Mississippi Nursing Home Administrator – Flashcards
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________________ of perishable foods for at least a (24) hour period and or non-perishable foods for a (3) day period shall be on the premises to meet the requirements of the planned menus. The non-perishable foods shall consist of commercial type processed foods.
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Food Supply
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Every facility located inside the boundaries of a municipality shall comply with all local municipal ____________________________ applicable thereto. In addition, each facility shall comply with all applicable state and federal laws.
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Codes and Ordinances
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No facility may be licensed until it shows conformance to the safety regulations providing minimum standards for prevention and detection of fire as well as for protection of life and property against fire.
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Fire Safety
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All fires, explosions, natural disasters as well as avoidable deaths or avoidable, serious, or life-threatening injuries to residents resulting from fires, explosions, and natural disasters is a ___________________ by telephone to the Life Safety Code Division of the licensing agency by the next working day after the occurrence.
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Duty to Report
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The ______________ shall mean a person who is delegated the responsibility for the interpretation, implementation, and proper application of policies and programs established by the governing authority and are delegated responsibility for the establishment of safe and effective administrative management, control, and operation of the services provided. The administrator may be titled manager, superintendent, director, or otherwise
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The term "administrator
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__________________ is largest number which can be installed or set up in a facility at any given time for use of residents, as printed on the certificate of licensure.
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Bed Capacity
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________________ is the number of beds that are actually installed or set up for residents in a facility at a given time
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Bed Count
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This happens ___________________________ when an entity acquires a majority interest (Fifty percent [50%] or more) of the facility or services, which includes, but is not limited to, intervivos gifts, purchases, transfers, leases, cash and/or stock transactions or other comparable arrangements whenever the person acquires 50% or more.
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Change of Ownership
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An ___________ is the use of Mississippi State Department of Health (MSDH) Form #210, or a copy thereof, which shall be placed in the individual's personal file.
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Affidavit
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An _________________, shall mean any individual employed by a covered entity, also includes any individual who by contract with the covered entity provides direct patient care in a patient's, resident's, or client's room or in treatment rooms.
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Employee
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A _______________________ means a licensed entity or a healthcare professional staffing agency.
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Covered Entity
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A ___________________ is a hospital, nursing home, personal care home, home health agency or hospice.
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Licensed Entity
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A ____________________________purpose is to prepare professionals to render patient care services in medicine, nursing, dentistry, occupational therapy, physical therapy, social services, speech therapy, or other allied-health professional.
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Health Care Professional/Vocational Technical Academic Program
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This person, _____________, is enrolled in a healthcare professional/vocational technical academic program.
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Health Care Professional/Vocational Technical Student
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___________________________ means direct hands-on medical patient care and services provided by an individual in a patient's, resident's or client's room, treatment room or recovery room. Individuals providing direct patient care may be directly employed by the facility or provides patient care on a contractual basis.
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Direct Patient Care or Services
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____________________ means any action taken against an employee for abuse or neglect of a patient.
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Documented Disciplinary Action
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_______________ is a minimum of eight (8) hour period between 6:00 a.m. and 6:00 p.m
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Day Shift
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________________ is a person currently licensed to practice dentistry in Mississippi by the State Board of Dental Examiners
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Dentist
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___________ is a person who is licensed as a dietitian in the State of Mississippi, or a Registered Dietitian exempted from licensure by statute
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Dietitian
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_______________ is a facility that has obtained licensure prior to the adoption of these regulations
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Existing Facility
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A _____________________ are owner(s), Board of Governors, Board of Trustees, or any other comparable body duly organized and constituted for the purpose of owning, acquiring, constructing, equipping, operating and/or maintaining a facility, and exercising control over the internal affairs of said facility
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Governing Authority
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____________________________ includes solid or liquid wastes which may contain pathogens with sufficient virulence and quantity such that exposure to the waste by a susceptible host has been proven to result in an infectious disease.
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Infectious Medical Waste
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_____________ Medical Wastes resulting from the care of residents and animals who have 1. Class I and (or) II diseases that are transmitted by blood and body fluid, 2. Cultures and stocks of infectious agents; including specimen cultures collected from medical and pathological laboratories, 3. Blood and blood products such as serum, plasma, and other blood components, and 4. All discarded sharps (e.g., hypodermic needles, syringes, Pasteur pipettes, broken glass, scalpel blades) which have come into contact with infectious agents
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Infectious
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__________________________ a place either governmental or private which provides group living arrangements for four (4) or more persons who are unrelated to the operator and who are being provided food, shelter, and personal care whether any such place be organized or operated for profit or not. also, includes nursing homes, pediatric skilled nursing facilities, psychiatric residential treatment facilities, convalescent homes and homes for the aged, provided that these institutions fall within the scope of the definition set forth above
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Institutions for the Aged or Infirm (Facility/ies).
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_______________________ is a document issued by the licensing agency and signed by the State Health Officer of the Mississippi State Department of Health. Licensure shall constitute authority to receive residents and perform the services included within the scope of these rules, regulations, and minimum standards.
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License
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____________________ is an employee of the licensed facility (i.e., including, but not limited to, administrator, assistant administrator, director of nursing, director of social services, and others), as designated by the administrator of the licensed facility.
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Licensed Facility Representative
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_____________________________ is a person who is currently licensed by the Mississippi Board of Nursing as a Licensed Practical Nurse.
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Licensed Practical Nurse
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_______________________ is the person to which the license is issued and upon whom rests the responsibility for the operation of the institution in compliance with these rules, regulations, and minimum standards
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Licensee
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_________________ this is a whole blood test used in to assist in diagnosing Mycobacterium Tuberculosis infection. blood test used must be approved by the U.S. Food and Drug Administration (FDA).
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IGRA(s) (Interferon-Gamma Release Assay(s).
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__________________ is the Mississippi State Department of Health.
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Licensing Agency
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_____________________ is a method of skin testing that is performed by injecting (0.1) milliliter of purified protein derivative-tuberculin containing (5) tuberculin units into the dermis (i.e., the second layer of skin) of the forearm with a needle and syringe. The area is examined between (48) and (72) hours after the injection. A reaction is measured according to the size of the induration. The classification of a reaction as positive or negative depends on the patient's medical history and various risk factors.
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Mantoux Test
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___________________ is all non- infectious waste generated in direct resident care or in diagnostic or research areas that is non-infectious but aesthetically repugnant if found in the environment
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Medical Waste
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___________________ is a facility that applies for licensure after the adoption of these regulations.
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New Facility
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_________________ is a person who is currently licensed by the Mississippi Board of Nursing as a nurse practitioner. The term "physician assistant" shall mean a physician assistant who is currently licensed as such by the Mississippi Board of Medical Licensure
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Nurse Practitioner/Physician Assistant
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_______________________ is a facility in which nursing care is under the supervision of a registered nurse. Either a registered nurse or a licensed practical nurse shall be on active duty at all times
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Nursing Facility
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The maximum nursing unit shall be ____________ beds
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60
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_________________ is any person admitted to a facility for care
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Patient/Resident
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A _________ is any individual, firm, partnership, corporation, company, association, or joint stock association, or any licensee herein or the legal successor thereof.
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Person
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___________________ is assistance rendered by personnel of the facility for residents in performing one or more of the activities of daily living which includes, but is not limited to, the bathing, walking, excretory functions, feeding, personal grooming, and dressing of such reside
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Personal Care
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______________ a person currently licensed to practice pharmacy in Mississippi by the State Board of Pharmacy
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Pharmacist
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___________________ is any person currently licensed in Mississippi by the Mississippi State Board of Medical Licensure
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Physician
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1. A Dietetic Technician who has successfully graduated from a Dietetic Technician program accredited by the American Dietetic Association Commission on Accreditation and Approval of Dietetic Education and earns 15 hours of continuing education units every year approved by the Dietary Manager's Association or the American Dietetic Association. 2. A person who has successfully graduated from a didactic program in Dietetics approved by the American Dietetic Association Commission on Accreditation and approval of Dietetic Education and earns 15 hours of continuing education units every year approved by the Dietary Manager's Association or the American Dietetic Association. 3. A person who has successfully completed a Dietary Manager's Course approved by the Dietary Manager's Association and who passes the credentialing examination and earns 15 hours of continuing education units every year approved by the Dietary Manager's Association or the American Dietetic Association. 4. A person who has successfully completed a Dietary Manager's Course approved by the Dietary Manager's Association and earns 15 hours of continuing education units every year approved by the Dietary Manager's Association or the American Dietetic Association
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Qualified Dietary Manager
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__________________ is a person who is currently licensed by the Nurses' Board of Examination and Registration of Mississippi Board of Nursing as a registered nurse.
