State of ohio LNHA Exam – Flashcards

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question
Who should the fee for application be made payable to?
answer
Treasurer, State of Ohio
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Application fee is specified in what section of the revised code
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3721.02
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An application must be submitted to the Director
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Not less than 60 days before proposed opening of NH
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Application must include
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Zoning ordinances, statement of financial solvency,statement of ownership,contact info of LNHA, contact of the business employed to manage NH,copies of certificate of occupancy,
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The director has the right to request additional info and the applicant must submit with in how many days of the request
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60 days
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The annual renewal fee is paid during what month of the year
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January
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If the renewal fee is not paid in January the cost for a late fee is?
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$100 for each week- must be paid by February 15
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The only time a separate license for each building is not required
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If each building are on same lot and constitute a single NH
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If license is revoked an applicant may not apply for one
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For one year
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The type and number of residents a NH can accommodate
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Maximum licensed capacity
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Maximum licensed capacity is determined by
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Physical facilities, personnel, and services and care
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Written notification must be provided to the director when closing home
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90 days prior to the proposed closing date
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Written notification must be provided to the director how many days in advance prior to moving existing beds or filling new beds
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60 days
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No NH may use the word in its name unless it is owned by one
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Hospital
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Prior to licensure how many residents can be accepted
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No more than 2
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No operator,administrator, or employee shall do what
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Interfere with inspection of NH,use profane language, knowing falsify records,
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Administrator must be present in the home
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16 hours each week
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Each NH must employ an RN who acts as DON and is on duty
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5 days a week, 8 hours a day, between hours of 6am and 6pm
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Can two RNs who share the DON position as co- directors full fill the DON requirement
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Yes- two RNs can share the position
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When can DON hours count toward RN staffing requirements
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When the N.H has less than 60 beds
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What is the minimum daily average of hours of direct care and services per resident per day
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2.75 hours
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What is the max ratio of STNAs to residents
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1 STNA:15 residents
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Director may grant variance to RN rule - NH must submit in writing
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N.H. Makes effort to recruit RN (NH offering prevailing wage and satisfactory work conditions), RN requirement causes undue hardship on NH
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NH shall adjust staffing levels based on needs and acuity of patients but shall not fail to meet requirement
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Input from medical director and DON
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NH must employ a full time LSW
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NH with more than 120 beds
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What must be met in order to share staff btwn another NH or adult day care on same lot with NH
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All facilities meet their minimum staffing requirements, separate staffing schedules are maintained, sharing does not adversely affect resident care, facilities are within in two mins response time, monitoring of call signal systems are. to disrupted,
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Activity schedule should reflect what
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Day time, evening, weekend, and community involvement programs to meet identified needs of each resident based on comprehensive assessment and care plan
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Adjustments of programming must be made based on
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Changes in abilities, physical, and mental status
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All NHs must provide Social Services to meet
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Physical,mental, and psychosocial well being of each 'R' and assist each 'R' in attaining or maintaining highest practicable level of functioning
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Visiting hours for a resident
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Family,guardian,friends,physician,spiritual advisors can visit anytime unless resident objects
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NH may establish what to ensure visits will not unduly disturb other residents or interfere with the operation of home
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Reasonable policies
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What must be provided in an area where private conversations can be had
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Telephone
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No nursing home shall interfere with a 'R' use of what
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Cell phone, computer, or other technological device owned by the resident, unless not medically advisable, disruptive to other residents, or the safe and orderly operation of NH
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Pets residing in nursing home must develop and implement a protocol that protects health and safety of residents in consultation with
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Medical director and a veterinarian
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The administrator shall ensure that all mail or other communication addressed the resident is delivered
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Unopened and unread immediately upon receipt at the nursing home
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Under what circumstance may the NH open and read a residents mail
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Upon the request of the resident
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The administrator shall ensure residents outgoing mail is delivered
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Unopened and unread to the regular postal channels promptly upon receipt
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Prior to admission, the nursing home shall obtain from the prospective residents physician, other licensed health professional, or transferring entity what
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Current medical history and physical, including discharge diagnosis, admission orders for immediate care, physical and mental functional status, and sufficient additional information to ensure care needs of and preparation for the perspective resident can be met
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The information prior to admission shall have been updated no more and how many days prior to admission
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Five days
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Upon admission, the nursing home shall assess each resident in the following areas
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Cardiovascular, pulmonary, neurological status including auscultation of heart and lung sounds, pulses and vital sounds and hydration and nutritional status and presenting physical psychosocial and mental status
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Subsequent to the initial comprehensive assessment a comprehensive assessment shall be performed how often
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annually.
