Mental Health & Nursing Home Regulations: Licensing, Meds, Quality, Staffing, Exams of Nursing

Download Mental Health & Nursing Home Regulations: Licensing, Meds, Quality, Staffing and more Exams Nursing in PDF only on Docsity! P a g e 1 | 37 Wisconsin NHA Exam verified solutions How much of a supply of an individual resident's drugs may be held by facility? - ANS; The supply shall not exceed 4 days for any one resident. Advanced practice nurse prescriber - ANS; A person who has been granted a certificate to issue prescription orders Authorized prescriber - ANS; A person licensed in this state to prescribe medications, treatments, or rehabilitative therapies "Dietitan" means a person who is any of the following.... - ANS; a) certified under s.448.78 stats b) licensed or certified as a dietitian in another state What is "full-time"? - ANS; 37.5 hours each week devoted to facility business What is "IMD"? - ANS; Institution for Mental Diseases What is intensive skilled nursing care? - ANS; care requiring specialized nursing assessment skills and the performance of specific services and procedures that are complex because of the resident's condition or the type or number of procedures that are necessary What is an "intermediate care facility"? - ANS; a Nursing Home which is licensed by the department as an intermediate care facility to provide intermediate nursing care What is "intermediate nursing care"? - ANS; Basic care consisting of physical, emotional, social and other rehabilitative services under periodic medical supervision. The nursing care requires the skill of a registered nurse for observation and recording of reactions and symptoms, and for supervision of nursing care. What is "involuntary administration of psychotropic medication"? - ANS; It can mean any of the following: a) placing psychotropic medication in an individual's food or drink with knowledge that the individual protests receipt of the psycho tropic medication b) Forcibly restraining an individual to enable administration of psychotropic medication c) Requiring an individual to take psychotropic medication as a condition of receiving privileges or benefits P a g e 2 | 37 What does "limited nursing care" mean? - ANS; It means simple nursing care procedures required by residents with long-term illnesses or disabilities in order to maintain stability and which can be provided safely only by or under the supervision of a person no less skilled than a licensed practical nurse who works under the direction of a registered nurse. What is a "nursing assistant"? - ANS; A person who is employed primarily to provide direct care services to residents but is not registered or licensed. What is a "physician extender"? - ANS; A person who is a physician's assistant or a nurse practitioner acting under the general supervision and direction of a physician What does "protest" mean? - ANS; To make more than one discernible negative response, other than mere silence, to the offer of, recommendation for, or other proffering of voluntary receipt of psychotropic medication. "Protest" does not mean a discernible negative response to a proposed method of administration of the psychotropic medication. How long is "Recuperative care" anticipated to be provided for? - ANS; For a period of 90 days or less for a resident whose physician has certified that he or she is convalescing or recuperating from an illness or a medical treatment. How long is "respite care" anticipated to be provided for? - ANS; For a period of 28 days or less for the purpose of temporarily relieving a family member or other caregiver from his or her daily caregiving duties What does short-term care mean? - ANS; It means recuperative care or respite care In determining whether a service is skilled, what three criteria shall be used? - ANS; 1. The service would constitute a skilled service where the inherent complexity of a service prescribed for a resident is such that it can be safely and effectively performed only by or under the supervision of professional personnel; 2. The restoration potential of a resident is not the deciding factor in determining whether a service is to be considered skilled or unskilled. Even where full recovery or medical improvement is not possible, skilled care may be needed to prevent, to the extent possible, deterioration of the condition or to sustain current capacities; and 3. A service that is generally unskilled would be considered skilled where, because of special medical complications, its performance or supervision or the observation of the resident necessitates the use of skilled nursing personnel. What does "supervision" mean? Does it require continuous presence of supervisor in same building as assistant? - ANS; At least intermittent face-to-face contact between supervisor and assistant, with the supervisor instructing and overseeing the assistant, but does not require the continuous presence of the supervisor in the same building as the assistant. P a g e 5 | 37 Upon admission, all residents must be.... - ANS; Fully informed in writing of all services and the charges for these services, and be informed in writing, during the resident's stay, of any changes in services available or in charges for services What is a "locked unit"? - ANS; A ward, wing or room which is designated as a protective environment and is secured in a manner that presents a resident from leaving the unit at will. Placement in a locked unity shall be based on... - ANS; the determination that this placement is the least restrictive environment consistent with the needs of the person. Under which conditions may a resident be housed in a locked unit? - ANS; 1. The resident consents 2. The court that protectively placed the resident made specific finding of the need for a locked unit 3. The resident has been transferred to a locked unit and the medical record contains documentation of the noticed provided to the guardian, the court and the agency designated. 4. In an emergency If a facility determines that a resident needs a locked unit, the facility must ensure what happens? - ANS; 1. The facility immediately attempts to notify the physician for instructions. 