ of Maslow Hierarchy of Needs

Lower needs

When reengineering, decisions must be made closer to an organization's what?

Lowest level

Unlike the heart, the _________ has the ability to repair itself after infection or damage

Lung

Medication with a ________________ must be returned to the pharmacy and you should receive a credit

MARRED LABEL

Emphasizes setting specific, jointly developed common goals (by management & employees with a time period for goal achievement & performance feedback. It means to identify goals, determine procedures, set time limits & continuously measure progress. Everyone knows what is expected & how long it should take.

MBO (Mgmt by objectives)

Cornerstone of building any team, and it helps reduce turnover & absenteeism

MBWA (Manage by walking around)

Medicare paid for 25%, MCD & other public funds paid 42%. The largest payer for long-term care services is?

MCD

Hospice providers will bill ________ for services provided

MCR A

SS Amendments of 1994 amended to raise the limit from $50 to $100 for the minimum about of resident's funds that facilities must entrust to an interest bearing account. This increase only applies to :

MCR SNF residents

Sources of healthcare revenue:

MCR, MCD, PVT pay, Insurance, & managed care

Is a standardized instrument process used to assess nursing home residents

MDS (Minimum Data Set ) or RAI (Resident Assessment Instrument)

uniform data set used to complete comprehensive exam

MDS (Minimum Data Set)

Examples of direct transmission illness include:

MRSA, VRE, FLU

Employees must be aware of hazardous chemicals in the workplace by using the?

MSDS (Material Safety Data Sheet) now called SDS (Safety Data Sheet)

Facility can not impose a charge against the personal funds of a resident for any item or service for which payment is

Made under Medicare or Medicaid

The secondary reason for performance appraisal is what?

Maintain performance at a acceptable level

In maintenance, work orders do not include how to fix the problem because?

Maintenance should already know how to fix the problem or know a vendor that can fix the problem

With the LBWA & MBWA methods the administrator is able to uncover problems before they become

Major problems

Performance of an unlawful or improper act

Malfeasance

What is an example of a lockout device need?

Malfunctioning electrical outlet

Pertaining to governing body ____________ employees must be disclosed

Management

With a organizational chart in a large organization, management must use the ______________ to understand what is going on

Management Control System

The governing body establishes and implements policies regarding

Management and operation of the facility

MBWA

Management by walking around

Douglas McGregor Theory X is ________________ leadership

Manager-Center

Th power to command, issue orders, or direct action by subordinate

Managerial Authority

Which of the alternative HR models decentralization occurs; so many people interpret organizational guidelines?

Managerial Model

commission of an unintentional act that results in the death of another person

Manslaughter

During the economic boom following WWII, health insurance programs became part of what?

Many organizations benefit packages

Schedule I drugs include:

Marijuana Heroin LSD

Choosing a market segmentation that provides the organization with the maximal opportunity to achieve a leadership position in the marketplace

Market positioning

Dividing a market into subsets in which each subset has characteristics in common.

Market segmentation

The process of planning & executing the conception, pricing, promotion, & distribution of goods, ideas, & services to create exchanges that satisfy both individual & organizational objectives

Marketing

Bridges the gap between the community and nursing facility residents

Marketing (Open House)

The product or service, price, promotion, & place of channels of distribution

Marketing mix

Needs become salient (powerfully motivating) at each successively higher level mainly after the needs at each lower level are satisfactorily met. Until the individual has met the needs for survival and basic security (lower level) these will dominate until met. Lower needs must be satisfied before higher needs can be used to motivate desired behavior.

Maslow's Hierarchy of Need

MSDS

Material Safety Data Sheet

The care plan must include _________ and __________ to meet a resident's medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment. it it person-centered

Measureable Objectives Timetables

Four foods required in a balanced diet

Meats Vegetables Milk Fruit

Adverse event reporting can be completed to MedWatch by mailing in?

MedWatch 3500

MedWatch disseminates important safety information to the medical community & general public via what?

MedWatch website & MedWatch E-List

Utilized to resolve disputes by using a third party

Mediation

Distinct part =

Medicaid portion of the facility Title 19

Drugs are not what?

Medical Devices

Provides medical supervision & is paid a contractual monthly fee. He/she responsible for the implementation of resident-care policies & the coordination of medical care in the facility

Medical Director

Responsible for implementation of resident care policies & the coordination of medical care in the facility

Medical Director

SNF or NF must have a designated __________ who is responsible for implementing care policies and coordinating medical care, and who is directly accountable to the management of the institution of which it is a distinct part

Medical Director

The MedWatch system is intended to detect safety hazard signals for medical products, if a signal is detected, the FDA can issue what?

Medical Product Safety Alerts Order product recalls, withdrawals, or labeling changes to protect public health

MedWatch system of voluntary reporting allows such information to be shared with who?

Medical community or general public

Pregnancy is considered a

Medical disability

Can order an autopsy without the consent of the next of kin

Medical examiner

Need higher ALOS for ________ patients

Medicare

Violation of law concerning _____________ would be brought in the U.S. District Court

Medicare

__________ guidelines stay the same under PPS

Medicare

Annual Uniform Cost Statement is required of __________ & __________ facilities by each state and _________ requires the financial statement to be filed at the end of the year.

Medicare & Medicaid Medicare

MAC

Medicare Administrative Contractor

It is considered a medical insurance plan?

Medicare B

Now separate from Social Security and the employee & employer each pays 50% of the tax

Medicare Tax

Is used for reporting an adverse event or sentinel event.

Medwatch

The Food & Drug Administration's Safety Information & Adverse Event Reporting Program. Is called what?

Medwatch

Working capital is used to

Meet short-term financial commitments/obligations

Periodic pay increase plans based on performance

Merit Pay

In smoking area _________ with self-closing covers are required

Metal containers

The use of mobile technologies for healthcare purposes

Mhealth

___________ managers & ___________ managers do not view themselves as change agents

Middle & Department

Is responsible for implementing policies

Middle level management

Authority invested in a supervisory nurse is

Middle management authority

The ___________ is prepared by the night nurse and forwarded to the facility's business office, where the report is used for calculating daily revenues for all patients

Midnight Census Report

In hiring the government may require a facility to increase the proportion of

Minority persons (ration hiring)

Deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident's belongings or money without the resident's consent.

Misappropriation

OBRA uses to mean theft of resident's property

Misappropriation

One of the primary reasons for employee dismissal is ________________

Misconduct

A crime that is punishable by a term of imprisonment of no more than 1 year

Misdemenanor

Improper performance of an act

Misfeasance

Explains goals & objectives of the facility

Mission Statement

Job summary should be related to the _____________ of the department and ______________ of the organizations

Mission Statement / Global Mission

The facility must develop and implement written policies and procedures that prohibit

Mistreatment Neglect Abuse Misappropriation of resident property

Each resident has the right to be free from

Mistreatment Neglect Misappropriation of Property

Type B

Moderate Achievers

A grant program that encourages a beneficiary discharged from an institutional care facility to remain in the community & receive services at home

Money follows the Person Program

Average cost per resident =

Monthly expense / # of residents

Generators must be tested _____________ with a full load for ___________ at __________ capacity

Monthly/30 min/30%

When mopping a hall you should?

Mop one side at a time and place wet floor sign

The facility may charge the resident for requested services that are

More expensive than or in excess of covered services

Many employers with how many employees are required to keep a record of serious work-related injuries & illnesses?

More than 10 employees

Schedule II drugs include:

Morphine Codeine Cocaine Opium

Job Identification

Must include, at a minimum, the position, title, the department location, & the last date which the content of the position description was verified

Are often used for residents with glaucoma problems, dilates the pupils of the eyes to relieve eye pressure

Mydriatics (Optical Medication)

___________ is considered upper level management

NHA

The focus on ADLS is to

NOT let them decline

Nonsteroidal Anti-Inflammatory Drugs

NSAIDs

The facility must inform each resident of the ___________, ___________, and ______________ the physician responsible for his or her care

Name Specialty Way of contacting

Non-cholinesterase inhibitor includes:

Namenda (Menmantine)

NFPA

National Fire Protection Association

Provided legal protection to labor unions & made the task of organizing workers considerably easier for unions than it has been.

National Labor Relations Act of 1935 (Wagner Act)

The first nationwide American legislation to favor the growth of trade unions, define the rights of workers, unionization, collective bargaining (unions). This act made it illegal for an employer to refuse to negotiate with a union. Governed relationships between work organizations & labor unions. Defines certain conduct of employees & employers as unfair labor practices & provides for hearings on complaints that such practices have occurred.

National Labor Relations Act of 1935 (Wagner Act)

It is an independent agency of the US government charged with conducting elections for labor union representation & investigating/remedying unfair labor practices

National Labor Relations Board

NLRB

National Labor Relations Board

Communities with a large proportion of older persons residing within a specific geographical area

Naturally Occurring Retirement Communities

For adequate workplace motivation, it is important that leadership understands which _______ are active for individual employee motivation

Needs

The comprehensive assessment must assess the resident's

Needs Strengths Goals Life history Preference

Failure to provide goods and services necessary to avoid physical harm, mental anguish, pain, emotional distress, or mental illness

Neglect

Failure to exercise the degree of care a reasonable person would exercise under the same circumstances, which results in injury to another.

Negligence

Negligence without proof. Occurs when the act complained of is in violation of a safety statute. Include acts that are so clearly harmful to others that it is plain to any reasonable person that negligence must have occurred.

Negligence per se

If an employee causes harm while working for the organization that failed to check references, the organization is at risk for being charged with what?

Negligent hiring

During a mediation, the mediator will attempt to get the union & facility to:

Negotiate a settlement

NW

Net Worth

Working capital is also called

Net current assets

Net Profit Margin

Net income after tax / Sales

Net Profit margin=

Net income after tax divided by sales

Physician who diagnosis and treats disease of the brain nervous system, and spinal cord

Neurologist

When should the RTF account be deposited into the facility operating account?

Never

Automatic sprinkler protection is required of all ?

New Health Care Facilities

Examples of training:

New employee orientation On-The-Job Off-Site Training

Most common medication prescribed for persons with angina

Nitroglycerin

Is there a cure for Parkinson's?

No

The purpose of COBRA is to ensure that?

No one is suddenly without coverage

C Corporations have ___________ on ownership

No restrictions

Prohibited smoking areas must have what?

No smoking signs

Makes profit, but invests profit into business operations

Non-profit corporation

Smoking area clearly marked & contain only ______________ ashtrays

Noncombustible

Employer pays for all cost of the insurance

Noncontributory insurance policies

Failure to act when there is a duty to act as reasonably prudent person

Nonfeasance

Ethical principle that requires caregivers to avoid causing patient harm

Nonmaleficence

The attempt to determine what moral standards should be followed so that human behavior and conduct may be morally right

Normative Ethics

Values of an organization are general expectations of all employees

Norms

Legalized union organizing activities & affirmed workers' rights to organize for collective bargaining purposes. It limits the power of the federal courts to issue injunction in cases involving or growing out of labor disputes.

Norris-LaGuardia Act 1932

Infections that are associated with institutionalization or acquired while in a health care facility

Nosocomial Infections

Residents that are deemed _________ may smoke only when supervised by staff, family, or volunteer

Not Responsible

The facility must also provide the resident with __________ prior to admission, upon admission, and during the resident's stay

Notice

Food must be:

Nourishing Palatable Attractive Well-balanced Served at proper temp Prepared to meet individual needs

Trailblazer Health Enterprises LLC was both the fiscal intermediary (Part A) and carrier (Part B) for providers in Texas. it is now called?

