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A resident was admitted to a facility on November 10. The comprehensive assessment was completed on November 27th. Per OBRA 1987, the comprehensive assessment was completed.
A resident was admitted to a facility on November 10. The comprehensive assessment was completed on November 27th. Per OBRA 1987, the comprehensive assessment was completed.
The ___ has ultimate legal responsibility for the operation of a nursing facility.
The ___ has ultimate legal responsibility for the operation of a nursing facility.
Per OBRA 1987, air temperature is measured ____
Per OBRA 1987, air temperature is measured ____
The ____ requires employers to give workers time off for illness or to care for a sick family member.
The ____ requires employers to give workers time off for illness or to care for a sick family member.
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The ___ hires, supervises and can fire the administrator
The ___ hires, supervises and can fire the administrator
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The administrator discovers the Director of Nursing has been giving nursing aides 6 months to complete their state certification requirements. The administrator should ___.
The administrator discovers the Director of Nursing has been giving nursing aides 6 months to complete their state certification requirements. The administrator should ___.
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The rights of an individual determined by a court to be incompetent would be exercised by a(n) ____.
The rights of an individual determined by a court to be incompetent would be exercised by a(n) ____.
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The maintenance director submitted a request for family leave to care for his ailing mother. He has worked 1,350 hours in the nine months he has worked for the facility. The administrator should ___.
The maintenance director submitted a request for family leave to care for his ailing mother. He has worked 1,350 hours in the nine months he has worked for the facility. The administrator should ___.
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Per OBRA 1987, a resident has the right to review all their records within of an oral or written request (excluding weekends and holidays).
Per OBRA 1987, a resident has the right to review all their records within of an oral or written request (excluding weekends and holidays).
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The comprehensive assessment was completed on June 1. The care plan was completed on June 6th. The care plan was completed .
The comprehensive assessment was completed on June 1. The care plan was completed on June 6th. The care plan was completed .
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The comprehensive assessment must be signed by ____.
The comprehensive assessment must be signed by ____.
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The ___ has legal responsibility for the day to day operation of a skilled nursing home.
The ___ has legal responsibility for the day to day operation of a skilled nursing home.
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The ___ is responsible for the day-to-day management of the facility’s nursing program
The ___ is responsible for the day-to-day management of the facility’s nursing program
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CMS stands for ____.
CMS stands for ____.
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HHS stands for ___.
HHS stands for ___.
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The new administrator starts December 1 2007 and reviews the minutes of the Quality Assurance Committee. The committee met the second Tuesday on January 7, 2007, June 21 2007 and November 15, 2007. The administrator should ____.
The new administrator starts December 1 2007 and reviews the minutes of the Quality Assurance Committee. The committee met the second Tuesday on January 7, 2007, June 21 2007 and November 15, 2007. The administrator should ____.
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A resident was only given lunch that day, was given the wrong medication in the morning, had her room changed without notification and was not given a bath as requested. Per OBRA 1987, how many resident rights were violated?
A resident was only given lunch that day, was given the wrong medication in the morning, had her room changed without notification and was not given a bath as requested. Per OBRA 1987, how many resident rights were violated?
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A resident was admitted on June 1. The attending physician charted a visit and physical examination on June 27, 2007, July 29 and Sept 4. With respect to required physician visits per OBRA 1987, the facility
A resident was admitted on June 1. The attending physician charted a visit and physical examination on June 27, 2007, July 29 and Sept 4. With respect to required physician visits per OBRA 1987, the facility
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The ___ has legal responsibility to adopt and implement facility policies.
The ___ has legal responsibility to adopt and implement facility policies.
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A resident was admitted on June 1. The attending physician charted a visit and physical examination of the resident on June 27, July 29, Sept 4 and November 17, 2007. Per OBRA 1987 with respect to required physician visits, the facility ____.
A resident was admitted on June 1. The attending physician charted a visit and physical examination of the resident on June 27, July 29, Sept 4 and November 17, 2007. Per OBRA 1987 with respect to required physician visits, the facility ____.