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Registered Nurse
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______________ include any means, physical or chemical, which is intentionally used to restrict the freedom of movement of a person.
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Restraint
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A ____________ is an individual employed, or hired on a contractual basis, by the licensing agency for the purpose of conducting surveys, inspections, investigations, or other related functions as part of the licensing agency's responsibilities for licensure and regulation of institutions for the aged and infirm.
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Surveyor
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A ____________________ is an induration of (5) millimeters or greater is significant (or positive) in the following: 1. Persons known to have or suspected of having human immunodeficiency virus (HIV). 2. Close contacts of a person with infectious tuberculosis. 3. Persons who have a chest radiograph suggestive of previous tuberculosis. 4. Persons who inject drugs (if HIV status is unknown). 5. An induration of (10) millimeters or greater is significant (or positive) in all other persons tested in Mississippi. A tuberculin skin test is recorded in millimeters of induration. For accurate results, measure the widest diameter of the palpable induration transverse (across) the arm.
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Significant Tuberculin Skin Test
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______________________ is a procedure used for the baseline testing of person who will periodically receive tuberculin skin tests (e.g., health care workers) to reduce the likelihood of mistaking a boosted reaction for a new infection. If the initial tuberculin-test result is classified as negative, a second test is repeated (1) to (3) weeks later. If the reaction to the second test is positive, it probably represents a boosted reaction. If the second test is also negative, the person is classified as not infected. A positive reaction to a subsequent test would indicate new infection (i.e., a skin-test conversion) in the person
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Two-step Testing
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__________________________ for each facility for which a license has been issued shall be inspected by the licensing agency by persons delegated with authority by the licensing agency at such intervals as the licensing agency may direct. The licensing agency and/or its authorized representatives shall have the right to inspect construction work in progress. New institutions shall not be licensed without having first been inspected for compliance with these rules, regulations, and minimum standards.
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Inspections Required
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Minimum requirements for nursing staff shall be based on the ratio of ________ hours of direct nursing care per resident per __________ hours. Staffing requirements are based upon resident census. Based upon the physical layout of the nursing facility, the licensing agency may increase the nursing care per resident ratio.
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2.80 / 24
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A registered nurse designated as the ________________________, who shall be employed on a full time ( [5] days per week) basis on the day shift and be responsible for all nursing services in the facility
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Director of Nursing Services
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Facilities of _________ beds or more shall have an assistant director of nursing services, who shall be a registered nurse.
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180
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In facilities with ______ beds or less, the director of nursing services may serve as charge nurse. In facilities with more than _______ beds, the charge nurse may not be the director of nursing services or the medication/treatment nurse.
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60
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Seven (7) day coverage on the day shift by a _________________________. A registered nurse or licensed practical nurse shall serve as a charge nurse and be responsible for supervision of the total nursing activities in the facility during the 7:00 a.m. to 3:00 p.m. and 3:00 p.m. to 11:00 p.m. shift. The nurse assigned to the unit for the 11:00 p.m. to 7:00 a.m. shift may serve as both the charge nurse and medication/treatment nurse. A medication/treatment nurse for each nurses' station shall be required on all shifts.
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Registered Nurse Minimum
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There shall be at least ________________ employees in the facility at all times in the event of an emergency
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2
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Expiration of License - Each license shall expire on _____________________ following the date of issuance.
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March 31
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A _____________________ must be completed prior to or at the time of admission, the administrator and the resident or the resident's responsible party shall execute in writing a financial agreement. This agreement shall be prepared and signed in two or more copies, one copy given to the resident or his sponsor, and one copy placed on file in the license facility. As a minimum this agreement shall contain: 1. Basic charges agreed upon (room, board, laundry, nursing, and/or personal care). 2. Period to be covered in the charges. 3. Services for which special charges are made. 4. Agreement regarding refund for any payments made in advance.
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Admission Agreement
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The licensed entity shall develop and maintain a written preparedness plan utilizing the "All Hazards" approach to emergency and disaster planning. The _______________________________________ must include procedures to be followed in the event of any act of terrorism or man-made or natural disaster as appropriate for the specific geographical location. The six (6) critical areas of consideration are: 1. Communications - Facility status reports shall be submitted in a format and a frequency as required by the Office of EOP. 2. Resources and Assets 3. Safety and Security 4. Staffing 5. Utilities 6. Clinical Activities. This plan must be exercised and reviewed annually or as directed by the Office of Emergency Preparedness and Response. Written evidence of current approval or review of provider EOPs, by the Office of Emergency Preparedness and Response, shall accompany all applications for facility license renewals.
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EMERGENCY OPERATIONS PLAN (EOP)
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Fire drills shall be conducted _______ per shift per quarter. Employees shall participate in a fire drill at least _________ times per year. Written records of all drills shall be maintained, indicating content of and attendance at each drill. A fire evacuation plan for the facility shall be posted in each facility in a conspicuous place and kept current.
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1 / 4
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_____________________________________________ must be done on all employees and if it discloses a felony conviction; a guilty plea; and/or a plea of nolo contendere to a felony for one (1) or more of the following crimes which has not been reversed on appeal, or for which a pardon has not been granted, the applicant/employee shall not be eligible to be employed at the licensed facility: a. possession or sale of drugs b. murder c. manslaughter d. armed robbery e. rape f. sexual battery g. sex offense listed in Section 45-33-23(g), Mississippi Code of 1972 h. child abuse i. arson j. grand larceny k. burglary l. gratification of lust m. aggravated assault n. felonious abuse and/or battery of vulnerable adult
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Criminal History Record Checks
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All staff of a facility shall receive a __________________________ by a licensed physician, registered nurse, or nurse practitioner/physician assistant prior to employment and annually thereafter. The extent of the screening shall be determined by committee consisting of at least a licensed physician, nurse practitioner/physician assistant or a registered nurse, and the facility's administrator. There shall be written evidence on file at the facility indicating that such a committee met to develop a policy for the facility's employee healthy screening program. The policy shall include: a. What constitutes an adequate health screening. b. The health professional designated to conduct the screening. The written policy shall be evaluated periodically by said committee.
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Employee Health Screening
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Medical, nursing, and personal service shall be provided in a specifically designated area which shall include bedrooms, special care room(s), nurses' station, utility room, toilet and bathing facilities, linen and storage closets, and wheelchair space. The maximum nursing unit shall be __________beds.
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60
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All resident bedrooms shall have an outside exposure and shall not be below grade. Window area shall not be less than ______ of the required floor area. The window sill shall not be over __________ inches from the floor.
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1/8; 36
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_______________________ shall be located so as to minimize the entrance of unpleasant odors, excessive noise, and other nuisances. and shall be directly accessible from the main corridor of the nursing unit providing that accessibility from any public space other than the dining room will be acceptable. In no case this room be used for access to another resident bedroom.
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Resident bedrooms
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Floor Area. Minimum usable floor area per bed shall be as follows: Private room ________, Multi-bed room __________, per resident. This provision shall apply only to initial licensure, new construction, additions, and renovations.
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100 square feet; 80 square feet
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Initial Licensure, New Construction, Additions and Renovations. Cubicle curtains, screening, or other suitable provisions for privacy shall be provided in multi-bed resident bedrooms. Cubicle curtains shall completely enclose the bed from ____ sides
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3
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The resident shall be provided with either an adjustable bed or a regular single bed, according to needs of the resident, with a good grade mattress at least ________ inches thick. Beds shall be single except in case of special approval of the licensing agency. Cots and roll-a-way beds are prohibited for resident use. Full and half bed rails shall be available to assist in safe care of residents.
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4
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a. Bed. b. Pillows, linens, and necessary coverings. c. Chair. d. Bedside cabinet or table. e. Storage space for clothing, toilet articles, and personal belongings including rod for clothes hanging. f. Means at bedside for signaling attendants. g. Bed pans or urinals for residents who need them. h. Over-bed tables as required.
