Assisted Living Regulations and Requirements in New Jersey, Study notes of Nursing

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NJ CALA EXAM 2024 WITH 100%

ACCURATE ANSWERS

NJ CALA EXAM 2024 WITH 100%

ACCURATE ANSWERS

Statement of Cash Flow - correct answersThe _______________ is a report that reconciles the cash balance at the beginning of the period with the cash balance at the end of the period. It provides an accountability of the sources of funds and the uses of accounting: cash and accrual. The date of the reports is "for the period" since it covers a specific beginning date and ending date. Trial Balance - correct answersA _______________ is a summary listing of an organization's accounts and their respective balances in numerical order according to the charts of accounts. Its indicated both debit and credit accounts, at all the trial balance debits and credits must equal. (Example: Itemized Raw Foods and Credit Tracking). Aging in Place - correct answersA process whereby individuals remain in their living environment despite the physical and/mental decline and growing needs for supportive services that may occur in the course of aging. ADLs (Activity of Daily Living) - correct answersThe functions or tasks for self-care, which are performed either independently or with supervision or assistance, such as: dressing, bathing, toileting, transfer, locomotion, bed mobility, and eating. Assisted Living - correct answersA coordinated array of supportive personal and health services 24 hours per day, to residents who have been assessed to need these services including persons who require nursing home level care. It promotes resident self direction and participation in decisions that emphasize independence, individuality, privacy, dignity, and homelike surroundings. Bounded Choice - correct answersLimits places on a resident's choice as a result of an assessment, in accordance with N.J.A.C. 8:36-5.18, which indicates that such resident's choices or preference place the resident or others at a risk of harm or lead to consequences which violate the norms of the facility or program or the rights of others. CPCH (Comprehensive Personal Care Home) - correct answersA facility which is licensed by the Department of Health and Senior Services to provide room and board and to assure that assisted living services are available when needed, to four or more adults unrelated to the proprietor. Residential units in this type of facility have no more than two residents and have a lockable door on the unit entrance.

Process of Medication Administration - correct answers1.) Removing an individual dose from a previously dispensed, properly labeled container (including a unit dose or unit-of-use container). 2.) Verifying it with the prescriber's orders. 3.) Giving the individual dose to the resident. 4.) Seeing that the resident takes it (if oral). 5.) Recording the required information, including but not limited to the method of administration, time administered, initials of individuals who administered the medication, and effect of the medication when "PRN" or as-needed medications are administered. Dignity - correct answersThe self-worth of a resident. Independence - correct answersThe support and enhancement of resident capabilities and facilitation of resident abilities so that the resident's preferences and choices may be implemented within a barrier- free environment. Individuality - correct answersEach resident's unique needs, capabilities, personalities, backgrounds and preferences. MAR (Medication Administration Record) - correct answersAn individual resident record that contains, but is not limited to: resident name, date of birth, diagnosis(es), age, physician, name and medication strength, dosage form, route of administration, frequency, date and time of administration, initials of individual administering the medication, a section containing the full signature and title of each individual who initials it, date medication ordered, stop date if appliacable, allergies, and all other professionally acceptable information that is appropriate. 30 - hour - correct answersA MATCEP or Medication Aide Training Competency and Evaluation Program is a department approved minimum ____________ training course conducted by a Department approved registered professional nurse and registered pharmacist, to instruct CNA, CHHA, or PCAs, in the administration of medications to residents, within assisted living residences, comprehensive personal care homes and assisted living programs. Nursing Home-Level Care - correct answersAn individual requires this as defined by N.J.A.C. 8:85-2.1. It is provided to individuals who have chronic medical condition(s) resulting in moderate to severe

impairments in physical, behavioral, cognitive, and/or psychosocial functioning. It is determined by a registered professional nurse and identified in a plan of care. Pain Management - correct answersIn accordance with N.J.A.C. 8:43E-6, means the assessment of pain and, if appropriate, treatment in order to assure the needs of patients or residents of health care facilities who experience problems with pain are met. Treatment of pain may include the use of medication or application of other modalities and medical devices such as, but not limited to, heat or cold, massage, transcutaneous electrical nerve stimulation (TENS), acupuncture, and neurolytic techniques such as radiofrequency coagulation and cryotherapy. Privacy - correct answersA resident's degree of control over a specific physical area and/or time; levels of intimacy with family and others; and communication and contact with others outside the facility or program environment. Shared Responsibility - correct answersResidents (and if the resident wishes the resident's family) and providers of assisted living services share responsibility for planning and decision making affecting residents. To participate fully in this, residents shaw be provided with clear and understandable information about the possible consequences of their decision-making, in accordance with the provisions of N.J.A.C. 8:35-5.18(a)2. Total Bed Complement - correct answersAnother term for resident census. Unit Dose Drug Distribution System - correct answersA system in which medications are delivered to the residents areas in single unit packaging, and which meets the following criteria: 1.) Each medication shall be individually wrapped and labeled with the generic or trade (brand) name and strength of medication, lot number or reference code, expiration date, and manufacturer's name, and shall be ready for administration to the resident. 2.) Cautionary instructions shall appear on the resident's record of medication administration, and the system shall include provisions for noting additional information, including but no limited to, special times or routes of administration and storage conditions. 3.) Commercial repackages shall comply with 21 CFR 201.1, incorporated herein by reference, as amended and supplemented, and N.J.A.C. 8:39. Unit-of-Use - correct answersA system of in which medications are delivered to the resident areas either in single unity packaging, bingo or punch cards, blister or strip packs, or other system where each

