Florida Guardianship and Nursing Home Regulations, Exams of United States Philosophy

Download Florida Guardianship and Nursing Home Regulations and more Exams United States Philosophy in PDF only on Docsity! Guardianship State Review Exam Questions with Verified Solutions. Florida Guardianship Chapter - ANS 744 Plenary Guardianship - ANS Total loss of rights of a person; Guardian can make all decisions regarding healthcare, and financial Incompetency was replaced by... - ANS Incapacity Qualifications to serve as a guardian.... - ANS 1- over the age of 18 2- No felony charges 3- Not a service provider 4- Never charged with abuse, abandonment, or neglect 5- Not a creditor Qualifications Florida Statute - ANS 744.309 Criminal investigation statute - ANS 744.3135 Criminal investigation statute terms - ANS guardians, including all of their employees that have a fiduciary responsibility to the guardian's wards undergo LEVEL 2 criminal investigations initially, then every 5 years. It is completed VIA Electronic fingerprinting. A LEVEL 1 must be conducted every 2 years Blanket Fiduciary Bond - ANS Each professional guardian who files a petition for appointment is required to post a blanket fiduciary bond with the clerk of the court in the county where the guardian's primary place of business is located. The bond must be in the amount of $50,000. Annual premium can range from 250-500 Registration - ANS Each guardian must register with the OPPG, formally SPGO. You need: 1- Completion of 40-hour course 2- Letter indicating passage of state exam 3- Copy of 50,000 blanket bond 4- Credit history report 5- Check for registration fee- $35 Parents Patria - ANS "King as Father"- responsibility and protection and care for the mentally disabled person with the King. Current practices recognize the state as the "Father". Guardian Advocate for mentally ill - ANS 394.4598 -Persona appointed to make medical and mental health decisions for an individual who has been hospitalized under FS 394 Guardian Advocate - ANS Appoints guardian for people who have developmental disabilities. Once appointed, the guardian advocate is governed by FS 744 and must abide by same requirements as other court appointed guardians Pre-need guardian - ANS 744.3045 - Competent adult may name a preneed guardian to serve in the event of becoming incapacitated. Written declaration can be filed with the clerk of court - Within 20 days after assuming duties, the preneed guardian must petition the court for confirmation of appointment P a g e 1 | 37 Natural Guardian - ANS 744.301 -Mother and father -Or parent who holds sole custody -Or mother who gave birth out of wedlock Voluntary Guardian - ANS 744.341 -petition for appointment of a guardian must be accompanied by a certificate of licensed physician specifying he or she has examined the petitioner and that the petitioner is competent to understand Advantages for ward under voluntary guardianship - ANS - receive copies of initial and annual reports -approve or disapprove actions of guardian -approve or disapprove of guardian fees -terminate the guardianship at any time as long as he or she is competent Emergency Temporary Guardianship - ANS 744.3031 -Prior to appointment of a guardian but after a petition for determination has been filed, appoint an emergency temporary guardian for the person or property, or both of an alleged incapacitated person. -court must find there appears to be imminent danger that the physical or mental health or safety of the person will be seriously impaired. Or that the property is in danger of being wasted. The Temp. Guardianship ends after 90 days or when the temp. Guardian becomes permanent, whichever comes first Plenary Guardianship - ANS 744.102 -guardian can exercise all delegable legal rights and powers Limited guardianship - ANS 744.102 -appointed by the court to exercise only those rights specifically designated by the court order which has been entered after the court has found the incapacitated person lacks capacity. -the ward will receive notice of petitions and reports because there is assumed some degree of capacity under a limited guardianship Standby guardian - ANS 744.304 -given the power to serve as guardian in the event the currently serving guardian dies or becomes incapacitated himself. -Allows for continuity of care of the ward Veteran’s guardianship - ANS 744.602 -Veterans Administration may determine that a person who is receiving a veteran's pension is not able to manage these funds and requires someone to do this for him. -Veteran's Administration is the petitioner for the appointment of a guardian Appointment of VA Guardian - ANS 744.613 -Veteran's Guardianship is over ward's property only, so initial and annual plans are not required -However, if the ward has also been adjudicated as being incapacitated through the court, then initial and annual plans must be completed Inventory of Ward's property - ANS 744.621 -guardian must file with the circuit court and veteran's administration an inventory of the ward's property within 30 days P a g e 2 | 37 -Lutheran ministries program Public guardians are appointed primarily for what kind of cases? - ANS indigent and/or when there is nobody else to serve Surrogate guardian may be appointed when the regular guardian is - ANS -unable to serve due to illness or on an extended vacation and unable to be reached The authority of a surrogate guardian is good for how many days? - ANS 30 -unless extended if court approves Fiduciary is defined as a person who occupies a position of - ANS -trust and acts in the best interests for another person If the ward wishes to express his religious beliefs the guardian should - ANS -assist the ward in doing so When the ward would benefit from outings or shopping excursions, the guardian should - ANS employ an aide or companion to take the ward out An advantage of preparing a form designating a pre-need guardian is - ANS -the person may choose who he wants to be his guardian A durable power of attorney may only be signed by a person who is - ANS -mentally competent 3 potential problems that could arise from putting another person on as a signer on a joint account are: - ANS - potential tax liens -may disqualify person for public benefits -co-signer can clean out the account If there is a durable power of attorney in effect for a person, the court