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minimum accommodations for each resident
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Bed Maximum. Bedrooms in new facilities shall be limited to ______beds
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two (2)
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Each facility shall have a ______________________ which shall be a single bedroom with at least a private half bath (lavatory and water closet). There shall be a room for each (30) beds or major fraction thereof. This room shall meet the requirements of Rule 45.20.2(3) and may be located anywhere in the building rather than a certain number per station
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Special Care Room.
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Each nursing unit must have a ___________________, which includes as minimum the following: a. Annunciator board or other equipment for resident's call. b. The minimum areas of the medicine storage /preparation room shall be (75) square feet. c. Storage space for residents' medical records and nurses' charts. d. Lavatory or sink with disposable towel dispenser. e. Desk or counter top space adequate for recording and charting purposes by physicians, nurse practitioners/physician assistants, and nurses. f. Must be well lighted. g. A refrigerator for the storage of drugs shall be provided at each nurses' station.
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Nurses' Station
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_______________________ may store drugs, food and beverages together only if separate compartments or containers are provided for the storage of drugs.
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Nurse's station refrigerator
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Each facility shall provide a separate _____________ for soiled and clean resident care equipment, such as bed pans, urinals, etc. The room for clean equipment shall have suitable storage. The room for soiled items shall contain, as a minimum, the following equipment. 1. Provision for cleaning utensils such as bed pans, urinals, et cetera. 2. Lavatory or sink and disposable towel dispenser.
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Utility Room
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Combination toilet and lavatory 2 per nursing unit. Handrails shall be provided for all tubs, showers, and commodes. In addition to the requirements set forth above, a lavatory shall be provided in each resident bedroom or in a toilet room that is directly accessible from the bedroom. In addition to the requirements set forth above, a toilet shall be located in a room directly accessible from each resident bedroom. The minimum area for a room containing only a toilet shall be _____________ feet by _________ feet.
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3 / 6
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Bathing Facilities 2 per nursing unit and As a minimum, showers shall be __________ inches by ________ inches without curbing, Handrails shall be provided for all tubs, showers, and commodes.
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30 / 60
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each nursing unit shall include the following rooms and areas: 1. linen closet; 2. wheelchair space.
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Other rooms
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Each resident shall be given a complete physical examination _________ days prior to admission and ______________ thereafter, including a history of tuberculosis exposure and an assessment for signs and symptoms of tuberculosis, by a licensed physician or nurse practitioner/physician assistant. The findings shall be entered as part of the Admission Record. The report of the examination shall include: 1. Medical history (previous illnesses, drug reaction, emotional reactions, etc.). 2. Major physical and mental condition. 3. Current diagnosis. 4. Orders, dated and signed, by a physician or nurse practitioner/physician assistant for the immediate care of the resident to include medication treatment, activities, and diet
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30 / annually
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The following are to be performed and documented within 30 days prior to the resident's admission to the "Licensed facility": _______________ signs and symptoms assessment by a licensed Physician, Physician's Assistant or a Licensed Nurse Practitioner, and A chest x-ray taken and a written interpretation. Admission to the facility shall be based on the results of the required tests
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Tuberculosis (TB)
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Each resident shall receive assistance as needed with ___________________________ to maintain the highest practicable well being. These shall include, but not be limited to: 1. Bath, dressing and grooming; 2. Transfer and ambulate; 3. Good nutrition, personal and oral hygiene; and 4. Toileting.
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Activities of daily living
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Residents with a __________________ shall receive necessary treatment and service to promote healing and prevent the development of new areas. Residents without these areas will not develop these areas unless the residents' clinical condition indicates they were unavoidable.
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Pressure sores
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Residents with __________________ shall be assessed for need of bladder retraining program. An indwelling catheter will not be used unless the resident's clinical condition indicates that catheterization is necessary. These residents shall receive treatment and services to prevent urinary tract infections.
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Urinary incontinence
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Residents with limited _______________ shall receive treatment and services to increase movement or prevent further decline in movement.
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Range of motion
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A resident who displays adjustment difficulty receives appropriate ______________________________ treatment and services to address the assessed problem
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Mental and psycho-social
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Residents who are eating alone or with assistance are not fed by this unless their clinical condition indicates that the use of a _________________________ is unavoidable. The residents who are fed by tube receive the treatment and services to prevent complications or to restore if possible, normal eating skills
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Gastric feeding tube
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The facility shall ensure that the residents' environment remains as free of ___________________ hazards as possible, and adequate supervision shall be provided to prevent them. If an unexplained incident occurs, this injury must be investigated and reported to appropriate state agencies
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Accidents
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Residents shall maintain acceptable parameters of ___________________ status, such as body weight and protein levels, unless residents' clinical condition indicates that this is unavoidable. All residents shall receive diets as orders by their physician or NP/physician assistant. Residents identified with significant problems shall receive appropriate medical therapy based on current professional standards.
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Nutrition
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Each resident shall be provided sufficient fluid intake to maintain proper ______________ and health
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Hydration
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Each resident with _____________________ shall receive proper treatment and care. These include, but are not limited to injections; parenteral and enteral fluids; colostomy, ureterostomy, ileostomy care; tracheostomy care; tracheal suction; respiratory care; foot care; and prostheses
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Special needs
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Each resident shall have a __________________ or nurse practitioner/physician assistant who is responsible for their care. In the absence of this person, another one or nurse practitioner/physician assistant shall be designated to supervise the resident medical care, The facility shall arrange for the provision of services (24) hours a day in case of an emergency.
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Designated physician
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The resident shall be seen by a physician or nurse practitioner/physician assistant every ___________ days
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60
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Residents shall be provided ____________________ as needed upon the written orders of an attending physician or nurse practitioner/physician assistant. 1. The therapies shall be provided by a qualified therapist. 2. Appropriate equipment and supplies shall be provided. 3. Each resident's medical record shall contain written evidence that services are provided in accordance with the written orders of an attending physician or nurse practitioner/physician assistant.
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Rehabilitative services
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The facility shall provide routine drugs, emergency drugs and biologicals to its residents or obtain them by _____________________________ agreement. Each facility shall have policies and procedures to assure the following: 1. Accurate acquiring; 2. Receiving; 3. Dispensing; 4. Storage; and 5. Administration of all drugs and biologicals
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PHARMACY SERVICES
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Each facility shall obtain a ________________________ from a licensed pharmacist who will be responsible for: 1. Establishing a system of records of receipt and disposition of all controlled drugs and to determine that drug records are in order and that an account of all controlled drugs are maintained and reconciled; 2. Provide drugs regimen review in the facility on each resident every thirty (30) days by a licensed pharmacist; 3. Report any irregularities to the attending physician or nurse practitioner/physician assistant and the director or nursing; and 4. Records must reflect that the consultation pharmacist monthly report is acted upon.
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Pharmacy Consultation
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Each facility shall follow the Mississippi State Board of Pharmacy ______________________ requirements.
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Labeling of drugs
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1. Unused portions of medicine may be given to a discharged resident or the responsible party upon orders of the prescribing physician or nurse practitioner/physician assistant. 2. The __________________ should be done according to the Mississippi State Board of Pharmacy disposal requirements for all Drugs and pharmaceuticals discontinued by the written orders of an attending physician or nurse practitioner/physician assistant or left in the facility on discharge or death of the resident.
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Disposal of drugs
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All ________________________________ such as insecticides, caustic cleaning agents, rodenticide, and other such agents must be plainly labeled and kept in locked cabinet or closet. No substances of this type shall be kept in the following areas: kitchen, dining area, food storage room or pantry, medicine cabinet or drug room, resident's bedroom or toilet, public rooms, or spaces
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Poisonous Substances
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All _______________ shall maintain the following information: identification data and consent form; assessments of the resident's needs by all disciplines involved in the care of the resident; medical history and admission physical exam; annual physical exams; physician or NP/physician assistant orders; observation, report of treatment, clinical findings and progress notes; and discharge summary, including the final diagnosis.
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medical records
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_____________________ should be in accordance with accepted professional standards and practices on all residents admitted to the facility. It shall be completely and accurately documented, readily accessible, and systematically organized to facilitate retrieving and compiling information. It should be safeguard medical record information against loss, destruction, or unauthorized use.
