California Nursing Home Administrator License – Flashcards
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How must washbasins be sanitized?
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30 minutes in boiling water, autoclave, or gas sterilization (not to be cleaned with chemicals)
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How much food should be kept on hand?
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Non perishable food 1 weeks worth, Staples 2 days worth
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At what temperature should readily perishable foods be stored?
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Below 45 degrees or over 140 degrees
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At what specifications should an autoclave function?
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15 pounds pressure, 250F, 20 minutes
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How long should utensils be disinfected (after washing with soap) by immersion in clean water?
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2 Minutes at 170F; 30 seconds at 180F; or in water containing bactericidal chemical (at least 110F)
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What is the minimum dishwashing water temperature?
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110F
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When must the initial assessment be completed?
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Within 7 days of admission
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Drugs that are to be stored at room temperature should be stored at what temperature?
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59F to 86F
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When must drugs be destroyed?
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90 Days
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The food service supervisor must complete a what type of course?
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90 Hour
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How often must care plans be completed?
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Quarterly
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How often must the dentist provide in-service for the staff?
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Annually
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How often must humidifier bottles be changed or sterilized?
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Q24 Hours (Every 24 hours)
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With what may a humidifier be filled?
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Water that is sterile distilled, deionized or demineralized.
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When should resident call lights be answered?
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Promptly
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All patients are to be assisted and encouraged to maintain?
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The highest level of self-care and independence
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All of the following are considered restraints (unless used for postural support)?
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Soft Ties, Seat Belts, Spring Release Trays, and Cloth Vests
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How long may treatment restraints be used?
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ONLY for the time required to complete the treatment.
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The planned menu may repeat less than what time frame?
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Every 3 weeks
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How often must the menu be revised?
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Q90 Days (every 3 months)
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A doctor must be notified for what weight gain in a 30 period?
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5lbs.
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The Dietary Manual must be review how often?
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Annually
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The Dietary Manual must be revised how often?
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Every 5 Years
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Drugs ordered Stat in 1 hours must be given how soon?
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2 Hours Maximum
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How must Glass Thermometers be cleaned?
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With 70% alcohol for minimum of 10 minutes
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How long must Drug Order records be kept?
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1 Year
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How long must Drug Destruction records be kept?
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3 Years
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How long is 1 hour of learning experience?
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50 Minutes
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How many hours of orientation must a C.N.A. have prior to providing care?
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8 Hours
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How many hours of orientation must a C.N.A. have during their first 40 hours worked?
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16 Hours
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What is the annual renewal fee for the C.N.A.'s certificate?
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20
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How long must Employee health records be kept?
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3 years
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How long must patient records be kept?
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7 years (title 22); 5 years OBRA
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How often must the Patient Care Policy committee meet?
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Annually
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How long must the unusual occurrence reports (24 hour reports) be kept?
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One Year
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When must a patients money be returned if they expire?
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30 days after death.
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When must prepaid room and board be returned upon discharge?
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Within 2 weeks
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Are nurses progress notes necessary?
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Yes
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How long must a bed be held should a patient go to an acute care facility?
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7 Days
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What is the minimum amount of light required for reading in a patient room?
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30 ft candles
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What is the minimum amount of light required in nonreading areas of patient room?
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20 ft. candles
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How often must drinking water be tested?
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Every 3 Months
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How often must Ice be tested?
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Every Month
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What is the minimum width of handicap parking spaces?
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13 Feet
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What is the acceptable height range for hand rails?
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34 Inches to 38 inches high
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What is the maximum height of the bottom of the window in a patient room?
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36 Inches
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Curtains must be how many inches below fire sprinklers?
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18 Inches
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How often must the autoclave be tested?
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Monthly
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How often must the autoclave thermometer be tested?
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Weekly
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When must DHS (Department of Health Services) be notified of construction?
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Within 5 Days
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Hot water for resident use must be how hot?
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Between 105F and 120F
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A warning sign must be posted if water from a faucet is over what temperature?
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125F (Sign must be at least 2 inch high letters)
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When must a C.N.A.'s training be completed?
