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?
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What does certification of noncompliance mean?
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What is a deficiency in the context of facility compliance?
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A dually participating facility has a provider agreement in both the Medicare and Medicaid programs.
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What are educational programs in the context of long-term care?
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What does enforcement action refer to?
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State monitoring is an option for alternative state remedies.
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What does an expanded survey involve?
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What does an extended survey evaluate?
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In facility compliance, what is the definition of a 'facility'?
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Who is considered to be immediate family under the compliance regulations?
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What is immediate jeopardy in the context of facility noncompliance?
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What does misappropriation of resident property mean?
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What does NATCEP stand for?
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What does neglect refer to in the context of facility care?
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New admission means a resident who is admitted to the facility on or after the effective date of a denial of payment remedy.
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What is noncompliance in the context of facility regulations?
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What does 'no opportunity to correct' mean?
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What does 'opportunity to correct' mean?
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What is the definition of a nursing facility?
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What is OBRA '87?
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A nurse aide means any individual providing nursing or nursing-related services to residents.
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What does a partial extended survey evaluate?
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What does past noncompliance refer to?
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Sufficient evidence must support that the facility corrected the noncompliance for it to be considered compliant.
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What is a per day civil money penalty?
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Who can be considered a representative for purposes of educational programs?
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What does self-reported noncompliance mean?
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What is a standard survey?
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What is the state survey agency responsible for?
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What does substandard quality of care mean?
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What is substantial compliance?
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Substantial compliance constitutes compliance with participation requirements.
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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.