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Medical Records Management
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Medical records of discharged residents shall be completed within _________ days following discharge. Medical records are to be retained for ________ years from the date of discharge or, in the case of a minor, until the resident reaches the age of (21), plus an additional(3) years.
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60 / 5
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Each facility shall provide a ___________________________to assist all residents in dealing with social and related problems through one or more case workers on the staff of the facility or through arrangements with an appropriate outside agency.
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Social Service Program
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A__________________________ contains information concerning each resident shall be obtained and kept. This information shall cover social and emotional factors related to the resident's condition and information concerning his home situation, financial resources and relationships with other people.
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Social Service Record
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All nursing personnel and employees having contact with resident shall receive __________________ toward understanding emotional problems and social needs of residents.
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Social Service training
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An _______________________ provisions shall be made for suitable recreational and entertainment activities for resident according to their needs and interests. These activities are an important adjunct to daily living and are to encourage restoration to self-care and resumption of normal activities. Variety in planning shall include some outdoor activities in suitable weather. Supplies and Equipment. The facility shall make available a variety of supplies and equipment adequate to satisfy the individual interests of residents
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Activity Program
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A _________________________ is an individual shall be designated as being in charge of resident activities. This individual shall have experience and/or training in group activities, or shall have consultation made available from a qualified recreational therapist or group activity leader. residents.
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Activity Coordinator
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A ______________shall be provided in facilities adequate to set at least 3/4 of the maximum capacity of the facility. This area may also be used for social, recreational, and/or religious services when not in use. A minimum of (15) square feet per person for (3/4) of the capacity of the facility shall be provided
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Dining area
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Each facility shall provide adequate _________________________ for residents and visitors. Each home should provide at least two areas for this purpose-one for small groups such as private visit with relatives and friends and one for larger group activities. A minimum of eighteen (18) square feet per bed shall be provided.
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Living and/or Recreational Room
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The _______________________of a facility shall be directed by a Registered Dietitian, a certified dietary manager, or a qualified dietary manager. If a qualified dietary manager is the director, he/she must receive frequent, regularly scheduled consultation from a licensed dietitian, or a registered dietitian exempted from licensure by statute.
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Dietary Department
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The facility shall provide residents with well-planned, attractive, and satisfying _____________ which will meet their nutritional, social, emotional, and therapeutic needs.
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meals
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A standard food planning guide (e.g., food pyramid) or _________________________(determined by nutritional analysis) shall be used for planning and food purchasing. It is not intended to meet the nutritional needs of all residents. This guide must be adjusted to consider individual differences. Some residents will need more or less due to age, size, gender, physical activity, or state of health.
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Nutrient Based Menu
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____________is one of the basic services provided by the facility to its residents. Careful attention to adequate nutrition and prescribed modified diets contribute appreciably to the health and comfort to the resident and stimulate his desire to achieve and maintain a higher level of selfcare.
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FOOD SERVICES
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At least three (3) meals in each twenty-four (24) hours shall be provided. The ___________________ shall meet the current recommended dietary allowance of the Food and Nutrition Board of the National Research Council of the National Academy of Science adjusted for individual needs.
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Daily food allowance
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The following is a ____________________________ 1. Protein food. A minimum of 2-3 servings of meat, poultry, fish, dried beans, eggs, or meats. (4-6 oz daily). 2. Milk, yogurt, and cheese group: A minimum of 2 servings daily. 3. Vegetables and fruits: A minimum of 5 servings daily of fruits and vegetables. This shall include a Vitamin C source daily and a Vitamin A source 3-4 times weekly. 4. Breads, cereals, and pastas: A minimum of 6 servings daily. 5. Fat, oil, and sweets: As needed for additional calories and flavor.
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Meal Planning Guidelines
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The _______________ shall be planned and written at least one week in advance. The current week's menu shall be approved by the dietitian, dated, posted in the kitchen and followed as planned. Substitutions and changes on all diets shall be documented in writing. Copies of menus and substitutions shall be kept on file for at least thirty (30) days.
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Menu.
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A time schedule for serving meals to residents shall be established. Meals shall be served during customarily-accepted timeframes. There shall be no more than _______ hours between evening meal and breakfast meal. There may be _____ hours between the evening meal and breakfast meal if approved by the resident involved and a substantial snack (including protein) is served before bedtime.
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14 / 16
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____________________ are a part of medical treatment shall be prescribed in written orders by the physician or nurse practitioner/physician assistant. They shall be planned in writing and posted along with regular menus. Liberalized Geriatric Diets are encouraged for elderly residents when there is a need for moderate diet therapy. A current diet manual shall be available to personnel. The dietitian shall approve all modified diet menus and the diet manual used in the nursing home.
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Modified Diets
question
____________________ should be served on table not more than four (4) or six (6) residents. Residents who are not able to go to the dining room shall be provided sturdy tables (not TV trays) of proper heights. For those who are bedfast or infirm tray service shall be provided in their rooms with the tray resting on a firm support.
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Serving of Meals
question
Foods shall be attractively and neatly served. All foods shall be served at proper _____________. Effective equipment shall be provided and procedures established to maintain food at proper temps during serving.
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temperature
question
_______________ in food service areas shall be of such construction so as to be easily cleaned, sound, smooth, non-absorbent, and without cracks or crevices. Also, they shall be kept in good repair.
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Floors
question
__________________ and ___________ in food service areas shall be of tight and substantial construction, smoothly finished, and painted in a light color. They shall be without horizontal ledges and shall be washable up to the highest level reached by splash and spray. Roofs and walls shall be maintained free of leaks. All openings to the exterior shall be provided with doors or windows that will prevent the entrance of rain or dust during inclement weather.
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Walls and ceilings
question
Openings to the outside shall be effectively ______________. Screen doors shall open outward and be equipped with self-closing devices.
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Screens
question
The kitchen, dishwashing area, and dining room shall be provided with well distributed and unobstructed natural _________________. Artificial light properly distributed and of an intensity of not less than thirty (30) foot candles shall be provided
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Lighting
question
The food service area shall be ventilated in a manner that will maintain comfortable working conditions, remove objectionable odors and fumes, and prevent excessive condensations
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Ventilation
question
_________________________ with lockers shall be provided for employees. They shall not open directly into any room in which food is prepared, stored, displayed or served, nor into any room in which utensils are washed or stored. They shall have a lavatory and shall be well lighted and ventilated.
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Employee Toilet Facilities
question
______________________ with hot and cold water, soap dispenser and a supply of soap, and disposable towels shall be provided in all kitchens. The use of a common towel is prohibited. Hands shall not be washed in sinks where food is prepared or where utensils are cleaned
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Hand washing Facilities
question
Adequate refrigeration facilities, automatic in operation, for the storage of perishable foods shall be provided. Where separate refrigeration can be provided, the recommended temperatures for storing perishable foods are _____ to ________ degrees Fahrenheit for meats and dairy products, and _____ to ______ degrees Fahrenheit for fruits and vegetables. If it is impractical to provide separate refrigeration, the temperature shall be maintained at ______ degrees Fahrenheit. Freezers shall be maintained at zero (0) degrees Fahrenheit or below. All refrigerators shall be provided with a thermometer. Homes with more than (24) beds shall have commercial or institutional type refrigeration.
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32 to 40 / 40 to 45 / 41
question
____________________________ shall be constructed so as to be easily cleaned and shall be kept in good repair.
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Equipment and Utensil
question
____________________________shall be located in a specifically designated area and shall include the following rooms and/or spaces: kitchen, dishwashing, food storage, and dining room
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Food service facilities
question
Kitchen-Size and Dimensions (food preparation only) for less than (25) beds shall be a minimum area of _______ square feet. In facilities with (25) beds to (60) beds, a minimum of (10) square feet per bed shall be provided. In facilities with (61) to (80) beds, a minimum of (6) square feet per bed shall be provided for each bed over (60) in the home. In facilities with (81) to (100) beds, a minimum of (5) square feet per bed shall be provided for each bed over (80). In facilities with more than (100) beds proportionate space approved by the licensing agency shall be provided.
