NURSING HOME ADMINISTRATOR LICENSURE

EXAM REVIEW COURSE

National Exam ◘MODULE 8

referencsection

Final Comprehensive Test

Examination
 Answer key
Answer Sheet

Stan Mucinic, LNHA

LEGAL NOTICES

Students enrolled in the “National Nursing Home Administrator Licensing Course” are purchasing the professional knowledge of the instructor to assist the student to prepare for the national licensure exam administered by the National Association of Boards of Examiners (NAB).

This is a 5-week intensive independent study program designed to provide students a unique personalized and structured learning environment where progress is monitored by the instructor through email to help students maintain focus and complete scheduled assignments timely.

THE INSTRUCTOR MAKES NO EXPRESS OR IMPLIED WARRANTY OR REPRESENTATION OF ANY KIND THAT COMPLETION OF THIS OR ANY LICENSURE PREPARATION COURSE OFFERED BY INSTRUCTOR WILL GUARANTEE A PASSING SCORE ON ANY LICENSING EXAM.

An individual’s ultimate success in passing the licensure exam is dependent on an individual’s professional experience, academic preparation, and the time and energy the individual can commit to exam study and preparation.

A student’s work schedule or other commitments may require more time to prepare for an exam than allotted. The student is solely responsible for licensing exam registration/testing and retesting fees.

Contact Information

You may contact Stan Mucinic by email at with any questions.

FINAL COMPREHENSIVE TEST – ANSWER KEY

1 / Per the ADA the range for a hearing compatible phone is 12 – 18 decibels
2 / Lip Smacking and uncontrolled facial gestures
3 / Chronic Obstructive Pulmonary Disease
4 / Congestive Heart Failure
5 / A blockage of the arteries is arteriosclerosis
6 / Hardening of the artery walls is called atherosclerosis
7 / Trans Ischemic Attack
8 / A TIA is a stroke)
9 / Electro Kardio (cardio) Gram (measures heart activity)
10 / Cerebral Vascular Accident
11 / A CVA is a stroke
12 / A physiatrist is a physician who works with the musculoskeletal system and works closely with the physical therapists
13 / OBRA 1987 does not specify any requirement that a resident must have a bath
14 / OBRA 1987 does not specify any requirement that a resident must have a shower – it is assumed that you will keep the resident clean
15 / Gerontology is the study of the aging process
16 / A gerontologist is a person who studies the aging process
17 / The 4 stages of a decubitis sore: 1. redness/warm to touch 2. a blister that opens with possible pus 3. Tissue loss of the upper and lower layers of the epidermis
4. tissue loss down to the bone
18 / Class 1 deficiency – no harm, no potential for harm, Class 2 deficiency – no harm but potential for harm (they could not identify any residents actually harmed), Class 3 deficiency – Harm but not immediate jeopardy and Class 4 deficiency is Harm and immediate jeopardy
19 / Substandard care would begin with the letter G
Class 1 – A – isolated B- patterned C – Widespread
Class 2 - D – isolated E- pattered F- Widespread
Class 3 - G – isolated H – patterned I- widespread
Class 4 - J - isolated K – Pattered L – Widespread
20 / A myocardial infarct is a heart attack
21 / The first stage of the annual survey is OFFSITE PREPARATION where the surveyors review the facility’s prior surveys, incident reports, ombudsman reports, quality indicators and other information from OSCAR
22 / In the EXIT CONFERENCE the survey team sits down with staff and discloses the results of the annual survey
23 / In the ENTRANCE CONFERENCE the team leader sits down with the facility staff and discusses the survey about to take place and what records they will need to see
24 / The FACILITY TOUR involves the survey team walking around the facility and identifying the layout of the facility
25 / SAMPLE SELECTION involves the survey team identifying which people they want to talk to and records they want to review
26 / INFORMATION ANALYSIS involves identifying which deficiencies, if any, the facility will cited for
27 / INFORMATION GATHERING involves the survey team observing residents and staff, taking notes, interviewing the resident council and other residents
28 / What is the correct order of the steps of an annual survey
  1. offsite preparation
  2. entrance conference
  3. sample selection
  4. information gathering
  5. information analysis
  6. exit interview