2. A physician's order for the confinement must be obtained within 12 hours. How long may a resident be confined for under the order of the physician? - ANS; No more than an additional 72 hours If more than one nursing home or other licensed health care facility is located on the same or contiguous property, how many administrators must there be? - ANS; One full- time administrator may serve all the facilities How long must a facility licensed for 5- beds or less employ an administrator? - ANS; For at least 4 hours per day on 5 days per week. No administrator shall be terminated unless... - ANS; recruitment procedures are begun immediately If the licensee loses an administrator, a replacement shall be employed or designated as soon as possible or within how many days of the vacancy? - ANS; 120 days When there is a change in administrator, what must the licensee do? - ANS; Notify the department within 2 working days. P a g e 6 | 37 Within how many days prior to employment must employees be screened for TB? - ANS; 90 days prior to employment When an employee or prospective employee has a communicable disease that may result in the transmission of the communicable disease, he or she may not perform employment duties in the facility until..... - ANS; the facility makes safe accommodations to prevent the transmission of the communicable disease. Before performing any duties, each new employee (including temp help) must receive proper orientation to the facility and its policies including.... - ANS; policies relating to fire prevention, accident prevention, and emergency procedures. When must employees be oriented to residents rights and to their position and duties by? - ANS; By the time they have worked 30 days How often and what type of education should be provided for dietary staff? - ANS; Education programs shall be held periodically for dietary staff, and shall include instruction in the proper handling of food, personal hygiene and grooming, and nutrition and modified diet patterns served by the facility. Personnel Records - ANS; A separate record of each employee shall be maintained , be kept current, and contain sufficient information to support assignment to the employee's current position and duties. Original medical record and court orders or other documents (i.e. POA) should be kept for how long? - ANS; These shall be retained for a period of at least 5 years following a resident's discharge or death. If the ownership of a facility changes, what happens with the medical records? - ANS; The medical records and indexes shall remain with the facility. In what situations may a rubber stamp reproduction or electronic representation of a person's signature be used instead of a handwritten signature? - ANS; If: a) The stamp or electronic representation is used only by the person who makes the entry b) The facility possesses a statement signed by the person, certifying that only that person shall possess and use the stamp or electronic representation When may symbols and abbreviations be used in medical records? - ANS; If approved by a written facility policy which defines the symbols and abbreviations and which controls their use What is the purpose of a facility's quality assessment and assurance committee? - ANS; To identify and address quality of care issues Who must be on a facility's QAA committee? - ANS; -The DON P a g e 7 | 37 -The Medical Director or a physician designated by the facility -At least 3 other members of the facility's staff Confidentiality of QAA - ANS; The department may not require disclosure of the records of the quality assessment and assurance committee except to determine compliance with the requirements of this section. Reportable diseases - ANS; Facilities shall report suspected communicable diseases that are reportable under ch. DHS 145 to the local public health officer or to the department's bureau of communicable disease. What is required of a facility that admits a person who has a developmental disability? - ANS; The facility must be certified as an intermediate care facility for the mentally retarded, expect that a person who has a developmental disability and who requires skilled nursing care services may be admitted to a skilled nursing facility. Except in emergency, no person with a developmental disability or who is under 65 and has a mental illness may be admitted to a facility unless? - ANS; The county of residence has recommended the admission . No person under 18 may be admitted, unless approved for admission by? - ANS; Must be approved for admission by the department. Admissions 7 days a week - ANS; No facility may refuse to admit new residents solely because of the day of the week A facility may provide day scare services to persons not housed by the facility if: - ANS; 1) Day care services do not interfere with the services for residents. 2) Each day care client is served upon the certification by a physician or phsyician's assistant that the client is free from TB; and 3) Provision is made to enable day care clients to rest. Beds need not be provided for this purpose, and beds assigned to residents may not be provided for this purpose. No person may be admitted as a resident except upon: - ANS; 1. Order of a physician 2. Receipt of information from a phsyician about the person's current medical condition and diagnosis, and receipt of a physician's intitial plans of care and orders from a physician for immediate care of the resident; and 3. certification that individual has been screen for the presence of clinically apparent communicable disease that could be transmitted to other residents or employees, including screen for TB within 90 days prior to admission. New residents must have a physical examination by a physician or physician extender when? - ANS; Within 48 hours following admission unless an examination was performed within 15 days before admission. P a g e 10 | 37 Transfer of a resident between rooms within a facility may be made only for what reasons? - ANS; For medical reasons or for the resident's welfare or the welfare of other residents. Decubiti - ANS; Bedsores Techniques to prevent decubiti may include - ANS; Periodic position change, massage therapy, and regular monitoring of skin integrity The nursing home shall provide appropriate assessment and treatment of pain for each resident suspected of or experiencing pain based on... - ANS; accepted standards of practice Accepted standard of practice for assessing and treat pain include... - ANS; a) An initial assessment of pain intensity b) Regular and periodic reassessment of the pain after the initial assessment, including quarterly reviews whenever the resident's medical condition changes, and at any time pain is