must make a determination at the incapacity hearing to.... - ANS overturn or let the DPOA stand when the person has been adjudicated as incapacitated Before proceeding with filing for guardianship, it may be beneficial to consider medication for a person who is.... - ANS -partially incapacitated or resisting A major problem that may be encountered for the person who has been named as Attorney- in-fact under a DPOA or as a healthcare surrogate is they cannot - ANS -enforce medical decisions -enforce placement if person is unwilling A SS rep payee does not have the authority to... - ANS -determine residence -make healthcare decisions Pro Bono means that the case is.... - ANS -non-fee generating A surrogate guardian may be appointed when the regular guardian is.... - ANS -on an extended vacation or becomes ill The term incompetent was formerly used to describe individuals who had been found legally incapable of managing their person or financial affairs, this has been replaced by the term... - ANS incapacitated P a g e 5 | 37 In the event of a development of an adverse conflict of interest between the guardian and his ward, a 1996 opinion from the Attorney General states that the duty of the attorney who represents the guardian is to... - ANS -the ward -and the attorney may report the guardian's misconduct It is the responsibility of------ to audit guardian reports - ANS -Clerk of Court A professional guardian must obtain and post with the court annually a blanket fiduciary bond in the amount of - ANS no less than $50k 3 key components of informed consent are... - ANS -full disclosure of all issues 0capacity to understand the information provided -ability to make the decision without coercion or force When a guardian must make a decision based on "Best Interest" he should obtain - ANS - independent professional opinions in writing A guardian should learn how the ward handled his affairs prior to becoming incapacitated so that the guardian will be able to make deacons for the ward based on the principle of... - ANS substituted judgment If the guardian is unable to determine what the ward would have done or decided on a particular issue, the guardian must make the decision based on - ANS -principle of best interest Employing the concept of least restrictive alternative means that the guardian will choose the option that allows the ward...... - ANS maximum autonomy- least restrictive environment while maintaining safety and protection An individual must be mentally competent in order to set up these pre-incapacity instruments - ANS -POA -DPOA -Healthcare surrogate -Living trust -co-owner of joint account Under voluntary guardianship, the ward has the right to... - ANS -receive and review guardian reports -fee petitions or other petitions -terminate guardianship at any time Case management and guardianship of the person are alike except that the.... - ANS guardian can enforce compliance with medications and placement while a case manager cannot An individual may set up a living trust to avoid - ANS -probate of estate -guardianship A healthcare surrogate does not have the authority to... - ANS -place patient into facility if patient is refusing to go Even though they may not be in effect, it is important for guardians to review advance directives because.... - ANS -there may be indications of the ward's wishes that will give guidance based on the principles of substituted judgment P a g e 6 | 37 Examples of agencies that provide case management services to as risk people in the community - ANS -DCF -CCE- Community care for the elderly Under voluntary guardianship, the guardian must submit - ANS a physician's statement that the ward is competent along with the annual report to the court A healthcare surrogate has the authority to perform these tasks: - ANS - consent/refuse treatment -authorize admission/discharge from facilities -authorize release of information -select/discharge care providers -apply for benefits -make decisions about life-sustaining treatment Services that may be provided to an individual under FS 415 are - ANS -emergency removal from residence -emergency medical treatment -emergency protective services for persons who are at risk of death or injury If an individual did not designate a healthcare surrogate, or prepare any advance directives prior to becoming incapacitated, a facility or healthcare provider may appoint a ----- to make decisions for that person - ANS proxy VA may appoint a ------ to manage funds for an incapacitated veteran - ANS fiduciary or guardian People with OCD often perform - ANS repetitive actions such as frequent hand washing and checking Hallucinations and delusions are sometimes manifested in people with.... - ANS delirium -mania -schizophrenia A guardian of the person will serve as...... when his ward has been Baker Acted - ANS guardian advocate Chapter 394 FL Mental Health Act, more commonly known as the Baker Act governs the actions of profession for the process of - ANS involuntary examination/treatment in a mental health facility An individual with alcohol or substance abuse problems may be involuntarily admitted to a treatment facility under the - ANS March man Act F.S. Chapter 397 How long a patient may be held in a psychiatric receiving facility before a decision is made to release him or set a hearing? - ANS 72 hours A ------ Hearing must be held if the guardian wants to admit his ward to a psychiatric facility for evaluation and/or treatment - ANS Baker Act Hearing Bi-polar disorder is the term used for an individual who displays episode of mania alternating with episodes of - ANS depression When a patient is admitted to a psychiatric facility under the Baker Act, he retains the right to - ANS -dignity respected P a g e 7 | 37 If ward is indigent, the fees for the court-appointed attorney and examining committee will be paid by - ANS state Authority to ETG is initially good for - ANS 90 days but may be extended for another 90 days Does the law allow a relative who lives out of state to be appointed as guardian for a ward in this state? - ANS yes Examining committee report must be received by the court how many days before the scheduled incapacity hearing? - ANS 10 days before Who pays the premium for the blanket fiduciary bond and the credit and criminal investigations? - ANS the guardian If AIP is purported to have very