3 Years - correct answersAn assisted living administrator certification shall be valid for a period of ____________ from date of issue. 3 Years - correct answersAt least once every ___________, on a schedule to be determined by the Department, an assisted living administrator shall file an application for renewal of current certification. 30 hours - correct answersComplete at least ____________, of continuing education regarding assisted living concepts and related topics, as specified and approved by the Department of Health and Senior Services. Eligibility for Renewal - correct answers1.) Complete 30 hours of CEUs, 2.) Criminal History Background Check Lapse of Certification - correct answersThe applicant shall be required to complete 10 hours of continuing education credit for each year in which the certification was inactive in addition to the required 30 hours of continuing education for the last completed triennial certification period in which the applicant's certification was active. 40 Hours - correct answersIn order to be an assisted living administrator trainer, they must complete at least ____________ of the basic concepts etc. of assisted living. Administrator's Responsibilites - correct answers1.) Ensuring the development, implementation, and enforcement of all policies and procedures, including resident rights; 2.) Planning for, and administration of, the managerial, operational, fiscal, and report components of the facility; 3.) Ensuring that all personnel are assigned duties based upon their ability and competency to perform the job and in accordance with written job descriptions; 4.) Ensuring the provision of staff orientation and staff education; 5.) Establishing and maintaining liaison relationships and communication with facility staff and services and with residents and their families; 6.) Establishing and maintaining liaison relationships and communications with community hospitals, social services agencies, and mental health service agencies. Ombudsman - correct answersAn advocate who is an official in charge of representing the interests of the public by investigating and addressing complaints of maladministration or a violation of rights.

Informed Consent in Different Languaes - correct answersThe resident has a right to refuse medication and treatment after the resident has been informed, in language that the resident understands, of the possible consequences of this decision. 30 Days - correct answersThe resident has the right to receive written notice at least ___________ in advance when the facility requests the resident's transfer or discharge, except in an emergency. This written notice shall include the name, address, and telephone number of the New Jersey Office of the Ombudsman for the Institutionalized Elderly, and shall also be provided to the resident's legally appointed guardian, if applicable, or, with the resident's consent, to the resident's family, ___________ in advance. Types of Services for ALF - correct answers1.) Assistance with Personal Care; 2.) Nursing; 3.) Pharmacy; 4.) Dining; 5.) Activities; 6.) Recreational; 7.) and Social Work services. Nursing Home Level Care Characteristics - correct answers1.) The resident requires 24/7 nursing supervision; 2.) The resident is bedridden for more than 14 days; 3.) The resident is consistently and totally dependent in four or more of the following activities of daily living: dressing, bathing, toilet use, transfer, locomotion, bed mobility, and eating; 4.) The resident has a cognitive decline severe enough to prevent the making of simple decisions regarding activities such as bathing, dressing, and eating and cannot respond appropriately to cueing and simple directions; 5.) The resident requires treatment of a stage 3 or 4 pressure sore or multiple stage two pressure sores; 6.) The residents requires than assistance with transfer; 7.) The resident is a danger to self or others; 8.) The resident has a medically unstable condition and/or has special health problems, and a regimen of therapy cannot be appropriately developed and implemented in the assisted living environment. 10 Percent - correct answersA new or existing assisted living residence or comprehensive personal care home licensed on or after Sept. 1st, 2001, shall attain a level of occupancy by Medicaid-eligible persons of at least ______________ of its total bed complement within 3 years of licensure (for new ALFs) and shall maintain this level of Medicaid occupancy thereafter. In cases in which either the total bed complement or the total number of beds added in an existing facility is less than that amount, at least one bed shall be reserved for a Medicaid-eligible person. (p.34-35) Specialized Long-Term Care - correct answersResidents who shall not remain in the assisted living residence or comprehensive personal care home and shall be transferred to a long-term care facility. Medicaid-Eligible Person - correct answersAn individual who has been determined as satisfying the financial eligibility criteria for medical assistance under the Medicaid program, and has been assessed as