suspected c) The delivery and evaluation of pain treatment interventions d) Consideration and implementation, as appropriate, of nonpharmacological interventions to control pain. Residents shall be served diets as ______________________. - ANS; Prescribed Regarding assisting with eating, what must facilities provide? - ANS; Adaptive self-help devices, including dentures if available, shall be provided to residents, and residents shall be trained in their use to contribute to independence in eating. Food and fluid intake and diet acceptance - ANS; A resident's food and fluid intake and acceptance of diet shall be observed, and significant deviations from normal eating patterns shall be reported to the nurse and either the resident's physician or dietitian as appropriate. Who must be notified of changes in condition? - ANS; A resident's physician, guardian, and any other responsible person designated in writing by resident or guardian to be notified shall be notified promptly Oral orders shall be immediately written, signed and dated by the nurse, pharmacist or therapist on the prescriber's order sheet, and shall be countersigned by the prescriber and filed in the resident's clinical record within how many days of the order? - ANS; 10 days In a nursing home, medication may be administered only by.... - ANS; A nurse, a practitioner, or a person who has completed training in a drug administration course approved by the department P a g e 11 | 37 The same person shall prepare, administer, and immediately record in the resident's clinical record the administration of medications except when? - ANS; When a single unit does package distribution system is used. Physical or chemical restraints shall be applied or administered only on the written order of a physician which shall indicate what? - ANS; -The resident's name -The reason for restraint -The period during which the restraint is to be applied What conditions must be met of physical restraints? - ANS; -They must be able to be removed promptly in an emergency -They shall be the least restrictive type appropriate to the resident How often shall nursing personnel check a physically restrained resident? - ANS; Nursing personnel shall check a physically restrained resident as necessary, but at least every 2 hours to see that the resident's personal needs are met and to change the resident's position. Except in the case of a person admitted for short-term care, within how many weeks following admission must a written care plan be developed? - ANS; Within 4 weeks Nursing personnel - ANS; Nurses, nurses aides, nursing assistants, and orderlies Every skilled care facility and immediate care facility shall employ a full-time director of nursing services who must be an RN and is responsible for: - ANS; a) Supervising the functions, activities and training of the nursing personnel b) Developing and maintaining standard nursing practice, nursing policy and procedure manuals, and written job descriptions for each level of nursing personnel c) Coordinating nursing services with other resident services d) Designating the charge nurses e) Being on call at all times f) Ensuring that the duties of nursing personnel shall be clearly defined and assigned to staff members consistent with level of education, preparation, experience, and licensing of each A skilled nursing facility must have at least ____ charge nurse on duty at all times - ANS; 1 A facility with fewer than _____ residents in need of skilled nursing care shall have at least one RN (who may be the DON) on duty as charge nurse every daytime tour of duty - ANS; 60 A facility with 60-74 residents in need of skilled nursing care, in addition to a DON, shall have at least ____ RN on duty as charge nurse during every daytime tour of duty - ANS; 1 P a g e 12 | 37 A facility with _____ to ____ residents in need of skilled nursing care shall have, in addition to the DON, at least 1 RN on duty as charge nurse during every daytime tour of duty. In addition, the facility shall have at least one RN on duty as charge nurse every day on at least one other non-daytime tour of duty. - ANS; 75 to 99 A facility with 100 or more residents in need of skilled nursing care shall have, in addition to the DON, at least one RN on duty as charge nurse how often? - ANS; AT ALL TIMES An intermediate care facility shall have a charge nurse when? - ANS; During every daytime tour of duty, who may be the DON What are the conditions of allowing an LPN to serve as a charge nurse? - ANS; An LPN who serves as a charge nurse shall be under the supervision and direction of a RN who is either in the facility or on call. A qualified director of food services is a person responsible for implementation of dietary services functions in the nursing home and meeting any of the following requirements: - ANS; a) Is a dietitian b) Has completed at least a course of study in food service management approved by the dietary managers association or an equivalent c) Holds an associate degree as a dietetic technician from a program approved by the American dietetics association What is required when the director of food services is not a dietitian? - ANS; The director of food services shall consult with a qualified dietitian on a frequent and regularly scheduled basis. Therapeutic diets shall be served only on? - ANS; Only on order of the physician Table Service - ANS; The facility shall provide table service in dining rooms for all residents who can and want to eat at a table, including residents in wheelchairs. Drinking water requirements - ANS; When a resident is confined to bed, a covered pitcher of drinking water and a glass shall be provided on a bedside stand. The water shall be changed frequently during the day, and pitchers and glasses shall be sanitized daily. All readily perishable food and drink, except when being prepared or served, shall be kept in a refrigerator which shall have a temperature maintained at? - ANS; 40 degrees F or below Within how long of the initiation of rehab treatment, must a report of the resident's progress be made to the physician? - ANS; Within 2 weeks P a g e 15 | 37 What does QMRP mean? - ANS; Qualified mental retardation professional: A person who has specialized training in mental retardation or at least one year of experience in treating or working with mentall retarded persons and is one of the following: 1. A psychologist 2. A physician 3. A social worker with a graduate degree 