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Within 4 months
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How many wires per square inch must a bug screen have?
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16 Wires per square inch
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How often must residents be weighed?
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Monthly
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When must an admission evaluation be performed?
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From 5 days prior to 48 hours after admission.
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What documentation is required for the HVAC system?
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Written Manual
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Drugs brought into the building must be checked by?
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Physician and Pharmacist
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What is the minimum RN hours in a day?
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8 Hours
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What Medicare info must be posted on the facility info board?
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Medicare fraud unit contact info
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During survey what three items do surveyors review?
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Facility Characteristics, QI profile, Resident Level Summary
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What is the penalty if not in compliance with surveyors in 3 months?
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No payment on new admits
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What is the penalty if not in compliance with surveyors in 6 months?
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23 Day fast track to termination
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How must no contest citations be handled?
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Pay 25% in 4 days
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How are the temperatures of pipes regulated?
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Title 24
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What type of equipment requires a 3 prong hospital grade plug?
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Oxygen Equipment
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Which type of survey follows a standard survey?
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Extended Survey
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What entity must approve the conversion a utility room to an office?
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DHS (Department of Health Services)
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What items must be present if storing non-legend (not ordered by prescriber) drugs at bedside?
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Original Container, Recorded in Chart, Record of Amount
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Who acts as the liaison between the administrator and the physicians?
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Medical Director
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What is the isolation bed ratio?
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0.0659722222222222
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Who dictates the administrative policy and procedures for a facility?
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The Governing Body
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Who makes up the PCP committee?
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DON, Activities Director, Administrator, Pharmacist and at least one Physician
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Should power from the grid fail the generator must come on in how many second?
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10 Seconds
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How long must a generator be able to provide power to the building?
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6 Hours
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How many beds must a facility have to require an RN at all times who is not the DON?
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100+ beds
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Who has the final responsibility of care in a SNF (skilled nursing facility)?
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Administrator
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Who has the final responsibility of care in a ICF (intermediate care facility)?
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Physician
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When there is a change of physician what must the new physician do?
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Review orders for care and treatment
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Who is responsible for screening patients for admission?
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The administrator or their designee
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What are the three required committees?
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PCP, Infection Control, and Pharmacy
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When may patient health records leave a building?
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May be put in storage after discharge
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May funds be mingled between buildings?
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No
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What information is required on an ID band?
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Resident Name and Facility Name
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When are phones not required in patient rooms?
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When the facility has less than 6 beds and all residents are ambulatory
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When may Audiology service be provided?
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As an optional service
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What treatment may trained competent non licensed staff provide?
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Medicinal Baths and Shampoo, Non Legend Cream or Ointment (to intact skin), and Laxative Suppositories
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How many buildings may an administrator manage?
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3 Buildings up to 200 beds IF same company
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When must the DHS (department of health services) be notified of a change in administrator?
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10 Days
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When must the Bowel and Bladder management be completed?
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Within 2 weeks of admission
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What entity governs the self administration of drugs?
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IDT
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When can survey come?
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At ANY Time
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Who must check the emergency supply of drugs?
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Pharmacist
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When must piped gases be inspected?
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Time of Installation, if Changes to the system are made, or the systems Integrity is Breached
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Where must soiled linen be sorted?
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In different room than the clean linen
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What must outpatient therapy have?
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A Separate hand washing facility
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Who is responsible for the for the informed consent?
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The Physician
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The mentaly disordered receive how many hours of special rehab in a week?
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27 Hours
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How often must reports be made on patients financials?
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Quarterly
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Who is required to CPR training?
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All nurses
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What are the unit dose medication amount requirements?
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Minimum of 24 hours supply and maximum of 48 hours supply
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Who must approve the Therapeutic Dietary Manual?
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Dietician and PCP
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When must signed orders be sent to the pharmacy?
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Within 48 hours
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How long is a provisional license valid?
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6 Months
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The medication error rate must be?
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5% or less
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Who must approve optional services?
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PCP
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When must the facility release drugs upon patient discharge?