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200
question
Also, the kitchen shall be of such size and dimensions in order to: a. Permit orderly and sanitary handling and processing of food. b. Avoid overcrowding and congestion of operations. c. Provide at least three (3) feet between working areas and wider if space is used as a passageway. d. Provide a ceiling height of at least eight (8) feet
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Kitchen-Size and Dimensions
question
Pot and Pan Sink is a ___________________ shall be provided for cleaning pots and pans. Each compartment shall be a minimum of (24) inches by (16) inches. A drain board of approximately (30) inches shall be provided at each end of the sink, one to be used for stacking soiled utensils and the other for draining clean utensils.
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three compartment sink
question
Commercial or institutional type dishwashing equipment shall be provided in homes with more than (24) beds. The dishwashing area shall be separated from the food preparation area. If sanitizing is to be accomplished by hot water, a minimum temperature of ___________degrees Fahrenheit shall be maintained during the rinsing cycle. An alternate method of sanitizing through use of chemicals may be provided if sanitizing standards of the Mississippi State Department of Health Food Code Regulations are observed. Adequate counter-space for stacking soiled dishes shall be provided in the dishwashing area at the most convenient place of entry from the dining room, followed by a disposer with can storage under the counter. There shall be a pre-rinse sink, then the dishwasher and finally a counter or drain for clean dishes.
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180
question
A ______________________room with cross ventilation shall be provided. Adequate shelving, bins, and heavy plastic or galvanized cans shall be provided. The room shall be of such construction as to prevent the invasion of rodents and insects, the seepage of dust and water leakage, or any other source of contamination. The room should be adjacent to the kitchen and convenient to the receiving area. The minimum area for the room shall equal (2 1/2) square feet per bed and the width of the aisle shall be a minimum of (3) feet.
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Food Storage
question
Water under pressure of at least (15) pounds per square inch shall be piped to all sinks, toilets, lavatories, tubs, showers, and other fixtures requiring water. It is recommended that the water supply into the facility can be obtained from two (2) separate water lines if possible. A dual hot water supply shall be provided. The temperature of hot water to lavatories and bathing facilities shall not exceed _______degrees Fahrenheit, nor shall hot water be less than __________ degrees Fahrenheit. Each facility shall have a written agreement for an alternate source of potable water in the event of a disruption of the normal water supply.
answer
115 / 110
question
All liquid and human waste, including floor-wash water and liquid waste from refrigerators, shall be disposed of through _____________ into a public sewer system where such system is available. The sewerage disposal system shall be of a size and capacity based on the number of residents and personnel housed and employed in the facility.
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trapped drains
question
The _____________ shall be kept neat, clean, and free of an accumulation of rubbish, weeds, ponded water, or other conditions which would have a tendency to create a health hazard
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Premises
question
_____________________ of floors, walls, ceilings, and fixtures shall be kept clean and free of objectionable odors. These rooms shall be kept free of an accumulation of rubbish, cleaning supplies, toilet articles, etc.
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Toilet Room Cleanliness
question
1. Garbage must be kept in water-tight suitable containers with tight fitting covers. ___________________containers must be emptied at frequent intervals and cleaned before using again. Proper disposition of infectious materials shall be observed.
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Garbage Disposal
question
Medical waste must be kept in water-tight suitable containers with tight fitting covers. __________________must be emptied at frequent intervals and cleaned before using again.
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Medical Waste Containers
question
h. Infectious medical waste and medical waste contained in __________________, shall be placed for storage, handling, or transport in disposable or reusable pails, cartons, drums, or portable bins. The containment system shall be leak-proof, have tight fitting covers and be kept clean and in good repair: Reusable containers for infectious medical waste and medical waste shall be thoroughly washed and decontaminated each time they are emptied by a method specified by the licensing agency
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disposable containers
question
a. Containment of infectious medical waste and medical waste shall be marked with prominent warning signs on, or adjacent to, the exterior of entry doors, gates, or lids. Infectious medical waste, except for sharps capable of puncturing or cutting, shall be contained in double ___________________________ or single bags (1.5 mills thick) which are impervious to moisture and have strength sufficient to preclude ripping, tearing, or bursting under normal conditions of usage. The bags shall be securely tied so as to prevent leakage or expulsion of solid or liquid wasted during storage, handling, or transport. All bags used for containment and disposal of infectious medical waste shall be of a distinctive color or display the Universal Symbol for infectious waste. Rigid containers of all sharps waste shall be labeled.
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Disposable plastic bags
question
________________________________ of infectious medical waste a. By incineration in an approved incinerator which provides combustion of the waste to carbonized or mineralized ash. b. By sterilization by heating in a steam sterilizer c. By discharge to the approved sewerage system d. Recognizable human anatomical remains shall be disposed of by incineration or internment. e, Chemical sterilization
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Treatment or disposal
question
_________________shall be provided with a mop-cleaning sink and be large enough in area to store house cleaning supplies and equipment. A separate area and equipment should be provided for the food service area.
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Janitor closets
question
____________________________ shall be kept clean and in proper working order. They shall not be used for laundering or for storage of soiled materials. Neither shall these facilities be used for cleaning mops, brooms, etc.
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Bathtubs, Showers, and Lavatories
question
Resident bedrooms shall be cleaned and dusted as often as necessary to maintain a clean, attractive appearance. All sweeping should be ____________________, all dusting should be damp dusting with a good detergent or germicide.
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damp sweeping
question
______________ of such items as beds, mattresses, mops, mop buckets, dust rags, etc. shall not be kept in hallways, corners, toilet or bathrooms, clothes closets, or resident bedrooms. The use of attics for storage of combustible materials is prohibited. If basements are used for storage, they shall meet acceptable standards for storage and for fire safety.
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Storage
question
Each facility shall have_________________ unless commercial laundries are used. The laundry shall be located in a specifically designated area, and there shall be adequate room and space for sorting, processing, and storage of soiled material. Laundry rooms or soiled linen storage areas shall not open directly into a resident bedroom or food service area. If commercial laundry is used, separate satisfactory storage areas shall be provided for clean and soiled linens. There shall be provided a clean linen storage area separate from the laundry area.
answer
laundry facilities
question
Provisions shall be made for proper mechanical ______________ of the laundry. Provisions shall be made to prevent the recirculation of air through the heating and air condition systems
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Ventilation
question
Adequate and effective ______________ shall be provided for driers
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Lint Traps
question
When __________________are provided they shall have a minimum diameter of two (2) feet; and they shall be installed with flushing ring, vent, and drain.
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Laundry Chutes
question
______________________ shall be of the type to adequately perform the laundry needs of the institution. The equipment shall be installed to comply with all local and state codes
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Laundry Equipment
question
Adequate heating and cooling shall be provided in all rooms used by residents so that a minimum temperature of ______ to _______ degrees Fahrenheit may be maintained
answer
75 to 80
question
Each resident's room shall have artificial light adequate for reading and other uses as needed. There should be a minimum of _____ foot-candles of lighting for general use in resident's room and a minimum of ______ foot candles of lighting for reading purposes. All entrances, corridors, stairways, ramps, cellars, attics, storerooms, kitchens, laundries, and service units shall have sufficient artificial lighting to prevent accidents and promote efficiency of service. Night lights shall be provided in all corridors, stairways, toilets, and bathing rooms.
answer
10 / 30
question
All screen doors and non-stationary windows shall be equipped with tight fitting full length, _________ mesh screens. Screen doors shall swing out and shall be equipped with self-closing devices
answer
16
question
All ceilings shall have a height of at least ________feet except that a height of _________ may be approved for corridors or toilets and bathing rooms where the lighting fixtures are recessed. Exception may be made for existing facilities
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8 / 7'6"
question
Handrails shall be installed on both sides of all corridors and hallways used by residents. The handrails should be installed from _______ to _______inches above the floors. The handrails should have a return to the wall at each rail ending. Exception may be made for existing facilities.
