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NHA
Nursing Home Administrator Exam
171
Other
Not Applicable
05/20/2019

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Term
the 1960 Kerr-Mills Act expanded their program by providing funds for what purpose?
Definition
"medical care of the aged"
Term
life safety code
Definition
-all fire incidents shall be reported w/n 72 hrs
-drills should be held 4x a year
-national fire protection association
Term
resident room design
Definition
-beds 3ft apart & clear aisle space of at least 3ft.
-closet space 15''Wx18"dx5ftH
Term
universal precautions
Definition
-blood
-body fluids, secretion, & excretions (except sweat)
-non-intact skin
-mucous membranes
Term
four factors in the environment that are relevant for organizational goal setting and goal attainment.
Definition
-customers
-suppliers of labor, materials, capital, etc.
-competitors for both markets and resources
-regulatory groups
Term
grieving process
Definition
-denial & isolation
-anger
-bargaining
-depression
-acceptance
Term
destruction of medications
Definition
-destroy w/n 72 hrs of a dr's order to discontinue.
-no med may be held for more than 30 days unless an order is written every 30 days.
-destruction of a med must be witnessed, signed & dated by 2 or more ppl
Term
basic principles of fall prevention
Definition
-fall risk assessment at admission
-fall intervention programs for staff strategies to prevent falls (PT, treating vision & hearing impairment, managing footwear, etc.)
Term
standard precautions
Definition
-hand hygiene
-PPE
-safe injection practices
-safe handling of potentially contaminated equip or surfaces
-respiratory hygiene/cough etiquette
Term
mechanical systems rules
Definition
-hot water used by residents may not exceed 110-115 degrees Fahrenheit
-period C facilities shall have night lighting
-B&C facilities should have at least one elevator & 1 duplex outlet
Term
no resident may be involuntarily transferred or discharged for non-payment, of charges, if they meet both of the following:
Definition
-in need of ongoing care and treatment has not been accepted by another facility.
-the funding of the residents care is reduced or terminated because either the resident requires a level or type of care not provided by the NH.
Term
requirements for all medication systems
Definition
-locked & sore near nurses station
-temp no more than 85 degres F (29 degrees Celsius)
-controlled substances sep. locked
labeled with name, exp. date, & residents name
Term
waivers & variances rules
Definition
-must not affect the health, safety or welfare of any resident.
-is in the interest of better care management
-must be made in writing
-can be made at anytime
-if a notice of denial is not made within 60days of receipt of the request, it shall automatically be granted.
Term
contingency (reserve) supply of medication
Definition
-must not exceed 10 units of any med.
-held at nurses station under the care of a pharmacist
-quality assessment & assurance committee shall determine which meds and strengths to store there.
-a copy of the pharmacy communication order shall be placed in the unit when meds are removed
Term
procedures of admission
Definition
-physician order
-exam or eval w/n 48 hrs of admission. unless performed w/n 15 days before admission.
-initial care plan
-family resources & referrals
Term
how to prevent caregiver misconduct
Definition
-prevention
-training & comm. on misconduct
-encourage comm. betwn managers & staff
-managers must be approachable & very visible
-caregivers need a support system
-direct caregivers are the key to the success of your facility. invest in training.
-they need to understand their duty to report.
Term
locked unit
Definition
-prevents a resident from "living" the unit at will
-consent by court order or guardian.
-in emerg. no more than 72hrs & there must be a physician order w/n 12hrs.
-resident may give consent but for only 90 days and can be revoked by the resident.
Term
basic principles of palliative care
Definition
-provides relief from pain & other distressing symptoms
-integrates psychological & spiritual aspects
-enhance quality of life
-support system for family w/team approach
Term
rehabilitative services
Definition
-report to physician w/n 2 weeks if initiation
-rehabilitative services re-evaluated at least quarterly by Dr. & therapist
Term
transfer & discharge
-non resident be transferred or discharged from a facility except:
Definition
-request of a guardian
-non payment of charges, following reasonable opportunity to pay
-requires care other than what can be provided.
-medical reasons ordered by a physician
-short term care period has expired
Term
the three areas causing crisis in the nursing home industry are:
Definition
1. losses accrued due to Medicaid reimbursement issues.