4. PT or OT 5. SLP 5. RN 7. A therapeutic recreation specialist 8. Human services professional All residents who are developmentally disabled shall receive what? - ANS; active treatment What is active treatment for the developmentally disabled? - ANS; Active treatment shall include the resident's regular participation, in accordance with the IPP, in professionally developed and supervised activities, experiences and therapies. Within how many days of an admission must the IDT develop an IPP for residents who are developmentally disabled? - ANS; Within 30 days following the date of the admission, the IDT shall review the preadmission evaluation and physician's plan of care and shall develop an IPP except in the case of a person admitted for short-term care. What shall an IPP include? - ANS; a) Evaluation procedures for determining whether the methods or strategies are accomplishing the care objectives; and b) A written interpretation of the preadmission evaluation in terms of any specific supportive actions, if appropriate, to be undertaken by the resident's family or legal guardian and by appropriate community resources How often shall individual care plans be reassessed and updated? - ANS; At least quarterly by the IDT with more frequent updates if an individual's needs warrant it How often shall a QMRP review the goals on the IPP? - ANS; At least every 30 days What is short-term care for? - ANS; Short-term care is for either respite or recuperative purposes These admission and resident care planning procedures may be carried out for residents admitting for respite care - ANS; a) An RN or physician shall complete a comprehensive resident assessment of the person prior to or on the day of admission b) The RN shall develop a written plan of care for the admitting person c) The facility shall send a copy of the comprehensive resident assessement, the physician's orders and the plan of care to the person's attending physician. The P a g e 16 | 37 attending physician shall sign the assessment and the plan of care within 48 hours after the person is admitted. Can respite and recuperative care residents bring medications into the facility? - ANS; Yes, as permitted by written policy of the facility How many pillows shall each resident be provided with? - ANS; Each resident shall be provided with at least one clean, comfortable pillow. Additional pillows shall be provided if requested by the resident or required by the resident's condition. Each bed shall have a ? - ANS; Mattress pad What type of mattress and pillow cover must be provided? - ANS; Moisture-proof mattress cover and pillow cover How many sheets and pillow cases shall be furnished to each resident each week? - ANS; At least 2 sheets and 2 pillow cases Beds occupied by bedfast or incontinent residents shall be provided with what? - ANS; Draw sheets In addition to a bed, what other furniture is required in a resident room? - ANS; At least one chair shall be in each room for each bed. A folding chair shall not be used. If requested by the resident or guardian, a wheel-chair or geri-chair may be substituted. Adequate compartment or drawer space shall be provided in each room for rach resident to store personal clothing and effects and to store, as space permits, other personal possessions in a reasonable secure manner. A sturdy and stable table that can be placed over the bed or armchairs An individual towel rack shall be installed where? - ANS; At each resident's bedside or at the lavatory. What shall be provided at each lavatory for use by staff? - ANS; Single service towels and soap What must windows be covered with? - ANS; With flame retardant shades, draw drapes, or other covering material or devices which, when properly used and maintained, shall afford privacy and light control for the residents. Where should first aid supplies be kept? - ANS; At each nursing unit What is required when oxygen is placed at the resident's bedside? - ANS; The oxygen tanks shall be securely fastened to a tip-proof carrier or base P a g e 17 | 37 When in use at a resident's bedside, how often shall the cannulas, hoses, and humidifier bottles be changed and sterilized? - ANS; At least every 5 days How often shall disposable inhalation equipment be replaced? - ANS; every 5 days Other inhalation equipment such as intermittent positive pressure breathing equipment, the entire resident breathing circuit, including nebulizers and humidifiers, shall be changed how often? - ANS; Daily Combustibles such as cleaning rags and compounds shall be kept in what type of containers? - ANS; Closed metal containers Where shall poisonous compounds be stored when not in use? - ANS; In a locked area separate from food, kitchenware, and medications. Shall be clearly labeled as poisonous Where shall garbage and rubbish be stored? - ANS; In a leakproof, nonabsorbent containers with close-fitting covers, and in areas separate from those used for the preparation and storage of food. Can paperboard containers be used to store garbage? - ANS; NO All windows and doors used for ventialtion purposes shall be provided with wire screening of not LESS than number ____ mesh - ANS; 16 Screen doors shall be ____-_______ and shall not interfere with exiting - ANS; self- closing What may be used in lieu of screens? - ANS; Airflow curtains or fans What does "Life safety code" mean? - ANS; The National Fire Protection Association's standard 101 What is a "Period A facility"? - ANS; A facility or portion of a facility which BEFORE July 1, 1064 was either a licensed nursing home and had plans approved by the department What is a "Period B facility"? - ANS; A facility or a portion of a facility the plans for which were approved by the department on or after July 1, 1964 but no later than December 1, 1974 What is a "Period C facility"? - ANS; A facility, the plans for which were approved by the department after December 1, 1974, including new additions to existing licensed facilities and major remodeling and alterations P a g e 20 | 37 platform size of the elevator be? - ANS; Large enough to hold a resident bed and attendant In period B and C facilities, what type of outlet shall be provided for every resident's bed? - ANS; At least on duplex-type outlet No bedroom housing a resident shall open directly to? - ANS; A kitchen or laundry How much space shall be between beds? - ANS; At least 3 feet A clear aisle space of at least ___ feet from the entrance to the room