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32 to 36
question
Ramps and inclines, where installed for the use of residents, shall not exceed ______ foot of rise in _____ feet of run, shall be furnished with a non-slip floor, and shall be provided with handrails on both sides. Exception may be granted for existing ramps and inclines on existing facilities.
answer
1 / 12
question
A _________________shall be in place at the nurses' station to receive resident calls through a communication system to include audible and visual signals from bedrooms, toilets, and bathing facilities
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Call System
question
The installation and/or use of trash chutes is __________________
answer
prohibited
question
1. Buildings constructed after the effective date of these regulations shall comply with the edition of the Life Safety Code (NFPA 101) effective on the date of construction. 2. Buildings constructed prior to the effective date of these regulations shall comply with Chapter 13 of the Life Safety Code (NFPA 101), 1985 edition
answer
Date of Construction and Life Safety Code Compliance
question
A food storage room shall be provided convenient to the kitchen in all future licensed homes. It should have cross ventilation. All foods must be stored a minimum of _______ inches above the floor.
answer
12
question
Adequate _________________shall be provided for residents or residents and guests. These areas shall be designated exclusively for this purpose and shall not be used as sleeping area or otherwise. It is recommended that at least two (2) such areas be provided and more in larger homes.
answer
Day room or living room
question
At least one (1)_______________ shall be provided for each floor. The closet shall be equipped with a mop sink and be adequate in area to store cleaning supplies and equipment. A separate janitor's closet shall be provided for the food service area.
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Janitor closet
question
The dining area shall be large enough to seat __________ of the maximum capacity of nursing home. The dining area can also be used for social, recreational, or religious activities. It is recommended that a separate dining area be provided for personnel
answer
3/4
question
A minimum area equal to at least five (5) square feet per bed shall be provided for _______________________
answer
General storage
question
_______________________ is one or more deficiencies related to the regulatory requirements in Rule 45.1.3, 45.18.1 and Subchapter 22, which constitute either immediate jeopardy to resident health or safety, or a pattern or widespread deficiencies at a Level 3 severity, or widespread deficiencies at a Level 2 severity.
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Substandard Quality of Care
question
_______________________ is a facility which is found to be in violation of any of the regulations in Rule 45.1.3, 45.18.1 and Subchapter 22, on the current licensure visit and has been found to be in violation of any of the afore cited regulations during the previous regular re-licensure visit, or any intervening revisit or complaint investigation.
answer
Substandard Facility
question
A ______________________ to a facility may be imposed by the licensing agency when it has been determined by the licensing agency that the facility is providing substandard quality of care as defined in Rule 45.9.2 above
answer
Ban on All Admissions
question
The _________________ is the Director of the Mississippi State Department of Health (otherwise known as the licensing agency), Division of Health Facilities Licensure and Certification
answer
Division Director
question
____________________________ is a Procedures set forth in Rule 45.24.1 provide facilities with one opportunity to dispute findings of licensure violations
answer
Informal Dispute Resolution
question
If a facility is designated as a substandard facility, the licensing agency may select a ___________________ in order to oversee correction of deficient practices cited as violations by the agency and assure the health and safety of the facility's residents while corrections are being made. This person may also be appointed to oversee the orderly closure of a facility. the licensing agency finds Widespread Level-3 Severity deficiency or deficiencies pursuant to Rule 45.9.11 and Rule 45.9.12 or Isolated, Pattern, or Widespread Level-4 deficiency or deficiencies pursuant to Rule 45.9.10, Rule 45.9.11 and Rule 45.9.12.
answer
Temporary Manager
question
In lieu of a temporary manager, the licensing agency may appoint a _____________________ to oversee the correction of cited deficiencies in a facility as a safeguard against further harm to residents, or when the potential for harm exists as a result of cited licensure violations at any level of severity or scope
answer
State Monitor
question
A _______________________________ is a plan which the licensing agency, or the temporary manager, develops to require a facility to take action within specified time frames.
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Directed Plan of Correction
question
1. Level 1 - Potential for causing no more than a minor negative impact on the resident(s). 2. Level 2 - Noncompliance that results in minimal physical, mental, and/or psychosocial discomfort to the resident and/or has the potential (not yet realized) to compromise the resident's ability to maintain and/or reach his/her highest practicable physical, mental and/or psycho-social well-being as defined by an accurate and comprehensive resident assessment, plan of care, and provision of services. 3. Level 3 - Noncompliance that results in a negative outcome that has compromised the resident's ability to maintain his/her highest practicable physical, mental and psycho-social well-being as defined by an accurate and comprehensive resident assessment, plan of care, and provision of services. 4. Level 4 - Immediate jeopardy, a situation in which immediate corrective action is necessary because the facility's noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident receiving care in a facility.
answer
Severity
question
The purpose of __________________________ is to provide basic knowledge to achieve compliance and remain in compliance with the requirements of these regulations.
answer
Directed In-Service Training
question
The Bureau Director is the Director of the Mississippi State Department of Health (otherwise known as the licensing agency), Bureau of Health Facilities Licensure and Certification
answer
Bureau Director
question
Monitors are identified by the licensing agency as appropriate professionals to monitor cited deficiencies. A ___________________ shall meet the guidelines regarding conflicts of interests .
answer
State Monitoring
question
All _______________________________of the State Monitor shall be paid by the facility. The licensing agency shall bill the facility for the costs of the State Monitor after termination of the monitoring services. The costs of the State Monitor for any weekly (40) hour period shall not exceed the maximum allowable owner/administrator salary of a like sized facility as described in the Mississippi State Medicaid Plan. Within fifteen (15) days of receipt of the bill, the facility shall pay the bill or request an informal dispute resolution procedure to contest the costs for which it was billed.
answer
Compensation and Per Diem Costs
question
1. A temporary manager has the authority to direct and oversee the correction of the deficiencies/licensure violations; to oversee and direct the management, hiring, reassignment and/or discharge of any consultant or employee, including the administrator of the facility; to direct the expenditure of or obligate facility funds in a reasonable and prudent manner; to oversee the continuation of the business and the care of the residents; to oversee and direct those acts necessary to accomplish the goals of the licensure and/or certification requirements; to alter facility procedures; and to direct and oversee regular accountings and the provision of periodic reports to the licensing agency. manager.
answer
Authority and Powers Of the Temporary Manager
question
Temporary management shall continue until a license is revoked and or the facility is terminated from participation in the Medicare or Medicaid programs, or the facility achieves substantial compliance and is capable of remaining in substantial compliance. The licensing agency may replace any temporary manager whose performance, in the discretion of the licensing agency, is deemed unsatisfactory. No formal procedure is required for such removal or replacement but written notice of any action shall be given to the facility, including the name of any replacement manager.
answer
Duration of Temporary Manager
question
The SNF or NF must have a designated _________________________who is responsible for implementing care policies and coordinating medical care, and who is directly accountable to the management of the institution of which it is a distinct part
answer
medical director
question
Upon an oral or written request, to access all records pertaining to himself or herself including current clinical records within ______hours (excluding weekends and holidays); and After receipt of his or her records for inspection, to purchase at a cost not to exceed the community standard photocopies of the records or any portions of them upon request and______ working days advance notice to the facility.
answer
24 / 2
question
Notice may be made as soon as practicable before transfer or discharge when— (A) the safety of individuals in the facility would be endangered (B) The health of individuals in the facility would be endangered, (C) The resident's health improves sufficiently to allow a more immediate transfer or discharge, (D) An immediate transfer or discharge is required by the resident's urgent medical needs, (E) A resident has not resided in the facility for 30 days.
answer
Immediate notice of discharge
question
the notice of transfer or discharge required under paragraph (a)(4) of this section must be made by the facility at least _______days before the resident is transferred or discharged.
answer
30
question
The facility must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless— (i) If it is necessary for the resident's welfare and the resident's needs cannot be met in the facility; (ii) If it is appropriate because the resident's health has improved sufficiently so the resident no longer needs the services provided by the facility; (iii) The safety of individuals in the facility is endangered; (iv) The health of individuals in the facility would otherwise be endangered; (v) The resident has failed, after reasonable and appropriate notice, to pay for (or to have paid under Medicare or Medicaid) a stay at the facility. (vi) The facility ceases to operate
answer
Transfer and discharge requirements
question
The written notice transfer and discharge must include the following: (i) The reason (ii) The effective date (iii) The location discharged to (iv) A statement that the resident has the right to appeal (v) The name, address and telephone number of the ombudsman; (vi) For residents with developmental disabilities, the mailing address and telephone number of the agency responsible for the protection and advocacy of developmentally disabled individuals and (vii) For residents who are mentally ill, the mailing address and telephone number of the agency responsible for the protection and advocacy of mentally ill individuals
answer
Contents of the notice
question
____________________________ are dining rooms, activity rooms, meeting rooms where residents are located on a regular basis, and other areas in the facility where residents may gather together with other residents, visitors, and staff.