2. a fast growing elderly population, combined with dwindling public finances.
3. staffing shortages
Term
transmission based precautions
Definition
1.contact-gloving/gowning-cleaning instruments & surfaces
2.droplet-use of surgical mask (influenza, pertussis, etc.)
3.airbone-require fit tested N-95 respirator (Tb, measles)
Term
basic principles of infection control
Definition
1.microorganism (causative agent)
2.reservoir
3.portal of exit
4.mode of transmission
5.portal of entry
6.susceptible host
Term
there are over "blank" vacant nursing position in nursing homes on a daily basis
Definition
100,000
Term
what year was the term "Nursing Home" created?
Definition
1936
Term
congress amended the SSA in "blank" to include section 1122. it allowed the federal govnt to withhold medicare & Medicaid funds from a hospital, nursing home or other health care facility if prior approval was not obtained from the official state health planning agency
Definition
1972
Term
dietary sanitation
(perishable food temp)
Definition
40 degrees F (4 degrees Celsius)
Term
turnover ratios exceed "blank" for all nurse staff positions and over "blank" for CNA positions.
Definition
50% & 70%
Term
nursing home quality improvement initiatives
Definition
CMS & health & human services compiles info about NH residents on 8 conditions or situations called quality measures, & makes the information available to consumers. (quality of care in nursing homes)
Term
"blank" does the certification and assigns the provider number of facilities.
Definition
CMS (centers for medicare and Medicaid services)
Term
chronic conditions
Definition
Conditions that persist over time. generally irreversible but must be kept under control.
(hypertension, diabetes, asthma, etc.)
Term
the payment for services at a flat rate depending on a diagnosis and without regard to the length of stay for a medicare patient, is a called a....
Definition
DRG or diagnosis related group
Term
"blank" are temporary modular homes that can be placed on single family property, perhaps in the back yard of a family member.
Definition
ECHO (elders cottage housing opportunity)
Term
closed system
Definition
EMPHASIZE INTER-RELATIONSHIPS BETWEEN THE VARIOUS INTERNAL COMPONENTS AND IGNORE THE EXTERNAL ENVIRONMENT. THE VARIOUS DEPTS WITHIN THE FACILITY WORK COHESIVELY, SUPPORT EACH OTHER AND DEVELOPE SYSTEMS TO IMPROVE QUALITY AND EFFICIENCY.
Term
embracing such programs as the "blank", as well as physical plants that incorporate neighborhood concepts and even near-revolutionary facilities is a current trend.
Definition
Eden Alternative
Term
name the two distinct types of managed care:
Definition
HMO: health maintenance organization
&
PPO: preferred provider organization
Term
the objective of the services offered in an "blank" is to maintain the optimal physical, intellectual, social, and/or vocational level at which the individual is presently or potentially capable of functioning.
Definition
ICF/MR
Term
"blank" is a facility whose primary purpose is to provide health and rehabilitative services for mentally retarded individuals or persons with relatedconditions.
Definition
Intermediate Care facility (ICF)-Mentally Retarded
Term
"blank" is a program that provides healthcare to the medically indigent(poor, needy)
Definition
Medicaid
Term
"blank" involves a means test to determine that "blank" services only go to the qualified need population
Definition
Medicaid
Term
"blank" is primarily operated by the state which handles the funds, licenses, and certifies facilities for compliance with federal/state standards.
Definition
Medicaid
Term
CMS determines eligibility for...
Definition
Medicare
Term
"blank" is essentially an insurance program for the elderly.
Definition
Medicare
Term
the state surveys "blank" facilities to determine compliance with federal/state standards.
Definition
Medicare
Term
the state Medicaid agency conducts a certification survey o "blank" facilities using essentially the same standards as for Medicaid.
Definition
Medicare
Term
in 1965 the SSA was amended to establish "blank" and "blank"; which is considered the biggest breakthrough for SSA.
Definition
Medicare and Medicaid
Term
all standard of "blank" are first approved by "blank".
Definition
Medicare; CMS
Term
all standard of "blank" are first approved by "blank".
Definition
Medicare; CMS
Term
what were the last two major stimuli for nursing home industry development?