to each bed shall be provided. - ANS; 3 Closets or lockers shall afford a space of not less than? - ANS; 15 inches wide by 18 inches deep by 5 feet in height All lavatories shall have hot and cold running water. Toilets shall be water flushed and equipped with open front seats without ____? - ANS; lids Utility room requirements for period A, period B, and period C facilities. - ANS; -Period A nursing homes shall have a utility room that shall be located, designed and equipped to provide areas for the separate handling of clean and soiled linen, equipment and supplies. -Period B nursing homes shall have a ventilated utility room with a flush-rim service sink -Period C-- central location of soiled utility rooms is not required in existing nursing homes Which period nursing homes shall have a nourishment station with sink, hot and cold running water, refrigerator and storage for serving between-meal nourishment if a kitchen is not open at all times? - ANS; Period C How much area may a nourishment station serve? - ANS; Nourishment stations may serve more than one nursing area but not more than a single floor Dietary areas shall comply with? - ANS; The local health or food handling codes If on-site construction above the foundation is not started within ___ months of the date of approval of the working plans the approval shall be void. - ANS; 6 What is a "basic nursing course"? - ANS; A course or combination of courses that contain the basic nursing skills, competencies and knowledge that the department is satisfied are generally equivalent in content to the skills What does "facility for the developmentally disabled" mean? - ANS; A place or a distinct part of a place where five or more unrelated persons reside and who, because of their developmental disabilities, require 24-hour nursing care or treatment P a g e 21 | 37 How old must a feeding assistant be? - ANS; 16 years Who can feeding assistants assist with the activities of eating and drinking? - ANS; clients who have no feeding complications What is a handicapping condition? - ANS; A physical or mental impairment that makes ability to care for oneself unusually difficult or limits one's capacity to work What does "mechanical support" mean? - ANS; Any article, device or garment that is used only to achieve the proper position or balance of the client What does "preliminary approval" mean? - ANS; The initial 3 months approval issued by the department following the completed review and verification of all aspects of the application What qualifies one to be a "primary instructor" for nurses aides courses? - ANS; Must be working as a registered nurse, at least one year of which must be in the provision of long-term care facilities, and who has completed a course in adult education or supervising nurse aides What is a "program trainer"? - ANS; An individual from a health related field who provides specialized training about that field to nurse aides under the general supervision of the primary instructor How may a health care provider contest the denial of a requested waiver or variance? - ANS; By requesting a hearing What is considered a reasonable distance in regards to nurse aide training programs? - ANS; 45 miles or 60 minutes away, one-way Within _____ days after receiving a [nurse aide] training program application, the department shall either issue a preliminary approval or deny the application. - ANS; 90 How long may preliminary approval of a nurse aide training program be granted for? - ANS; 3 months If an application for approval of a training program is denied, when can the program resubmit an application for approval to train nurse aides? - ANS; 6 months from the date of the denial of the application Before issuing a preliminary approval for a training program, what must the department conduct? - ANS; A preliminary approval onsite review P a g e 22 | 37 Following the 3 month preliminary approval period for a training program, what must the department do? - ANS; Conduct an onsite review to verify compliance with the requirements How often shall the department conduct a post-approval review of a training program? - ANS; Every 2 years after the date on which the department formally approves the program How often shall a training program designee submit a report to the department? - ANS; Annually The training program will be required to submit a new application in its entirety if the period of inactivity is _____ consecutive months or longer. - ANS; 36 When program approval is withdrawn, the program shall submit a plan to the department within how long after the withdrawal of the program's approval for the completion of the program? - ANS; 10 business days How long shall training programs who approval is withdrawn provide custody for training records? - ANS; A 3 year time period What are the requirements for the primary instructor for a training program? - ANS; -A registered nurse licensed to practice in Wisconsin -Has at least 2 years of experience working as an RN -One of the years of experience shall be actual work experience in providing care in a nursing home A primary instructor is considered active for how long? - ANS; As long as the instructor remains affiliated with an approved course. If the primary instructor leave the program and does not become affiliated with another program the instructor's approval as a primary instructor is inactivated as the of the date the instructor leaves Difference between program trainer and primary instructor - ANS; Primary instructor must be the RN with 2 years experience. A program trainer shall have at least one year of work experience in the area the program trainer will provide training. Program trainer shall work under the general supervision of the primary instructor How long shall the training course for primary instructors be? - ANS; A minimum of 16 hours in length Can a nurses aide take vital signs? - ANS; yes What describes the following: the application of assistive devices for ambulation; eating and dressing; maintenance of ROM through appropriate exercises; proper turning and positioning both in b ed and chair; proper transferring techniques; bowel and bladder P a g e 25 | 37 Feed assistant training programs shall maintain records for how long? - ANS; At least 3 years Feeding assistant training programs may request a waiver of the feeding assistant training prohibition by submitting a request in writing to the department. The department shall issue