answer
Common areas
question
A ___________________________long term care facility is one that has all areas sprinklered in accordance with National Fire Protection Association 13 "Standard for the Installation of Sprinkler Systems" without the use of waivers or the Fire Safety Evaluation System.
answer
fully sprinklered
question
A ____________________________is a distinct part consisting of two or more noncontiguous components that are not located within the same campus,
answer
composite distinct part
question
A ___________________________SNF or NF is physically distinguishable from the larger institution or institutional complex that houses it, SNF or NF may be comprised of one or more buildings or designated parts of buildings (that is, wings, wards, or floors) that are: In the same physical area immediately adjacent to the institution's main buildings; other areas and structures that are not strictly contiguous to the main buildings but are located within close proximity of the main buildings; and any other areas that CMS determines on an individual basis, to be part of the institution's campus. This area must include all of the beds within the designated area, and cannot consist of a random collection of individual rooms or beds that are scattered throughout the physical plant.
answer
distinct part
question
___________________means the modification of more than 50 percent, or more than 4,500 square feet, of the smoke compartment
answer
Major modification
question
A facility must immediately inform the resident; physician; resident's legal respresentative or an interested family member when there is— (A) An accident involving the resident which results in injury (B) A significant change in the resident's physical, mental, or psychosocial status (C) A need to alter treatment significantly (D) A decision to transfer or discharge the resident from the facility
answer
notification of change
question
The facility must deposit any residents' personal funds in excess of $50 in an ___________________________ (or accounts) that is separate from any of the facility's operating accounts, and that credits all interest earned on resident's funds to that account. (In pooled accounts, there must be a separate accounting for each resident's share.)
answer
interest bearing account
question
The facility must notify each resident that receives Medicaid benefits— (i) When the amount in the resident's account reaches ____________less than the SSI resource limit for one person, (ii) That, if the amount in the account, in addition to the value of the resident's other nonexempt resources, reaches the SSI resource limit for one person, the resident may lose eligibility for Medicaid or SSI.
answer
$200
question
Upon the death of a resident with a personal fund deposited with the facility, the facility must convey within ______ days the resident's funds, and a final accounting of those funds, to the individual or probate jurisdiction administering the resident's estate
answer
30
question
The facility must purchase a ________, or otherwise provide assurance satisfactory to the Secretary, to assure the security of all personal funds of residents deposited with the facility.
answer
surety bond
question
items and services that the facility may charge to residents' funds if they are requested by a resident, (A) Telephone. (B) Television/radio for personal use. (C) Personal comfort items, including smoking materials, notions and novelties, and confections. (D) Cosmetic and grooming items and services (E) Personal clothing. (F) Personal reading matter. (G) Gifts purchased (H) Flowers and plants. (I) Social events and entertainment offered outside the scope of the activities program, (J) Noncovered special care services such as privately hired nurses or aides. (K) Private room, except when therapeutically required (for example, isolation for infection control). (L) Specially prepared or alternative food requested instead of the food generally prepared by the facility,
answer
charge to residents' funds
question
Before a nursing facility transfers a resident to a hospital or allows a resident to go on therapeutic leave, the nursing facility must provide written information to the resident and a family member or legal representative that specifies— (i) The duration of the _______________________ under the State plan, if any, during which the resident is permitted to return and resume residence in the nursing facility; and (ii) The nursing facility's policies regarding bed-hold periods, which must be consistent with paragraph (b)(3) of this section, permitting a resident to return.
answer
bed hold policy
question
At the time of transfer of a resident for hospitalization or therapeutic leave, a nursing facility must provide to the resident and a family member or legal representative ___________________which specifies the duration of the bed-hold policy described in paragraph (b)(1) of this section.
answer
written notice
question
A nursing facility must establish and follow a _________________under which a resident, whose hospitalization or therapeutic leave exceeds the bed-hold period under the State plan, is readmitted to the facility immediately upon the first availability of a bed in a semi-private room if the resident— (i) Requires the services provided by the facility; and (ii) Is eligible for Medicaid nursing facility services.
answer
written policy
question
The facility must provide for an ongoing program of activities designed to meet, in accordance with the comprehensive assessment, the interests and the physical, mental, and psychosocial well-being of each resident. The activities program must be directed by a qualified professional who— (i) Is a qualified therapeutic recreation specialist or an activities professional who— (A) Is licensed or registered, (ii) Has 2 years of experience in a social or recreational program within the last 5 years, 1 of which was full-time in a patient activities program in a health care setting; or (iii) Is a qualified occupational therapist or occupational therapy assistant; or (iv) Has completed a training course approved by the State.
answer
activities director
question
The facility must provide medically-related social services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. (2) A facility with more than 120 beds must employ a ______________________on a full-time basis. (3) Qualifications of social worker. A qualified social worker is an individual with— (i) A bachelor's degree in social work or a bachelor's degree in a human services field including but not limited to sociology, special education, rehabilitation counseling, and psychology; and (ii) One year of supervised social work experience in a health care setting working directly with individuals.
answer
qualified social worker
question
Comfortable and safe temperature levels. Facilities initially certified after October 1, 1990 must maintain a temperature range of ________________
answer
71-81 °F
question
a facility must conduct a __________________ of a resident in accordance with the timeframes specified (i) Within 14 calendar days after admission, excluding readmissions in which there is no significant change in the resident's physical or mental condition. (ii) Within 14 calendar days after the facility determines, or should have determined, that there has been a significant change in the resident's physical or mental condition. (iii) Not less often than once every 12 months.
answer
comprehensive assessment
question
A facility must assess a resident using the __________________instrument specified by the State and approved by CMS not less frequently than once every 3 months.
answer
quarterly review
question
A facility must maintain all resident assessments completed within the previous ________months in the resident's active record and use the results of the assessments to develop, review, and revise the resident's comprehensive plan of care.
answer
15
question
Within 7 days after a facility completes a resident's assessment, a facility must ____________________ the following information for each resident in the facility: (i) Admission assessment. (ii) Annual assessment updates. (iii) Significant change in status assessments. (iv) Quarterly review assessments. (v) A subset of items upon a resident's transfer, reentry, discharge, and death. (vi) Background (face-sheet) information, if there is no admission assessment.
answer
encode data
question
Within 14 days after a facility completes a resident's assessment, a facility must ____________________________, accurate, and complete MDS data to the CMS System, including (i) Admission assessment. (ii) Annual assessment. (iii) Significant change in status assessment. (iv) Significant correction of prior full assessment. (v) Significant correction of prior quarterly assessment. (vi) Quarterly review. (vii) A subset of items upon a resident's transfer, reentry, discharge, and death. (viii) Background (face-sheet) information, for an initial transmission of MDS data on a resident that does not have an admission assessment.
answer
electronically transmit encoded
question
The facility must transmit data in the format specified by CMS or, for a State which has an alternate __________ approved by CMS, in the format specified by the State and approved by CMS.
answer
RAI
question
Under Medicare and Medicaid, an individual who willfully and knowingly— (i) Certifies a material and false statement in a resident assessment is subject to a civil money penalty of not more than $1,000 for each assessment; (ii) Causes another individual to certify a material and false statement in a resident assessment is subject to a civil money ___________ of not more than $5,000 for each assessment.
answer
penalty
question
A comprehensive care plan must be— (i) Developed within 7 days after completion of the comprehensive assessment; (ii) Prepared by an __________________, that includes the attending physician, a registered nurse with responsibility for the resident, and other appropriate staff in disciplines as determined by the resident's needs, and, to the extent practicable, the participation of the resident, the resident's family or the resident's legal representative; and (iii) Periodically reviewed and revised by a team of qualified persons after each assessment.
answer
interdisciplinary team
question
When the facility anticipates discharge a resident must have a _____________________ that includes— (1) A recapitulation of the resident's stay; (2) A final summary of the resident's status, at the time of the discharge that is available for release to authorized persons and agencies, with the consent of the resident or legal representative; and (3) A post-discharge plan of care that is developed with the participation of the resident and his or her family, which will assist the resident to adjust to his or her new living environment
answer
discharge summary
question
______________________ requires A nursing facility to not admit, on or after January 1, 1989, any new resident with— (i) Mental illness, unless the State mental health authority has determined, based on an independent physical and mental evaluation performed by a person or entity other than the State mental health authority, prior to admission, (ii) Intellectual Disability, unless the State intellectual disability or developmental disability authority has determined prior to admission
answer
Preadmission Screening
question
Based on the comprehensive assessment of a resident, the facility must ensure that— (1) A resident's abilities in _________________ do not diminish unless circumstances of the individual's clinical condition demonstrate that diminution was unavoidable. This includes the resident's ability to— (i) Bathe, dress, and groom; (ii) Transfer and ambulate; (iii) Toilet; (iv) Eat; and (v) Use speech, language, or other functional communication systems
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activities of daily living
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The facility must ensure that— (1) It is free of_____________________rates of five percent or greater; and (2) Residents are free of any significant medication errors.