Definition
Medicare; Medicaid
Term
what were the last two major stimuli for nursing home industry development?
Definition
Medicare; Medicaid
Term
the "blank" developed a "state health plan" guideline for reviewing the need for additional facilities based on population and health care facility statistics
Definition
SHPDA (state health planning and development agency)
Term
the primary purpose of "blank" & the state health plan was to prevent the overbuilding of health care facilities and the duplication of highly specialized, expensive equipment
Definition
Section 1122 of SSA
Term
"blank" is a nursing home that provides 24 hr/day skilled nursing services which cannot be provided in a facility other than a hospital
Definition
Skilled Nursing Facility(SNF)
Term
"blank" is a nursing home that provides 24 hr/day skilled nursing services which cannot be provided in a facility other than a hospital
Definition
Skilled Nursing Facility(SNF)
Term
is it true that the 1950 amendments to SSA required states to establish a standard-setting or licensing agency, so each state up an official state Medicaid agency
Definition
Yes. Federal/State standards were established to license several types of nursing facilities.
Term
is it true that the 1950 amendments to SSA required states to establish a standard-setting or licensing agency, so each state up an official state Medicaid agency
Definition
Yes. Federal/State standards were established to license several types of nursing facilities.
Term
medical nutrition therapy
Definition
a diet ordered by a physician as part of treatment for a disease, clinical condition, or to eliminate, decrease or increase specific nutrients in the diet.
Therapeutic diet
Term
period B facility
Definition
a facility or a portion of a facility that the plans for which were approved by the dept on or after July 1,1964, but no later than Dec 1, 1974
Term
extended survey
Definition
a federal survey conducted within 14 days of a finding of substandard care during a standard federal survey
Term
extended survey
Definition
a federal survey conducted within 14 days of a finding of substandard care during a standard federal survey.
Term
minimum data set (MDS)
Definition
a federally mandated resident assessment instrument used to assess resident physical, mental, emotional, cognitive, & functional limitations & strengths. It must be administered to all residents in medicare or Medicaid certified facilities at the time of admission. annually, quarterly & when a significant change in a residents condition occurs.
Term
environmental assessment
Definition
a formal analysis and evaluation of environmental trends to understand their potential implication for a facility's long term success.
Term
open system
Definition
a give and take with the external environment. the organization depends on the environment to receive essential input and it transforms those inputs and supplies outputs that benefit the environment.
Term
hypnotic medication
Definition
a psychoactive medication given to sedate or calm (seroquel,sonata,restoril,ambien)
Term
bedhold
Definition
a resident who is on leave or temporarily discharged to a hospital & expressed intent to return shall not be denied readmission.
-up to 15 days following the leave
Term
immediate jeopardy
Definition
a situation in which a providers non-compliance with one or more regulations has caused or is likely to cause serious injury, harm, impairment, or death to a resident.
Term
incidence
Definition
a type of CHRSA QI that provides a description of what has taken place with a resident over the course of the last 2 MDS or oasis assessments
Term
individual program plan
Definition
a written statement of the services to be provided, based on a comprehensive functional assessment of an individuals active treatment needs.
Term
"blank" psychological changes include marked memory loss, confusion and a loss of judgment.
Definition
abnormal
Term
"blank", are accessory dwellings within or attached to a home. usually have a bedroom, bath, kitchen and living area with separate entrance.
Definition
accessory apartments
Term
facilities that provide care usually between the hours of 8am to 5pm.
Definition
adult day care
Term
the "blank" is both psychological and physiological
Definition
aging process
Term
online survey certification & reporting
Definition
also known as OSCAR database.
it includes medicare & Medicaid certified facility demographic info, results of onsite surveys & aggregate nursing home resident characteristics for comparison with state & national peer information
Term
the federal govn't supports and encourages development of home care and community services that serve as "blank" to nursing facility placement.
Definition
alternative care
Term
nosocomial infection in the long term care facility
Definition
an infection that develops after admission to the long term care facility. they usually develop w/n 48 to 72 hrs of admission
Term
initial survey
Definition
an on-site federal survey to determine whether provider meets the requirements to begin participating in the Medicare and Medicaid programs.