29 / The facility must receive a report of the results of a compliance survey within 10 days of the exit interview
30 / A facility must submit a plan of correction for any alleged deficiencies within 10 days from receipt of the report of deficiencies
31 / Your date certain for re-survey ( the earliest the survey team can return to verify the facility corrected all cited deficiencies) is 30 days from the date the survey team exited the facility
32 / You will receive a form 2567 that will detail any deficiencies found during an annual or complaint survey
33 / You have 20 days from the date you receive the 2567 to file a request for administrative hearing to dispute a citation
34 / An IDR is an informal dispute resolution (i.e. sending a letter to the survey team leader or requesting a face to face meeting with the local licensing office to dispute a citation)
35 / An FDR is a formal dispute resolution which involves requesting a hearing before an administrative law judge within 20 days of receipt of the 2567
36 / OSCAR stands for Online Survey and Certification Reporting
37 / The CMS created OSCAR and it is a national base that collects all of the information collected from the MDS data entered into the system from each of the 17,000 nursing homes in the nation
38 / The survey team will printoff:
1)the facility profile report
2)the facility characteristics report
3)resident level summary
from OSCAR before they enter your facility
39 / A standard survey is an annual survey
40 / An abbreviated standard survey is a complaint survey
41 / A extended survey would be imposed if the surveyors found substandard care during an annual survey
42 / A partial extended survey would be imposed if the surveyors find substandard care during a complaint survey
43 / A re-survey is done to verify a facility corrected any cited deficiencies where the facility was cited for no more than a level F citation
44 / A psychiatrist is a physician who specializes in mental disorders
45 / An MDS is a minimum data set
46 / The MDS is required to maintain a continuing evaluation of each residents physical, mental and psychosocial well-being throughout the year
47 / A facility must maintain each resident’s highest practical physical, mental and psychosocial well being and minimize decline per OBRA 1987
48 / You must provide residents an environment that is homelike and de-emphasizes the institutional look of most nursing homes
49 / Type 1 Diabetes is insulin dependent diabetes and is treated with regular insulin injections
50 / Type 2 diabetes is adult onset and is treated with diet, exercises and pills
51 / CMS stands for the Centers for Medicare and Medicaid Services
52 / A facility must be surveyed at every 15 months
53 / A class 1 deficiency is no harm and no potential for harm
54 / What is a class 2 deficiency is no harm but potential for harm
55 / What is a class 3 deficiency is Harm but not immediate jeopardy
56 / What is a class 4 deficiency is harm and immediate jeopardy
57 / A class A fire extinguisher would be used to put out a PAPEROR WOOD fire
58 / A class B fire extinguisher would be used to put out a FLAMMABLE LIQUID FIRE like kerosene
59 / A class C fire extinguisher would be used to put out an ELECTRICAL fire
60 / A class D fire extinguisher would be used to put out a flammable METALS fire like magnesium
61 / An MDS must be signed by a registered nurse
62 / A care plan must be signed by a registered nurse
63 / A comprehensive assessment must be completed within 14 days of admission to a facility
64 / A care plan must be completed within 7 days of the completion of the MDS
65 / A significant change must be processed within 14 days (the comprehensive assessment is the MDS and a significant change means doing a completely new MDS)
66 / A comprehensive assessment must be reviewed every 3 months (quarterly) and completely updated annually or since last significant change.
67 / A care plan must be reviewed every 3 months (quarterly) and completely updated annually. (The care plan must be updated every time the MDS is revised)
68 / HCFA stands for the Health Care Financing Administration
69 / HCFA is the sister organization to the CMS. HCFA sets the rates for Medicare and establishes the RUG rates that SNF’s are paid
70 / OIG is the office of the Inspector General. This is the inspector general for the Department of Health and Human Services which oversees the CMS and HCFA
71 / The OIG investigates Medicare and Medicaid Fraud
72 / The AmericanCollege of Health Care Administrators represents health care administrators
73 / The AHCA represents for profit nursing homes
74 / The AAHSA represents non-profit long term care facilities