a written decision, either approving or denying the request within ____ calendar days - ANS; 45 A request for feeding assistant training program appeals shall be filed with the department of administration's division of hearing and appeals no later than _____ days after the date of the denial - ANS; 30 All medication aide training programs based in nursing homes shall be approved by who? - ANS; The department A proposal for a medication aide training program shall be submitted by the nursing home and the proposal will be approved or denied by the department. The department shall issue a decision within _____ calendar days - ANS; 30 After a medication aide program proposal is approved, course material shall be submitted to and approved by the department before the training program can be implemented. The department will issue a decision on a completed course submittal within _____ calendar days. - ANS; 90 The department will limit the number of approved medication aide training programs to a maximum of how many? - ANS; 10 How often shall the department conduct a post-approval review of a medication aide training program? - ANS; Every 2 years How often shall the program designee of a medication aide training program submit a report to the department? - ANS; At least every 2 years A medication aide training program shall report a substantial change in the program to the department in writing within _____ days of the change. - ANS; 10 How old does a medication aide have to be? - ANS; 18 years of age, and must have a high school diploma or a high school equivalency diploma To be a medication aide, a student shall have at least _________ hours of experience as a nurse aide in direct patient care within the last ___ years. And must have worked a minimum of _____ hours as a nurse aide within the last 90 days. - ANS; 2,000; 3; 40 To be a medication aide, a student shall have how many written recommendations, and who must they be from. - ANS; 4 written recommendations: P a g e 26 | 37 -2 from licensed charge nurse -1 from DON of the nursing home where the student will be working during clinicals -1 from NHA of nursing home where student will be working during clinicals What are the six "rights" of medication administration? - ANS; -Right patient -Right drug -Right dose -Right route -Right time -Right documentation The total number of students in any one medication aide class shall not exceed how many? - ANS; 24 The medication aide training program shall contain a minimum of how many hours of instruction? - ANS; 100 hours. 60 of those shall be spent in classroom and 40 shall be clinical experience in a nursing home The curriculum of a medication aide training program sh all contain a minimum of how many quizzes? - ANS; 6 What must a medication aide student's average score on the quizzes be before being allowed to take the final written exam? - ANS; 85% The medication aide training curriculum shall require the student to achieve a grade of ____ % of better on the final written exam before being allowed to take the practicum exam. - ANS; 85%; this is also the minimum required score for the practicum exam The records of a medication aide training program shall be retained for how long? - ANS; At least 3 years A medication aide training program may request a waiver of the medication aide training program prohibition by submitting a request in writing to the department. The department will issue a written decision either approving or denying the request, with ____ calendar days - ANS; 45 How many hours shall a HOSPICE medication aide training program be? - ANS; A minimum of 40 hours of instruction of which 32 hours is lecture and 8 hours of which is quizzes, final examination and practicum. The 32 hours of lecture shall contain hands- on and demonstrations of the appropriate techniques of medication administration Every nursing home administrator shall complete at least ____ contact hours in approved continuing education programs in each biennial renewal period. - ANS; 24 How long shall every nursing home administrator maintain records of continuing education hours? - ANS; For at least 5 years P a g e 27 | 37 How many contact hours from an accredited college or university can an NHA claim towards the required 24 contact hours? - ANS; 18 One semester credit hours earned from an accredited college or university shall equal ___ contact hours and one quarter credit shall equal ____ contact hours - ANS; 4; 2 Any continuing education program submitted to NAB in a timely manner according to NAB procedures which is not approved may be submitted to the board for consideration. The request must be submitted on formed provided by the board at least ______ days prior to the date the program will be offered. - ANS; 20 What is a medical review officer? - ANS; A medical doctor or doctor of osteopathy who is a licensed physician and who has knowledge of substance abuse disorders Read page 66/101 - ANS; Read page 66/100 Can credential holders who have committed violations of law be eligible for the Professional Assistance Procedure? - ANS; Yes A credential holder determined to be ineligible for the professional assistance procedure may, within _____ days of notice of the determination, request the credentialing authority to review the adverse determination - ANS; 10 Professionals participating in the professional assistance procedure shall notify the coordinator of any changes in the credential holder's employer within ____ days - ANS; 5 If a board liaison does not approve a treatment facility or therapist as requested by the credential holder, the credential holder may, within ____ days of notice of the determination, request the board to review the board liaison's adverse determination - ANS; 10 To participate in the professional assistance procedure, the credential holder shall have who file reports with the coordinator and how often? - ANS; Quarterly reports from the supervising therapist and work supervisors To participate in the professional assistance procedure, the credential holder shall notify the coordinator of any changes in the credential holder's employer within ____ days. - ANS; 5 How long does a credential holder participate in the professional assistance procedure for? - ANS; A period of time as established by the board P a g e 30 | 37 The department shall request that the planning commission or agency send send to the department, within ____ days, a description of any