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NAB FINAL EXAM Questions and
Answers Graded A+ Latest Update
What is forecasting? - CORRECT ANSWER trend identification and analysis What skills are needed for forecasting? - CORRECT ANSWER ability to accurately predict the future implications for the nursing facility of new trends to which the current environment may offer clues. What will survival in the nursing home industry depend on? - CORRECT ANSWER ability to forecast the future and to learn entirely new ways of thinking, behaving, motivating, and communicating in the nursing facility. It will also depend on the ability and willingness to change. What is the purpose of planning - CORRECT ANSWER provide an integrated decision system that, based on the changes forecast by the administrator, establishes the framework for all facility activities. What are plans? - CORRECT ANSWER statements of the organizational goals of the facility What is strategic planning? - CORRECT ANSWER process of analyzing the facility's competitive position, developing the strategic goals, devising a plan of action, and allocating the resources that will best achieve those goals. What is phase one in planning? - CORRECT ANSWER Decide what ought to be
done: governmental permissions, analyzing the competition, factoring in economic considerations, account for marketing concerns. What is phase two in planning? - CORRECT ANSWER Set short and long range goals What is phase three in planning? - CORRECT ANSWER Decide on the means to achieve the objectives In assessing your community, what three areas must an administrator appraise? - CORRECT ANSWER governmental permissions, competition and economic considerations What are some of the governmental permissions an administrator should consider when appraising their community - CORRECT ANSWER zoning requirements, building codes and local fire codes what competition should the administrator assess when appraising for their community? - CORRECT ANSWER the level of unmet need - would the facility fill up sufficiently and maintain the desired level of occupancy over an extended period of at least 5 years, preferably 10 years - local hospital with long term care facilities what economic considerations should the administrator assess when appraising their community - CORRECT ANSWER are the residents apt to have the present and future income to keep occupancy levels high and with the desired mix of resident.. Would the facility be competitive with daily charges? what are the trends among third-party payers in the community? What market considerations should the administrator assess when appraising their community - CORRECT ANSWER the role of the proposed nursing facility in
how does the administrator exercise control? - CORRECT ANSWER by comparing the actual care given to residents to the actual output with the care called for I the organizational policies and plans of action What is control of quality - CORRECT ANSWER the process of asking if the work accomplished by the facility is up to expected stands and if not taking corrective actions to remedy the problem what does the administrator use as guidelines for the output - CORRECT ANSWER the policies and plans of action What is feedback - CORRECT ANSWER a form of control what are types of feedback - CORRECT ANSWER resident council regulatory feedback external feedback what percentage of bills for nursing homes are paid by medicare/medicaid - CORRECT ANSWER 80 - 90% What does the centers for Medicaid and medicare define the system as - CORRECT ANSWER minimum data set and the resident assessment protocols what is entropic process? - CORRECT ANSWER universal law of nature that all organisms move toward death what is negative entropy? - CORRECT ANSWER an organization that keeps on growing with no time constraints. It receives more energy from the environment than it consumes what is staffing? - CORRECT ANSWER hiring the right person for the jobs in
the organization What determines the quality of life in a nursing home? - CORRECT ANSWER the interactions between residents and staff What is directing? - CORRECT ANSWER process of communicating to employees what is to be done by each of them and helping them to accomplish it What is a policy? - CORRECT ANSWER verbal, written or implied overall guide that sets up boundaries supplying the general limits and direction in which managerial action will take place What is the difference between a policy and procedure - CORRECT ANSWER a policy is a statement that contains some degree of freedom, some further need for interpretation. Procedures are step-by-step instructions on how a specific task is to be carried out What happens if a facility receives a K or L deficiency? - CORRECT ANSWER the facility is typically given notice that Medicare/Medicaid certification will be terminated within 30 days if deficiencies are not satisfactorily corrected What is an effective leader? - CORRECT ANSWER a person who have foresight combined with an ability to guide the organization to successfully take advantage of the opportunities the future offers. What is the allowable medication error rate? - CORRECT ANSWER 5% What is polypharmacy - CORRECT ANSWER 9 or more meds What are types of thickened liquids - CORRECT ANSWER honey, nectar, pudding
What is PPS - CORRECT ANSWER Prospective Payment System (Medicare payment system) When was the National registry of Nursing Home Aides established - CORRECT ANSWER 1998 What is Phase I in the survey process - CORRECT ANSWER survey sample - used to select appropriate residents for survey - done through the resident level summary What is a torte? - CORRECT ANSWER a civil wrong Who brought about nursing home terminology in 1961? - CORRECT ANSWER Nursing Home Standards Guide What is working capital? - CORRECT ANSWER an organizations current assets or short-term assets Who added the affordable care act - CORRECT ANSWER Social security act Who came up with deficiency citations - CORRECT ANSWER HCFA (Health Care Financing Administration) What are the 5 elements of QAPI - CORRECT ANSWER Design and Scope Government and Leadership Feedback, Data Systems and Monitoring Performance Improvement Projects
Analysis and Systemic Action How many hours can there be between Dinner and Breakfast if a nourishing snack is provided and the resident agrees? - CORRECT ANSWER 16 hours When is the MDS completed for a Medicare Patient - CORRECT ANSWER 5 days 14 days 30 days change of condition When is the MDS completed for a Medicaid patient - CORRECT ANSWER 14 days Quarterly Change of condition What is not a quality indicator? - CORRECT ANSWER loss of appetite What is a sentinel event - CORRECT ANSWER fecal impaction What is corporate compliance - CORRECT ANSWER deterrence education detection What is a community nosocomial infection? - CORRECT ANSWER infection developed with 48-72 hours after admission
How often do employees receive health exams? - CORRECT ANSWER initially and yearly What is the maximum penalty for falsifying OSA records - CORRECT ANSWER $70, What percentage o the revenue for nursing home industry is Medicaid? - CORRECT ANSWER 50% What is the payback period - CORRECT ANSWER total investment divided by annual savings Under Medicaid and Medicare what accounting system must be used> - CORRECT ANSWER accrual What depreciation method is required by Medicare - CORRECT ANSWER straight line What is important to use when developing the capital budget? - CORRECT ANSWER debt or equity financing What percentage of nursing home costs is payroll? - CORRECT ANSWER 70% Who issues fraud alerts? - CORRECT ANSWER Office of inspector General What is listed on the 941 - CORRECT ANSWER FUTA, FICA for the employee/employer, and Medicare
What does the current ratio indicate - CORRECT ANSWER the ability to pay current debt (current assets divided by current liabilities) What hours is it not necessary to sound the fire alarm? - CORRECT ANSWER 9p-6a What test must decorations pass? - CORRECT ANSWER large and small scale test by the NFPA What are the steps for marketing efforst - CORRECT ANSWER 1. deciding on primary and secondary market
- analyzing area population (age, education, gender)
- deciding on number of patients by category (long term, rehab, dementia).