Novitas Solutions (Highmark Medicare Services before that)

An RN meeting state requirements governing qualifications of a nurse practitioner

Nurse Practitioner

There should be a non-discriminating policy also regarding admitting patients to _______ and _________

Nursing Facility & Room assignments

_________ requires that a licensed nurse must serve as the charge nurse on each work shift

OBRA

CAA (Care Area Assessment) are not required for Medicare PPS assessment. They are required for

OBRA comprehensive assessment (admission, annual, significant change in status, or significant correction of a prior full) However, when a Medicare PPS assessment is combined with a OBRA comprehensive assessment, the CAA must be completed in order to meet the requirements of the OBRA comprehensive assessment

___________ of the US DHHS enforces corporate compliance

OIG

A single institution can have a maximum of __________ distinct part SNF and _________ distinct part NF

ONLY ONE / ONE

Imposes on employers a general duty to provide each employee a safe work place, free from recognized hazards causing or likely to cause death or serious physical harm.

OSHA

A log & summary of occupational injuries & illnesses that occur within the nursing home each calendar year

OSHA 300

A summary of OSHA 300, but does not contain the names of the employees who were involved in accidents or injuries

OSHA 300A

Standardized records of illness & injuries must be recorded on the what?

OSHA form (Log & summary of Ocuupational Injuries & Illnesses)

An ____________ must be displayed to inform employees of their rights & responsibilities, & compiling annual figures on work-related illnesses & accidents

OSHA poster (OSHA 300 log)

Prohibits age-based employment discrimination against persons 40 years of age or older

OWBPA (Older Workers Benefit Protection Act of 1990)

The ADEA (Age Discrimination Employment Act) allowed reductions in benefits for older workers in situations where added costs were incurred to provide the benefits. Who removed employers' option to just lower benefits for older workers?

OWBPA (Older Workers Benefit Protection Act of 1990)

OSHA

Occupational Safety and Health Administration

Upper limbs focus

Occupational Therapy

Average % of Occupancy =

Occupied bed days / {# of facility Beds x # of days in the month}

Cash accounting records expenditures and receipts as they _________

Occur

Each resident must be offered an influenza immunization ___________________

October 1 - March 31 Annually

OIG

Office of Inspector General

OAA

Old Age Assistance

Immediate access to the residents must be granted to the ____________, _______________, and ________________

Ombudsman Rep of the State Resident's physician

Failure to do something that causes neglect

Omission of an act

The drug regimen review is completed by the licensed pharmacist and must be reviewed at least

Once a month

Residents must be seen by a physician at least

Once every 30 days for the first 90 days of admission Once every 60 days thereafter

Consistency; accounting reports are prepared the same year after year

Ongoing concern concept

A planning and controlling device. Generally deals with actual short-term revenues and expenses necessary to operate the facility

Operating Budget

What contains the expense budget & revenue budget?

Operating budget

Types of budgets include:

Operating budget Cash Budget Capital Budget

Non-cash employee retention incentives include:

Opportunities for training & development Tuition Assistance Programs Career development Succession Planning Programs

The facility must inform the resident both _________ and ____________in a language that the resident understands of his or her rights and all rules and regulations governing resident conduct and responsibilties during the stay in the facility

Orally and written

HR generally make recommendations for changes in compensation, which are usually reviewed by who before implemented?

Organization's Board of Directors

Shows the organizational structure

Organizational Chart

A set of shared values, norms, or rituals that organization members have regarding the functioning and character of their organization

Organizational Culture

Cross-training employees with similar types of jobs provides what?

Organizational Flexibility

It is the method of ensuring the work necessary to achieve a goal is broken down into segments, each of which can be handled by one person. First step in implementing a plan & where departmentalization occurs. Takes place at all levels of the organization

Organizing

Foundation for employment & a use of a checklist is valuable.

Orientation

________ & _________ of employees is an important factor affecting employee retention

Orientation & Supervision

The cartilage and other components of the joint begin to wear way or degenerate as the disease progresses

Osteoarthritis

Softening of the bones and it is common among many elderly people. Caused by a lack of calcium.

Osteoporosis

Many older persons are at risk for breaking bones. Diagnosis:

Osteoporosis & Osteopenia

Involves assisting displaced employees in finding new employment

Outplacement

When employees are discharged _________ could be offered?

Outplacement

Personalities. Type A

Overachievers-more stressed-perfectionist

Damp linens are not to be left in the machine

Overnight

Who has ultimate responsibility for the facility?

Owner

Money that a company owner has taken from the business for personal use, similar to a company that pays dividends

Owner's Drawings

Sum of business resources owned by the owner

Owner's capital

At the option of the physician, required visits in SNF after the initial visit may alternate between personal visits by the physician & visits by a

PA NP Clinical Nurse Specialist (CNS)

A unique capitated managed care benefit for the frail and elderly

PACE (Program of All-Inclusive Care for the Elderly

The changes OBRA brought to nursing home care are enormous. Some of the most important resident provisions include: PASARR

PASARR Level I-Indentification Function PASARR Level II-Evaluation function to determine whether NF services and specialized services are needed

A textual resource for the use of drugs and side effects

PDR or Physician Desk Reference

Example of a outsourcing organization is?

PEO (Professional Employer Organizations)

Control tools showing the relationship among the activities that makeup a project (completion times/dates for each step/task in the project). It involves development of a flowchart which shows an event, and a plan with a completion that can be measured at a given time. It is a tool that facilities decision-making.

PERT/CPM

Plans that use primary care physicians as gatekeepers to coordinate and control medical care

POS (Point-of-Service Plans)

5 functions of managers

POSDC Planning Organizing Staffing Directing (Decision making) Controlling

Purchased for continued and long care use in earning profit in a business

PPE (Property, plant, & equipment)

Entities through in which employer health benefit plans and health insurance carriers contract to purchase healthcare services for covered beneficiaries from a selected group of participating providers

PPO (Preferred Providers Organizations)

Budget Reform Act of 1997 established a:

PPS (Prospective Payment System)

New payment method for skilled nursing facilities. It establishes new rules for assessment of Medicare A skilled residents, and for determining the amount to be paid to skilled nursing facility. It sets per diem rates for resident care

PPS (Prospective Payment System)

A growing area of responsibility for nursing because it often involves nursing judgements about when to give pain medication if the medication is not prescribed on a fixed dosage

Pain management

Alleviating suffering

Palliative Care

The comprehensive, multidisciplinary care of patients with life limiting illnesses

Palliative Medicine

Class A fire extinguishers are used for what type of material?

Paper, wood, rubber, plastic, linen, wool, etc)

Degenerative disorder of the central nervous system affecting the motor system

Parkinson's Disease

Requires input from staff member on several levels of the organization

Participatory approach

Sympathetic, fathering/mothering style that provides many rewards

Paternal Leadership

Also known as Healthcare Reform

Patient Protection & Affordable Care Act of 2010

Which act concerns advanced directives and advanced directives should be discussed in writing and provided to the resident upon admission?

Patient Self-Determination Act (PSDA) of 1990

Employees want to know first about _________ and then _____________

Pay / Benefit

Mandatory submission of staffing information based on _______ in a uniform format

Payroll data

Direct costs for nursing department would include

Payroll taxes Salaries Benefits Medical supplies Capital equipment involved with a particular department Any other costs that impact the respective department

Variable expense:

Payroll taxes, raw food cost, salary expense, repairs, and supplies

Staff should check for smoke barrier ___________

Penetration

An example of antibiotic includes:

Penicillin

PBGC

Pension Benefit Guarantee Corporation

PBGC

Pension Benefit Guaranty Corporation

Requires organizations with underfunded pension plans to make additional payments to the Pension Benefit Guarantee Corporation (PBGC)

Pension Protection Act of 1987

One who may be responsible for financial matters of a Medicaid resident

Pension Trustee

Buildings don't take care of people, ___________ take care of people

People

Primary focus is on people (producers) instead of machines

People-centered managers

With Worker's Compensation employees receive a ________ of lost wages due to work-related accident or illness

Percentage

What do line departments do?

Perform an organization's work & advances the work of the organization

In termination, dismissal is related to what?

Performance

It is used to facilitate improvement in employee performance, provide formal or official feedback to employees concerning their job performance, & collect information for decisions concerning compensation & other personnel transactions such as promotions & transfers.

Performance Appraisal

A systematic employee review that occurs on a regular basis in which the employee receives feedback about his/her job performance

Performance appraisal

Each facility must have a written disaster plan and it should be reviewed __________

Periodically

May be performed for bedridden patient. It involves filtering out the excess fluids from the peritoneum, which lines the abdominal organs

Peritoneal Dialysis

Recommended to maintain and accurate count of inventory on hand (an accurate count of supplies used and those remaining in the storeroom)

Perpetual Inventory System

Direct transmission

Person to person

Focus on the resident as the locus of control & support the resident in making their own choices & having control over their daily lives

Person-centered

The resident has the right to ___________ and __________ of his or her personal & clinical record

Personal privacy & confidentiality

What is the most effective marketing tool?

Personal tour through the building that includes meeting staff & patients

Fringe benefits are found in ________ not job descriptions or job analysis

Personnel policies

Process of deciding which of the applicants best fits the requirements of the job

Personnel selection

Destruction of discontinued drugs should be under supervision of the

Pharmacist

Only a ______________ or ________________ may fill prescriptions, and thus dispense drugs

Pharmacist or physician

Only the ______ can re-label medication

Pharmacy

It is illegal to ask an applicant to provide what with application?

Photograph

Physician who specializes in physical medicine, body movements, and conditioning

Physiatrist

Each resident must received and the facility must provide the necessary care and services to attain or maintain the highest practicable ________, _________, and _______ well-being, in accordance with the Comprehensive Assessment and Plan of Care

Physical Mental Psychosocial

Two types of restraints?

Physical & Chemical

Lower limbs focus

Physical Therapy

PT

Physical Therapy

All residents exercises such as therapy must be ordered by a _______ and included in the patient plan of care

Physician

During drug regimen pharmacist must report irregularities to

Physician

Each resident must be under the care of a

Physician

At the time each resident is admitted, the facility must have

Physician orders for the resident's immediate care

PDR

Physician's Desk Reference

Lab & X-ray or other diagnostic services must be provided and a __________ must be written and the nurse must notify the _______________ of lab results that fall outside the clinical reference range

Physician's order Physician, PA, NP, or certified nurse specialist

Per the teachings of Abraham Maslow there are general needs which have to be fulfilled before a person is able to act unselfishly

Physiological Safety Love Esteem

Requirements for human survival (water, food, clothes)

Physiological Needs

List Maslow's Hierarchy of Needs from bottom to top

Physiological Needs Safety Needs Social Needs Esteem Needs

Deming's Process Improvement Cycle

Plan Do Study/Check Act

The first step, where we set the objectives of the organizations. Long-range goals are identified, established, & accomplished during strategic planning. It helps facility to re-evaluate its mission & identify its long-term goals

Planning

Unless adjudged incompetent or incapacitated under the laws of the state, the resident has the right to participate in __________ and ____________

Planning care & Treatment

Moving party in filing of a negligent action. The party bringing the lawsuit to court.

Plantiff

Two common nosocomial infections are:

Pneumonia & UTIs

What is the most common reason for transferring NH residents tot he hospital?

Pneumonia (especially aspiration pneumonia)

A trained professional, who is not a medical director, concerned with care of feet

Podiatrist

Broad statements of goals & procedures; can be verbal, written, or implied overall guide that sets up boundaries supplying the general limits & direction in which mangerial action will take place; generalized statements of intention

Policies

Alzheimer's disease could lead to ________ and ___________

Poor appetite and weight loss

What is a MAJOTR cause of malnutrition among the elderly?

Poor dentition

Anorexia (loss of appetite) among some elderly leads to skipping meals, bu the primary cause of malnutrition in a nursing facility is

Poor dentition (teeth)

Responsibilities & duties performed by one individual?