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medication error
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The facility must develop policies and procedures that ensure that— (i) Before offering the __________________, each resident or the resident's legal representative receives education regarding the benefits and potential side effects of the immunization; (ii) Each resident is offered an influenza immunization October 1 through March 31 annually, (iii) The resident or the resident's legal representative has the opportunity to refuse immunization; and (iv) The resident's medical record includes documentation that indicates, at a minimum, the following: (A) education regarding the benefits and potential side effects of influenza immunization; and (B) medical contraindications or refusal.
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influenza immunization
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The facility must develop policies and procedures that ensure that— (i) Before offering the ____________________, each resident or the resident's legal representative receives education regarding the benefits and potential side effects of the immunization; (ii) unless the immunization is medically contraindicated or the resident has already been immunized; (iii) has the opportunity to refuse immunization; and (iv) The resident's medical record includes documentation that indicates, (v) Exception. As an alternative, based on an assessment and practitioner recommendation, a second pneumococcal immunization may be given after 5 years following the first pneumococcal immunization, unless medically contraindicated or the resident or the resident's legal representative refuses the second immunization.
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pneumococcal immunization
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The facility must post the following information on a ___________________: (i) Facility name. (ii) The current date. (iii) The total number and the actual hours worked by the following categories per shift: (A) Registered nurses. (B) Licensed practical nurses or licensed vocational nurses (C) Certified nurse aides. (iv) Resident census.
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daily basis
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The ___________________________must— (1) Review the resident's total program of care, including medications and treatments, (2) Write, sign, and date progress notes at each visit; and (3) Sign and date all orders with the exception of influenza and pneumococcal polysaccharide vaccines, which may be administered per physician-approved facility policy after an assessment for contraindications.
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physician visit
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The resident must be seen by a physician at least once every ______ days for the first _________ days after admission, and at least once every _______ days thereafter. (2) A physician visit is considered timely if it occurs not later than 10 days after the date the visit was required. (3) all required physician visits must be made by the physician personally. (4) At the option of the physician, required visits in SNFs after the initial visit may alternate between personal visits by the physician and visits by a physician assistant, nurse practitioner, or clinical nurse specialist
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30 / 90 / 60
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The facility Must provide or obtain from an outside resource, __________________ to meet the needs of each resident: (i) Routine dental services (to the extent covered under the State plan); (ii) Emergency dental services; (i) In making appointments; and (ii) By arranging for transportation to and from the dentist's office; and (3) Must promptly refer residents with lost or damaged dentures to a dentist
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dental services
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The facility must employ or obtain the services of a licensed _______________who— (1) Provides consultation on all aspects of the provision of pharmacy services in the facility; (2) Establishes a system of records of receipt and disposition of all controlled drugs in sufficient detail to enable an accurate reconciliation; and (3) Determines that drug records are in order and that an account of all controlled drugs is maintained and periodically reconciled.
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pharmacist
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The __________________________of each resident must be reviewed at least once a month by a licensed pharmacist. The pharmacist must report any irregularities to the attending physician and the director of nursing, and these reports must be acted upon.
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drug regimen
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A facility must maintain a _______________________________consisting of— (i) The director of nursing services; (ii) A physician designated by the facility; and (iii) At least 3 other members of the facility's staff.
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quality assessment and assurance committee
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The quality assessment and assurance committee— (i) Meets at least _________________ to identify issues with respect to which quality assessment and assurance activities are necessary; and (ii) Develops and implements appropriate plans of action to correct identified quality deficiencies.
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quarterly
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Where fire barriers serving horizontal exits, terminate at outside walls, and the outside wall are at an angle of less than 180 degrees for a distance of 10 ft on each side of the horizontal exit, the outside walls shall have not less than a _______ hour fire resistance rating with not less than ________ hour fire protection rating opening protective for a distance of 10 ft on each side of the horizontal exit
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1 / 3/4
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Fire _____________forming horizontal exits shall not be penetrated by ducts, unless such ducts are existing penetrations protected by approved and listed fire dampers.
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barriers
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________________shall be permitted in horizontal exits, providing the following: 1. the doors shall swing in the direction of egress travel. 2. where a horizontal exit serves areas on both sides of the fire barrier, there shall be adjacent openings with swinging doors that open in opposite directions, with signs on each side
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swinging fire doors
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All fire doors in horizontal exits shall be self-closing or automatic-closing. Each bridge or balcony shall not be less than the width of the door to which it lead and not be less than _____ inches wide for new constructions
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44
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In both of the connected buildings or fire areas, all wall openings, any part of which is within 10 ft of the bridge or balcony, as measured horizontally or below, shall be protected with fire doors or fixed fire window assemblies having a ______ hour fire protection rating. The minimum _______hour fire resistance rated barrier required for vertically from the ground to a point 10 ft above the bridge or to the roofline
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3/4 / 2
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Aisles, corridors and ramps required for exit access in a hospital or nursing home shall be not less than ____ ft in clear and unobstructed width. In psychiatric care shall be not less than ___ ft
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8 / 6
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The minimum clear width for doors in the means of egress from sleeping rooms, diagnostic, and treatment areas in hospitals and nursing homes ____ inches and in psychiatric hospitals and limited care facilities 32 inches
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41 1/2
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Any patient sleeping room, or any suite that includes patient sleeping rooms of more than ________square feet shall not have less than 2 exit access doors. Any room other than patient sleeping room of more than _______ square feet shall not have less than 2 exit access doors.
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1000 / 2500
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Doors protecting corridor openings shall be constructed to resist the passage of smoke. Compliance of NFPA 80, standard for fire doors and fire windows, shall not be required clearance between the bottom of the door and the floor covering not exceeding _____ inch shall be permitted for corridor doors.
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1
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Roller latches and Hold‐open devices that release when the door is pushed or pulled shall be _____________________
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prohibited
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Any required _______________shall be constructed in 1 hour fire resistance rating.
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smoke barrier
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No more than _______ of the resident census of the A/D (Alzheimer/Dementia) unit shall require assistance during any staffing shift. A resident who requires a wheelchair must be capable of transferring to and propelling the wheelchair independently or with prompting
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10%
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The term __________ means a chronic progressive disease of unknown cause that attacks brain cells or tissues
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Alzheimer's Disease
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The term ______________ means a clinical syndrome characterized by a decline of long duration in mental function in an alert individual.
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Dementia
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Minimum requirements for nursing staff shall be based on the ratio of ______ hours of nursing care per resident per ______ hours Licensed nursing staff and nursing aides. A RN or LPN shall be present on all shifts. A minimum of 2 staff members shall be on the A/D unit at all times
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3 / 24
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Orientation training and ____________ training must be provided to all staff who may be in direct contact with residents of the A/D unit.
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quarterly
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______________________ shall be provided to the residents of the A/D unit 7 days per week. Activities shall be delivered at various times.
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Therapeutic activities
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The contents of the ________ shall contain the following information unless the information is unobtainable by the person reporting: (a) occupation and employer's address and telephone number of the person reporting; (b) The name and address of the patient or resident (c) The details, observations and beliefs concerning the incident; (d) Any statements relating to incident made by the patient or resident; (e) The date, time and place of the incident; (f) The name of any individual(s) believed to have knowledge of the incident; (g) The name of the individual(s) believed to be responsible for the incident and their connection to the patient or resident; and
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reporting