little funds, what can be filed with the court to have the fees waived - ANS Affidavit of indigence What is the criteria to determine if an individual is indigent? - ANS -usual the criteria to qualify for Medicaid If a petitioner pays the filing fees to initiate a guardianship, the guardian can or cannot petition to reimburse the petitioner after the guardianship has been established? - ANS CAN Standard of proof that must be met to find a person legally incapacitated is - ANS clear and convincing evidence The guardian is required to - ANS take an OATH that he or she will faithfully perform his or her duties as required by the court and FL statutes. Potential resources a guardian may utilize to determine the ward's needs: - ANS -the ward -CARES staff -neighbors/friends -PCP -social services director -medical records -private consultations -caregivers -advance directives -ward's family -religious advisor ADL's - ANS -bathing -toileting -dressing -continence -transferring -ambulating Functional assessment measures the ward's ability to - ANS perform ADLs Placement alternatives to consider in priority order: - ANS -ward's home -independent living facility -ALF -Extended care facility -skilled nursing facility P a g e 10 | 37 ECF and SNF are - ANS nursing homes When there are accusations that a nursing facility or ALF has violated patient's rights, who will investigate? - ANS Ombudsman How much notice is required if a nursing home wants to discharge or transfer a resident - ANS at least 45 days 3 disadvantages of keeping a ward in their own home - ANS -safety -cost -not handicap accessible -greater increase of accidents -potential for mismanagement of medicine -possibility of wandering What information can a guardian provide to an Ombudsman who is investigating an abuse call against a guardian - ANS -any information requested that has not been sealed by the court- financial reports, guardian plans, etc. are sealed 2 valid reasons for moving a ward to another living environment - ANS -safety issue -facility cannot meet the LOC required 3 rights a patient in a nursing home retains - ANS -civil and religious liberties -private and uncensored communications -notification of room change -right to privacy -receive 30 day notice of discharge -free from abuse Some indications of exploitation - ANS -personal items missing -frequent changes to wills, POAs, or titles to property -missing checks or bank statements -inappropriate gifts or use of credit cards -utilities turned off due to non-payment Isolating a person from others or confining him to restricted area is - ANS abuse Not provided appropriate food, shelter, clothing, or medical care is considered - ANS neglect Neglect should be reported to - ANS abuse registry To document exploitation the guardian should obtain - ANS copies of cancelled checks and bank statements -interview witnesses -list of ward's assets pre and post exploitation -record effect on ward First action guardian should take if they suspect abuse or neglect - ANS -investigate/compile information -report to abuse registry Guardian of the person must obtain court approval before consenting to - ANS -abortion -sterilization -Baker Act P a g e 11 | 37 -initiate petition for dissolution of marriage -consent to termination of parental rights -experimental procedures -psychosurgery -move ward to non-adjacent county Guardian should abide by the ward's preferences when - ANS it will cause no harm to the ward or his property Guardian should withhold information when - ANS it will cause harm to ward When ward needs surgery, the guardian should obtain a second opinion.... - ANS only if situation warrants one Rationale should be asked when - ANS recommendations are made by the ward's attending physician Guardian should first obtain court approval before proceeding with - ANS -elective surgery -amputation of body part -when ward's family disagrees or objects When making decisions, the guardian should consider - ANS -ward's wishes -LOC -assessments/recommendations of professionals -least restrictive environment -availability of supportive services -credentials of caregivers/facilities -ward's financial resources to pay for care Does a guardian have the right to terminate services of the ward's physician? - ANS yes When a family objects to surgery... - ANS guardian should petition the court for authority to act of Instruction to Act Guardians may obtain a copy of the discharge summary for a ward's hospitalization by submitting a copy of - ANS LOG and written request to medical records department 4 issues guardian should consider when physician suggests surgery - ANS -second opinion? -how urgent is it -beneficial outcome? -how intrusive is it? -what are ward's wishes? -religious beliefs? -family wishes? -advance directives? -covered by insurance? Considerations when choosing physician - ANS -qualifications -experience in ward's disability -Medicare/Medicaid provider -covered by insurance plan -nursing home affiliation -will they honor ward's wishes in living will? P a g e 12 | 37 What documentation should be attached to initial inventory? - ANS -bank statements -appraisals or proof of value of real property -investment account statements FL statutes require that information regarding a trust created for the ward prior to guardianship be included in the inventory? - ANS TRUE Guardian could be sued by the ward's heirs if they think that they were..... - ANS too prudent Investments considered to be of minimum risk - ANS -savings account -money market accounts -mutual funds -certificates of deposit -tax exempt mutual funds Ancillary property - ANS property located in a different state Credentials to look for when selecting financial advisor - ANS -Certified Financial Planner- CFP -Registered Investment Advisor- RIA -Chartered Financial Advisor- CHFC -International Association of Financial Planners- IAFP When must a guardian get court approval to sell a ward's asset? - ANS ALWAYS What can a guardian invest in without obtaining court approval? - ANS -checking and savings accounts -Money Market accounts -certificates of deposit Prudent Investor Rule - ANS a test of conduct and not performance results Investments considered very high risk are: - ANS -collectibles -raw land -precious metals For financial planning, what can a guardian utilize to determine how long the ward might