Position

______________ are integral to an organization's efforts to be fair an equitable to all employees

Position Description

Job description is now known as

Position description

Supervisors who take time for one-on-one relationships are usually rewarded with ___________ and ___________ that far exceed the time invested in employee interactions

Positive employee attitudes Increased Productivity

PAC

Post acute care

Help the transition of individuals needing additional support after a discharge from hospital-based, acute care setting

Post-Acute Care Units or Transitional Care Units

To make a entry in a ledger

Posting

Balancing mechanisms appear to function less well, resulting in some persons aged 65 and over being progressively at risk of tripping

Postural Imbalances

The ability to influence/control the behaviors of others

Power

An agreement in which a person (principle) gives another person the authority to make decisions on behalf of the principal (Attorney in fact)

Power of attorney (POA)

POA

Power of attorney (POA)

Under the common law, a POA becomes ineffective if its granter dies or becomes incapaciatted meaning unable to grant such power, because of physical injury or mental illness. Unless the granter has specified that the POA will continue to be active is the granter becomes incapacitated.

Power of attorney with durable provisions in US Enduring Power of attorney elsewhere

OBRA requires ___________ of any new resident who might have some for of mental illness or mental disability that prohibits admission

Preadmission Screening

PASARR

Preadmission Screening and Annual Resident Review

Defined that discrimination on the basis of pregnancy, childbirth, or related medical conditions as unlawful sex discrimination under Title VII of the Civil Rights Act of 1964

Pregnancy Discrimination Act of 1978

Cash accounting does NOT recognize expenses that are _________ such as insurance paid up to several months to years ahead

Prepaid

These are expenses paid in cash and recorded as assets before they are used or consumed

Prepaid expense

The gradual loss of acute hearing in which the resident may hear what is said but has poor word acuity. It is characterized by inability to hear certain tones

Presbycusis

Area where the skin and underlying tissues are eroded as a result of a lack of blood flow

Pressure sore

Residents that are bedfast or chairbound for long periods of time are at high risk for developing ____________

Pressure ulcers

The purpose of the EEOC is to

Prevent any person from engaging in any unlawful employment practice

The primary reason for employee incident reports is to

Prevent future accidents

An internal control for risk management would be to improve the ______________, which is to ensure safe operation of equipment

Preventative Maintenance Program

Used to ensure all equipment is monitored & operating effectively

Preventive Maintenance

Since the early 1990s the free exchange of wage information has been legally regarded as what?

Price fixing under antitrust regulations, however the Justice Department eventually decided that not-for-profit healthcare organizations should be held to the same standards as other industries.

PPS is a __________

Priced based system

Duties are broken down by tasks, & the task that are most critical are listed first

Principal duties performed

Notice of Rights and services must be provided when?

Prior to or upon admission

Resident rights must be provided to resident when?

Prior to or upon admission

Gave federal staff the right to examine their HR records, including letters of reference, unless they waived the right when they requested the letter

Privacy Act of 1974

Davidson has $3,000 in trust fund in May, what will happen to Davidson for the month of May?

Private Pay

Step by step guide by which a task is to be performed in order to attain a goal.

Procedures

Reengineering focuses on ________ and not people

Process

Routine use of polygraph tests are only permitted in organizations that?

Produce & distribute controlled substances Nuclear Power Transportation Currency Commodities Proprietary Information

Example of Norms

Professional standards for nurse & nurse aides

Shows whether revenues were sufficient to cover expenses during a certain time period. Shows if you made or lost money. It is the statement of current income and expenses.

Profit & Loss (P&L) aka Income Statement

With S Corporations ________ and ________ are divided and passed on to shareholders

Profits and losses

Outlook for a resident's future condition

Prognosis

PERT

Program Evaluation and Review Technique

Battery operated smoke detectors must be installed in resident's sleeping rooms and public areas by May 24, 2006, the facility must have

Program for testing Maintenance Battery replacement to ensure the reliability of the smoke detectors

Portable space heaters are what?

Prohibited except in non-sleeping staff & employee areas where the heating element do not exceed 212 degree F

Taft-Hartley Act of 1947

Prohibited unions & managers from doing certain actions Prohibited unfair labor practices It is a US Federal Law that monitors activities & power of labor unions Favors labor unions

TITLE VI of the Civil Rights Act

Prohibits people from discrimination based on race, color, or national origin in programs or activities that receive Federal Financial Assistance

A key element in reducing costs of work related illnesses & injuries is what?

Proper training of all employees upon hire & annually thereafter

Fixed expenses include:

Property tax, liability insurance, and property insurance

to give federally-funded protection and advocacy systems (P&As) authority to investigate possible abuse or neglect occurring in the community, including in facilities, like schools, that provide services to people with mental illness.

Protection and Advocacy for Mentally ill Individuals Act

Necessary for growth, repair of damaged tissue, transporting nutrients and chemicals throughout the body, & producing various hormones and enzymes. The building block of all cells

Protein

Primary purpose of HR management is to

Provide quality resident care with efficiency & economy

Before a nursing facility transfers a resident tot he hospital or allows a resident to go on therapeutic leave, the nursing facility must

Provide written information to the resident and resident's family member or Legal Rep that specifies the facility's bed hold policy

NEVER discipline staff in

Public

Involves a party & governmental subdivision

Public Law

Exists when employees believe managers has ability to punish unacceptable behavior & it is usually the last resort

Punishment power aka Coercive power

The resident or his legal rep has the right after receipt of his or her records for inspection, to

Purchase at a cost not to exceed the community standard photocopies of the records or any portions of them

Physician may delegate the task of writing dietary orders to a _____________ and delegate the task of writing therapy orders to a ____________

Qualified dietitian Qualified therapist

Employee Assistance Program (EAP) Addressing personal problems contributes to improvements in ________ & ___________

Quality & Productivity

QAPI

Quality Assessment & Performance Improvement

The focus of the NF should be ____________ regardless of it is profit or not for profit

Quality Care

A private, not for profit organization staffed by trained professionals who review medical care & help beneficiaries with complaints about the quality of care & implement improvements in the quality of care available throughout the spectrum of care

Quality Improvement Organization

QIO

Quality Improvement Organization

A fundamental principle that applies all treatment and care provided to the facility residents

Quality of Care

Resident care practices utilized by staff must reflect _____________ which promtes the highest practicable physical, mental, & psychological well-being

Quality of Care

QAPI meets at least

Quarterly

Residents with trust fund accounts must receive from the facility a ______________ statement and on request to the resident or his or her legal rep

Quarterly

The infection control committee should meet at least _____________

Quarterly

Fire drills must be conducted how often?

Quarterly on each shift

Acid test ratio =

Quick assets/current liabilities

Nosocomial infections should be identified _______________, paying special attention to residents at high risk of infection

Quickly

Fire Drill Steps:

R-Rescue A-Alarm C-Calm E-Extinguish

Fire drill steps:

RACE

___________ must coordinate or conduct each comprehensive assessment with appropriate health professionals, and cetify that the assessment is complete

RN

Is the best way to avoid stiffening (contractures) of hand and leg joints

ROM or Range of Motion

The best treatment for contractures is

ROM or Range of motion because the resident is unable to do exercises for themselves

Payment level for reimbursement?

RUG (Resource Utilization Group)

Once the MDS is completed it will generate a

RUG (Resource Utilization Group) with is used to bill MCD, MCR, or Hospice entities

__________, __________, and __________ impact the financial stability of nursing home

RUGs, PPS, Managed Care

What can you not ask a applicant about?

Race Color Religion Creed National Origin Sex Marital Status Birth Control Practices Previous worker's comp

First Federal legislation sanctioning union organization & the right to bargain collectively with management

Railway Labor Act of 1926

A distinct part must include all of the beds within the designated area, and cannot consist of a

Random collection of individual rooms or beds that are scattered throughout the physical plant

The facility must make the most recent survey results available for examination in a place

Readily accessible to residents and must post a notice of their availability and receive information from agencies acting as client advocates and be afforded the opportunity to contact these agencies

A form of therapy for demented, confused, or disoriented individuals & consists of reiteration of the person's identity, orientation to time & place, & reinforcement of consistency in daily routine

Reality orientation

MedWatch also disseminates medical product safety alert such as what?

Recalls & other clinical safety communications-via its website, email list, Twitter, & RSS feed

Individuals with disabilities can not be excluded from participation in an activity that what?

Receives Federal Financial Assistance

OSHA 300 log only records injuries & illnesses that OSHA classifies as _______ & _________

Recordable & Work Related

Process of locating prospective staff

Recruitment

Addressing something that is currently being done & redesigning a process & the same result is achieved.

Reengineering

Power to influence based on liking or identifying with another person & employees are more apt to do what the administrator asks

Referent Power

Employee Assistance Program (EAP) is primarily a __________ program that helps individuals to identify & focus on their own needs & problems

Referral

Oursourcing

Refers to the practice of contracting with third-party companies or vendors outside the organization (usually in another country) to deliver products and services to customers or produce products.

If an employee refuses to sign performance evaluation

Refusal is noted on evaluation & signed by the employee's supervisor

Relaxing the restrictions in some modified diets, called liberalized diet, may help prevent malnutrition

Regarding Dietary Services

Activity Director must be:

Registered or licensed therapeutic specialist eligible for certification a qualified OT or COTA Completed a training course approved by the state or has 2 years of experience in a social or recreational program within the last 5 years, 1 of which was full-time in a patient activity program in a health care setting.

Usually a consultant. Responsible for drug regimen review, med pass observations, and recording/reporting drug error rates.

Registered pharmacist

Applied only to employees of the federal government & to employees doing specified amount of business with the government. Prohibits discrimination in hiring, promotion, & other employment of the handicapped, paralleling Title VII of the Civil Rights Act of 1964

Rehabilitation Act of 1973

What Act is the precursor of the American with Disabilities Act (1990)?

Rehabilitation Act of 1973

Should focus on restoring the resident to his/her maximum functional level

Rehabilitation Services

employer must guarantee that, upon returning from leave, an employee will be

Reinstated to the previous position held or placed in a fully equivalent position with no loss of benefits or senority

TITLE VI Civil Rights Act in 1964 does not apply to a

Religious Corporation

_____________ and _____________ of conduct sometimes conflict with the ethical duty of caregivers to save lives

Religious beliefs and codes

Remembering & in some ways reliving past experiences

Reminiscence

RACE

Remove (residents from danger) Alarm (pull the alarm) Control (fire if possible, but use correct extinguisher Evacuate (adjacent areas)

States that most organizations are rated on a 4 point scale ranging from exploitive authoritative to participate authoritative

Rensis Likert

Reengineering includes:

Reorganizing Downsizing Rightsizing Repositioning Revitalizing Modernizing

If the facility has reason to believe that a resident's representative is making decisions or taking actions that are not in the best interest of the resident, the facility shall

Report such concerns in the manner required under state law

MedWatch form 3500B was introduced to facilitate what?

Reporting by healthcare consumers

Administrator of the SNF or NF __________ and ________ to the management of the institution of which the SNF or NF is a distinct parts

Reports to and is directly accountable

When transferring or discharging a resident other than notice to the resident in writing the facility must send a copy of the notice to

Representative of the Office of the State Long-Term Care Ombudsman

Statutory benefits are what?

Required by law

Requirements which nursing homes must meet to provide services to MCR and MCD patients?