specific hazards which may affect the health and safety of the resident. - ANS; 30 No license may be granted to a CBRF until what? - ANS; Until the 30-day period has expired or until the department receives the response of the planning commission or agency, whichever is sooner How long is a CBRF license valid for? - ANS; It is valid until it is revoked or suspended How often does a CBRF licensee have to submit a report in the form and containing the information that the department requires, including payment of the fees? - ANS; Every 24 months The department may revoke a CBRF facility license for failure to timely and completely report within _____ days after the report date established under the schedule determined by the department. - ANS; 60 How long is a nursing home license valid for? - ANS; It is valid until it is revoked or suspended. How often shall a nursing home licensee submit a report in the form and containing the information that the department requires, including payment of the fee? - ANS; Every 12 months Each nursing home license shall be issued only for who? - ANS; Each license shall be issued only for the premises and persons named in the application and is not transferable or assignable When does the department issue a probationary license? - ANS; If the applicant for licensure as a nursing home has not been previously licensed under chapter 50 or if the nursing home is not in operation at the time application is made How long is a probationary license valid for? - ANS; A probationary license shall be valid for 12 months from the date of issuance unless sooner suspended or revoked If the applicant for licensure as a CBRF facility is not in operation at the time application is made, the department shall issue a probationary license, except that the department may deny licensure to any person who....? - ANS; To any person who conducted, maintained, operated, or permitted to be maintained or operated a CBRF for which licensure was revoked within 5 years before application is made. If a nursing home desires to contest the revocation of a license, the nursing home shall, within ____ days after receipt of notice, notify the department in writing of its request for a hearing. - ANS; 10 P a g e 31 | 37 If a nursing home requests a hearing to contest the revocation of a license, when shall the department hold the hearing? - ANS; Within 30 days of receipt of such notice All forfeitures shall be paid to the department within ___ days of receipt of notice - ANS; 10 When the department needs to remove a resident from a facility, the resident shall be provided with opportunity for ____ visits to potential alternative placements prior to removal - ANS; 3 If any removal of residents is conducted, the department shall provide written notice, and the facility and resident shall advise the department within ____ working days if a hearing is requested - ANS; 10 If a hearing is requested to challenge the emergency removal of a resident, the department shall hold the hearing within _____ days of receipt of request - ANS; 30 The department shall establish a uniform classification of accounts and accounting procedures for each level of licensure which shall be based on generally accepted accounting principles and which reflect the allocation of _________________ and __________________ by primary functions - ANS; revenues and expenses Any petition for review of department action under chapter 50 shall be filed within ____ days after receipt of notice of the final agency determination - ANS; 15 Whenever ownership of a facility is transferred from the person or persons named in the license to any other person or persons, the transferee must obtain what? - ANS; A new license The treansferee shall notify the department of the transfer, file an application, and apply for a new license at least _____ days prior to final transfer - ANS; 30 The transferor shall notify the department at least ____ days prior to the final transfer - ANS; 30 Violations reported in departmental inspection reports prior to the transfer of ownership shall be _______, with corrections verified by department survey prior to the issuance of a full license to the transferee. - ANS; corrected If the department disapproves a preliminary plan from a facility that is relocating residents, the department shall notify the facility within how many days after receiving the preliminary plan? - ANS; 10 Upon agreement of a plan for relocation, the facility shall establish a date of closing or services changing. The date may not be earlier than _____ days from the date of P a g e 32 | 37 approval ir 5-50 residents will be relocated, or _____ days from the date of approval if more than 50 residents will be relocated. - ANS; 90; 120 What is a "class 'c' repeat violation"? - ANS; A class "C" violation by a nursing home under the same statute or rule which, within the previous 2 years, the department has served the nursing home a notice of violation or a correction order or has made a notation in the report. Each nursing home shall employ a charge nurse. The charge nurse shall either be an LPN acting under the supervision of a _______________________ or a ___________________, or shall be a professional nurse. - ANS; Professional nurse; physician The department may enforce nursing home minimum staffing requirements based on ___________ staffing levels for a nursing home if the secretary determines that the nursing home is unable to comply with nursing home minimum staffing requirements based on daily staffing levels - ANS; weekly For each resident in need of intensive skilled nursing care, _____ hours per day, of which a minimum of _____ hour shall be provided by a registered nurse or LPN. - ANS; 3.25; .65 For each resident in need of skilled nursing care, _____ hours per day, of which a minimum of ____ hour shall be provided by an RN or LPN. - ANS; 2.5; .5 For each resident in need of intermediate or limited nursing care, _____ hours per day, of which a minimum of ___ hour shall be provided by an RN or LPN. - ANS; 2.0; .4 A nursing home shall, within the time period prescribed by the department by rule, refer to a resource center a person who is seeking admission, who is at least ____ years of age or has developmental disability or physical disability and whose disability or condition is expected to last at least 90 days, unless: -For a person for whom a screening for functional eligibility has been performed within