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If the doctors orders do not include provision for drug disposition
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How often must the external disaster plan be reviewed?
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Annually
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When can rights be denied or taken away?
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Never
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How long must the hours and dates worked by employees be kept?
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12 Months
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How long must the log of registry workers be kept?
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3 Years
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When may a SNF have more patients than licensed beds?
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With the approval of the director of DHS
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What are the bed requirements?
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Clean, comfortable, must have a blanket, sheets, pillow (with pillowcase), and a Mattress
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What are the requirements for non movable solid waste containers?
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Must be leak proof, rodent proof, tight fitting lids, and external handles (labels are not required)
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What is required if equipment is maintained by an outside company?
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Must have documentation of the required standards
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Who is responsible for standards
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surveillance, coordination and improvement of medical care?,Medical Director
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Who acts as consultant to DON
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liaison be Administrator and Doctors, and is responsible for employee physicals?,Medical Director
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Who must approve storing infectious waste and other waste together?
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DHS (Department of Health Services)
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How long must patient bacteriological tests be kept?
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12 Months
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Fridges storing drugs must have?
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Accurate Thermometers
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When can the DON act as the charge nurse?
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If facility ADC (average daily census) is less than 60
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How much notice must a resident be given if they are being involuntarily Dc'd (discharged)?
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30 Days (written notice)
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Which committee is not required by Title 22?
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QA Committee
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What bond amount is required for a patient trust with $750 or less?
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$1,000 bond
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Who must be notified if a resident is injured?
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Physician, Family Member, or Legal Representative
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How often must the administrator be present at a facility?
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Sufficient Hours to run the facility
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Patients may only be admitted with what?
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Physicians Orders
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When may "approved by DHS" be used in advertising?
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Never
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What must a transfer record include?
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Date, Time, Condition of patient, and Reason for transfer (Name is Not Included)
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When may a patient smoke in bed?
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Only if supervised.
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If Administrator is absent for how many days he/she must appoint an acting administrator?
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30 Days
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When must employee health exams be completed?
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90 prior to or 7 days after employment; Annually Thereafter
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When must the DHS (department of health service) be notified if patient records are damaged or defaced?
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Within 3 Days
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When must the patients chart be closed upon discharge?
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30 Days
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How long must X Ray film be kept?
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7 Years
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When must fire drills be performed?
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Quarterly, for all shifts
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What items must be in a patients room (other than the bed)?
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Bedside Table, Chair, Reading Light, and Over bed Table
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How long must the thermometer check log be kept?
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12 Months
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How often must mop heads be changed?
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The must be removed and changed daily
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The head of housekeeping is qualified through?
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Training and Experience
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How much linen should be at the facility?
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Sufficient for 3 complete changes at capacity
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What type of containers should be used to transport soiled linens?
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Closed Containers
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How often must generators be tested? For what interval?
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Every 14 Days, for 30 minutes load conditions
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A hand washing facility may not have?
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Aerators
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Who may not transfer gasses between containers?
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Staff
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What must the inspection and cleaning records of air filters include?
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Information on static pressure drop
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Where must bedpans be emptied?
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In Utility Rooms or in Toilets with flushing attachments
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Piped oxygen tests are to what agencies standards?
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NFPA (National Fire Protection Agency)
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No additional liscensed personal are need at an ICF if fewer than how many beds?
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50 Beds
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What organization establishes dishwasher standards?
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National Sanitation Foundation
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How must drugs for internal and external use be stored?
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Separately
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How must emergency drugs be stored?
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In a portable sealed container
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How often must activities in-service occur?
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Annually
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Your activities leader may be?
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Occupational Therapy Assistant
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What size of room is stipulated in the regulations?
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The size of the room is not stipulated
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What is demonstration and return demonstration?
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Clinical Training
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What is the standard for measuring student learning?
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Student Performance Standard
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What are mandatory reports?
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Brucellosis, TB (tuberculoses), Pertussis
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What type of lighting is required for the emergency supply?
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Working Flashlights
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Where must the dentists contract be located?
