SOM Chapter 7 Flashcards
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Questions and Answers

What is the term for a survey that gathers information primarily through resident-centered techniques on facility compliance?

Abbreviated Standard Survey

An abbreviated standard survey may be premised on complaints received, a change in ownership, management, or director of nursing.

True

What does abuse mean in the context of resident care?

Means the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish.

What does certification of compliance indicate about a facility?

<p>The facility is in at least substantial compliance and is eligible to participate in Medicaid or Medicare.</p> Signup and view all the answers

What does certification of noncompliance mean?

<p>The facility is not in substantial compliance and is not eligible to participate in Medicaid or Medicare.</p> Signup and view all the answers

What is a deficiency in the context of facility compliance?

<p>A skilled nursing facility's or nursing facility's failure to meet a participation requirement specified in the Act or in regulations.</p> Signup and view all the answers

A dually participating facility has a provider agreement in both the Medicare and Medicaid programs.

<p>True</p> Signup and view all the answers

What are educational programs in the context of long-term care?

<p>Programs that include any subject pertaining to the long-term care participation requirements, the survey process, or the enforcement process.</p> Signup and view all the answers

What does enforcement action refer to?

<p>The process of imposing one or more remedies, such as termination of a provider agreement or civil money penalty.</p> Signup and view all the answers

State monitoring is an option for alternative state remedies.

<p>True</p> Signup and view all the answers

What does an expanded survey involve?

<p>It means an increase beyond the core tasks of a standard survey.</p> Signup and view all the answers

What does an extended survey evaluate?

<p>Additional participation requirements subsequent to finding substandard quality of care during a standard survey.</p> Signup and view all the answers

In facility compliance, what is the definition of a 'facility'?

<p>A skilled nursing facility or nursing facility, or a distinct part of such a facility.</p> Signup and view all the answers

Who is considered to be immediate family under the compliance regulations?

<p>A husband or wife; natural or adoptive parent, child or sibling; and others specified in the regulations.</p> Signup and view all the answers

What is immediate jeopardy in the context of facility noncompliance?

<p>A situation where the facility's noncompliance has caused or is likely to cause serious injury, harm, impairment, or death to a resident.</p> Signup and view all the answers

What does misappropriation of resident property mean?

<p>The deliberate misplacement, exploitation, or wrongful use of a resident's belongings or money without consent.</p> Signup and view all the answers

What does NATCEP stand for?

<p>Nurse Aide Training and Competency Evaluation Program.</p> Signup and view all the answers

What does neglect refer to in the context of facility care?

<p>Failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness.</p> Signup and view all the answers

New admission means a resident who is admitted to the facility on or after the effective date of a denial of payment remedy.

<p>True</p> Signup and view all the answers

What is noncompliance in the context of facility regulations?

<p>Any deficiency that causes a facility not to be in substantial compliance.</p> Signup and view all the answers

What does 'no opportunity to correct' mean?

<p>The facility will have remedies imposed immediately after a determination of noncompliance.</p> Signup and view all the answers

What does 'opportunity to correct' mean?

<p>The facility is allowed an opportunity to correct identified deficiencies before remedies are imposed.</p> Signup and view all the answers

What is the definition of a nursing facility?

<p>A Medicaid nursing facility.</p> Signup and view all the answers

What is OBRA '87?

<p>Omnibus Budget Reconciliation Act of 1987.</p> Signup and view all the answers

A nurse aide means any individual providing nursing or nursing-related services to residents.

<p>True</p> Signup and view all the answers

What does a partial extended survey evaluate?

<p>Additional participation requirements and verifies the existence of substandard quality of care during an abbreviated standard survey.</p> Signup and view all the answers

What does past noncompliance refer to?

<p>A deficiency citation at a specific survey data tag that meets three criteria related to compliance.</p> Signup and view all the answers

Sufficient evidence must support that the facility corrected the noncompliance for it to be considered compliant.

<p>True</p> Signup and view all the answers

What is a per day civil money penalty?