75 / DHHS stands for the Department of Health and Human Services and it administers the Social Security Administration, CMS, HCFA, and the FD
76 / NIOSH provides research to OSHA
77 / OSHA stands for Occupational Safety and Health Act or the Occupational Safety and Health Administration which enforces the Act
78 / OSHA protects American workers by ensuring a safe workplace
79 / The Occupational Safety and Health Administration enforces OSHA
80 / ANSI or the American National Standards Institute sets the standards for the for the American with Disabilities Act?
81 / NFPA develops and publishes the life safety code
82 / WE follow the life safety code of 2000
83 / The life safety code is designed to prevent deaths due to structural fires
84 / The Civil Rights Act of 1964 prohibits discrimination on the basis of (RRGCRN) _Race, religion, gender, color and national origin.
85 / The EEOCenforces the Civil Rights Act
86 / The EEOC enforces the provisions of the Americans with Disabilities Act with respect to discrimination in employment based on physical disabilities?
87 / The Age in Discrimination Actprohibits discrimination against workers 40 years and older
88 / Need 20 employees to be subject to the Age in Discrimination Law
89 / The EEOC enforces the Equal Employment Opportunity Act
90 / ADVERSE IMPACT is the standard we use today to determine if discrimination in hiring employees has occurred per the EEOA
91 / If I hire 10 white people (the majority group), then I need to hire 80% of the majority or 80% x 10 = 8 minorities.
92 / Ratio Hiring
93 / NFPA stands for National Fire Protection Association
94 / NFPA researches and publishes the life safety code. It does not enforce the code.
95 / ANSI means the American National Standards Institute
96 / ANSI develops and publishes the Americans with Disabilities Act. It does not enforce the Act?
97 / NFPA enforces the Life Safety Code
98 / The Architectural Barriers Compliance Board enforces the ADA with respect to access to public buildings by the handicapped
99 / The EEOC enforces the Discrimination in Pregnancy Act
100 / The main objective of the Equal Pay Act is to ensure that females are paid the same wages as males for the same work
101 / Plegia means paralysis
102 / Paraplegia is paralyzed from the waist down
103 / Quadriplegia means paralyzed from the neck down
104 / Hemiplegia means paralyzed on one side of the body
105 / FMLA stands for family medical leave act
106 / Must work 12 months or 1250 hours to be eligible for FMLA
107 / Cannot accrue more than 240 compensatory hours each year (this is time off to compensate overtime exempt employees for hours they work and are not paid time and a half)
108 / False the employer is not required to provide paid leave while on FMLA. You can be required to use up any vacation and sick leave before you go to unpaid status
109 / False – the employer is required to pay for health insurance premiums while an employee is on FMLA. You must pay it back if you do not return to work
110 / False – they worked more than 1250 hours and that qualifies them for FMLA
111 / The administrator of a facility is considered overtime exempt or salaried. Salaried employees do not punch a clock
112 / An exempt employee is not entitled to over time pay
113 / An employee who punches in on a time clock is considered hourly or non-exempt
114 / A salaried employee is not entitled to overtime pay
115 / An hourly employee is not an overtime exempt employee. They must be paid overtime
116 / MUST KNOW THIS - Respondent Superior means the superior must respond for the inferior or servant. The employer must pay for injury or damage to third persons caused by employees
117 / the federal employer liability Act says the employer must pay for the medical bills and lost time for a worker injured on the job
118 / The state licenses each nursing home
119 / The CMS certifies nursing homes to be a provider for Medicaid and Medicare
120 / A facility subject to a federal survey would receive an F tag or Federal Tag
121 / A facility subject only to a state survey would receive an N tag or Non-Federal tag)
122 / A facility with life safety violations would receive a K tag
123 / The CMS administers Medicare and Medicaid contracts
124 / Substandard care means a resident was harmed and is a class 3 or 4 violation
125 / Businesses file business taxes quarterly while individuals file annually
126 / Businesses use form 941 file FICA and workers compensation taxes
127 / Employees are provided a W-2 that is a statement of their wages and taxes paid
128 / Each employee fills out a Form W-4 to declare number of exemptions
129 / The Immigration law requires workers to complete an I-9