3 or more hours - correct answersInterruption for ____________________ of basic physical plant services, such as heat, light, power, water, food, or staff is a reportable event. Reportable Events - correct answersAny major occurrence or incident of an unusual nature, including, but not limited to, all fires, disasters, elopements, and all deaths resulting from accidents or incidents in the facility or related to facility services. Incidents shall also contain information about injuries to residents and/or personnel disruption of services, and extent of damages; All suspected cases of resident abuse, neglect, or misappropriation of resident property, including incidents reported to the Ombudsman; All alleged or suspected crimes which are serious crimes commitment by or against residents, reported at the time of occurrence to the local police department; Occurrence of epidemic disease in the facility; Termination of employment of the administrator, and the name and qualifications of his or her replacement. Notices for Residents & the Public - correct answers1.) All waivers granted by the Department 2.) A copy of the last annual licensure inspection survey report and the list of deficiencies from any valid complaint investigation during the past 12 months. 3.) Policies and procedures regarding resident rights. 4.) Business hours of the facility. 5.) Policies and procedures for maintaining security of the assisted living residence and comprehensive personal care homes. 6.) The toll-free hot line number of the Department; telephone numbers of county agencies and the of the State of New Jersey Office of the Ombudsman. 7.) The names of, and a means to formally contact, the owner and/or members of the governing agency. Register - correct answersThe facility shall maintain an annual chronological listings of residents admitted and discharged, including the destination of residents who are discharged. It contains a current census of all residents, along with other pertinent information, shall be maintained by each assisted living residence, comprehensive personal care home, or assisted living program. The following standards for maintenance shall apply: 1.) The adminstrator or the administrator's desginee shall make all the entries and shall be responsible for its maintenance and safe-keeping. 2.) It shall be kept up-to-date at all times. Admissions, discharges and discharge destinations, and other changes shall be recorded within in 48 hours. 3.) It is a permanent record and shall be kept in a safe place.

4.) All entries into it shall be clear, legible, and written in ink or typed. Maintenance of Records - correct answersA register of residents are to be maintained, along with statistical data; such as resident census and facility characteristics shall be forwarded to the Department on request, in a format provided by the Department. Resident Interview - correct answersThis shall include at least orientation to the facility's or program's policies, business hours, fee schedule, services provided, residents rights, and criteria for admission and discharge. Documentation of this shall be included in the resident record. 15 Days - correct answersIf an applicant, after applying in writing, is denied admission to the assisted living residence, comprehensive personal care home, or assisted living program, the applicant and/or his or her family, guardian, or responsible person shall, upon written request, be given the reason for such denial in writing, signed by the administrator, within ____________ of the receipt of the written request. 30 Days - correct answersWritten notification of by the administrator shall be provided to a resident and/or his or family, guardian, or designated responsible person, of a decision to involuntarily discharge the resident from the facility or program. Such involuntary discharge shall only be upon grounds contained in the facility's or program's policies and procedures and shall only occur only if the resident has been notified and informed of such policies in advance. The notice of discharge shall be given at least __________ in advance and shall include the reason for discharge and the resident's right to appeal. This _________ advance notice shall not apply if the discharge is for reasons in accordance with the criteria specified at N.J.A.C. 8:36-5.1(d) (such as an emergency situation). A copy of the notice shall be entered into the resident's record. Notification Requirements - correct answers1.) The resident acquires an acute illness requiring medical care. 2.) Any serious accident, criminal act or incident occurs which involves the resident and results in serious harm or injury or results in the resident's arrest or detention. 3.) The resident is transferred from the facility. 4.) The resident expires. Interpretation Services - correct answersThe facility or program shall demonstrate the ability to provide a means to communicate with any resident admitted who is non-English-speaking and/or has a communication disability, using available community or on-site resources.