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A state surveyor learns in interviews with residents that when residents are admitted, they were provided a written list of names of physicians who cared for residents in the facility in their admission packet. The facility assigned an attending physician to each resident prior to admission from a rotating list of physicians. Per OBRA 1987, the facility ____.
A state surveyor learns in interviews with residents that when residents are admitted, they were provided a written list of names of physicians who cared for residents in the facility in their admission packet. The facility assigned an attending physician to each resident prior to admission from a rotating list of physicians. Per OBRA 1987, the facility ____.
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A housekeeper notices a resident is asleep in the room she needs to clean. She knocks on the resident’s door, identifies herself as a house keeper, and seeing there is no response from the resident, decides to enter the room and begins cleaning. The housekeeper should be .
A housekeeper notices a resident is asleep in the room she needs to clean. She knocks on the resident’s door, identifies herself as a house keeper, and seeing there is no response from the resident, decides to enter the room and begins cleaning. The housekeeper should be .
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____ is not an element of a Total Quality Management (TQM) program.
____ is not an element of a Total Quality Management (TQM) program.
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The ___ is responsible to prepare and serve nutritious meals under sanitary conditions.
The ___ is responsible to prepare and serve nutritious meals under sanitary conditions.
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All furniture, equipment, boxes and supplies must be elevated ____ inches above the floor to allow the floor directly underneath to be cleaned.
All furniture, equipment, boxes and supplies must be elevated ____ inches above the floor to allow the floor directly underneath to be cleaned.
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____ is the most comprehensive and effective improvement model.
____ is the most comprehensive and effective improvement model.
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The ____ coordinates all work activities in the facility and resolves conflict between departments.
The ____ coordinates all work activities in the facility and resolves conflict between departments.
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What does HCFA stand for?
What does HCFA stand for?
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What is the minimum length for telephone cords?
What is the minimum length for telephone cords?
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What action should the governing body take when the hours of the dietary service manager are reduced?
What action should the governing body take when the hours of the dietary service manager are reduced?
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What is the primary effect of adding baking soda to food?
What is the primary effect of adding baking soda to food?
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What is the focus of the resident’s quality of life and physical condition?
What is the focus of the resident’s quality of life and physical condition?
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Which one is not typical of a Total Quality Management (TQM) program?
Which one is not typical of a Total Quality Management (TQM) program?
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In the given scenario, who would the administrator ask to help a resident who recently lost her husband and is tearful and worried about paying for her stay?
In the given scenario, who would the administrator ask to help a resident who recently lost her husband and is tearful and worried about paying for her stay?
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How many inches above the floor must electrical switches be located?
How many inches above the floor must electrical switches be located?
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Which disease is characterized by stooped posture, shuffling gait, garbled speech, and tremors?
Which disease is characterized by stooped posture, shuffling gait, garbled speech, and tremors?
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What are the minimum and maximum decibels above normal for hearing aid compatible phones in nursing homes?
What are the minimum and maximum decibels above normal for hearing aid compatible phones in nursing homes?
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What is the minimum weight that grab bars and railings must support?
What is the minimum weight that grab bars and railings must support?
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How often must the emergency generator be visually inspected and checked?
How often must the emergency generator be visually inspected and checked?
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Federal resident care standards are now ____and ____and are no longer considered minimal standards.
Federal resident care standards are now ____and ____and are no longer considered minimal standards.
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Which payor source is the largest for long term care?
Which payor source is the largest for long term care?
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What is the average short term stay for a Medicare resident?
What is the average short term stay for a Medicare resident?
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What does ANSI stand for?
What does ANSI stand for?
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What would non-compliance affecting a limited number of residents and locations be assigned a scope of?
What would non-compliance affecting a limited number of residents and locations be assigned a scope of?
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TQM is characterized by all of the following EXCEPT:
TQM is characterized by all of the following EXCEPT:
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Who do administrators consult to compare outcomes to expectations?
Who do administrators consult to compare outcomes to expectations?
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What would a resident with Parkinson’s not benefit from?
What would a resident with Parkinson’s not benefit from?
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What can states not do to compel facilities to correct class 1 deficiencies found during inspections?
What can states not do to compel facilities to correct class 1 deficiencies found during inspections?