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NH provides ongoing activity program designed to meet
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Physical, mental, emotional, psycho social well being, and personal interest of each resident
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The annual comprehensive assessment shall be performed within how many days of the anniversary date of the completion of the last comprehensive assessment
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30 days
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Comprehensive assessment is to include what
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Medical diagnosis, psychological and mental retardation along with history, health history and physical including cognitive and sensory and physical impairments, psychosocial history and preferences including hobbies, food preferences, bathing preferences, sleeping patterns, and socialization and religious preferences, prescription and over the counter medications, nutritional requirements and need for supervision of meals, height and weight, vision, dental and hearing function, functional assessment evaluating ability to perform activities of daily living
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Subsequent to the initial comprehensive assessment, the nursing home shall periodically reassess each resident at a minimum of what
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Every three months, unless a change in the residents physical or mental health or cognitive abilities requires an assessment sooner
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Beginning July 1, 2015, each nursing home shall participate in advance care planning with each resident or residents family how often
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Advance care planning shall be provided on admission to the nursing home and quarterly there after
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Advanced care planning means
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Providing an opportunity to discuss the goals that maybe met through the care provided by the nursing home
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The nursing home shall perform a comprehensive assessment within how many days after an individual begins to reside in the facility
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14 days
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Each nursing home shall establish an infection control program to
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Monitor compliance with homes infection control policies and procedures, to investigate, control and prevent infections in the home, and to institute appropriate interventions
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The nursing home shall designate who to serve as the infection control Coordinator
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Appropriate license health professional with competency in infection control
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Employees must wash their hands with
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Soap and water for at least 10 to 15 seconds or with an alcohol-based product
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Disposable articles contaminated with body substances must be placed into what
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In a container impervious to moisture
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Disposable gloves are to be worn for
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Contact with any residents body substances, non-intact skin or mucous membranes and shall be changed before and after contact with another resident and disposed of
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When would you wear an impervious cover gown or other appropriate protective clothing
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If soiling of clothing with body substances is likely to occur
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When would you wear a mask and protective goggles or face shield
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If splashing of a body substance is likely to occur or if a procedure that may create an aerosol is being performed
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LNHA or designee must notify resident,responsible party, and consult with physician immediately when?
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Resident involved in accident requiring physician attention; a significant change in residence physical, mental, or psycho social status such as deterioration in health, mental, or psycho social status and either life-threatening conditions or clinical complications; A need to alter treatment significantly such as to discontinue an existing form of treatment or to commence a new form of treatment
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Notification shall include what
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Description of the circumstance and cause. A notation of the change in health status and any intervention taken shall be documented and medical record
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If the resident is a patient of a hospice care program the notification shall be the responsibility of who
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The hospice care program
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The death of a resident must be reported within how many hours to the appropriate third-party payer
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Within 24 hours; if the office is closed, as soon thereafter as it is open
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Report any incident of fire, damage due to fire and any incidence of illness, injury or death due to fire or smoke and inhalation of a resident within how many hours
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24 hours
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What office do you report any incident of fire, damage from fire or any illness,injury,or death caused by fire to?
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The office of the State fire Marshal and the director
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What chapter of the administrative code list diseases required to be reported
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3701-3
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The medical director in collaboration with the administrator the nursing director and other health professionals shall
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Develop formal resident care policies; make available medical care for residents not under the care of their own PCPs and to make available emergency medical care to all residents; meet periodically with nursing home to discuss clinical/administrative issues; monitor and discuss clinical practices of attending physicians and intervene as needed on resident or facility's behalf; maintain surveillance of health of nursing home staff; assist administrator and professional staff and ensuring safe and sanitary conditions for the residents
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How often does the medical director need to observe residents and facilities
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At least quarterly or more frequently as needed
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How often does the medical director need to review pharmacy reports
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At least quarterly
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The nursing home shall not administer any medications or treatments to any resident unless
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Ordered by a physician or other license health professional
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If orders are given by telephone they shall be recorded with what
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Health professionals name, date, specific orders, signed by person taking the order
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All orders must be signed by the physician how many days after the date the order was taken
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14 days
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How often is the resident to be evaluated by a physician or other licensed health professional for the first 90 days after admission or three evaluations
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At least once every 30 days
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After the 90 day period how often is each resident of a nursing home to be evaluated by a physician
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At least every 60 days
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A physician or licensed health professional visit is considered timely if it occurs
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No later than 10 days after the date the visit was required
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The nursing home shall ensure the development of a plan of care is initiated upon admission and completed and implemented for each resident after how many days of completion of the initial comprehensive assessment
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seven days
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The plan of care shall be prepared by an interdisciplinary team that includes
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The attending physician or other licensed health professional, a registered nurse, and other appropriate staff in disciplines determined by the needs of the resident such as dietary recreation and social work staff, and resident and family
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The plan of care shall be consistent with comprehensive assessment and shall contain a written description of
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What services, supplies and equipment, are needed, when, how often, and by whom services, supplies and equipment will be provided and the measurable goals or outcomes