live? - ANS -Life expectancy charts The safer the investment, the lower the... - ANS return will be A guardian may not be able to obtain what kind of insurance coverage if the ward's residence is vacant? - ANS liability insurance A formal appraisal of the ward's real property should be obtained when the - ANS guardian plans to sell the property After the sale of an asset, the guardian should review the amount of the surety bond to determine if it is necessary to... - ANS increase the bond if an asset if specifically designated in the ward's will, but the guardian must sell it in order to generate funds for the ward's care, the guardian should consider.... - ANS -offering the beneficiary the first right of refusal P a g e 15 | 37 A guardian DOES have a responsibility to file income tax returns if the ward had previously failed to do so? - ANS TRUE Annual accounting must be filed with the court within how many days? - ANS 90 days after the end of the report year An individual becomes eligible to receive reduced SS benefits at what age? - ANS 62 If a person who is receiving SS benefits dies on the last day of the month and the check comes in on the 3rd of the next month the check must... - ANS be returned to SSA Even though a person may have been adjudicated as legally incapacitated, in order to receive SS disability, they will still need to - ANS apply and be approved What can be obtained from the SSA that provides a record of a person's benefit eligibility over their lifetime? - ANS Benefits Planning Query When an eligible person turns 65 he or she may sign up for ------ regardless of whether he or she has reached full retirement age to collect SS benefits - ANS Medicare Once the annual deductible has been met for Part B benefits, Medicare will pay the medical expenses for a beneficiary in an amount up to - ANS 80% of their Medicare approved charges It is necessary to purchase a Madigan policy for persons on Part C Medicare Advantage plan? - ANS False 2 benefits of person having HMO plan - ANS -covers vision, hearing, dental and wellness programs -no need to purchase Madigan supplement A SS rep payee is responsible for - ANS -receiving person's benefits -paying bills for beneficiary Part A under Medicare pays for - ANS -hospital care -SNF care up to 20 days -durable medical equipment -related expenses during hospitalization -hospice care Medicare does not cover - ANS -acupuncture -routine dental care -eyeglasses -hearing aids -dentures -cosmetic surgery -routine foot care -custodial care in nursing home To be eligible for Medicare - ANS -65 -deemed disabled by SSA for at least 24 months Part D Medicare - ANS helps pay for prescription drugs P a g e 16 | 37 Formulary is a list of - ANS medications covered by specific Medicare Part D plan When a physician agrees to "accept assignment" - ANS -they accept what Medicare pays and will not bill the patient for any difference A person can qualify for SS disability insurance if - ANS -diseases of heart, lungs, or blood -severe arthritis -loss of kidney function -mental illness -progressive cancer -brain damage Optional State Supplement - ANS OSS- cash assistance program that pays for a person's care in an ALF Person qualified and receiving OSS is entitled to keep how much per month for personal needs? - ANS $54 Funds in a special needs trust for a disabled person D4A- may only be used to pay for - ANS -items not covered under Medicaid program -may be used to pay guardian or attorney fees or purchase a van or housing for beneficiary Beneficiary does not have the ability to direct how funds will be dispersed in a third-party self-settled trust - ANS True If a facility refuses to honor the ward's living will provisions, the facility must - ANS take reasonable effort to transfer the patient to another facility What should the guardian do in regards to the ward's wishes to refuse medical and/or surgical treatments if the ward had outlined those wishes in a valid living will before he was adjudicated - ANS the guardian should follow them? A DNR or NO CODE means - ANS No efforts will be taken if the patient goes into cardiac arrest Is it legal for a guardian to prepare and sign a living will for a ward who has been adjudicated incapacitated and not previously prepare one? - ANS No Hospice provides what for terminally ill patients? - ANS -comfort and pain control A DNR must be signed by who if the patient is not mentally competent to provide consent? - ANS -physician and legal representative What action may be sought if a patient's physician, family member or other interested party believes that the healthcare surrogate has abused his power? - ANS seek judicial intervention Once a PEG tube has been inserted in the patient, is it ethically wrong to later seek removal of the tube? - ANS No it is not ethically wrong TPN, total parenteral nutrition, is fed into the patient via what method? - ANS PICC Line What 3 sanctions can be imposed if a facility compels a patient to make an advance directive as a condition of admission? - ANS -Loss of license -fined up to 1K per incident P a g e 17 | 37 A guardian may petition the court for fees how often - ANS twice a year for Pinellas County, 4 times a year for Pasco County or as set by the court The fee petition for the attorney of record must be reviewed and approved by who? - ANS guardian If ward becomes indigent, who pays the fees? - ANS nobody To expedite the court's consideration of his fee petition, the guardian may attach consents from? - ANS -parents in minor's guardianship -ward in voluntary one -interested parties in involuntary one If guardian objects to items on attorney of record's fee petition, the guardian should? - ANS discuss with attorney and try to resolve or request court hearing Why is it important for guardian to maintain detailed progress notes on the ward even if they are indigent - ANS guardian is legally responsible -ward may come into funds or assets to pay fees If court fees have been waived due to indigence, guardian fees will not be approved until the indigence is... - ANS reversed and all waived fees have been paid, including audit fees, filing fees, and fees for the examining committee Generally, the attorney of record may petition for fees how often - ANS -once a year or as the judge allows in each judicial circuit Guardian and attorney fee petitions must be accompanied