<p>A civil money penalty imposed for each day a facility is not in substantial compliance.</p> Signup and view all the answers

Who can be considered a representative for purposes of educational programs?

<p>Family members, legal guardians, friends, and ombudsmen assigned to the facility.</p> Signup and view all the answers

What does self-reported noncompliance mean?

<p>Noncompliance that is reported by a facility to the State Survey Agency before it is identified by the State.</p> Signup and view all the answers

What is a standard survey?

<p>A periodic, resident-centered inspection to determine compliance with participation requirements.</p> Signup and view all the answers

What is the state survey agency responsible for?

<p>Conducting most surveys to certify compliance with Centers for Medicare and Medicaid Services' participation requirements.</p> Signup and view all the answers

What does substandard quality of care mean?

<p>Deficiencies related to participation requirements that constitute either immediate jeopardy to resident health or safety.</p> Signup and view all the answers

What is substantial compliance?

<p>A level of compliance with the requirements of participation such that identified deficiencies pose no greater risk than minimal harm.</p> Signup and view all the answers

Substantial compliance constitutes compliance with participation requirements.

<p>True</p> Signup and view all the answers

Study Notes

Abbreviated Standard Survey

  • A survey that gathers information primarily through resident-centered techniques to assess facility compliance with participation requirements.

Compliance and Noncompliance

  • Certification of Compliance indicates a facility meets substantial compliance for CMS participation in Medicaid or Medicare.
  • Certification of Noncompliance signifies that a facility fails to meet substantial compliance and thus is ineligible for Medicaid or Medicare programs.
  • Noncompliance refers to any deficiency causing a facility not to be in substantial compliance.

Abuse and Neglect

  • Abuse involves the willful infliction of harm, unreasonable confinement, or intimidation resulting in physical or mental distress.
  • Neglect pertains to the failure to provide necessary goods and services to prevent physical harm or mental anguish.

Deficiency and Immediate Jeopardy

  • Deficiency indicates a facility's failure to meet participation requirements as specified in the Act.
  • Immediate Jeopardy means noncompliance that can likely cause serious injury, harm, impairment, or death to a resident.

Surveys and Evaluation Types

  • Standard Survey: Periodic inspections to assess service quality and compliance with participation requirements.
  • Abbreviated Standard Survey: May occur based on specific complaints, changes in management, or indication of concerns.
  • Expanded Survey: An extension of a standard survey due to suspected substandard care.
  • Extended Survey: Evaluates additional participation requirements found to be deficient during previous surveys.
  • Partial Extended Survey: Assess participation requirements subsequent to identifying substandard care.

Survey Entities

  • State Survey Agency (SA) is responsible for conducting surveys to certify compliance with CMS participation requirements.
  • State Medicaid Agency oversees the administration of the Medicaid program.

Training and Competency

  • NATCEP: Nurse Aide Training and Competency Evaluation Program, essential for nurse aides providing services in facilities.

Enforcement and Remedies

  • Enforcement Action can include penalties like termination of provider agreements or temporary management during noncompliance.
  • No Opportunity to Correct (NOTC) leads to immediate remedies following noncompliance determination.
  • Opportunity to Correct (OTC) allows facilities to address deficiencies before penalties are applied.

Family and Representation

  • Immediate Family includes legal relations such as spouse, parent, child, sibling, etc.
  • Representative is defined for purposes of educational programs as those involved in advocating for residents, including family and legal representatives.

Quality of Care Standards

  • Substandard Quality of Care denotes levels of compliance resulting in immediate jeopardy or widespread harm.
  • Substantial Compliance indicates identified deficiencies pose minimal risk to resident health or safety.

Miscellaneous

  • Self-Reported Noncompliance is when a facility alerts State agencies to its deficiencies before official identification by regulators.
  • Per Day Civil Money Penalty applies daily for periods not in substantial compliance; civil penalties can also be imposed per incident of noncompliance.

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Test your knowledge on the critical concepts from Chapter 7 of the SOM. These flashcards cover terms and definitions related to resident-centered survey techniques and compliance requirements. Perfect for those studying healthcare regulations and facility standards.

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