Term
strategic planning
Definition
an organizations process of defining its strategy, or direction, and making decisions on allocating its resources to pursue this strategy.
Term
the cost of recruitment and retention is estimated to exceed the four billion mark....
Definition
annually
Term
"blank" provide additional services to those offered retirement housing. is considered a major threat to the nursing home occupancy rates.
Definition
assisted living units
Term
decubiti
Definition
bedsores
Term
each state must license through its healing arts provisions or appoint a "blank" that is required to develop, impose and enforce standards of licensing, etc.
Definition
board of examiners
Term
How is Medicare administered?
Definition
by CMS, with assistance from the states.
Term
basics of pain management
Definition
classifying the pain:
(chronic or acute)
(neuropathic vs. non-neuropathic)
effective treatment plan
Term
comorbidity
Definition
coexisting multiple health problems
Term
patient centered care concepts
Definition
collaboration btwn the patient & the healthcare team. patient centered incorporates the patients, values, beliefs, and preferences regarding overall health & well being into the plan of care.
Term
"blank" or "blank" usually involves a large house where residents have their own bedrooms, meals are usually provided as well as housekeeping services.
Definition
congregate housing or group homes
Term
"blank" provide a full spectrum of living options, including retirement home that range from efficiency apartments to garden homes, assisted living units, and nursing homes
Definition
continuing care retirement center (CCRC)
Term
the American health care association declared the industry as one in....
Definition
crisis
Term
"blank" is placing a renewed emphasis on quality of life in the nursing home setting.
Definition
culture change
Term
dental exams
Definition
dental exam w/n 6 months after admission unless one was performed 6 months before admission
Term
medicare patients are classified into groups according to....
Definition
diagnosis
Term
for every elderly person in a nursing home, there are approximately 1.4 people in the community with equal degrees of ....
Definition
disability
Term
each state & the district of Columbia are "blank" to appoint one representative to the NAB board of governors upon payment of state membership dues.
Definition
eligible
Term
"blank" is a licensed adult care facility that is operated for the purpose of providing LTC to at least 5 persons in a community-integrated setting
Definition
enriched housing
Term
acute conditions
Definition
episodic. require short-term but intensive medical intervention. Generally respond to medical treatment.
Term
the direct cost to the facility due to turnover of direct care employees alone is "blank" to be $2500 per employee.
Definition
estimated
Term
period A facility
Definition
facility or portion of a facility which before July 1, 1964 was either licensed as a nursing home or had the plans approved by the department
Term
neglect
Definition
failure to provide goods and services to prevent resident harm
Term
proof of use records
Definition
for schedule II drugs
-each drug listed on a separate sheet
date, time administered
residents name
physicians name
dose
signature of person administering
**they need to be audited daily
Term
"blank" provide meals, laundry, transportation, and other services to an elderly person on a fee basis.
Definition
foster homes
Term
hospitals that developed nursing beds that were licensed as a SNF and or NF and have a nursing home license separate from the hospital's license are called....
Definition
free standing
Term
waiver
Definition
grant of an exception from a requirement.
"waiving a right or claim"
"you do not have to pay or obey something."
Term
variances
Definition
granting of an alternative requirement, in place of the requirement.
Term
in 1965, the Medicare and Medicaid programs were assigned to the....
Definition
health care finance administration department of the U.S. department of health and human services.
Term
schedule II drug
Definition
high potential for abuse
-dilaudid, morphine, methadone, opium, Demerol, codeine, oxycontin, hydrocodone, Percocet, fentanyl
Term
"blank" is an assisted living service provided to the homebound. it provides a variety of health care services such as nursing care, personal care and rehabilitative services.
Definition
home health
Term
elopement "wandering" prevention
Definition
identify residents who are at risk.
-staff training #1
-use bed & door alarms
-video cameras
-resident tracking devices
-have a protocol in place
Term
guardian
Definition
legal representative appointed by a court, to make decisions for a person not competent to make their own decisions.
Term
psychosocial aspects of aging
Definition
life challenges
work, retirement, migration, sexuality, stress, widowhood, mental health, social support & friendships.
Term
certified facilities are permitted to develop a private pay wing of the NF to be used by private pay residents. this may provide a wider variety of services and is call a ....