by what - ANS description of services performed Guardians are required to send out 1099 forms for fees paid to - ANS independent contractors working for the ward if the amount paid was over $600 for the year On each fee petition submitted, the guardian is required to list previous..... That have been approved on that particular case - ANS fees and costs awarded A ward's actions and documentation of the guardian's actions must be kept for how long after guardian's discharge from that case - ANS 3 years What services allows guardian to give back to the community? - ANS Pro-bono Employees of the guardian must submit what to SPGO or OPPG along with guardianship registration? - ANS -credit checks and criminal background checks Information on locating a facility or facility deficiencies may be found on - ANS AHCA- Agency for healthcare administration Progress notes detail what and will be useful when the guardian must justify changes in care, or residence, or petitioning for fees - ANS -actions taken on behalf of the ward If guardian is unavailable for extended time and unable to act, he or she should petition the court for appointment of - ANS surrogate guardian Part one chapter 744 - ANS General Provisions -101- Short title- Florida guardianship law P a g e 20 | 37 744.1012 - ANS Legislative intent- legislature finds person incapacitated 744.102 - ANS Definitions - Audit- systematic review of financial and all other documents to ensure compliance with 744-368 -Guardian ad litem- person appointed by court having jurisdiction of guardianship Guardian advocate - ANS Person appointed to represent a person with developmental disabilities under 393.12 or person determined incompetent to consent to treatment under 394.4598 744.104 - ANS Verification of documents - Document should include an oath or affirmation 744.105 - ANS Costs 744.106 - ANS Notice 744.107 - ANS Court monitors -can investigate, seek information, examine documents, or interview ward and report to court findings 744.108 - ANS Guardian and attorney fees and expenses -court decides on fee schedule and considers the individual fees 744.1083 - ANS Professional guardian must register with statewide public guardianship office 744.1095 - ANS Hearings AIP has right to remain silent, testify, present evidence, call witnesses, confront and cross examine witnesses Part 2- Venue - ANS 744.201- domicile of wars 744.202- venue 644.2025- change of ward's residence - must notify court within 15 days of relocation Part 3- types of guardianship - ANS 744.301- natural guardians 744.3021- guardians of minors 744.3025- claims of minors 744.3031- ETG 744.304- standby guardians 744.3045- preened guardian 744.3046 preened guardian for minors 744.306- foreign guardians 744.307- foreign guardian can manage property for nonresident ward 744.308- resident guardian of property of nonresident ward 744.3085- guardian advocates Part 4 - ANS Guardians 744.309- who can be appointed of a resident ward 744.3115- advance directives for healthcare 744.312-considerations in appointment of guardian 744.3125- application of appointment 744.3135- credit and criminal investigation P a g e 21 | 37 744.3145- guardian education requirements Part 5 - ANS Adjudication of incapacity and appointment of guardians 744.3201 - ANS Petition to determine incapacity 744.3203 - ANS Suspension of power of attorney before incapacity determination 744.3215 - ANS Rights of persons determined incapacitated 744.331 - ANS Procedures to determine incapacity 744.334 - ANS Petition for appointment of guardian or professional guardian 744.3371 - ANS Notice of petition of appointment of guardian and hearing 744.341 - ANS Involuntary guardianship 744.342 - ANS Minors guardianship 744.344 - ANS Order of appointment 744.345 - ANS LOG 744.347 - ANS Oath of guardian 744.351 - ANS Bond of guardian 744.354 - ANS Validity of bond 744.357 - ANS Liability of surety 744.358 - ANS Liability of guardian 744.359 - ANS Abuse neglect or exploitation by guardian Cognitive disorders - ANS Dementia or Delirium- involve problems with sorting, retrieval, and manipulation of information and affect memory, attention, problem solving, and appropriate use of language. Mood disorders - ANS Depression, Mania, Bipolar disorder Anxiety disorders - ANS GAD, panic disorder, post-traumatic stress disorder, OCD A professional guardian, who is the proposed guardian of a person should - ANS - Be the petitioner to determine capacity only if there is no one else available to do so Personal relationships between the guardian of the ward's family or the ward's friends - ANS should be avoided to allow the guardian independence in decision-making Monitoring the conduct of a guardian is the responsibility of... - ANS the court Which of the following is not considered a breach of the guardian's fiduciary - using the ward's estate credit rating to get a loan or credit -co-mingling the ward's funds with the guardians or other wards P a g e 22 | 37 Who is responsible for investigating a report of possible abuse or neglect in a facility? - ANS Ombudsman Under FL statute 393, WHO may be appointed for a person who has developmental disabilities? - ANS Guardian advocate Extent of a person's testamentary capacity is critical if the person wants to..... - ANS make changes to his will Which of the following is NOT true when employing an agency to provide services to a ward? -agency will provide replacements if caregiver is unable to provide services -agency pays the caregivers directly -agency caregivers have no restrictions on types of services they can provide -Agency caregivers are screened and bonded - ANS -agency caregivers have no restrictions on types of services they can provide When a guardian must make a decision for a ward who never had capacity, he should utilize the principle of..... - ANS Best interest The principle which is thought to best protect the ward's autonomy, values, beliefs, and preferences is.... - ANS substituted judgment The principle of-------- means that the guardian would make a decision based on what the ward would have done if her could make the decision on their own - ANS Substituted judgment In order to make a decision based on Best Interests, the guardian should... - ANS request evaluations and written opinions from qualified professionals To determine the least restrictive living environment