3.) The resident's need, if any, for assistance with transportation. 30 days - correct answersWithin ____________ prior to admission to the assisted living residence, comprehensive personal care home, or assisted living program, a physician, advanced practice nurse or physician assistant shall specify in writing that the resident is appropriate for this level of care to have a health service plan. Physician and Dentist - correct answersAt the time of admission, arrangements shall be made between the administrator and the resident, guardian, or responsible person regarding the _______________and ______________ to be called in case of illness, or the individual to be called for a resident who, because of religious affiliation, is opposed to medical treatment. 14 days - correct answersIf the initial assessment of N.J.A.CC. 8:36-7.1(a) indicates that the resident requires health care services, a health care assessment shall be completed within __________ of admission by RN using an assessment instrument available from the Department, or an assessment instrument adopted by the facility or program, equivalent to the instrument available from the Department, and which meets the requirements. Health Care Assessment - correct answers1.) Need for assistance with ADLs. 2.) Cognitive patterns. 3.) Communication/hearing patterns. 4.) Vision Patterns. 5.) Physical functioning and structural problems. 6.) Continence. 7.) Psychosocial well-being. 8.) Mood and behavior problems. 9.) Activity pursuit patterns. 10.) Disease diagnoses. 11.) Health conditions and preventative health measures, including, but limited to, pain, falls, and lifestyle. 12.) Oral/nutritional status. 13.) Oral/dental status. 14.) Skill conditions.

15.) Medication Use* 16.) Special treatment and procedures. 17.) Restraint use. 18.) Outside service utilization. Health Service Plan - correct answers1.) Orders to treatment or services, medications, and diet, if needed. 2.) The resident's needs and preferences for himself or herself. 3.) The specific goals of treatment or services, if appropriate. 4.) The time intervals at which the resident's response to treatment will be reviewed. 5.) The measures to be used to assess the effects of treatment. Semi-annually - correct answersThe resident general service plan shall be reviewed and, if necessary, revised _______________, and more frequently as needed based upon the resident's response to the care provided and any changes in the resident's physical or cognitive status. Quarterly - correct answersThe resident health service plan shall be reviewed, and if necessary, revised ________________, and as needed, based upon the resident's response to the care provided and any changes in the resident's physical or cognitive status. Annually - correct answersThe facility shall be responsible for reassessing residents who have neither a general service or health service plan in response to changes in the resident's functional and/or cognitive status at least ______________ and more frequently if such reassessment is predicted to change in the resident's functional and/or cognitive status. 14 days or less - correct answersIf a resident who has not been receiving a health care service requires a health care service on a temporary basis (meaning a period of time reasonably expected to be _____________________ and not involving a significant change in condition or a life-threatening illness), neither a health care assessment nor a health service plan be required. The administrator shall develop a system to identify the residents receiving a health care service on a temporary basis. Annual, Annually - correct answersEach resident shall have an ____________ physical examination by a physician, advanced practical nurse or physician assistant which shall be documented in the resident's record. The physician advanced practical nurse or physician assistant shall certify _________________

20 hours - correct answersIn order to be eligible to renew a current certification, the certified personal care assistant shall complete at least ____________ every two years of continuing education in assisted living concepts, and related topics, including cognitive and physical impairment and dementia. CMA (Certified Medical Assistant) - correct answersCertified as a CNA, CHHA, or PCA; Successfully completion of medication administration training coursed approved by the Department; Successful completion of a Department of Health and Senior Services approved standardized examination regarding medication administration for PCAs. An oral examination shall not substitute for the written component of this examination. 2 years - correct answersMedication aide certification shall be valid for a period of ___________ from the date of issue. At least once every __________, on a schedule to be determined by the Department, a medication aide shall file an application for renewal of current certification. 30 hours - correct answersIn order to be eligible to renew for a current certification, the medication aide have completed at least _________ of continuing education, seminars, or in-service training every two year certification period. This includes continuing education for review of the fundamental principles of medication administration, the skills and knowledge necessary for the task of medication administration, and topics of current drug use relevant to the elderly. 6 Months - correct answersAn applicant for medication aide certification shall sit for the standardized examination within __________ of successful completion of an approved medication administration training course. Minimum PCA Staffing - correct answersThe facility shall provide on the premises at all times (per building) the following minimum numbers of employees: 1.) At least one awake PCA in accordance with N.J.A.C. 8:36-9.1(a). 2.) At least one additional employee. Dietician Qualifications - correct answersThe dietitian shall possess a bachelor's degree from an accredited collage or university with a major area of concentration in a nutrition-related field of study, and one year of full-time professional experience or graduate-level training in nutrition. Provision of Meals - correct answersThe assisted living residence or comprehensive personal care home shall provide dining services to meet the daily nutritional needs of residents, directly in the facility.