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The Administrative Office
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What must be included in the disaster program?
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P&P for recalling off duty staff, unified medical command, P&P for patient relocation
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Each facility must maintain what types of storage space?
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General and Specialized
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Where must telephones be installed?
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Each floor with residents
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Which types of housekeeping schedules should be maintained?
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Daily, Weekly, and Monthly
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What sign must be posted outside of ambulatory rooms?
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"Reserved for Ambulatory Patients"(in 1/2 inch letters)
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Grab bars must be maintained where in residents rooms?
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In the bathroom
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What must utility rooms contain?
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Rim Flush Sink, Work Counters, and Storage Cabinets (call system not required)
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What gases are utilized for medical use?
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CO2, NO, O2, Ethylene, Cyclopropane, Helium (not nitrogen or CO)
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What must autoclaves have?
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Time Record, Mercury Thermometer
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How often does the PCP meet?
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Annually
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When calculating floor space what does the OT floor space equal?
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The PT floor space
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What organization certifies occupational therapy assistants?
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AOTA
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Is a hospital licence correction required for ownership change?
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No
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Dieticians are certified by which organization?
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American Dietetic Association
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How are violations with direct relationship to health and safety of patients classified?
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Class B Violations
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Where must he supervisor be located as defined by "direct supervision"?
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In the Same building as the employees being supervised
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Admitting a patient without an attending MD is what type of violation?
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Class B Violation
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Water that is too hot in fixtures is what type of violation?
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Class A Violation
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What may be shared by facilities?
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Centralized Services
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At a citation review conference the licencee may not?
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Subpeona Witnesses, Record Testimony, or Cross Examine
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Unauthorized administration of medication is what type of violation?
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Either a Class A or B Violation
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When must physicians visit?
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As needed, or every 30 days
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What factors are taken into consideration when deciding the time for elimination of a condition of a vilation?
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Department considers the number of patients, seriousness, and availability of resources
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What factors are considered during a physical therapy evaluation?
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Functionality, Muscles, and Joints
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What factor is no considered during a physical therapy evaluation?
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Pain
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What items must a physical therapy gym contain?
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Training Stairs, Full Veiw Mirror, Overhead Pulley and Weights, and Treatment Table with Curtain
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How are violations relating to care plans classified?
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Class B Violations
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What should be included on a dietary card?
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Likes, Dislikes, Alergies, and Diet Order
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What nurse staffing requirment is mandated for facilities with 59 or fewer beds?
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At least on RN or LVN on duty and awake at all times
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How are vilations relating to employee personnel records classified?
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Class C Violations
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Physical Therapists are registered through?
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California Board of Medical Quality Assurance
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How are violations related to nursing staff classified?
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Class B Violations
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Interpersonal relationship programs include?
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Outings, Educational and Recreational Therapy, and Social Counselling
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Interpersonal relationship programs do not include?
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Mental Health Counselling
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How are violations related to fire safety procedures classified?
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Class A or Class B Violations
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Refridgerated drugs must be stored at what temperature?
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Between 36F and 46F
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What is the maximum distance from the nurses station to room door?
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90 Feet
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What is the minimum square footage for a Utility Room?
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100 sq.ft.
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What is the minimum square footage for the dining room?
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12 sq.ft. per bed plus 100 sq.ft.
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What is the minimum square footage for clean linen storage?
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8 sq.ft. per unit
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What is the minimum square footage for soiled linen storage?
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10 sq.ft. per unit
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What is the minimum square footage for supply storage?
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15 sq.ft. per unit
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Who must reseal the 72 hour kit when drugs are replaced after having been used?
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Pharmacist
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What is the maximum allowable time between the dinner and breakfast?
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14 hours
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How long must itemized food records be kept?
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1 Year
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When must menus be posted in the kitchen?
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One week before the meals will be prepared
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How long must the menu "as served" be kept?
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1 Month
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What is the minimum Physical therapy space?
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300 sq.ft. (no dimension less than 12 feet)
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What is the minimum square footage for wheelchair storage?