for a ward, the guardian should... - ANS seek professional evaluations and assessments Employing the concept of ------ means that the guardian will make decisions that allow the ward maximum independence while maintaining his or her safety - ANS Least restrictive environment Which one is NOT considered to be an Advance Directive? -appointment of Rep Payee -designation of health care surrogate -signing a living will document -Creation of a DPOA - ANS appointment of Rep Payee Allowing a DPOA to stand instead of initiating a guardianship is appropriate when... - ANS - When the DPOA authority is sufficient to meet the disabled person's needs IF the ward had executed valid advance directives prior to the appointment of a guardian, the court will.... - ANS Specify in the LOG what authority, if any, the guardian shall exercise over the surrogate When award has a living trust, the guardian has an obligation to.... - ANS file a copy of the trust in the Initial Inventory P a g e 25 | 37 In order for a living trust to be effective, the grantor should.... - ANS Rename his assets in the name of the trust Which of the following statements is NOT true? -case manager can give consent for medical treatment for his client -guardian can hire a case manager to assist him on a case -case manager can arrange for a client to reside in a facility -guardian can arrange for a ward S placement even through the ward objects - ANS -case manager can give consent for medical treatment for his client Which of the following is NOT a duty or responsibility of a healthcare surrogate -file a lawsuit against a negligent health care provider -make all health care decisions for the principal -provide written consent to a DNR -Apply for public benefits - ANS file a lawsuit against a negligent health care provider IF the patient's designated surrogate or alternate is unable or unwilling to make decisions.... - ANS healthcare facility make seek the appointment of a healthcare proxy A healthcare surrogate's authority will commence when... - ANS after the patient's attending physician concludes that the patient lacks capacity As soon as possible after the appointment, the guardian should communicate the following to his ward... - ANS the rights retained by the ward and the role of the guardian Which is the LEAST important consideration when planning for the ward's involvement in decisions? -what effect the information will have on the ward -what the wad's potential reaction to the information might be -how the ward's family feels about the decisions made -How to adequately and appropriately deal with the ward's reaction - ANS -how the ward's family feels about the decisions made Which of the following is NOT A right that the guardian must ensure for his ward? -the right to receive services and rehab -the right to have spending money -the right to have access to courts -the right to have uncensored mail and receive visitors - ANS -the right to have spending money The guardian should ----- when making decisions on behalf of the ward -encourage the ward to participate, to the maximum extent of the ward's abilities -avoid any conflicts with the ward's family -encourage the ward's family to participate -Obtain written recommendations from the "experts" - ANS -encourage the ward to participate, to the maximum extent of the ward's abilities If a 26 year old DD female is sexually active, the guardian should... - ANS inform the ward about birth control methods and encourage her to use them If the ward wishes to have interpersonal relationships that include sexual expression, the guardian should... - ANS Take steps to ensure that the relationship is consensual and conducted in private P a g e 26 | 37 A resident of this state may be appointed as guardian if he meets the requirements and is "sui juries", which means him or her..... - ANS mentally competent Laws governing guardianship can only be changed or amended by action of.... - ANS FL Legislature The petition to determine capacity must be.... - ANS Served on and read to the AIP When a petition to determine capacity is filed, the authority granted under a DPOA..... - ANS Suspended until a determination of incapacity is made by the court The venue for the incapacity proceedings is chosen according to.... - ANS Where the AIP resides Members of the examining committee may include all of the following except? -psychiatrist -professional guardian -Licensed social worker -NP - ANS -professional guardian A copy of the examining committee report must be served on the petitioned and attorney for the AIP at least ------ days before the hearing or the hearing to determine capacity will be postponed - ANS 5 days The legal standard of proof that must be met in order for the court to remove a person's rights is... - ANS clear and convincing evidence A guardian must ----- prior to moving award from one county to another county that is NOT adjacent to the county where the ward currently resides - ANS obtain court approval When a guardian wishes to move the ward from one county to an adjacent county, the guardian must notify who? - ANS -the court having jurisdiction within 15 days after relocation of ward Guardian does not have to obtain prior court approval for which of the following.... -consent to experimental treatments -sell ward's property -pay taxes on ward's property -Consent to psychosurgery - ANS pay taxes on ward's property In 1996 the FL Attorney General's office issued an opinion that the attorney for the guardian.... - ANS has a special obligation to the ward and may report any misdeeds of the guardian to the court Guardianship where only some rights were removed... - ANS Limited guardianship A petition to determine capacity will be dismissed by the court if - ANS a majority of the examining committee finds the AIP is not incapacitated An ETG may be appointed for an individual.... - ANS if a petition to determine capacity of the individual has been filed Authority for an ETG may be extended for an additional ---- days if the emergency still exists - ANS 90 days P a g e 27 | 37 IF a guardian pays an independent contractor more than $600 in one year, the guardian must - ANS Send the independent contractor a form 1099 The guardian of the person must file an annual guardianship plan with the court within ---- days after the end of the anniversary month of the signing of the