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The plan of care shall be reviewed when
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Significant change and at least quarterly
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True or false: each resident shall have access to his or her assessment and plan of care at any time upon request
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True
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Skilled nursing care shall be provided by
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A nurse; except a nurse may delegate certain tasks
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Each nursing home shall provide adequate supervision of residents who were assessed for
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Risk of falls, or elopement, or both
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In anticipation of a discharge, the nursing home shall prepare the following information to be shared with appropriate persons and agencies upon consent of the resident
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An updated assessment that accurately identifies condition and continuing care needs, a plan developed with resident outlining what services supplies and equipment needed and how to access them; also any accommodations needed to the physical environment to meet needs
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True or false : The nursing home with the consent of the resident may arrange in advance any needed supplies or services
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True
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Except in emergency situations a nursing home may not physically or chemically restrain a resident or subject a resident to prolonged isolation
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Without a physician order that includes date, restraint used, medical reason, and duration
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Restraints or isolation cannot be used for
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Punishment, incentive, or convenience
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What restraints are prohibited in nursing homes
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Prone restraints and transitional holds
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Items not to be misconstrued as isolation or restraints
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Devices that assist the resident and do not restrict freedom of movement or bodily access, medications that are standard of treatment for residents medical or psychiatric condition, placing cognitively impaired individuals on a specialized care unit
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Placing cognitively impaired individuals on a specialist care unit under what circumstances
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Nursing home determines they need to be placed on the unit, care is provided for an individual resident needs and not convenience, needs to be in a locked unit is reviewed with each periodic assessment, locked unit meet State building and fire codes, residents not cognitively impaired are able to enter and exit unit without assistance
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Prior to authorizing the use of a physical or chemical restraint the nursing home shall ensure the physician
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Makes a personal examination of the resident and determines the need for the use of a restraint, in conjunction with interdisciplinary team conducts an individualize comprehensive assessment of the resident
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In regards to restraints the individualize comprehensive assessment shall
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Identify specific medical symptoms that warrant the use of the restraint; determine the underlying cause of the medical symptom and whether that underlying cause can be mitigated; investigate and determine if possible alternative interventions have been attempted and found unsuccessful. Determine least restrictive device; discuss with resident or authorized representative the risks and benefits of the restraint; obtain written consent from resident or residents representative
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The restraint or isolation of a resident transferred from another healthcare facility may be used for how many hours after the transfer or admission
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Twenty -Four hours
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Residents with restraints must be monitored every
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30 mins
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What may not be used as restraints
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Canvas, leather, or metal
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Restraint orders are valid for how long
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30 days
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To continue use of a restraint at the end of the 30 days the physician must
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Examination the resident and written authorization stating the reason for continuing the restraint
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Use of the physical or chemical restraint or isolation should not be continued for more than how many hours after the onset of the emergency without personal examination and authorization
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12 hrs
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When isolation or confinement is used the nursing home shall ensure
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Resident is continually monitored and periodically reassessed for continued use in need of isolation, doorway is secured in such a way as to be readily open in case of an emergency, the resident is isolated for the least amount of time to achieve desired outcome
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The quality assurance committee will review the use of restraints or isolation and any issues coming from them how often
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Monthly
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How many hours of direct care for STNAs
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Two hours
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How many hours per resident per day for RN
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0.2 hours per resident
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The remaining hours by nurses, aids, activity aids, therapists, dietitians, and social worker
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0.55 hours
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Nurses can be counted towards STNAs hours
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As long as they work as an aid and don't count towards nursing
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A resident shall be provided with an individual bed
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Not less than 36 inches wide- with clean comfortable flame resistant mattress, sheets, pillows,and covering suitable for season
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Upon the request of a married couple or consulting adults the N.H. must arrange for
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At least double bed
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Mattresses shall be protected with
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Waterproof material
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The NH May not use what as beds
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Roll away beds,cots, double deck beds, or bunk beds
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The NH must provide what in rooms
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Bedside table, lamp (sufficient for reading and staff rendering bedside care), bureau, wast basket with liner, chair, closet or wardrobe
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Rooms must be designed to
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Provide full visual privacy for each resident by means of curtain, movable screen, or private room
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Call system must be maintained at a minimum of what room
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Resident rooms, toilet, and bathing facilities
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The NH must have what necessary supplies and equipment to provide to resident care at all times
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Wheelchairs, gerichairs, quad canes, adaptive eating utensils, and other assistive devices
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In areas generally accessible to residents what must be kept in locked area separate for medications and food
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All disinfectants, pesticides, and posions
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In regard to pharmacy services, residents may
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Continue to use and obtain medicines,drugs, and biological dispensed to them from a pharmacy choice
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Each NH shall provide pharmacy services by employing
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A pharmacist on either full time, part time, or consultant basis or by contracting with a pharmacy
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What is the pharmacy or pharmacist responsible for
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Maintaining supervision and control of the stocking and dispensing of meds
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NH In conjunction with pharmacy is to
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Maintain emergency drug supply in absence of pharmacy and maintained within state pharmacy rules
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Med containers to be properly labeled containing?