Requirements of participation

"A thing decided" once the court makes a decision, that decision continues to bind those parties in any future litigation on the same issue

Res judicata

Every effort should be made to include the input of the ___________, _____________, or ___________ in creating the individualized care plan

Resident Family Resident's Rep

IDT includes;

Resident Resident's Family Legal Representative Physician RN responsible for resident Nurse Aide responsible for resident Member of FANS

Revenue Centers generate revenue, usually through __________________

Resident Care

QAPI is ___________ regardless of facility department

Resident Centered

RTF

Resident Trust Fund

Direct costs directly impacts a revenue center and are often called _______________

Resident care costs

The resident has the right to exercise his or her rights as a ___________ and as a ___________

Resident of the facility and as a citizen or resident of the US

Only the ___________ and the ____________ are authorized to review/receive medical records

Resident/Documented legal rep

Owner's equity (also known as stakeholder's equity & capital) included:

Residual claim or interest, after all liabilities are paid. If liability exceeds assets, negative equity exists Remaining interest in assets of a company, spread among individual shareholders of common or preferred stock Last or residual claim against assets, paid only after all other creditors are paid. In such cases where even creditors could not get enough money to pay their bills, nothing is leftover to reimburse owners' equity. Those owners' equity is reduced to zero.

Assets are

Resources

The facility must conduct & document a facility-wide assessment to determine what?

Resources necessary to care for its residents competently during both day to day operations & emergencies

When family needs a break from caring for relatives in which they are paid _________ is used?

Respite Care

Let the master speak, according to the law, the employer is responsible for the actions of its employees while they are on duty

Respondeat Superior

Malpractice is a must because of ______________

Respondent Superior

Restoring to normal function from an impaired physical or disease disability

Restorative Nursing

Used for sleep induction

Restoril

Cannot be removed easily which restrict freedom of movement or normal access to one's body

Restraint

RE

Retained Earnings

Used when an employee terminates an employee generally for reasons other that work-performance related causes, such as reporting an employer for illegal conduct, filing a discrimination charge, or opposing unlawful activity

Retaliatory Discharge

If age is a bona fide occupational qualification (BFOQ) the person is forced to ________

Retire

Withdrawing from ones occupation, business, or office and pursuing new activties

Retirement

Strengthens & accelerates funding of underfunded pensions & increases Pension Benefit Guarantee Corporation (PBGC) premiums for plans that pose the greatest risks

Retirement Protection Act of 1994

Projects monthly income for the next fiscal year

Revenue Budget

____________ is not prepared on a department basis. It is usually prepared at a corporate level

Revenue Budget

Departments that generate revenue such as therapy, nursing, pharmacy, lab, dietary, barber shop, beauty shop, & vending machines

Revenue Centers

Earnings from operations

Revenue also known as Inflow

Nursing, physical therapy, occupational therapy, speech therapy, pharmacy, cafeteria (guest meals), adult day care program, and lab are ___________________

Revenue centers

The indirect cost has to be allocated to _________________ that are also cost centers

Revenue producing Departments

Administrators are given reward power to induce/persuade employees or residents to do what the administrator asks, this is called

Reward Power

5 rights of medication administration

Right Medication Right dose Right time for administration Right Route Right Patient (ID band, facesheet, or photo)

Any event or process that can lead to actions which result directly or indirectly in economic losses or damage to the facility is defined as:

Risk

A program to reduce occurrences (incidents) that may lead to action that result in damage to the facility and its reputation or in an economic loss

Risk Management

Who studies loss trends such as costs associated with workers' compensation?

Risk Manager

Schedule V drugs include:

Robitussin

Chronological review of an event to identify what, how, why, when, and where an unwanted event occurred in order to prevent reoccurrence of the event

Root Cause Analysis (RCA)

RCA

Root cause analysis

Specify certain actions to be taken or not taken

Rules

Pays no corporate taxes with some exceptions regarding long-term capital gains.

S Corporation

MSDS (Material Safety Data Sheet) is now called?

SDS

When leaving an SNF, a resident can choose to make bed hold payments to the ________

SNF

What amended to raise the limit from $50 to $100 for the minimum about of resident's funds that facilities must entrust to an interest bearing account?

SS Amendments of 1994

The facility must provide a ________, _________, ___________, and _________, allowing the resident to use his or her personal belongings to the extent possible

Safe Clean Comfortable Homelike Environment

OBRA requires that the facility provides a

Safe Clean Comfortable Homelike environment

Managers should ensure that employees are thoroughly educated in what?

Safe work practices Safe handling of needles & sharp objects Safe lifting

Homelike is okay, but please be concerned about __________ 1st over the residents rights

Safety

SDS

Safety Data Sheet

Personal security, financial security, health & well-being, overall safety

Safety Needs

The MedWatch system is intended to detect what?

Safety hazard signals for medical products

Valid reasons for immediate transfer

Safety of the individuals in the facility would be endangered Health of the individuals in the facility would be endangered Health of the resident improved sufficiently to allow more immediate transfer or discharge Immediate transfer is required by the resident's urgent medical needs The resident has not resided in the facility for 30 days

Begins when a group of employees at one organization applies pressure for more money, this is called what?

Salary Bumping

Requires publicly held companies to implement internal controls over their financial reporting, operations, and assets to evaluate the strengths and weaknesses of these internal controls (segregation of duty-check and balances, IT security, cameras) in official documents filed with the SEC and to make regular disclosures concerning the viability of these controls and potential fraud or losses that may affect the company's financial position

Sarbanes-Oxley (SOX) Act of 2002

Outsourcing can what?

Save money

Is the chain of command ranging from the highest authority to the lowest rank

Scalar Chain

Most frequently used. It demonstrates a line organization in which the structure is characterized by a vertical flow of authority

Scalar Chain

These are high abuse potential and no accepted medical use in the US

Schedule I Drugs

Accepted medical use in the US, has high abuse & dependency potential.

Schedule II drugs

A separate key must be used to gain access to the ________ and another key is used to gain access to __________________

Schedule II drugs / Non-Schedule II drugs

Less abuse potential that schedule II

Schedule III drugs

Less abuse potential than schedule III drugs

Schedule IV drugs

Less abuse potential than schedule IV

Schedule V drugs

The facility must develop and implement written policies and procedures that prohibit Mistreatment, Neglect, Abuse, and Misappropriation of resident property. These policies and procedures must include 7 components outlined by OBRA

Screen potential employees Training Prevention Identification Investigation Protection Reporting/Response

Pre-employment procedures to ensure that workers are qualified to work; includes conducting extensive criminal background checks, viewing registration boards for clinical personnel in every state where the person is licensed or certified, and drug testing

Screening

A specialized housing subsidy program under the US dept of Housing & Urban Development that provided financing for construction of housing for low-income senior citizens & those with disabilities.

Section 202

What section on the Rehab Act of 1973 covers the rights of all individuals with disabilities?

Section 504

An affordable housing assistance program under the US dept of Housing & Urban Development that provides funds to landlords who designate a portion of their property for section 8 tenants & rental vouchers to individuals who then select their own housing

Section 8

SEC

Securities and Exchange Commission

The job description (position description) can be used to ?

Select Train Evaluate Compensate Employees

Can be a productive component of a performance appraisal system. It is not for everyone. Some employees may be intimidated by it

Self Appraisal

The desire to become more & more of what we are & to become everything that you are capable of becoming

Self-Actualization

The # after the title may indicate the level of the position in the organization. Higher numbers usually mean what?

Senior Level Positions

Incorporates therapies that stimulate the senses in patients with dementia or in those in comatose or vegetative states

Sensory stimulation

Drugs used for external purposes must be stored ______ from drugs used for internal purposes

Separately

Schedule II drugs must be ____________ locked.

Separately

Facility must provide ______________ and ______________ for storage of controlled drugs listed in Schedule II of the Comprehensive Drug Abuse Prevention & Control Act of 1976 & other drugs subject to abuse

Separately locked Permanently affixed compartments

The changes OBRA brought to nursing home care are enormous. Some of the most important resident provisions include: New opportunities for potential & current residents with mental retardation and mental illnesses for

Services inside and outside of a nursing home (PASARR)

What does the attitude of the organizations' CEO do?

Sets the tone for the rest of the employees

Employers must not ask questions that might be construed as violating the Civil Rights Act, Title, & or the Americans with Disabilities Act. DO not ask questions related to

Sex Age Race National Origin Education Religion Arrest & Conviction Records Marital Status Credit Rating Disabilities

It is unwelcome sexual advances, demands, or requests for sexual favors, or other conduct of a sexual nature

Sexual Harrassment

Under the Civil Rights Act of 1964, ______________ is a form of sex discrimination

Sexual Harrassment

Obvious symptoms of Parkinson's Disease include:

Shaking Rigidity Slowness of movement Difficulty walking unstead gait

Setup to ensure businesses do not monopolize

Sherman anti-trust act

Can be sold, liquidated, or converted to cash to pay liabilities within 1 year

Short-term asset

Include securities bought and held for sale in the near future to generate income on short-term price differences (trading securities)

Short-term investments

One that causes a resident discomfort, or jeopardizes his health & safety or a medication error rate >5%

Significant Medication Error

Suggested parameters for evaluating significance of unplanned and undesired weight loss. 6 month

Significant loss 10% Severe loss >10%

Suggested parameters for evaluating significance of unplanned and undesired weight loss. 1 month

Significant loss 5% Severe loss > 5%

Suggested parameters for evaluating significance of unplanned and undesired weight loss. 3 month

Significant loss 7.5% Severe loss >7.5%

What makes a isolation room?

Single occupancy Ventilated to the outside Negative air flow pressure Private toilet Hand washing facilities Identified by signs when in use

Concerned with the outcome or consequences of an action in which the ends can justify the means.

Situational Ethics

Facilities that provide medical, nursing, or rehabilitative services on an inpatient basis

Skilled Nursing Facilities

Capable of organizing resources & finances available to best meet the needs of the resident

Skilled administrator

Documentation must be done daily for residents on ____________

Skilled services

Physiological

Skin loses elasticity, bruises & tears easily, wrinkles, decline sense of taste & smell, problems with balance, depressed immune system, some loss of hearing, Parkinson's disease, dementia, strokes, & incontinence

Oral/verbal defamation is __________

Slander

Increased pension protection & makes it easier for workers to roll over (change to another fund or plan) their retirement savings upon changing employment

Small Business Job Protection Act of 1996

The fire alarms must automatically be activated by __________ and ____________

Smoke & fire

Battery operated __________________ must be installed in resident's sleeping rooms and public areas by May 24, 2006`

Smoke detectors

The facility must offer _________ at bedtime daily

Snacks

Caring for residents with C-Diff, employees must use what to clean hands?

Soap and Water

Need for love & belonging (friendship, intimacy, & family)

Social Needs

A federal government program that pays benefits to senior citizens & certain other individuals.

Social Security

It often serves as the primary source of retirement income for low income elderly persons

Social Security

Is a program that provides block grants for social services. These grants are fixed amounts of funding given to states for various purposes, including community based care for the elderly & disabled

Social Security Act created by Title XX

Old age insurance policy

Social Security Act of 1935

Indirectly responsible for the NH industry as it exists today

Social Security Act of 1935 aka Old Age Insurance

3 most common sources of retirement income

Social Security Benefits Employee pensions Personal savings

The employer is required/mandated also to pay a certain share of what?

Social Security taxes (per the Social Security Act of 1935) 50%

____________ is the oldest form of ownership

Sole Proprietorship

Unincorporated business ownership by one person

Sole proprietorship

A balance sheet or statement of financial condition reflects the firm's

Solvency (Ability to Pay)

Palliative care extends the principles of hospice but begins at an earlier point in the disease process, and accepts that

Some curative therapies may be appropriate even though the patient has been diagnosed with a fatal disease

Residents have the right to retain and use personal possessions including:

Some furnishings, appropriate clothing, as space permits, unless to do so would infringe upon the rights or safety of other residents

The number of employees a manager is required to direct & control

Span of management or span of control

A managers should use ___________ when conducting appraisal interviews

Specifics

Focuses on Aphasia, Dysarthria, Apraxia, & Dysphagia

Speech Therapy

If Anthony has $1800.50 in his trust fund, what needs to happen to this balance and what purchases should be suggested to the family/responsible party/cognitive patients?