130 / Must complete the I-9 within 3 days of hire
131 / The Fair Labor Standards Act requires employers to pay their employees a minimum federal wage
132 / SMDA means Safe Medical Devices Act
133 / You have 10 days to report any injuries from a medical device
134 / Must report injuries from medical devices to the manufacturer and the FDA
135 / A power of attorney is for financial matters only and a durable power of attorney can be for both financial and health care decisions as well
136 / A guardian would make decisions for a person declared not competent by a court
137 / A living will specifies whether an individuals wants artificial life prolonging measures if they cannot sustain bodily functions on their own
138 / PSDA stands for the Patient Self Determination Act
139 / The PSDA requires a facility to inform a resident they have the right to make an advanced directive but cannot require them to do so
140 / Must keep OSHA medical records for the course of employment plus 30 years
141 / Must enter all injuries into the OSHA summary log of occupational injuries and illnesses within 7 days
142 / Must report any injuries that require medical attention or lost time
143 / You enter most injuries into the summary log and supplemental log of injuries and illnesses within 7 days. If several workers are hospitalized or killed then you must call within 8 hours
144 / Need11 employees to be subject to the OSHA injury reporting requirement
145 / OSHA requires the safety committee
146 / The safety committee must meet monthly
147 / The quality assurance committee must meet quarterly
148 / OSHA requires nursing home staff to use universal precautions
149 / Universal precautions are gloves and a gown and handwashing and standard precautions means total body protection and involves a gown, face mask, gloves and head covering
150 / OSHA Blood-borne Pathogen Program requires a written plan in case of exposure
151 / The Hazard communication standard focuses on the MSDS
152 / An “employee’s right to know” means the MSDS
153 / OSHA does requires employees to have a physical exam
154 / OSHA requiresa TB test and vaccination against Hepatitis B
155 / Workers need annual TB test and offer Hepatitis B exam
156 / OSHA general duty clause requires employers to provide workers a safe workplace
157 / If 3 or more workers are hospitalized or killed, how must you notify OSHA and within 8 hours by telephone
158 / HIPAA stands Health Insurance Portability and Accountability Act
159 / HIPAA makes a workers insurance portable by limiting the period of time a workers new insurance company can refuse to cover pre-existing conditions to 12 months
160 / The Wagner Act requires employers to bargain collectively with unions
161 / The Norris LaGuardia Act prohibits federal courts from issuing an order preventing unions from striking
162 / The Taft Hartley Act created the National Labor Relations Board?
163 / A union must give employers 10 days notice before they can strike
164 / Must provide 90 days notice of an intent to change an existing union contract.
165 / Employers must provide employees training in any changes in OSHA laws within 90 days
166 / A nursing home may have 2_ bargaining units.
167 / The National Labor Relations Board must approve any bargaining unit
168 / Can only have 2 bargaining units – professional and non professional
169 / The president may halt a union strike for 80 days
170 / A manager tell workers how they feel about a union but they cannot ay anything else or ask any questions about union participation of meetings or donate monehy ot a union
171 / A mission statement is simply the purpose of a corporation
172 / The by-laws are the governance of a corporation – by these laws we govern
173 / The certificate of incorporation is filed with the state to form a corporation
174 / The by-laws details the name of a corporation, the officers and directors, the number and amount of stock to be issued, and how the corporation will be run?
175 / The governing body has ultimate legal responsibility for the operation of a nursing home?
176 / The administrator has responsibility for the day-to-day operation of a nursing home
177 / The National Labor Relations Board must supervise union elections
178 / The governing body must make the critical decisions for a nursing home
179 / The governing body must approve the budget for a nursing home
180 / The governing body must implement facility policies in a nursing home
181 / The governing body must develop the mission statement for a nursing home
182 / Have you ever been convicted – cannot ask you have ever been arrested
183 / Can they do the tasks of the job – show them the job description