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A ___ violation is where the severity of negative outcomes that compromises a resident’s ability to maintain the highest physical, mental and psychosocial well-being.
A ___ violation is where the severity of negative outcomes that compromises a resident’s ability to maintain the highest physical, mental and psychosocial well-being.
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Parking spaces must be at least ____” wide with an accessible handicap aisle at least ” wide.
Parking spaces must be at least ____” wide with an accessible handicap aisle at least ” wide.
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What is the correct term for a broad statement of goals?
What is the correct term for a broad statement of goals?
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When should long-term residents be surveyed regarding satisfaction with services?
When should long-term residents be surveyed regarding satisfaction with services?
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Which of the following is not true of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)?
Which of the following is not true of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)?
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When does communication occur?
When does communication occur?
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What does NFPA stand for in the context provided?
What does NFPA stand for in the context provided?
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According to the Nursing Facilities Protection Act, how long must the emergency generator be run under full load?
According to the Nursing Facilities Protection Act, how long must the emergency generator be run under full load?
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When can the fire alarm be silenced during a fire drill as per the Nursing Facilities Protection Act?
When can the fire alarm be silenced during a fire drill as per the Nursing Facilities Protection Act?
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Who is responsible for assembling and analyzing incident reports, infection rates, safety issues, medication errors and restraint use according to the Nursing Facilities Protection Act?
Who is responsible for assembling and analyzing incident reports, infection rates, safety issues, medication errors and restraint use according to the Nursing Facilities Protection Act?
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Which organization publishes and promotes fire safety in nursing homes?
Which organization publishes and promotes fire safety in nursing homes?
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What does 'listening intently, acceptance, empathy and understanding the message' describe in the context of communication?
What does 'listening intently, acceptance, empathy and understanding the message' describe in the context of communication?
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What is the focus of the nursing home survey/inspection process?
What is the focus of the nursing home survey/inspection process?
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Who enforces the Americans with Disabilities Act construction standards?
Who enforces the Americans with Disabilities Act construction standards?
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What is the main purpose of a grievance procedure in a nursing home?
What is the main purpose of a grievance procedure in a nursing home?
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Who must nursing facilities be licensed by?
Who must nursing facilities be licensed by?
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What is the responsibility of facilities licensed by the state and certified to receive Medicare and Medicaid reimbursement?
What is the responsibility of facilities licensed by the state and certified to receive Medicare and Medicaid reimbursement?
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What process does the administrator engage in when challenging the findings and citations issued during a survey?
What process does the administrator engage in when challenging the findings and citations issued during a survey?
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Who develops the Americans with Disabilities Act construction standards?
Who develops the Americans with Disabilities Act construction standards?
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What do patients and family primarily look for when selecting a nursing home?
What do patients and family primarily look for when selecting a nursing home?
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By whom must facilities licensed by the state be certified to receive Medicare and Medicaid reimbursement?
By whom must facilities licensed by the state be certified to receive Medicare and Medicaid reimbursement?
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What must all nursing facilities be licensed by?
What must all nursing facilities be licensed by?
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Who is responsible for overseeing federal inspection of resident care in nursing facilities?
Who is responsible for overseeing federal inspection of resident care in nursing facilities?
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What type of reports for nursing homes available through the CMS would not include the nursing home watch list?
What type of reports for nursing homes available through the CMS would not include the nursing home watch list?
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What does a state survey team NOT review prior to entering a facility?
What does a state survey team NOT review prior to entering a facility?
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Who is responsible for identifying and addressing safety hazards in nursing facilities as required by OSHA?
Who is responsible for identifying and addressing safety hazards in nursing facilities as required by OSHA?
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How many different survey types are there in the federal nursing home certification survey program?
How many different survey types are there in the federal nursing home certification survey program?
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Which phase of the state survey involves gathering information from OSCAR, the ombudsman, and other sources prior to entering a facility?
Which phase of the state survey involves gathering information from OSCAR, the ombudsman, and other sources prior to entering a facility?
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What is the phase of the state survey where the survey team analyzes and compares observations and findings called?
What is the phase of the state survey where the survey team analyzes and compares observations and findings called?