Spend down/purchase items

Protection to spouses of people receiving home & community based services

Spousal Impoverishment Protections

Pest control the facility can not use

Spray pesticides and must not use non-aerosol pesticides

Administrative assistant has ____________ authority

Staff (can not make decisions on behalf of the Administrator is only ADVISORY)

Dotted lines on org charts

Staff authority

Person with advisory role to the manager with no authority to make decisions for the organizations

Staff authority

If there is no apparent short-term effect on workflow, it is what?

Staff operation

______________ cannot attend the resident or family council meeting unless invited

Staff or administrator

Ensuring that the facility is staffed appropriately & staff have been trained on the care needed by the residents

Staffing

Outstanding check for over 60 days

Stale Check

Two common sources of carbohydrates includes:

Starches & Sugars

Who regulations water temperatures?

State

Nursing hours per resident day are established by

State & Federal approval

Dietary manager requirements are per ____________

State requirement

Residents have the right to send and promptly receive mail that is unopened and have access to ____________, ___________, and ________ at the resident's own expense.

Stationary Postage Writing implements

Law enacted by legislation

Statutory Law

Employer is required by law to provide what?

Statutory benefits

__________, __________, __________, and ___________ food in accordance with professional standards for food service safety

Store Prepare Distribute Serve

Acceptable Accounting Methods of depreciation:

Straight Line Sum of the digits Declining Balance

Depreciation method which historical cost of an asset is spread evenly over its useful life

Straight line depreciation

The long-term planning process by key stakeholders in which the organization's goals, measurable objectives, & direction for the immediate future are determined

Strategic planning

Violence in the workplace is often a result of what?

Stress

An organized work stoppage orchestrated by a union

Strike

Department managers who want to personally become involved in checking applicant references should be what?

Strongly discouraged or forbidden to do so

Performance appraisal is a ____________ event

Structured

An institution cannot designate a distinct part SNF or NF, but instead must

Submit a written request with documentation that demonstrates it meets the criteria set forth to CMS to determine if it may be considered a distinct part

Involves preparing a single, designated successor

Succession planning

What type of planning is critical to success of any organization?

Succession planning

A symptom exhibited by some people with Alzheimer's or other dementias characterized by confusion, anxiety, and agitation in the early evening or into the night

Sundowning

What does decision making authority do?

Supervisor hires Fires Makes judgmental evaluations

What does staff operations do?

Support & enhance the work of an organization by making it possible to continue producing products or delivering services as intended.

Indirect costs are also known as:

Support Service Costs

Facility must purchase a _____________ to assure the security of personal funds deposited i the resident's trust fund

Surety Bond

An agent who acts on behalf of a patient who lacks the capacity to participate in a particular decision

Surrogate Decision Maker

Examples of speech therapy include:

Swallowing Chewing Communicating

HR should be available to minimize undesirable occurrences to an organization through the what?

Systematic Identification of Potential problems

The simplest account structure is shaped like the letter

T

Each general account has _______________

T-account (debit & credit side)

TC (Total Cost)=

TFC (total fixed cost) + (VC per unit x volume units)

TC (Total cost)=

TFC + (VC per unit x volume units)B

Continously improving the quality of products & processes

TQM (Total Quality Measurement)

A philosophy of total organizational involvement in improving all aspects of quality of service

TQM/CQI

Break even is where

TR (Total Revenue=Total Cost)

What changes with volume?

TVC (Total variable costs)

Used when a energy source is not capable of being locked out

Tagout Device

Used when an energy source is not capable of being locked out. A prominent warning device such as a tag that can be easily fastened is attached.

Tagout Device

Contain various subclasses, including current assets & fixed assets.

Tangible

________________ are those that have a physical substance and can be touched. Such as currency, buildings, real estate, vehicles, inventories, equipment, and precious metals

Tangible Asset

Most common employee problem is?

Tardiness to work

A difficult to treat and often incurable disorder resulting in involuntary, repetitive body movements,

Tardive Dyskinesia

A coordinated and aggregated series of work elements used to produce an output?

Task

A weakness is the inevitable difference that exits among individuals

Team appraisal

The delivery of health related services & information via telecommunication technology

Telehealth

The practice of using technology, such as computer or telephone, to monitor the medical condition of a patient from a long distance or consult with colleagues in different locations

Telemedicine

Items and services that may be charged to the resident's fund IF they are requested by resident, the facility informs the resident of a charge, or payment is not made by MCR and MCD

Telephone Radio Smoking items Novelties Cosmetics Flowers Plants Personal clothing Private room

TTY

Telephone Text

Residents have the right to privacy while making a

Telephone call

T

Temperature

A person who dies with a will

Testate

Facilities should ensure residents do not receive psychotropic drugs pursuant to a PRN order unless

That medication is necessary to treat a diagnosed specific condition that is documented in the clinical record

________________ mandates nursing homes implement corporate compliance and ethics programs

The Affordable Care Act of 2010

Calls for denial of payment under MCR and MCD to facilities charged with abuse and mistreatment of patients. It also directed the states to establish nurse aide registries

The Balanced Budget Act of 1997

Who administers & enforces Title III of the Consumer Credit Protection Act?

The Department of Labor Wage Hour Division

Sets minimum funding levels for pension funds (also called vesting)

The Employee Retirement Income Security Act of 1975

Responsible for establishing & implementing policies in the nursing facility

The Governing Body

Taft-Hartley Act of 1947 is also known as

The Labor Management Relations Act

The separate Federal Nursing Home Reform Act along with many other separate bills was rolled into one bill to insure final passage of all the elements is?

The Omnibus Budget Reconciliation Act of 1987 or OBRA '87

Who ensures that the automatic control valve on the water heaters are checked regularly?

The administrator

Blue prints on the building & any renovations must be kept for inspection by who?

The agency that monitors LSC (Life Safety Code) compliance

Every state's unemployment system bases the employer's tax rate on?

The amount of benefits paid to former workers

The SNF must inform residents in advance of their option to make bed-hold payments, as well as

The amount the facility charges

The IDT (Interdisciplinary Team) includes but not limited to:

The attending physician A RN with responsibility of the resident CNA with responisibility for the resident A member of Food & Nutrition Service Staff Representative of the resident

Objective evaluations of employees should not include

The attitude of the supervisor toward the employee

Administrators has the power from ____________ or ____________ to tell employees what to do & to expect them to do it

The board or owner

Hospice provider also bill Medicare Part A for services rendered, hence the reason that you can NOT skill someone that is on Hospice UNLESS

The diagnosis is different or NOT related to the Hospice diagnosis

What should the facility do with information on how to apply for Medicaid & Medicare benefits?

The facility must prominently display the written information Provide to the residents and applicants for admission either orally or written Include information on receiving refunds for previous payments covered by these benefits

If an employee accepts COBRA after they leave they are required to pay?

The full insurance premium

Is the policy making arm of the organization & has legal & fiduciary responsibility for how the organization functions. Responsible & accountable for ensuring that an ongoing QAPI program is defined, implemented, & maintained & addresses identified priorities.

The governing body

Long term care continuum has 3 major subsystems

The informal system The community based system The Institutional System

The facility must inform each resident who is entitled to Medicaid benefits, in writing, at the time of admission to the nursing facility or when the resident becomes eligible for Medicaid of

The items and services under the State plan and for which the resident many not be charged Those other items and services that the facility offers and for which the resident may be charged, and the charges for those services Inform each resident when changes are made to the items and services listed above

Cost of expenses account purchased one month is expensed over

The next several months

Medication error:

The observed medication administration of drugs does not comply with physician orders The administrator's primary focus is on the effect on the resident Report to physician IMMEDIATELY Accidentally giving a dehydrated patient a diuretic is a significant medication error

In the case of an a resident adjudged incompetent under the laws of a state by a court of competent jurisdiction, the rights of the residents are exercised by

The person appointed under state law to act on the resident's behalf

Job ID must include:

The position title The department location Last date on which the content of the position description was verified It could include title of the supervisor to help show how the position fits within the organizational structure

A resident has the right to refuse transfer to another room within the institution if

The purpose of the transfer is to relocate a resident of a SNF from the distinct part of the institution that is a SNF to a part of the institution that is not a SNF A resident of the NF from the distinct part of the institution that is a NF to a distinct part of the institution that is a SNF

Records of serious work-related injuries & illnesses help employers, workers, & OSHA evaluate what?

The safety of a workplace Understand industry hazards Implement worker protection to reduce & eliminate hazards Prevent future workplace injuries & illness

ANSI (American National Standards Institute) and ADAAG (ADA Accessibility Guidelines) are both what?

The same

Skilled nursing facilities participating in MCR must meet certain specified requirements and the __________ may impose additional requirements if necessary for the health and safety of individuals to whom services are furnished in the facilities

The secretary

If the automatic control valve of the water heater malfunctions, what could happen?

The water temperature could rise sufficiently and burn resident

Most business managers believe that employees naturally dislike work, prefers to receive extensive direction from superiors, wishes to avoid taking responsibilities in the organization, has little ambition, & is motivated more by a need for security than any other factor. REQUIRES MANAGERS TO USE FEAR OR PUNISHMENT TO MOTIVATE EMPLOYEES

Theory X

Opposite of Theory X & more positive

Theory Y

Tends to promote stable employment, high productivity, high employee morale & satisfaction. It applies to motivating employees, 7 situational leadership theories align easily

Theory Z by William Reddin

A person requires the Heimlich Maneuver if:

They cannot breathe, cough, or speak They make high pitch sounds when they breath Lips and nails turn blue

An intermediary pays for the legal obligations incurred by residents?

Third party Payer

Concept used by financial planner to describe the 3 most common sources of retirement income Social Security Benefits Employee pensions Personal savings

Three-legged stool of economic security

The 3 most important factors in fire prevention & control planning are:

Time Smoke Closed Door

Overtime is paid at ______ and ______

Time & a half

The interval covered by the financial reports, usually 1 year

Time period concept (Accounting Period)

______________ sets minimum standards for participation in the MCR & MCD programs that must be met by all facilities regardless of location

Title 42

Primary purpose of Life Safety Code is to what?

To ensure there is a reasonable degree of safety to protect people from fire & related hazards in public facilities.

The primary purpose of a performance appraisal is what?

To improve employee performance in the present job

Unemployment insurance system was designed with two major goals in mind

To provide workers that lose their job through no fault of their own with weekly checks To promote economic stability by rewarding those employers who minimize their workforce turnover, and by maintaining the flow of dollars through the economy even when there is widespread unemployment

With a organizational chart in a small organization, top management will be able

To see what is happening

Administrator (or corporate) alone prepares the annual budget with little or no guidance from department heads

Top down approach

Two method of budget preparation:

Top down approach & Participatory approach

A wrong or literally means "twisted". Exists when plantiff is harmed as a direct result of breach of duty. Facility fails to provide care to residents causing harm to the residents.

Tort

TC

Total Cost

Cost per patient day =

Total annual operational costs / total patient days for the year

Working capital (Net current Assets)=

Total current assets minus total current liabilities

ALOS (Average length of stay)=

Total patient days in the year divided by number of admissions in the year (or month)

An approach that leaders use to ensure the organization will have the best possible chance to survive & grow in the future

Training

Facilities must have a __________ with a hospital

Transfer Agreement

Facilities must have a written transfer agreement with one or more hospitals approved for participation under the Medicaid & Medicare programs

Transfer agreement

Symptoms of Parkinson's disease include

Tremor or trembling, of any of the limbs while at rest, rigidity or muscle stiffness, and bradykinesia

TF

Trust fund

The termination of employment, which can be voluntary or involuntary

Turnover

Employees that are often ignored or taken for granted contribute to what?