Definition
luxury wing
Term
a significant trend in health care delivery that has a major impact on the nursing home industry is....
Definition
managed care
Term
"blank" is a complex system that involves the active coordination of, and the arrangement for, the provision of health services and coverage of health benefits.
Definition
managed care
Term
percentile rank
Definition
means of ranking providers based on how they compare with each other on each separate QI.
Term
the 1960 Kerr-Mills act program required a "blank" to ensure that funds went only to the health care of the needy.
Definition
means test
Term
under the section 1122 agreement of SSA, as a measure of control, unapproved facilities could not participate in ...... or .......
Definition
medicare or medicaid
Term
in all states it is a crime, usually a "blank" , to represent oneself as a nursing home administrator without being duly license.
Definition
misdemeanor
Term
in the nursing facility depression may be "blank" for dementia since the resident is slow, complains of poor memory, and is withdrawn.
Definition
mistaken
Term
the 1950 amendment to the Social Security Act gave what to the Nursing Home industry?
Definition
momentum
Term
referred to as the state health plan and approved by CMS, each state may establish its own "blank"
Definition
needs review program
Term
harm
Definition
negative effect that has occured to a resident, infrigement of a residents rights, for compromising of resident ability to meet their highest practical level of physical, mental, or psychosocial well-
Term
harm
Definition
negative effect that has occurred to a resident, infringement of a residents rights for compromising of a resident ability to meet their highest practical level of physical, mental, or psychosocial well-being
Term
alternative placement
Definition
no resident may be involuntarily transferred/discharged unless alternative placement is arranged in advance.
-give reasonable notice of at least 30 days
Term
were nursing homes federally regulated during the 1930's-40's?
Definition
no. by the late 40's many states had begun to regulate these facilities and there were many nursing home associations.
Term
"blank" has developed into an expansive program that provides transportation to and from medical, dental, and other healthcare providers.
Definition
non-emergency medical transportation
Term
a "blank" nursing facility is one not certified for not participating in medicare or Medicaid.
Definition
nonparticipating
Term
"blank" psychological changes include slowed memory retrieval, difficulty handling change, resistance to change and depression.
Definition
normal
Term
change in "status" of resident
Definition
notify guardian of any:
-non-medical changes
-financial situation
-plan to discharge the resident
Term
change in "condition" of the resident
Definition
notify physician and/or guardian of:
accident
injury or
adverse change in residence condition
Term
effective Oct 1 of 1990, OBRA changed the name of the ICF to...
Definition
nursing facility (NF)
Term
effective Oct 1 of 1990, OBRA changed the name of the ICF to...
Definition
nursing facility (NF)
Term
in 1972, representatives of several state boards of examiners, organized the national association of boards of examiners of.....
Definition
nursing home administrators
Term
depression may be "blank" because the person presents physical complaints instead of dysphoria, restlessness, pacing and agitation.
Definition
overlooked
Term
dementia, delusions, and hallucinations represent "blank" thought processes.
Definition
pathological
Term
"blank" considers physical defects associated with deterioration of tissues or organs, resulting in diminished vitality of body processes.
-organ & system declining
Definition
physiological aging
Term
the "blank" sought to put into one package all of the federal governments interests in health care matters
Definition
planning and resource development act
Term
NF administrators are experiencing an ever-growing request for....
Definition
private rooms
Term
energy metabolism
Definition
process in the body of breaking down calories consumed into usable energy to allow the body to perform normal body functions
Term
"blank" provides comprehensive medical and social services to certain frail, dwelling elderly individuals.
Definition
program of all inclusive care for the elderly (PACE)
Term
one to one programing
Definition
programming provided to residents who will not or cannot effectively plan their own activity pursuits or residents needing specialized or extended programs to enhance their overall daily routine & activity pursuit needs
Term
the "blank" must be used by the facility in all correspondence, billing and other operational actions.
Definition
provider number
Term
no funds are ever distributed unless the "blank" is included.
Definition
provider number
Term
CMS determines eligibility, handles the funds, and certifies facilities and individuals who serve as.....
Definition
providers of service
Term
it is imperative to train staff to "blank" normal and abnormal characteristics of aging.