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Which entity is responsible for federal inspection of resident care in nursing facilities?
Which entity is responsible for federal inspection of resident care in nursing facilities?
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What is the name of the phase in which the survey team gathers information from OSCAR, the ombudsman, and other sources before entering a facility?
What is the name of the phase in which the survey team gathers information from OSCAR, the ombudsman, and other sources before entering a facility?
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Which entity is responsible for identifying and addressing safety hazards in nursing facilities as required by OSHA?
Which entity is responsible for identifying and addressing safety hazards in nursing facilities as required by OSHA?
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How many days does the administrator have to prepare a plan of correction for all deficiencies cited in the survey?
How many days does the administrator have to prepare a plan of correction for all deficiencies cited in the survey?
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What is communication from subordinates directed to upper management called?
What is communication from subordinates directed to upper management called?
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What level of deficiency has the potential for no more than minor negative impact on a resident?
What level of deficiency has the potential for no more than minor negative impact on a resident?
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Which factor has the least impact on influencing a resident or their family in choosing a facility?
Which factor has the least impact on influencing a resident or their family in choosing a facility?
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At what point should short term residents be surveyed about satisfaction with services?
At what point should short term residents be surveyed about satisfaction with services?
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What technology connects cell phones, hand held devices and keyboards to a computer by high speed cable?
What technology connects cell phones, hand held devices and keyboards to a computer by high speed cable?
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How long does the implementation of a TQM program typically take?
How long does the implementation of a TQM program typically take?
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What is the key consideration in determining the minimum level of staffing in a nursing facility?
What is the key consideration in determining the minimum level of staffing in a nursing facility?
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What is managing risks of negative outcomes called?
What is managing risks of negative outcomes called?
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What is the key to a successful TQM program?
What is the key to a successful TQM program?
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What does a tag indicate according to the provided text?
What does a tag indicate according to the provided text?
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What is the phase of the state survey where the survey team discusses the findings with the administrator, DON, and department heads called?
What is the phase of the state survey where the survey team discusses the findings with the administrator, DON, and department heads called?
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When services in a facility are inconsistent from day to day and from shift to shift, it is known as?
When services in a facility are inconsistent from day to day and from shift to shift, it is known as?
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What is the communication between staff of equal rank or status called?
What is the communication between staff of equal rank or status called?
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When consumers perceive a facility renders poor care due to the performance of one employee, this is called:
When consumers perceive a facility renders poor care due to the performance of one employee, this is called:
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What does the survey team send the administrator if the facility was substantially in compliance with only isolated or minor problems which caused no actual harm, and no plan of correction is required?
What does the survey team send the administrator if the facility was substantially in compliance with only isolated or minor problems which caused no actual harm, and no plan of correction is required?
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Which residents are most at risk for pressure ulcers?
Which residents are most at risk for pressure ulcers?
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What is the primary factor that puts residents at risk for pressure ulcers?
What is the primary factor that puts residents at risk for pressure ulcers?
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What is a common contributing factor for residents at risk of developing pressure ulcers?
What is a common contributing factor for residents at risk of developing pressure ulcers?
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The organization responsible for researching safety protocols to protect workers in the work place from diseases and occupational hazards is NIOSH. NIOSH stands for ____?
The organization responsible for researching safety protocols to protect workers in the work place from diseases and occupational hazards is NIOSH. NIOSH stands for ____?
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Per OBRA 1987, resident medical records must be retained for a minimum of year(s) from discharge
Per OBRA 1987, resident medical records must be retained for a minimum of year(s) from discharge
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____ would not be covered by Medicare.
____ would not be covered by Medicare.
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The width required for 2 wheelchairs to pass is
The width required for 2 wheelchairs to pass is
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_____ can provide nursing aide services and be included in calculating minimum staffing hours.
_____ can provide nursing aide services and be included in calculating minimum staffing hours.
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Managing risks of negative outcomes is called ___.
Managing risks of negative outcomes is called ___.
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The nosing on a stair must project no more than ___.
The nosing on a stair must project no more than ___.
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Smoke detectors must be located no further than ___feet apart and no more than ___ feet from any wall.