Turnovers

Schedule II drugs include:

Tylenol Codeine

A therapeutic diet must also state ________ and _________ of the diet

Type & consistency

It is the most common form of catheter-related infections

UTI or Urinary Tract Infection

What accounts for 30% of all nosocomial infections?

UTI or Urinary Tract Infection

Satisfied employees leaves most often due to feeling _____________ and _______________

Underused Under appreciated

Adverse Event

Undesireable experience associated with the use of a medical product

Employees that are laid off must be reported to the state so they can receive what?

Unemployment Compensation

Concerned with donation of one's body or body parts at time of death

Uniform Anatomical Act

Established the standards by which federal agencies determine acceptability of validation procedures used for written tests & other selections, has become the handbook for decision making in HR

Uniform Guidelines on Employees Selection procedures

running anti-organizing campaigns, conducting negotiations, and administering contracts...what are these?

Union related activities

The most cost and time efficient method of passing medications is to use the __________. This will decrease medications errors.

Unit dose method (pill punch packet)

Emphasizes the importance of each person being accountable to only 1 supervisor

Unity of command

An approach to infection control that assumes that all human blood and certain bodily fluids are to be treated as if they are infectious for HIV, HBV, and other bloodborne pathogens

Universal Precautions

Means of egress must be ___________ at all times & resident's doors must lead to a corridor with a exit

Unobstructed

The basis of Maslow's theory of motivation is that human beings are motivated by

Unsatisfied needs, and that certain lower needs need to be satisfied before higher needs can be addressed.

Employees are unlikely to remain loyal or maintain their employment if they feel what?

Unwelcome Excluded Or think they have few opportunities to excel

Section 703 of TITLE VII & the EEOC defines sexual harassment in employment as unwelcome sexual advances, requests for sexual favors, & or other verbal or physical conduct of a sexual nature when this conduct explicitly or implicitly affects an individual's work performance; or creates an intimidating, hostile, or offensive work environment. Sexual conduct is only illegal when?

Unwelcomed by the victim

Pain assessments must be completed upon __________, ___________, and ___________

Upon admission Quarterly As needed

The resident or his legal rep has the right after receipt of his or her records for inspection, to purchase at a cost not to exceed the community standard photocopies of the records or any portions of them when?

Upon request and 2 working days advance notice to the facility

Resident or legal rep can request copies of medical record when?

Upon request and two working days advanced notice to facility (which would be by day 3)

A written fire safety plan provides the following:

Use of alarms Transmitting of alarm to fire dept Response to alarms Isolation of fire Evacuation of immediate area

W-9

Used to setup new vendors for tax purposes (A/P)

The number of years the item can be expected to be used

Useful life of an asset

TVC (Total variable costs)=

VC (Variable Cost) per unit x volume units

What does not change with volume?

VC (Variable cost)

TVC (total variable cost) is

VC (variable cost) per unit x volume units

A person's belief that he or she is actually living in the past is accepted & validated by the staff members working with the patient

Validation therapy

Schedule IV drugs include:

Valium Diazepam

Amount of insurance required =

Value of building x coinsurance percentage

The _____________ that is lost while a position remains vacant can cost a lot

Value of output

VC

Variable Costs

Varies according to to volume such as dietary food, supplies, etc

Variable Costs (VC)

A written contract is required for all _______________ such as lab, x-ray, dental, audiology

Vendor Services

Types of abuse:

Verbal Sexual Physical Involuntary seclusion Mental

Pertaining to abuse residents have the right to be free from

Verbal Sexual Physical Mental Abuse Corporal punishment Involuntary seclusion

Progressive Discipline is

Verbal-written-final-termination

One disadvantage of ERISA rules are

Very demanding & many employers choose not to offer pension plans

Redundant cueing of residents combines _________ with music

Visual

The purpose of the ANSI (American National Standards Institute) regulations was to make building accessible to and useable by the ___________ and _____________ handicapped

Visually & Physically

Act to control certain body functions and regulate the body's utilization of other foods

Vitamins

Used in replacement therapy

Vitamins

__________ and ___________ are the most common classes of medication Rx to the elderly nursing home residents

Vitamins & Minerals

Any waivers or release of age discrimination must be _________ & part of an understandable, written agreement between employer & employee.

Voluntary

Medicare Part B is ______________

Voluntary

Intentional killing of another person

Voluntary Manslaughter

Managers can not be involved in decertifictaion of a union, and they can not what?

Volunteer info to employees about decertification

Could be held personally liable if he/she works outside his/her assignment/scope

Volunteer worker

It is okay for ___________ in the activity department to handout mail and it also shows active community involvement

Volunteers

Fair Labor Standards Act (FSLA) also known as?

Wage & Hour Act

Should be based on merit increase, depending upon the quality of work the employee performs

Wage Evaluation Program

The EEOC (Equal Employment Opportunity Commission) was created by?

Wagner Act in 1935

The act by a person with dementia of walking, riding, or driving off supervised, leading to a potentially dangerous situation

Wandering

Walking around aimlessly, in and out of rooms and outside of the building, with little or no awareness of potential dangers

Wandering

Example of emetic includes:

Warm salt water

Dish washing 3 step process

Wash Rinse Sanitize

Low temp dishwasher temps:

Wash 120 degrees Final rinse 50 pp, hypochlorite on dish surface in final rinse

High temp dishwasher temps:

Wash 150-165 Degrees Final rinse 180 degrees

Class A fire extinguishers are _______ based

Water

Class C (Electrical) & __________ can never be used together because it conducts electricity & may injure the person using this

Water

The best form of protection against bloodborne pathogens is

Wearing latex gloves and use proper handling techniques

Generators must be started at least how often?

Weekly

It is legal to ask an applicant is they are a citizen of the United States, however it is illegal to ask what?

What country they are a citizen.

Performance appraisal reminds employees

What employers expect of them

You cannot ask a applicant their native language, but you can ask what?

What languages they speak & write fluently

What information does MDSD or SDS give?

What to do if there is a spill Contact with eyes, skin, etc. What to wear proper PPE Compounds in chemical Where to store the chemical Emergency telephone number

Reasonable accommodations must be made by an employer for an applicant with a disability, except

When the accommodations would impose undue hardship or unreasonable expense on the operation of the business

Facility must notify each resident that receives MCD benefits:

When the amount in the resident's account reaches $200 or less than the SSI resource limit ($2000) for one person If the amount in the account, in addition to the value of the resident's other nonexempt resources, reaches the SSI resource limit ($2000) for one person, the resident may lose eligibility for MCD or SSI

A resident may approve or refuse the release of personal & clinical records to any individual outside the facility except

When the resident is transferred to another health care institution or record release is required by law.

The fire safety code specifies what?

Which materials must be 2 hour & 1 hour fire-resistant or less

A person who reports corruption & criminal & unethical business practices in the workplace to appropriate government authorities

WhistleBlower

Bequest of real/personal property effective at the death of the testor

Will

Nursing homes must report to the manufacturer (FDA if manufacturer is unknown) within how many days after the incident or incidents in which the medical devise causes serious injury?

Within 10 work days of becoming aware

Employers must report any worker fatality within how long?

Within 8 hours

Employees should not have to pay for injuries that occurred at work, this is called

Worker's Compensation

What has the government mandated as a statutory benefit?

Workmen's Comp

Firing or laying off an employee for illegal reasons in violation of existing civil law

Wrongful termination

The FUTA tax is imposed at a single flat rate on the first $7,000 of wages that you pay each employee. Once an employee's wages for the calendar year exceed $7,000

You have no further FUTA liability for that employee for the year

______________ affect your tax rate in unemployment insurance. This is one of the few times in life when you can influence your tax rate by ______________

Your actions

Break even in days =

[FC/(Revenue - VC)] x # of patient days in the period

Break even in days=

[FC/(Revenue-variable cost)] x number of days in the period

Perpetual Inventory System is recommended to maintain and accurate count of inventory on hand (an accurate count of supplies used and those remaining in the storeroom). A Bar Coding System is often used for this purpose. It involves keeping

a daily record of supplies received, issued, and left in inventory

There must be no more than 14 hours between a substantial evening meal & breakfast the following day, except when

a nourishing snack is provided at bedtime

Threshold

a strip of wood, metal, or stone forming the bottom of a doorway and crossed in entering a house or room.

cerebrovascular accident (CVA)

a.k.a. "Stroke". Lack of blood supply to the brain causing brain damage

Food danger zone temp range

above 41 degrees and below 135 degrees that allow the rapid growth of pathogenic microorganisms that can cause foodborne illness

AROM

active range of motion

Facility must record and periodically update the __________ and ___________ of the resident's legal rep or interested family memeber

address/phone number

The success of the NH depends directly on

adequate staffing

The facility must ensure that all alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source, and misappropriation of resident property are reported immediately to the

administrator of the facility Other officials in accordance with state law through established procedures (including to the state survey & certification agency)

pc

after meals

palatable

agreeable to the taste

The resident has the right to ________ any discharge

appeal

AHD

arteriosclerotic heart disease

The facility must ensure that the resident environment remains

as free of accident hazards as is possible and each resident receives adequate supervision & assistance devices to prevent accidents

PRN

as needed

prn

as needed

Administrator is to ensure all employees make the right decisions for the organization as often

as possible

A resident who enters the facility with an indwelling catheter or subsequently receives one is

assessed for removal of the catheter as soon as possible unless the resident's clinical condition demonstrates that the catherization is necessary

The most important reason for depreciation is for

asset replacement

In "T" structure accountants record increase in __________, ___________, and _____________ on the debit side

asset, expense, and owner drawing accounts

ALF

assisted living facility

hs

at bedtime

Final cooking temp for grounds meat, ground fish, and eggs held for service

at least 155 degrees

ADC

average daily census

Percent of occupancy or occupancy rate=

average daily census divided by number of beds (Occupied beds divided by total beds)

In some cases, a resident may decline particular services or treatments that the IDT believes may assist him or her to attain the highest practicable level of well-being. In such cases, the resident's wishes should

be honored and documented in the clinical record and alternatives should be offered before the care plan is finalized

Daily staffing at the beginning of the shift must

be posted in a prominent place that is accessible to visitors and well as residents.