LOG - ANS 90 days Care plan conferences are held to..... - ANS evaluate the status of the patient and any problems that need attention Chapter 744 requires that a professional guardian visit the ward how often? - ANS at least once a quarter A guardian should abide by the ward's preferences.... - ANS when they will not cause harm to the ward or his property to do so The guardian should withhold information from the ward.... - ANS If the ward is likely to suffer substantial harm from hearing the information. To ensure that the ward receives appropriate and effective services, the guardian should.... - ANS Do periodic assessments and continually monitor the ward's progress and needs It is important for a guardian to sign the visitor's log when visiting a ward in an ALF or SNF because... - ANS it documents the visit The main purpose of maintaining progress notes is to document... - ANS any contact with, or action on behalf of the ward The guardian's attendance at Care Plan Conferences is.... - ANS important and should not be missed if possible If the guardian is responsible for making funeral arrangements upon the ward's death but is unable to determine what the ward's preferences were, the most conservative plan would be... - ANS Arrange for a traditional burial When making pre-need funeral arrangements for an indigent ward, the guardian should - ANS Determine the ward's wishes and investigate how they might be implemented -------- Is the state agency responsible for serving the needs of Floridians with Developmental Disabilities - ANS Agency for Persons with Disabilities? ------- Is a program through the Department of Elder Affairs that provides information and assistance for insurance matters - ANS SHINE? AHCA stands for... - ANS Agency for Healthcare Administration All of the services listed below can be provided by CARES EXCEPT.... -Free comprehensive on-site assessment to determine LTC needs. -Financial assistance to pay for LTC in a facility -Information on LTC alternatives -Information on caregiver support, respite services, and caregiver training - ANS Financial assistance to pay for LTC in a facility is not provided When preparing the Initial Inventory, the guardian should list the value of an asset as of.... - ANS GID P a g e 30 | 37 The most accurate value of the ward's real property for the Initial inventory may be obtained by which method.... - ANS A certified appraisal Which of the following is NOT considered to be a liquid asset? -automobile -personal jewelry -stamps and coin collections -Stocks or other investments - ANS -automobile Taking a witness when conducting an inventory of the ward's residence - ANS is a good idea for all inventories since it protects the ward and the guardian An amended inventory listing "found assets" must be filed within ----- after the assets have been discovered - ANS 30 days A ----- Is a person, agency, or organization that has agreed to undertake a special obligation of trust and confidence on behalf of another person - ANS Fiduciary The guardian is responsible for submitting which of the following forms to IRS to inform them of the guardian's fiduciary relationship to the ward? - ANS Form 56 The current FDIC limit of protection for funds deposited for an individual in one bank is.... - ANS $250,000 ITF on a bank account indicates that the funds in the account..... - ANS Can be turned over to the listed beneficiary upon presentation of a death certificate for the ward A certificate of Deposit may be liquidated with no penalty charged when.... - ANS the owner of the CD is designated as legally disabled The guardian is required to file an inventory of the ward's safe deposit box within how many days after opening the box? - ANS 10 days The witness to the inventory of the ward's safe deposit box must be.... - ANS bank representative A guardian must obtain ----- before he may remove any items from the ward's safe deposit box? - ANS court approval The guardian of the person should communicate with the guardian of the property of a ward when? - ANS On a regular basis The guardian should have a copy of the ward's Will...... why? - ANS to determine how to manage estate assets and property The guardian must make reasonable efforts to ---- property designated in the ward's will - ANS preserve the property When the guardian must dispose of the ward's personal property, he should.... - ANS notify next of kin and give them an opportunity to obtain them A guardian should NOT sell the ward's property to whom? - ANS guardian's employees or self P a g e 31 | 37 When the guardian must sell the ward's residence, he should obtain.... - ANS current formal appraisal; physician's statement that the ward can no longer live in the residence; and approval from the attorney regarding the contract for sale a guardian may make gifts on behalf of the ward if... - ANS the estate has sufficient funds to do so; the guardian can determine that there was a history of the ward making gifts; the guardian obtains court approval to do so If an indigent ward inherits money, any court fees that have been waived..... - ANS must be paid before the guardian will be awarded fees The guardian may ----- property belonging to the ward that costs more to maintain than its value - ANS obtain court approval to abandon Upon the death of the ward, the guardian should immediately.... - ANS notify the ward's next of kin, attorney of record, and other interested parties A social security representative payee is responsible for what? - ANS paying the beneficiary's bills Social security administration requires the rep payee to ----- each year - ANS file a report on how the beneficiary's SS payments were dispersed or saved If a person who is receiving SS benefits dies on the last day of the month, the check that comes in on the 3rd of the next month must..... - ANS be returned to SS office Medicare part A does not cover what> - ANS outpatient medical services If a person does not sign up for Medicare Part B when he becomes eligible, but then wants to enroll.... what happens? - ANS a penalty will be charged for each full 12 month period that the patient could have had Part B Medicare part B does NOT pay for what? - ANS eye glasses When a physician agrees to accept "assignment" this means what? - ANS agrees to bill Medicare directly and not bill the patient for amounts not covered