Definition
recognize
Term
"blank" are available for those residents that have just been d/c'd from the hospital, especially for strokes, fractures, and post-surgical stays.
Definition
rehabilitative services
Term
section 1902 of the SSA as amended in 1965 "blank" nursing home administrators to be licensed by the states.
Definition
required
Term
"blank" is promoted by private enterprise. units are constructed with needs of the elderly in mind-w/c access, sturdy and stable furniture, good lighting, tight security,etc..
Definition
retirement housing or senior apartments
Term
"blank" involves someone or several people living with an elderly person sharing his/her home and various household chores.
Definition
shared housing
Term
the 1950 amendments to the SSA required states to establish a "blank" or "blank" for Nursing Homes. This gave official status nationwide to Nursing Homes or facilities providing long term care.
Definition
standard setting or licensing agency.
Term
the building of any participating nesting home and any major renovation must have prior approval of the "blank" and usually the state fire marshall.
Definition
state Medicaid agency
Term
the planning & resource development act of 1975 required each state to set up a ....
Definition
state health planning and development agency
Term
what does SHPDA stand for?
Definition
state health planning and development agency
Term
there is no continuum of predictable behavior or of the aging process itself, so the elderly group cannot and should not be....
Definition
stereotyped
Term
hospitals operating fewer than 100 beds could have a limited number of beds certified for use as acute or LTC beds. these are called.
Definition
swing beds
Term
in October 1987, the federal govnt "blank" its section 1122 of SSA agreements with the states and abolished the requirement for a state health plan
Definition
terminated
Term
the Omnibus Budget Reconciliation Act of 1987 (OBRA) is also referred to as...
Definition
the Nursing Home Reform Act
Term
the Omnibus Budget Reconciliation Act of 1987 (OBRA) is also referred to as...
Definition
the Nursing Home Reform Act
Term
in 2001, Health Care Finance Administration was renamed...
Definition
the centers for Medicare and Medicaid services (CMS)
Term
misappropriation
Definition
the deliberate, misplacement, exploitation, or wrongful temporary, or permanent use of a residents belongings or money without the residents consent.
Term
period C facility
Definition
the plans for which were approved by the dept after Dec 1, 1974 including new additions to existing licensed facilities & major remodeling & alterations
Term
appeal procedure for transfer/discharge
Definition
the resident shall write a letter to the bureau of quality assurance w/n 7 days asking for a review
-the facility has 5 days, after receiving the appeal, to send in their justification
-the bureau has 14 days to make a decision
Term
what was the original purpose of the social security act?
Definition
to provide supplemental income for working people and their dependents. Also to provide old age assistance. (OAA), a form of public assistance to the needy who were age 65 or older.
Term
safety and systems
Definition
toilet room doors should not be less than 3ft x6ft & should not swing into the toilet
raised thresholds should not be installed if a bed or wheelchair can not roll over it.
Term
one of the initial purposes of the NAB association was to conduct research and make recommendations on questions of common interest to long-term care administrators' examination and licensing boards and to licensing authorities of the states.
Definition
true
Term
one of the initial purposes of the NAB association was to study and recommend professional and educational standards for LTC administrators in order to promote and protect public health and welfare.
Definition
true
Term
some hospitals developed nursing beds that were a distinct part of the hospital, required to meet all federal/state standards, but were licensed under the hospital's license.
Definition
true. this is called Distinct Part.
Term
There are "blank" distinct types of managed care
Definition
two
Term
environmental scanning
Definition
using various formal and informal processes to identify significant trends and events on an ongoing basis.
Term
was the Social Security Act the primary stimulus for the development of the Nursing Home industry?
Definition
yes
Term
do nonparticipating facilities accept only private pay or insurance cases?
Definition
yes
Term
person appropriate activities
Definition
refers to the idea that each resident has a personal identity & history that involves more than just his or her medical illnesses or functional impairment
Term
medicare bed requirement
DHS 105.09
Definition
sufficient number of medicare certified beds
-each county shall have atleast 3 beds per 1,000 persons 65+ years
-can be fined $10-100 per day
-you have 90 days from the date of the notification to fix.
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