Decubitis Ulcer

bedsore

ac

before meals

BARS

behaviorally anchored rating scale

Risk Management is identifying and solving problems before they get out of hand, preventing _____________________

being sued

non-cancerous

benign

Twice per day

bid

Hematuria

blood in the urine

BP

blood pressure

Cyanosis

bluish discoloration of the skin

Patients with osteoporosis are at risk for

bone breaking in falls

Unlike some other payroll taxes, the ___________ must pay the FUTA tax

business

po

by mouth

Pay back period

calculated by dividing purchase price by how much will new purchase reduce annual operating costs per year

It is the most liquid asset, which includes currency, deposit accounts, and negotiable instruments (money orders, checks, bank drafts)

cash and cash equivalents

Types of current assets:

cash and cash equivalents, short-term investments, receivables, inventories, prepaid expenses

CNS

central nervous system

CVA

cerebrovascular accident (stroke)

COTA

certified occupational therapy assistant

Checking performance & taking corrective action, with planning you constantly ____________, ___________, & ____________ the plan as necessary

check recheck modify

COLD

chronic obstructive lung disease aka COPD

COPD

chronic obstructive pulmonary disease

Liabilities + Capital is

claims on resources

Social worker should assist resident & family to use

community resources

Paid feeding assistants cannot feed anyone with

complicated eating disorders such as swallowing difficulties & aspiration problems

Records are

confidential

If you allow consultants to discipline your staff, it is

confusing & a big concern & it leads to role ambiguity

CCRC

continuing care retirement community

CQI

continuous quality improvement

The resident's bedrooms must have direct access to a

corridor

If a business owner losses $5000 of the company's cash while gambling, the cash account, which is an asset, must be ___________ for $5000

credited

Working capital=

current assets - current liabilities

current ratio=

current assets/current liabilities

Resident's bedroom must be cleaned

daily

Each general account has a T-account _________ is left side and ________ is right side

debit/credit

Per the teachings of Abraham Maslow there are general needs which have to be fulfilled before a person is able to act unselfishly. These needs are dubbed?

deficiency needs

Neuritis

degeneration lesion and inflammation of nerves

Osteoarthritis

degenerative joint disease

Osteoarthritis is also called

degenerative joint disease

Ultimate responsibility can not be

delegated

5 stages of grief

denial, anger, bargaining, depression, acceptance

If the dietitian is not employed on a full time basis, the facility must

designate and employee to manage the food service department

In the case of an a resident adjudged incompetent under the laws of a state by a court of competent jurisdiction, the adjudged resident has the right to

designate the representative

advanced directive (living will)

details the conditions under which life support measures should be used

Each resident has a right to self-administer drugs, provided that the IDT has

determined for each resident that this practice is safe & per physician order

The facility must provide equal access to care regardless of

diagnosis severity of condition payment source

Under a durable power of attorney, the authority of the attorney in fact and/or makes decision on behalf of the grantor continues until the grantor __________

dies

Under the common law, a POA becomes ineffective if its granter __________ or _____________ meaning unable to grant such power, because of physical injury or mental illness. Unless the granter has specified that the POA will continue to be active is the granter becomes incapacitated.

dies or becomes incapacitated

Aphasic

difficulty communicating

Dysphagia

difficulty swallowing

Dysphagia

difficulty swallowing (ST involved)

OBRA specifies the facility must ensure the resident's ADLs do not

diminish unless the resident's condition demonstrates that diminution is unavoidable

Cost associated with turnover could be _________ or _________

direct or indirect

Too many fringe benefits can be a _________

disadvantage

Facility must promptly within 3 days refer residents with lost or damaged dentures for dental services. If a referral does not occur within 3 days facility must

document what they did to ensure resident could still eat & drink adequately while awaiting dental services & the extenuating circumstances that led to the delay

gtt, gtts

drops

DPOA

durable power of attorney

Resident's bedroom must have privacy curtain for

each bed in a multiple-bedded room

ou

each eye

EKG

electrocardiogram

E.D.P

electronic data processing

All employees must be trained in

emergency procedures

Induces vomiting

emetic

Non-exempt employees

employees covered by the FLSA requirements for overtime pay & clock in

If the employee refuses the Hep B series upon hire, but wants it later, who pays for it?

employer as long as the employee is still occupationally exposed

When all debits and credits are totaled each month they should ___________

equal

The facility must have a Governing body (board of directors) or designated persons functioning as a governing body that is legally responsible for

establishing & implementing policies regarding the management & operations of the facility Appoints a licensed administrator who is licensed by the state where licensing is required & responsible for the management of the facility

Facility must complete a performance review of every nurse aide at least once

every 12 months

QH

every hour

____________ communication is the best method of communicating with employees

face to face

First step in developing a marketing program is to define the ______________ and ________________

facilities goals and objectives

S Corporations pay no ____________

federal income taxes

Once the receiver decodes the message, the receiver will send ____________

feedback (verbal or non-verbal)

FUO

fever of unknown origin

FIFO

first in first out (In case of deflation)

FI

fiscal intermediary

Fx

fracture

Facilities must ensure that the environment is _________ of accident hazards

free

FTE

full time equivalent

GDR

gradual dose reduction

Resident's bedroom must have a floor at or above

ground level

ss

half

Residents, family, or resident rep should be invited to participate in team discussions in an ongoing manner, and be encouraged to share their perspectives on the delivery of care. This can be accomplished by

having individual team members discuss preliminary care plan ideas with the resident, family, or resident rep in order to get suggestions, confirm agreement, or clarify reasons for developing specific goals and approaches

Arteriosclerotic Heart Disease

heart disease caused by hardening of the arteries

Hypertension

high blood pressure

If fire occurs, _________ on duty is in charge until firemen arrive

highest ranking person

HPPD

hours per patient day

Low body Temperature

hypothermia

SOS

if necessary

Face to face communication allows the administrator or supervisor to confirm

if the employee understands

While a person is motivated to fulfill basic needs and desires, they continue to move towards growth, and eventually self-actualization. The satisfaction of these needs is quite healthy while preventing gratification makes us

ill or act evilly

Discrimination on the basis of race or national origin is what?

illegal

stat

immediately

An effective supervisor is one that who establishes a reputation of ___________

impartiality

Dysarthria

imperfect articulation of speech (Involve ST)

Cholinesterase Inhibitors are beneficial if used

in early stages of Alzheimers

Residents have the right to share a room with his or her spouse when marries residents live

in the same facility and both spouses consent to the arrangement

Aphasia

inability to speak or form language (ST involved)

Drying food preparation equipment & utensils with a towel or cloth may

increase risks for cross contamination

Change is _________

inevitable

ICP

infection control practitioner.

Arthritis

inflammation of a joint

Myocarditis

inflammation of the heart muscle

Nephritis

inflammation of the kidney

gatritis

inflammation of the stomach

Phlebitis

inflammation of the walls of a vein

IDDM

insulin dependent diabetes mellitus

Fraud is ______________ deception that results in injury to another

intentional

The facility must have evidence that all alleged violations are thoroughly

investigated, and must prevent further potential abuse while the investigation is in progress

Staff or visitors may attend resident groups if

invited by group

KUB

kidneys, ureters, bladder

Anemia

lack of a normal number of red blood cells

LIFO

last in first out (In case of inflation)

os

left eye

With sole proprietorship there is no ____________ between the business and the owner as entities.

legal distinction

In "T" structure accountants record increase in __________, ___________, and _____________ on the credit side

liability, revenue, and owner's capital account

With a LLP or limited liability partnership the partners are not ___________ for partnership debts beyond the amount of funds contributed.

liable

Administrator has _____________ from governing board

line authority

Acid-test ratio=quick assets/current liabilities. Quick assets can be converted to cash quickly, such as AR. If the answer is greater than 1 the company is safe. Reflects the ____________ of the assets

liquidity

Anorexia

loss of appetite

A patient with dementia cannot

make informed decisions

cancerous

malignant

MBO

management by objectives

Administrator must be licensed by the State & responsible for

management of the facility

Peritoneum

membrane that lines the abdominal cavity

A common misconception about the aging process is

memory loss to the brain decreasing in size

There must be a ___________ for communication to occur

message

MRSA

methicillin-resistant staphylococcus aureus

DON & Dept heads are considered _______ management

middle level

Daily staffing sheets have to be kept for

minimum of 18 months

Drug regimen review must be done on each resident at least ______________

monthly

The higher the contribution margin the

more profitable the company is

As depicted in the Maslow's Needs Pyramid when a need is satisfied it no longer

motivates & the next higher need takes its place

NORC

naturally occurring retirement community

Residents whose care is funded by Medicaid the facility must deposit resident's personal funds in less than $50 in an

non interest bearing account, interest bearing account, or petty cash fund

NIDDM

non-insulin dependent diabetes mellitus

In a MCR facility Funds less than $100 must be maintained in an:

non-interest bearing account, interest bearing account, or petty cash fund

Pressure ulcers are sometimes ___________ in certain disease states

non-preventable

Chopping boards must be

nonporous

A resident that enters the facility without an indwelling catheter is

not catharized unless the resident's condition demonstrates that catherization is necessary

Replacement therapy is used when

not getting enough from food source

Quarterly assessment must be completed

not less frequently than once every 3 months

NPO

nothing by mouth

Turnover rate in percent =

number of employees terminated x 100 divided by total FTE (full time equivalent) or number of positions the facility has divided by the # of employees who leave in a given period.

HPPD (hours per patient day)=

number of hours worked divided by number of patients

OT

occupational therapy

ung

ointment

MCD & private pay patients comprehensive assessment must be completed not less than

once every 12 months

For every debit entered, there is _____________ credit entries that equal the debit

one or more

A distinct part SNF or NF may be comprised of

one or more buildings or designated parts of the building

People centered environments focus on ___________ and not __________

output / pace

Productivity =

output/input

OTC

over the counter

OTC

over the counter drugs (Non-Rx drugs)

quadriplegia

paralysis of all four limbs

Hemiplegia

paralysis on one side

ppm

part per million

PROM

passive range of motion

Intangible assets include:

patents, trademarks, copyrights, franchises, goodwill, computer programs, and financial assets including accounts receivable, stocks, and bonds

The Federal Unemployment Tax Act or FUTA imposes a _____________ on employers, based on the wages they pay their employees

payroll tax

With sole proprietorship the owner is responsible for both ________ and ________ debts

personal and business

With sole proprietorship the financial activities of the business are kept separately from the proprietor's _______________ activities

personal financial

PPE

personal protective equipment

PTA

physical therapist assistant

Treat all substances containing blood as

potentially infectious

A resident can receive a second pneumococcal immunization, upon a

practitioners recommendation, five years after the first immunization and as long as that vaccine was administered before the age of 65

Rx

prescription

Inflation or deflation only means

price changing

Title 7

prohibits employment discrimination based on race, color, religion, sex, or national origin

A facility must __________ and ___________ the rights of each resident

protect and promote

Drug regimen review must include review of residents on

psychotropic drugs

P

pulse

PEARL

pupils equal and reactive to light

payback period =

purchase price/how much will new purchase reduce annual operating costs per year

Acid-test ratio=

quick assets divided by current liabilities

ROM

range of motion

MCD and private pay patients comprehensive assessments must be completed within 14 calendar days after admission, excluding

readmission in which there is NO significant change in resident's physical or mental condition

A signed employee handbook __________ should be retained as evidence that an employee has received & reviewed the handbook

receipt

RD

registered dietician (Dietary Consultant)

COBRA

regulations that give employees who lose their health benefits because of unemployment, the right to choose to continue group health benefits provided by their group health plan.