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15 sq.ft. per unit
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What is the minimum ceiling height?
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8 Feet
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What is the minimum shower ration?
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1 (shower):12(Beds)
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What is the minimum toilet ratio?
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1 (toilet):6 (Beds)
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How wide must corridors be in patient areas?
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8 Feet wide
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How wide must corridors be in service areas?
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6 Feet wide
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What is the minimum square foot requirement for trash storage?
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25 sq.ft.
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How must supervisory experience must DON have?
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One year of experience in the last 5 years
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When may standing orders be used?
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Standing orders may not be used.
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When may powdered milk be used?
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For cooking but NOT for drinking.
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If the department intiates a disciplinary action a nurse has how many days to request a hearing?
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15 Days (hearing must be within 5 days of request)
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How is immediate supervision defined?
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Instructor is in the building and present when clinical procedure is performed
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What is the maximum instructor to student ratio?
answer
0.0520833333333333
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What are the requirements for the DSD?
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One year of patient care and one year planning and implementing educational programs
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What are the DSD weekly hours worked requirments for facilities (with certification program) with 100 beds
answer
60-99 beds, and 59 or fewer beds?,40 hours (100 or more beds); 30 hours (60-99 beds); 20 hours (59 or fewer beds)
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When must C.N.A. training be completed?
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Within 4 months of being hired.
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3 hours of clinical training equals how many CEU's?
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1 CEU
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How long must certifcation programs records be kept?
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4 years
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Medications must be given how soon after preparation?
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Within 2 Hours of being prepared and given by preparer.
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When is drug preparation for more than one administration time permitted?
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Never
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How many hours of training should a C.N.A. have each year?
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24 hours
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How long must C.N.A. training records be kept?
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4 Years
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Who is responsible for the unit dose system?
answer
Pharmacist
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Physical restraints may not have which type of order?
answer
PRN
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Physcial restraint order must include?
answer
Written physicians order specifying duration and circumstances of use
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What type of restraint may not be used?
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Seclusion
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What is the maximum number and doses allowed in the Ekit?
answer
6 emergency drugs, 4 doses each
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How much time must a pharmacist spend in a facility?
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As much as needed, must attend required quarterly review
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When may the administrator act as patients authorized representative for money and valuables?
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IF the administrator is a close blood relative
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How may a facility dispute survey findings?
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With an Informal Dispute Resolution
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How high above the floor must dryfoods be stored?
answer
12 Inches
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How often must restraints be checked?
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Every 30 minutes
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Infectious disease rooms must have the following?
answer
Vented to the outside; Separate Towel, Handwashing Facility, Soap Dispenser, and Toilet
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How many facilities may a DON work in?
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One
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What are the required working hours for a DON?
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A minimum of 8 hours per day, and 5 days per week (on the day shift)
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The DON must be an?
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RN
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Orientation must include?
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Facility Tour, Emergency P&P's, and Intro to Patient Care (Must be 8 hours)
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Legend drugs must have what warning on the label?
answer
Federal Law Prohibits dispensing withou a prescription
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Legend drugs include?
answer
Dangerous drugs un the business professions code
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Who licences clinical social workers?
answer
California Board of Behavioral Science Examiners
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Substantial Compliance is defined as?
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Conformity to regulations to an extent that patient safety, welfare and quality of care are assured
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The Freezer temperature must be below?
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0F (-18C)
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What must the temperature be on water during the rinse cycle of automatic dishwashers?
answer
180F
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Drug labels must be?
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Legible
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Legend drugs stored as bedside must be (6 items)?
answer
Locked, Recorded in Chart, Be ordered by Prescriber, Stored in Original Containers, Sublingual or Inhalation, and Not kept in Stock after Expiration
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Drug orders must be signed within how many days?
answer
5 Days
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Drug orders must be transmitted in?