other than deductibles Medicare Part D was established to help pay for what? - ANS Prescription drugs Approval for OSS benefits entitles an individual to receive what? - ANS cash supplement to help pay for care in an ALF An individual who has been approved to receive OSS is allowed to have --- for personal expenses? - ANS $54 a month The governmental agency that processes application for Medicaid in a SNF is? - ANS Department of Children and Families An individual may have the following asset and still qualify for Medicaid - ANS 1 car If the ward meets the asset test for Medicaid ICP but has $1 over the income cap, the guardian may do what in order to make his ward eligible to receive Medicaid benefits? - ANS Obtain court approval to set up a QIT P a g e 32 | 37 Which of the following is NOT a symptom of tradeoff dyskinesia- -incontinence of bladder or bowel -involuntary movements of limbs -rapid eye blinking, grimacing -Tongue protrusion, lip smacking - ANS -incontinence of bladder or bowel Delusions and hallucinations may be exhibited by a person who suffers from.... - ANS schizophrenia Dementia may be described as..... - ANS a loss of cognitive function and loss of memory Psychotropic medications are used primarily to.... - ANS manage behavior PDR is an information resource for.... - ANS medications Which of the following is a form of artificial nutrition -PICC line -NG tube -Peg tube -TPN - ANS TPN HIPPA stands for - ANS Health information portability and accountability act A facility must give a resident --- day’s prior notice if they want to discharge or transfer the resident - ANS 45 days If you suspected that your ward might have Diabetes, which medical practitioner would you take your ward to for an evaluation? - ANS endocrinologist A "Baker Act" hearing is held to determine what? - ANS if the person should be examined and treated for mental illness a ------ is appointed at a Baker Act hearing to make decisions for an individual in a mental health facility when the individual has no legal representative to act on his behalf - ANS Guardian Advocate NGA standard 7 - ANS Each decision made by the guardian shall be an informed consent decision based on what the person wants or would have wanted. If this is unobtainable, the guardian shall use the principle of BEST Interest Substituted judgment - ANS principle of decision making that substitutes the decision the person would have made when the person had capacity Person must be competent to set up the following - ANS -DPOA -Living Trust -Joint Tenancy -Health Care Surrogate -Voluntary guardianship Person can be partially incapacitated to set up the following - ANS -Case management -Rep Payee -Money management strategies, Bank custodial account If person is not competent - ANS -involuntary guardianship P a g e 35 | 37 -Health Care Proxy Qualifications to serve as guardian - ANS -over 18 -never convicted felony -complete 40 hour course -criminal background check -credit report To be a professional guardian.... - ANS -obtain blanket fiduciary bond- if have 3 or more wards -complete 16 hours of CEU every 2 years -pass exam -register annually with SPGO Rights removed but not delegated to guardian - ANS -right to marry -vote -driver’s license -travel -seek or retain employment Rights pertaining to person - ANS -consent to medical treatment -determine residence -make decisions about other social aspects Rights pertaining to property - ANS -sue or defend lawsuits -contract -manage property and make gifts -apply for government benefits Ex parte - ANS hearing held without the patient Development disabilities - ANS may begin before birth, manifests before age 18, Living will - ANS providing, withholding, or withdrawal of life-prolonging procedures when the person is terminally ill, in a persistent vegetative state, or has an end-stage condition. PEG tube - ANS eternal nutrition- being fed directly into your stomach or small intestine FL statutes Chapter 518 - ANS Investment of fiduciary funds Blanket fiduciary bond - ANS -no less than $50,000 -about $250 premium -guardian pays this premium -set by Law in FS 744 -Guardian is person obtaining bond -required Surety bond - ANS -Amount based on ward's liquid assets -depends on coverage - Minimum bond of $5,000 to 7,500 is about $75 -ward's estate pays for this -judge determines coverage -Attorney of Record obtains surety bond -can be raised or lowered according to assets P a g e 36 | 37 Persons eligible for Medicare - ANS - 65 or older and paid into SS -Purchased privately -Receiving SSDI for 2 years Part A - ANS Hospital, SNF up to 20 days, home health care, hospice, blood Part B - ANS Medical, physicians, labs, X-rays, surgery, Durable medical equipment- limited, outpatient services, mental health services- pays 80% Enrollment period - ANS - 7 month window- 3 months before you turn 65, the month you turn 65, and 3 months after you turn 65 Annual enrollment - ANS January 1- March 31 - coverage begins July 1 If over assets cap for Medicaid - ANS -Pre=paid irrevocable funeral- court will approve up to $6,000 if established after guardianship. If established prior, there is no limit -pay guardian and attorney fees -Set up pooled trust- d4C -Set up special needs trust- under age 65- d4A - Annual accounting - ANS - start with the inventory value -add income from Schedule A -Deduct disbursements in Schedule B -Calculate gains and losses in schedule C -the net amount will be added or debuted on the summary page -Resulting total must equal Schedule D- New Inventory Value Steps for appointing guardian - ANS - petition to determine capacity ; ETG if needed; court appoints examining committee; service of process on AIP; examining committee examination and report; adjudicatory hearing; order determining incapacity and guardian; appointment of guardian Annual accounting schedules - ANS A- income B- disbursement's C- Gains, losses, adjustments D- Cash assets; personal property E- bank transfers F- Sale of personal property Signature page and audit fee Initial inventory schedules - ANS A- real estate; real property liabilities B- Cash assets; intangible assets; personal property; personal property liabilities Part 1- sources of income Part 2- lawsuits and outstanding debts Part 3- ward has right to sue Part 4- trusts for ward Part 5- joint owners Signature page and audit fee P a g e 37 | 37