Under PPS, the facility should manage costs with the ______________ price

reimbursement

Emergency Dental Services. Facility must assist residents who are eligible & wish to participate to apply for

reimbursement of dental services as an incurred medical expense under the state plan

Injury of unknown origin is

reportable

the thing speaks for itself

res ipsa loquitur

RAI

resident assessment instrument (aka MDS)

A resident has the right to organize and participate in

resident groups in facility

If the generator goes out, the main focus is

residents on life support equipment

Nurses' station must be equipped to receive residents calls through a communication system from the

residents rooms, toilet, & bathing faiclities

R

respiration

Facility must use the services of an RN for at least 8 consecutive hours a day, 7 days a week. Unless, there is a waiver. If there is a waiver, it is subject to

review annually by the Secretary of the Department of Health & Humans services (DHHS)

od

right eye

Ownership equity is also known as

risk capital or liable capital

Facility must assist residents in obtaining __________ and ________ dental care

routine and 24-hour emergency

As long as a job meets the FLSA test professional, administrative, or executive it is a __________ exempt from overtime requirements of FLSA

salaried position

A physician may give a resident ____________ drugs

sample

The __________ send the message, which is decoded by the ____________

sender/receiver

Isolation rooms should not be

shared (not even with spouse)

During interviews, avoid what?

short-answer & open-ended questions Leading questions Writing during interview

SOB

shortness of breath

Each person who completes a portion of the assignment must

sign & certify the accuracy of that portion of the assessment

RN must ________ and ________ that the assessment is completed

sign and certify

For facilities constructed or reconstructed after November 28, 2016, each resident room must have a

sink & commode

Bradykinesia

slowness of movement

ST

speech therapy

Managers should always either _______________ or _____________ to ensure tasks have been completed effectively & efficiently

spot check or randomly audit

If a facility policy or procedure sets higher standard than the state or federal requirements, the facility will be held to that higher standard both at the

state & federal surveys & in courts of law

Comatose

state of unconsciousness

Nursing hours per resident day are determined by

state with federal approval

Paid feeding assistant must complete a ___________ and they must work under the supervision of a _____ or _________

state-approved training course RN or LVN

SWOT

strengths (Internal), weaknesses (Internal), opportunities (external), threats (external)

Nitroglycerin is administered

sublingually

Written order issued by the court to require the appearance of a person in the court

subpeona

OBRA requires facilities have ______________ nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessment and individual plans of care

sufficient

tab

tablet

TO

telephone order

Residents are more likely to participate in activities if

the activities are personally satisfying

PRN order for psychotropic drugs are limited for 14 days and can not be renewed unless

the attending physician or prescribing practitioner evaluates the resident for the appropriateness of that medication

Resident's room must have a call light that must reach

the bed (the best system is one that has to be turned off by the resident's bed)

A resident has the right to perform services for the facility when

the facility has documented the need or desire for work in the plan of care, the plan must specify the nature of the services performed and whether services are voluntary or paid, Compensation for paid services is at or above the prevailing rates Resident agrees to the work arrangement described in the plan of care

Each resident must be offered an influenza immunization October 1 - March 31 Annually, unless

the immunization is medically contraindicated or the resident has already been immunized during the time period

Each resident must be offered a pneumococcal immunization, unless

the immunization is medically contraindicated or the resident has already been immunized.

A resident has a right to examine the results of

the most recent survey of the facility conducted by federal and state surveyors and any POC in effect with respect to the facility

Substitutions for the four foods required are allowed as long as

the substitutions are comparable nutrients

Supervisors will direct employees to complete certain tasks, however it is the delegator's responsibility to ensure

the task is completed

Facility must use the services of an RN for at least 8 consecutive hours a day, 7 days a week. Unless,

there is a waiver.

An organization uses financial resources to acquire both

things (material resources) & people (human resources)

A resident has the right to voice grievances without discrimination or reprisal. Such grievances include

those with respect to treatment which has been furnished as well as that which has not been furnished & prompt efforts by the facility to resolve grievances the resident may have, including those with respect tot he behavior of other residents

tid

three times a day

Effective managers can devote _________ and ___________ to all subordinates

time & attention

New remedies that need to be applied to certified nursing homes that fail

to meet minimum federal standards

Negligence is a __________ and is intentional

tort (a civil wrong)

PPD (Cost per patient day)=

total costs in month divided total patient days in month

Current ratio (Current ratio or working capital ratio)=

total current assets divided by total current liabilities

TFC

total fixed cost

FTE (full time equivalent)=

total number of hours worked or budgeted divided by 40 (40 hour work week for full time employee)

Average Daily Census (ADC) =

total patient days divided by days in the month

TQM

total quality management

TR

total revenue

TVC

total variable cost

Assault DOES NOT require ____________

touch

Direct costs are ____________ to the cost object and indirect costs are _____________ to the cost object

traced/allocated

TCU

transitional care unit

Administrators when confront with external changes that might affect the organization, will

try to ignore them

TB

tuberculosis

Sublingually

under the tongue

The facility should report any knowledge it has of actions by a court of law against an employee, which would indicate

unfitness for service as a nurse aide or other facility staff to the State nurse aide registry or licensing authority

Residents have the right to send and promptly receive mail that is

unopened

Facility must have reports with respect to any surveys, certification, and complaint investigations made respecting the facility during the 3 preceding years, and any POC in effect with respect to the facility, available for any individual to review

upon request

URI

upper respiratory infection

Levels of management

upper, middle, lower and line staff

UTI

urinary tract infection

VO

verbal order

vs

vital signs

qui tam relator

whistle-blower

WBC

white blood cell

s

without

Afebrile

without fever

Worker's compensation insurance only covers

work related injuries

A state program that provides healthcare to the medically indigent?

Title 19

Meals on wheels _____________ pays for home delivered meals

Title 3c of the older American Acts

Resident have the right to return to the ____________ after a hospital stay or an overnight visit with family and friends

Nursing home

As minimum standard, Long-Term Care Ombudsmen should view ________ as a baseline that should be built upon to reach not only resident "well-being" but also happiness and fulfillment.

OBRA

In its 1986 report the Quality of Care in Nursing homes, the expert panel recommended:

1. Stronger federal role in improving quality 2. Revisions in performance standards, the inspection process, and the remedies to improve nursing home services 3. Better training of nursing home staff 4. Improved assessment of resident's needs 5. A dynamic and evolutionary regulatory process

What set in motion forces that changed the way state inspectors approached all their visits to nursing homes?

OBRA

How many weeks of work are required for an employee to be eligible for unemployment benefits?

26 weeks

Because of OBRA antipsychotic drug use declined by __________ and physical restraint use was reduced by approximately ______________

28-36% 40%

With Medicare Part A skilled services, therapy must provide __________ days per week, g-tube, pressure ulcer treatment multiple stages 2, 3, or 4.

5

In Medicare Part B physicians are paid __________ of the approved charge

80%

Medicare limits inpatient respite care to stays to

<=5 consecutive days

The changes OBRA brought to nursing home care are enormous. Some of the most important resident provisions include: NF must notify the state mental health authority or state intellectual disability authority, as applicable, promptly after

A significant change in mental physical condition of a resident who has a mental disorder or intellectual disability for resident review

The Medicare & Medicaid legislation included those distinct advocacy roles and subsequent regulations and other guidance has given LTCOPs __________.

Additional tools to serve residents interests

The ___________ is the ONLY person held accountable for the entire financial operation of the facility or institution

Administrator

PACE (Program of All-Inclusive Care for the Elderly) is targeted at elders who are eligible for MCD and MCR funding to stay in nursing homes but prefer to

Age in the community. They can live in the community safely without 24 hour supervision

Telephones accessible to ______________ and privacy while using the phone, including TTY and TDD services

Bed-ridden patients

Continuity of care according to the need and cost of service rendered?

Case Mix Management

Uniform ________________ for Medicare & Medicaid homes

Certification Standards

CNAs must be __________ and ____________ in every state that they work

Certified & Registered

OBRA has changed the care of lives of nursing home residents across America. There have been significant improvements in the

Comprehensiveness of Care Planning

Amount of money Medicare recipients must pay for hospital service?

Deductible

The changes OBRA brought to nursing home care are enormous. Some of the most important resident provisions include: A resident assessment process leading to

Development of an individualized care plan

Observing _________ and ___________ administration are a focal point of every annual inspection

Dining & Medications

DME

Durable Medical Equipment

Prohibitions on turning to ______________ to pay for Medicare & Medicaid services

Family Members

Under OBRA, Long Term Care Ombudsmen Programs have defined roles to

Fulfill and tools to use in the annual inspection process to nurture the conversations between residents/families and inspectors and life in the nursing home

Given to persons believed to be at the end of their lives, with about 6 months or less to live.

Hospice Care

___________ from all disciplines assess residents needs.

IDT (Interdisciplinary Team)

IoM

Institute of Medicine

OBRA also recognized the unique and important role performed by the ___________ for nursing home residents

LTCOP (Long-Term Care Ombudsmen Program)

LTCOP

Long-Term Care Ombudsmen Program

The changes OBRA brought to nursing home care are enormous. Some of the most important resident provisions include: New expectations that each resident's ability to walk, bathe, and perform other activities of daily living will be

Maintained or improved absent medical reasons

Requires facility to provide an adequate dining area, large enough to accommodate comfortably the

Maximum # of people who usually occupy the space

___________ is the predominant payer source in NH

Medicaid (MCD)

A federal insurance program for the elderly (<=65 years of age) and some disabled (ESRD)

Medicare (MCR) Title 18

Hospice provider also bill __________ for services rendered

Medicare Part A

Which Medicare service plan is skilled services?

Medicare Part A

Pays for healthcare provided in home as well as Medicaid patients that have Medicare B

Medicare Part B

HMO/Managed Care

Medicare Part C

MDC medications for drugs (medication)

Medicare Part D

The Federal Nursing Home Reform or OBRA '87 creates a set of ________________ of care and rights for people living in certified nursing facilities

National Minimum Standards

Residents have the right to remain in the nursing home absent

Nonpayment Dangerous behaviors Significant change in resident's medical condition

A form of public assistance to the needy who were age 65 or older and lived in the community

Old Age Assistance (OAA)

Social Security Act of 1935. The purpose of this act was to provide a supplemental retirement income for working people and their dependents. It also provided

Old Age Assistance (OAA)

Administrator should get the ___________ involved when there is an involuntary discharged of residents

Ombudsman

Employers are taxed according to their:

Past records

The residents have the right to be free of unnecessary and inappropriate _____________ and ____________

Physical & Chemical Restraints

Residents have the right to choose a personal ___________ and to access medical records

Physician

Medicare part B pays for:

Physician Services Home Health Therapy Lab Enteral Feeding DME (Durable Medical Equipment) X-Ray

PACE

Program of All-Inclusive Care for the Elderly

MCD facilities are certified by the state and assigned a ____________ by the state

Provider Number

MCR facilities are certified by CMS and CMS assigns the ___________

Provider Number

A fundamental principle that applies to all treatment & care provided to facility residents

Quality of Care

According to OBRA '87 resident-care practices utilized by staff must reflect ____________ which promotes the highest practicable physical, mental, and psychosocial well-being of each resident utilizing sufficient to provide nursing & related services

Quality of Care

A fundamental principle that applies to all care and services provided to facility residents

Quality of Life

The changes OBRA brought to nursing home care are enormous. Some of the most important resident provisions include: Emphasis on a resident's

Quality of Life & Quality of Care

Congress asked the institute of medicine (IoM) to study how to better

Regulate the quality of care in the nation's Medicaid and Medicare certified nursing homes.

Provides relief to primary caregiver.

Respite Care

Residents have the right to choose their own ______________

Roommate

The purpose of this act was to provide a supplemental retirement income for working people and their dependents.

Social Security Act of 1935

Who gives finance assistance for disabled or elderly?

Social Security Administration

26 weeks of work are required for an employee to be eligible for unemployment benefits. ___________ employees should be terminated during the probationary period.

Substandard

What became a law with growing public concern with poor quality of care in too many nursing homes and the concerted advocacy of advocates, consumers, provider associations, and health professionals?

The Federal Nursing Home Reform Act

Congress, then and now, usually completes a huge measure of its budgetary and substantive work in one large bill. The bill accomplishing that function in 1987 was entitled

The Omnibus Budget Reconciliation Act of 1987 or OBRA '87

Employers that decrease its unemployment claims by employees will decrease its:

Unemployment tax cost

Minimum federal health and care requirements for nursing homes are to be delivered through

Variety of established protocols within nursing homes and regulatory agencies

Best practice is to have a case mix meeting _________ to review MCD RUGS or case mix index

Weekly

The first step in determining a resident's potential is

assessing the resident's needs

Inspectors no longer spend their time with staff and facility records, but with

conversations with residents and their families

IDT

interdisciplinary team

CNAs are not

licensed personnel

Residents have the right to organize and participate in a __________ or __________ council

resident or family

RUG

resource utilization group

Residents have the right to __________ or ____________ funds with the nursing home

safely maintain or bank personal

TDD

telecommunication device for the deaf


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