Designation of a Food Coordinator - correct answersThe facility shall designate a food service coordinator who, if not a dietitican, functions with scheduled consultation from a dietician. When meals are prepared in the facility, the food service coordinator or designee shall be present in the facility. The food service coordinator shall ensure that dining services are provided as specified in the dining portion of the health care plan. Responsibilities of Dietitians - correct answersIf indicated, according to residents' needs, a dietitian shall be responsible for providing resident care, including, but not limited to, the following: 1.) Assessing the nutritional needs of the resident. If indicated, preparing the dietary portion of the health care plan on the basis of the assessment, providing dietary services to the resident as specified in the dietary portion of the health plan, reassessing the resident, and revising the dietary portion of the health care plan. Each of these activities shall be documented in the resident's record; and 2.) Providing nutritional counseling and education to residents. 14 days - correct answersWritten, dated menus shall be planned at least _________ days in advance for all diets. 7 day - correct answersThe same menu shall not be used more than once in any continuous __________ period. 30 days - correct answersMenus, with changes or substitutes, shall be kept on file in the facility for at least _____________. Supervision of Medication Administration - correct answers1.) The facility or program shall document the provision of training (received from the RN or licensed pharmacists, and documented) to each employee who has been designated to provide resident supervision of self-administration of medications. 2.) The facility or program shall document any instances where medications are not taken in accordance with the prescribers orders. 3.) The facility shall keep a record of all prescribed medications for which the resident is receiving supervision of medication administration. OTC (Over the Counter) - correct answers_____________ solid and liquid dosage forms may be dispensed in a non unit-of-use or non unit-dose medication distribution system.

Quarterly - correct answersDesignation of Pharmacist 1.) Training of employees. 2.) Educating residents regarding medications. 3.) Establishing policies and procedures which ensure safe appropriate self-administration of medications. 4.) Reviewing medication administration records on ____________ basis, and at least ___________, inspecting all common areas of the facility or program where medication are stored or administered, documenting any problems and proposing solutions to these problems, and maintaining records of such inspections. Storage and Control of Medications - correct answers1.) The storage area shall be kept locked when not in use. 2.) The storage area shall be used only for storage of medication and medical supplies. 3.) The key to the storage area shall be kept on the person of the employee on duty who is responsible for resident supervision. 30 days - correct answersDiscontinued or expired medications shall be destroyed within _____________ in the facility, or, if unopened and properly labeled, returned to the pharmacy for credit, if allowable, and in conformance with N.J.A.C. 13:39 and other State and Federal laws, codes, and regulations. Medication Destruction - correct answersAll ________________________________ in the facility shall be witnessed and documented by two individuals, each of whom shall either be the administrator, the registered professional nurse, the licensed practical nurse, or the provider or consultant pharmacist. Resident Council - correct answersResidents shall have the opportunity to organize and participate in a ______________________ that presents the resident's concerns to the administrator of the facility. Social Worker - correct answersThe facility shall arrange for the provision of social work services to residents who require them, by social workers licensed. Each social worker shall be licensed or certified by the New Jersey State Board of Social Work Examiners in accordance with N.J.A.C. 13:44G and N.J.S.A. 45:15BB.

Emergency Medical Services - correct answersEmergency medical services shall be available to or arranged for residents requiring these services. The facility shall develop a written plan for arranging for emergency transportation of residents for medical care and returning them to the assisted living residence. One - correct answersAt least _______ employee trained in cardiopulmonary resuscitation (CPR) and the Heimlich maneuver shall be available in the facility at all times. The facility shall have an automatic external defibrillator (AED) on site. At least _______ employee trained in the use of the AED shall be available in the facility at all times. Emergency Plan and Procedures - correct answersThe facility shall develop written emergency plans, policies, and procedures which shall include plans and procedures to be followed in case of medical emergencies, power failures, fire, and natural disasters. The emergency plan shall be filed with the Department and the Department shall be notified when the plans are changed. Copies of the emergency plans shall also be forwarded to other agencies in accordance with State and municipal laws. Nothing in these rule shall supersede or imply non-compliance with the Uniform Fire Act or Uniform Fire Code, N.J.A.C. 5:70, or NFPA 101. Month - correct answersThe facility shall conduct at least one drill of the emergency plans every _____________. 4 - correct answersThe 12 drills shall be conducted on a rotating basis, to ensure that _______drills occur during each working shift on an annual basis. Year - correct answersThe facility shall maintain documentation of all drills, including the date, hour, description of the drill, participating staff, and signature of the person in charge. In addition to the drills for emergencies due to fire, the facility shall conduct at least one drill per _________ for emergencies due to a disaster other than fire, such as storm, flood, other natural disaster, bomb threat, or nuclear accident (a total of 12 drills). Annually - correct answersAll staff shall participate in at least one drill ______________, and select residents may participate in drills. Annually - correct answersThe facility shall request of the local fire department that at least one joint fire drill shall be conducted _______________. Upon scheduling a joint fire drill, the facility shall notify first aid and civil defense agencies of this drill and shall participate in community-wide disaster drills.