Smoke detectors must be located no further than ___feet apart and no more than ___ feet from any wall.
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Minimum wheelchair passing width for two wheelchairs is ___ inches.
Minimum wheelchair passing width for two wheelchairs is ___ inches.
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Minimum clear width for a single wheelchair is ___” continuously and ____” at any one point.
Minimum clear width for a single wheelchair is ___” continuously and ____” at any one point.
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There must be a passing space in an accessible route for wheelchairs every __feet.
There must be a passing space in an accessible route for wheelchairs every __feet.
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A passenger loading zone must be at least ___” wide and ___” long.
A passenger loading zone must be at least ___” wide and ___” long.
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The force required to open all doors, flush a toilet, operate faucet handles, and operate a water fountain cannot exceed ___lbs of pressure.
The force required to open all doors, flush a toilet, operate faucet handles, and operate a water fountain cannot exceed ___lbs of pressure.
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Minimum wheelchair turning space is ___inches.
Minimum wheelchair turning space is ___inches.
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The high forward reach from a wheel chair is ___.
The high forward reach from a wheel chair is ___.
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Study Notes
Comprehensive Assessment and OBRA Guidelines
- A resident's comprehensive assessment must be completed within specified timelines as per OBRA 1987.
- The assessment for a resident admitted on November 10 was conducted by November 27.
- OBRA 1987 mandates that a resident has the right to inspect their records upon oral or written request.
Legal and Operational Responsibilities
- The governing body holds ultimate legal responsibility for the nursing facility's operation.
- The facility's administrator is tasked with hiring and supervising staff, including the Director of Nursing.
- Day-to-day operations of a skilled nursing home fall under the responsibility of the administrator.
Employee Rights and Family Leave
- The Family and Medical Leave Act requires employers to provide time off for employees' illnesses or to care for sick family members.
- A maintenance director who has worked for 1,350 hours in nine months is eligible for family leave to care for his mother.
Quality Assurance and Care Planning
- Comprehensive assessments must be signed by authorized personnel to ensure accountability.
- Care plans should be completed within a specified timeframe after the comprehensive assessment.
Compliance and Facility Policies
- Facilities must adopt and implement policies that align with legal standards and best practices.
- PHYSICIAN visit requirements are stipulated by OBRA 1987, ensuring appropriate medical oversight for the residents.
Communication and Resident Rights
- Effective communication is vital; however, the housekeeper should have obtained resident consent before entering a room.
- Violations of resident rights can occur if residents do not receive adequate meals, medications, and personal care.
Facility Standards and Safety
- All furniture and supplies must be elevated at least 6 inches above the floor for proper cleaning.
- National standards, including those from NFPA, govern fire safety and equipment inspections in facilities.
Emergency Protocols
- Emergency generators must undergo regular inspections as mandated by health and safety regulations.
- The Nursing Facilities Protection Act stipulates specific protocols for fire alarms during drills.
Resident Care and Quality Management
- Total Quality Management (TQM) emphasizes systematic improvement and is key to enhancing resident care.
- TQM strategies focus on maintaining consistency in service delivery across various shifts.
Survey and Compliance Processes
- State survey teams review various documents, but they do not evaluate grievance procedures prior to facility entry.
- Administrators have a limited time frame to prepare a corrective action plan following deficiency citations during surveys.
Risk Management and Resident Safety
- Identifying and mitigating safety hazards is a fundamental responsibility of all facility staff, in line with OSHA regulations.
- Residents at risk for pressure ulcers often include those with limited mobility and inadequate nutritional intake.
Technology and Innovation in Care
- Advanced technology is utilized to connect communication devices within the facility’s operational framework.
- The implementation of TQM programs may take significant time, necessitating consistent monitoring and support.
Communication Dynamics
- Communication from subordinates to management is termed upward communication and is essential for effective leadership.
- Peer communication, or lateral communication, occurs among staff of equal rank and is crucial for teamwork.
Summary of Federal and State Standards
- Federal standards for resident care are no longer considered minimal and emphasize enhanced quality of life and physical well-being.
- Facilities must be licensed by state authorities and certified for Medicare and Medicaid reimbursement to ensure compliance with health care policies.
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