the previous 6 months -The person is seeking admission to the nursing home only for respite care -The person is an enrollee of a care management organization -For a person who seeks admission or is about to be admitted on a private pay basis and who waives the requirement for a financial and cost-sharing screening - ANS; 65 No nursing home may admit any patient until a physician does what? - ANS; Completes a plan of care for the patient and the patient is assessed or the patient is exempt from or waives assessment No later than ____ hours after the death of a resident of a nursing home, the nursing home shall report the death to the department if on of the following applies: P a g e 35 | 37 Regarding forfeiture appeal hearings, the division shall commence the hearing within ____ days of receipt of the request for hearing and shall issue a final decision within _____ days after the close of the hearing - ANS; 30; 15 Forfeitures must be paid within how many days of receipt of notice? - ANS; 60 If a nursing home does not contest a notice of violation and does not contest an assessment of a forfeiture for a class "A" or "B" violation and pays the forfeiture to the department within 60 days after receipt of the notice of assessment of forfeiture, the department shall reduce the amount of the forfeiture by ______ percent. - ANS; 35 If a facility desires to have a case conference regarding a written notice to issue a conditional license, the facility shall within ___ days of receipt of notice send a written request for a case conference to the department. The department shall, within ____ working days from the receipt of the request hold a care conference in the county in which the facility is located. - ANS; 4;4 If the licensee desires to contest the basis for issuance of a conditional license, the licensee shall send a written request for eharing to the department within ___ working days after issuance of the conditional license. - ANS; 4 If the department determines that a conditional license shall expire without renewal or replacement, the department shall notify the licensee at least ___ days prior to expiration of the license. - ANS; 30 With respect to a natural person, what does affiliate mean? - ANS; Any person related in the first degree of kinship to that person What is a "principal stockholder" of a corporation? - ANS; Any person who, directly or indirectly, beneficially owns, holds, or has the power to vote, 10% or more of any class of securities issued by the corporation. What does a person who acts as a monitor in a facility do? - ANS; The monitor shall observe operation of the facility, assist the facility by advising it on how to comply with state regulations, and shall submit a written report periodically to the department on the operation of the facility. Who is the only person that may apply for a court order appointing the secretary or the secretary's designee receiver of the facility? - ANS; Only the secretary, represented by the department of justice The court shall appoint a receiver for a specified time period requested by the secretary up to ______ days, if it finds that any ground exists which would authorize the appointment of receiver - ANS; 120 P a g e 36 | 37 The court may extend the period of receivership in ____-day increments only on the petition of the department and if the the court finds tat the department has determined that it is necessary for the receivership to be extended - ANS; 30 If there is probable cause to believe that an emergency exists in the facility, the court shall immediately issue the requested order for appointment of receiver. Notice of the petition and order shall be served on the operator, administrator, or designated agent of the facility or shall be posted in a conspicuous place in the facility within _____ hours after issuance of the order and a hearing on the petition shall be held within ____ days after notice. - ANS; 24; 3 A receiver may correct or eliminate any deficiency in the structure or furnishings of the facility which present an immediate or serious danger to the residents, provided the total cost of correction does not exceed __________. - ANS; $3,000. The court may order expenditures for this purpose in excess of $3,000 only on application from the receiver. If the receiver is in possession of real estate or goods subject to lease, mortgage or security interest, the receiver may apply to the court to set up a reasonable rental, price or rate of interest to be paid by the receiver during the duration of receivership. The court shall hold a hearing on the application within ____ days. The receive shall send notice of the application to any known owners of the property involved at least ____ days prior to hearing - ANS; 15;10 A receiver may be held liable in a personal capacity only for the receiver's own gross negligence, intentional acts or breach of fiduciary duty - ANS; True A receiver may not be required to post any bond - ANS; True If the court terminates a receivership and the department grants a license for the facility to the same applicant under which the facility was licensed immediately prior to appointment of receiver, the court may require that person to post a bond for a period of not less than ______ days in an amount fixed by the court as security for maintaining compliance - ANS; 120 Within _____ days after termination, the receiver shall give the court a complete accounting of all property of which the receiver has taken possession, of all funds collected and of the expenses of the monitor, if any is placed in a nursing home, and the receivership. - ANS; 30 The department has a lien for any deficiency upon any beneficial interest of any operator or controlling person in the building, the land, equipment & goods. Within ____ days after termination of the receivership, the receiver shall file a notice of any lien created. No action on a lien created may be brought more than ___ years after the date of filing. - ANS; 60; 2 P a g e 37 | 37 Violators of section 50.07(Prohibited acts.) may be imprisoned up to ___ months or fined not more than ____________ or both for each violation - ANS; 6; $1,000 Physical restraints may be used in an emergency when necessary to protect the resident from injury to himself or herself or others or to property. However, authorization for continuing use of the physical restraints shall be secured from a physician or PA with in ____ hours - ANS; 12