- implementing plan
- monitor progress What is express corporate authority - CORRECT ANSWER authority delegated by a state statute What is implied corporate authority - CORRECT ANSWER authority delegated by corporate bylaws Who must you report abuse allegations to? - CORRECT ANSWER the administrator
What is prospective rate setting - CORRECT ANSWER pre-determined rates to reimburse nursing facilities without adjusting payment to cover actual cost. What are safe harbors - CORRECT ANSWER permissible referral practices What is situational leadership? - CORRECT ANSWER having to make a choice without input from others What is SWAT - CORRECT ANSWER Strength, weaknesses, opportunities, threats part of strategic planning What is the time frame for strategic planning to develop and implement - CORRECT ANSWER 3 - 5 years What are the 3 dimensions of quality - CORRECT ANSWER structure processes outcomes What are the 4 steps in demings process for quality improvement - CORRECT ANSWER initiate action analyze confirm or plan do
study act when are quarterly financial statements due to residents - CORRECT ANSWER within 30 days after the quarter ends What must a facility have a surety bond? - CORRECT ANSWER to provide assurance of financial security for resident's personal funds When do the results of an abuse investigation have to be reported - CORRECT ANSWER within 5 working days to the appropriate agency When should abuse be reported - CORRECT ANSWER immediately - within 24 hours How long does the facility need to maintain the posted daily nursing staff data - CORRECT ANSWER 18 months What is the abbreviated standard survey - CORRECT ANSWER survey visits facility on a complaint What is a partial extended survey - CORRECT ANSWER follow-up to a finding of substandard quality of care during an abbreviated survey When is the extended survey conducted - CORRECT ANSWER within 14 days of finding substandard care
below 135 degrees Fahrenheit above 41 degrees Fahrenheit What are the food contamination categories - CORRECT ANSWER biological chemical physical When does rapid death of most bacteria occur? - CORRECT ANSWER 165 degrees Fahrenheit how much time should you wait in between eye drops - CORRECT ANSWER 3 - 5 minutes how much time should you wait in-between inhaler puffs - CORRECT ANSWER 1 minutes What is the hot holding temperature required for fresh, frozen or canned fruits or vegetables? - CORRECT ANSWER 135 degrees Fahrenheit How long should the internal food temperature be monitored and maintained? - CORRECT ANSWER 15 seconds What is the internal temperature for poultry - CORRECT ANSWER 165 degrees Fahrenheit What is the internal temperature for ground meat, pork and fish? - CORRECT ANSWER 155 degrees Fahrenheit
When is their most risk for being in the danger zone? - CORRECT ANSWER improper cooling and re-heating What is the dose reduction requirement for sedatives/hypnotics? - CORRECT ANSWER quarterly unless contraindicated What is the dose reduction requirement for psychopharmacologicals? - CORRECT ANSWER 2 separate quarters within the first year with at least a month apart How often must the pharmacist perform a drug regimen? - CORRECT ANSWER monthly When must schedule 2 drugs be reconciled? - CORRECT ANSWER on each shift What is the self determination act? - CORRECT ANSWER required residents to be made aware of their rights in writing upon admission. How often should disaster drills be conducted - CORRECT ANSWER six month intervals on all 3 shifts What is substantial compliance - CORRECT ANSWER notice of isolated deficiencies What is the new name for the resident assessment protocol - CORRECT ANSWER CAA's care area assessments
Who has direct supervisory responsibilities for the staff that actually does the work? - CORRECT ANSWER Lower-level management
What position(s) would be considered lower level management? - CORRECT ANSWER nurse supervisor or charge nurse What type of authority does a person who is empowered by the administrator to make decisions have? - CORRECT ANSWER line authority What role is considered a line position? - CORRECT ANSWER Director of Nurses What positions are expected to advise the administrator or appropriate others in the facility on what to do, but they have been given no authority by the administrator to make decisions on behalf of the facility? - CORRECT ANSWER Staff Position What are positions in a nursing facility that are considered staff positions? - CORRECT ANSWER accountant in business office paid consultants (local pharmacists, registered dietitian) Hot water dishwasher wash cycle temperature 150⁰ F Hot water dishwasher rinse cycle temperature 160⁰ F Hot water dishwasher final rinse cycle temperature 180⁰ F 3rd compartment sink in kitchen contains: sanitizer 3rd compartment should be: 75⁰ F with 50 PPM if bleach is used or 12.5 PPM (parts per million) if iodine is used