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48 Hours
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How often must a pharmacist review a patients drug regimin?
answer
Monthly
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ICF - when must the special programs evaluation be completed?
answer
30 Days prior to or within 15 days after admission
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ICF - How many hours of oreintation must be comleted?
answer
20 hours in the first 60 days of employment
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ICF - Who must be provided if attending physician is unavailable?
answer
Facility must provide a physician for emergency care
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ICF - How long must the drugs returned log records be kept?
answer
3 Years
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ICF - What must be obtained prior to aquiring more than 10% ownership in a facility?
answer
Written Department Approval
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ICF - What services must the facility provide?
answer
MD, Intermittent nursing, Dietary, Pharmacy and Activities
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ICF - What must be provided if there are only LVN on the day shift?
answer
RN consultant (at least 4 hours a week)
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ICF - What are the menu requirments?
answer
Posted 3 days in advance, Written 1 week in advance
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ICF - How often must a resident by seen by a physician after the first 90 days after admission?
answer
Every 60 Days
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ICF - Specialty Treatment programs must initially have how many points?
answer
30 Points
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ICF - Specialty Treatment programs may not drop below how many points?
answer
27 Points
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ICF - What three types of Special Disability services are provided?
answer
Mentally Disordered, Substance Abusers, and Developmentally Disabled
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ICF - Specialty treatment programs for the mentally disordered include?
answer
Money Management, Use of Community Resources, Use of Public Transportation
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ICF - Specialty treatment progrmas for the mentally disordered do not include?
answer
Homemaking
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ICF - basic patient rights include?
answer
Privacy for Visits, Reimbursement for lost property, and visiting hours daily for clergy
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ICF - What are the weekly minimum number of hours in activities for each patient?
answer
10 hours for each patient
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ICF - What are the actvities staffing requirments for 50+ beds
answer
25-49 beds, 24 and under beds?,50+ beds (full time staff); 25-49 beds (20hrs per week); 24 and under beds (10 hrs per week)
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ICF - How often must the E-Kit be checked?
answer
Monthly
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ICF - What position many the DON and Administrator no have?
answer
Special Program Director
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ICF - What are the minimum patient room square foot requirement for each bed?
answer
110 sq.ft. for a single bed room; 80 sq.ft. per bed in mulitbed rooms
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ICF - What is the minimum storage requirement per bed?
answer
12 sq.ft. per bed
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ICF - When may bedside nursing be provided?
answer
IF doctors says temporary and minor
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ICF - What is the minimum nursing hours ppd?
answer
1.1 ppd
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ICF - When is skilled care allowed?
answer
When it is non continous
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ICF - When must the drug order be signed?
answer
Within 48 hours
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ICF - Who must review the drug orders monthly?
answer
Pharmacist or RN
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ICF - When must the meal menu be written and posted?
answer
Written 1 week in advance; Posted 3 days in advance
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ICF - What is the maximu number of drug doses in the Ekit?
answer
3 Doses Maximum
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ICF - How many hours of psychiatric special treatment per week?
answer
30 hours per week
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What must be received to show the resident was fully informed of their rights?
answer
Signed Acknowledgement
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Residents must be fully informed of?
answer
Services and Charges
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Residents must be informed by the doctor of?
answer
Their health status and be involved in their plan of care
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Patients have the right to refuse or consent to?
answer
Treatments, Procedures, or involvement in Research
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Patients are intitled to what material to their decision to consent or refuse treatment?
answer
All Information Material to the Decision
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Patients may only be transferred or discharged for the following reasons?
answer
Medical Reasons, Patients or other patients welfare, or nonpayment of stay
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Patient have a right to be?
answer
Encouraged and Assisted
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Patients have what rights regarding policies and services?
answer
The right to voice grievances and recommend changes
question
Patients have what right regarding their finances?
answer
To manage their fiancial affairs and to be given quarterly accounting of transactions on their behalf
question
Patients have what rights regarding abuse?
answer
To be free from physical and mental abuse
question
Patients have a right to confidentiality of what information?
answer
Health and Financial Information
question
Patients have a right what type of treatment?
answer
To be treated with respect, full recognition of dignity and individuality, including privacy and care or personal needs
question
Patients are not required to perform which services?
answer
Those that are not for therapeutic purposes