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1.date dispensed, 2. Name of resident, 3.directions for use, 4, name of the prescriber, 5.name of drug strength,and prescription number
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Containers to small to contain complete prescription label must have
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Labeled with prescription number and name of resident and shall be dispensed in a container earring complete prescription label
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Each NH shall ensure what requirements regarding individual residents drugs are met
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1. Meds are sent with resident upon temporary absence other than hospital, 2. At order of prescriber drugs shall be sent or arranged upon discharge or transfer
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The drug regimen of every resident is to be reviewed and documented by a pharmacist how often
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Monthly
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For hospice patients who is responsible for coordinating and ordering medications
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The NH
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Between breakfast and lunch and lunch and dinner meals must be served at what hour intervals
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At least 4 hrs
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There shall bend more than how many hours between the evening meal and breakfast
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No more than 16 hours
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The NH must offer what following evening meal
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Beverage and food
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NH May provide home style or buffet if resident agrees to participate and NH
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Uses precaution to prevent food contamination, assist residents when necessary
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NH must maintain how much perishable food items
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2 day supply
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NH must maintain how much staple food
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At least one weeks supply
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Planned menus must be approved by dietician how far in advance
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At least one week
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Records of meals served must be kept for how long
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One year from date served
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Records of the meals must include
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Date served and any food substitutions
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Notification of any significant unplanned or undesired weight change shall be made to
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Physician and dietician
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Significant unplanned weight change means
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5% (+)(-) over month, 7.5% (+) (-) over 3 months, or 10% (+) (-) over 6 months
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If NH does not employ a full time dietician
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Must employ food service manager
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Dietician must consult at a minimum
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Monthly
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Dietician must monitor food prep staff and residents with special diets how often
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At least quarterly
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Dietician must evaluate residents response to new complex therapeutic diets and the homes compliance when
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One month after NH commences providing diet
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Records may be kept in what formats
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Electronically,microfilm,or other format that ensures a true copy is available
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In regards to controlled substances the NH must contain records of
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Purchase,delivery,dispensing,and administering of controlled substances
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Records must be kept how long after the date of the residents discharge
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7 years
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If the resident is a minor records shall be kept
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For three years past the age of majority but not less than 7 years
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Upon closure of NH the operator must arrange for records to be kept
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For not less than 7 years
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Upon request of resident or legal representative the NH shall provide
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Access to medical and financial records within 24 hours ( excluding holidays and weekends)
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What must be posted in areas or on doors of rooms where O2 is stored or in use
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No smoking signs
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Indoor resident smoking shall only be permitted in
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Separately enclosed and separately ventilated designated areas
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What is not to be designated as resident smoking areas
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Dining and recreation rooms, resident rooms, and any area/room where O2 is stored
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What area may be designated as a smoking area if not used for original purpose
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Dining and recreation room/area
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At designated smoking area the NH must
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Post smoking sign
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NH may establish smoke free environment
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Residents must be notified prior to admission,
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Burnable material receptacles shall be
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Non combustible or carry fire resistant UL or FM rating
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Ash trays shall be
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Self closing or have cigarette island in middle
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Ash trays shall not have
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Any cigarette holders located around the outside of the rim of the tray
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The NH must have a room used for no other purpose than
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Dining and resident activities
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If facility built after 1964 it must have the following dining room requirements
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25 sq. feet per resident for 75% of number of resident
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Employees must wash their hands when
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After using the toilet; before direct contact with a resident, dispensing medications, or handling food; immediately after touching body substances; after handling potentially contaminated objects; between direct contact with different residents; and after removing gloves
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