Texas Nursing Home Administrator Exam

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Facility License Period
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2 years
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Licensed Nurse Ratio in 24 hr period
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1 to 20
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TDADS approval for plans for new buildings, additions, conversion is good for…
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Two years
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Must not use any nurse aide who has worked less than…
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4 months
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A written report of suspected abuse is required by TDADs within…
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5 days
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Dietary department days of perishables supply
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2 days
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Dietary department days of staples supply
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7 days
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Days the Hep B vaccination must be offered to employees at risk
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10 days
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Frequency of review of drug regimen by a licensed pharmacist
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Once a month
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Minimum square footage for single bed
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100 sq ft
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Minimum square footage for semi-private room
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160 sq ft
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Maximum number of residents per ward
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4
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Maximum number of residents per toilet
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8
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The amount of time an initial Admin license is good for
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1 year
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Maximum distance between resident room and nurse station
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150 feet
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The annual balance in the trust fund
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10 million
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Maximum time to inventory personal property of new admission
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72 hours
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Minimum discharge notice
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30 days
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CNAs must complete new training if they have not worked for…
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24 months
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Amount of days still considered timely by physician after a visit is required
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10 days
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Annual CEU hours for CNAs
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12 hours
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Timeframe a prospective new owner must complete a license application
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30 days before sale
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Amount of time required to retain discharge resident records
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5 years after discharge
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Amount of time required to retain nursing schedules
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2 years
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Number of days required to notify TDADS that an agreement will not be renewed
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30 days
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Time of Accountability period
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24 months
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Number of years DHS looks back on applicant record
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5 years
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Time TDADS can place vendor payments on hold during change of ownership
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12 months
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Maximum number of days between physician visits during 1st quarter of stay
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30 days
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Minimum space between beds
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36 inches
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Number of days after the last day of the month to submit to TDADS the List of resident deaths
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10
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Combined minimum sq feet for dining and living area per licensed bed
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19 sq ft
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Number of working days to submit reason for refusal of patient from closing facility
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10
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Annual cost reports to TDADS are due
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3 months after provider fiscal year ends
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The requirement for physician recertification for a resident is how many days?
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180
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OBRA mandated hours for initial CNA training
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75
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Number of Days required for disclosure of business transactions
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35 days
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Number of CEUs to be completed by Activities Director annually
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8
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The maximum number of hours for a physician approved therapeutic home visit
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72
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Maximum number of days to complete a comprehensive assessment of a new resident
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14
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Minimum number of times a year a comprehensive assessment must be done
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Once
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Maximum amount of time to provide a clinical record once a request is received
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24 hours
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The frequency that an MDS must be examined and reviewed
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Quarterly
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Frequency of providing written transactions of resident funds
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Once a quarter
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Maximum and minimum kitchen temperatures
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70 to 85
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Amount of fresh air mixing required from an air system
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10%
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The licensure period for an administrator
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2 years
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CEUs required for an administrator per licensure period
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40
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Medication errors must be less than ____%
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5
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The maximum percentage of licensed beds that can be in wards
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50%
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Minimum illumination in resident rooms
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10 foot candles
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Time required to run emergency generators on full load weekly
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30 minutes
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Minimum measurement for medication rooms
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50 sq ft
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Minimum and maximum medication room temperatures
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59 to 86
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Minimum size of mirrors in resident rooms
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15″ x 30″
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Number of inches mirrors must be off the floor
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40
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Minimum width of fixed wire in door between kitchen and dining area
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1/4 inch
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Minimum storage room (in sq ft) per resident bed
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2
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Maximum amount of time to screen a new employee for TB
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2 weeks
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Minimum distance of generators from facility
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3 feet
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Minimum distance of generators from a building opening
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5 feet
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Maximum distance (in feet) between outlets in corridors
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50
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Maximum distance of an outlet in relation to the end of a corridor
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25 feet
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Height of lamps directly above resident’s bed
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5 ft 6 in
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Influenza vaccinations must be completed by
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November 30th
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The number of flashlights that must be kept at each nursing station
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1
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Schedule II drugs must be inventoried every….
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8 hours
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Notice of vacancy of the administrator position must be reported to TDADS
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Immediately
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An initial monthly claim must be received by TDADS within…
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180 days
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Maximum amount of days in to submit a Care Form for a new Medicaid admission
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20
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A continued stay review must be completed every _____ days
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180
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The amount of days a renewal application of a license must be submitted before it expires
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45
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Penalty for not submitting renewal application on time
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$500
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Time in which the Care Plans must be completed after the MDS assessment
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7 calendar days
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Amount of days after an annual survey a facility can request a Rapid Response Team
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60
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Height of commodes
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17 to 19 inches
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Number of days to correct a violation with administrative penalties
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45
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Number of days the NHIC will accept CARE forms before expiration of LOC/MN
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45
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Minimum area of enclosure for Alzheimers Units
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800 sq ft
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Minimum sq. feet per resident in Alzheimers Unit
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15 sq ft
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Number of days to request a hearing after TDADS notifies of a suspension action
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15
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Number of days to give written consent or hearing request after a written notice of recommended assessment of administrative penalty is sent
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20
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The maximum gap between patient room door and floor
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3/4 inch
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Time a medical record must be retained
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5 years
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A facility must comply with which version of the NFPA Life Safety code?
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2000 The facility must meet the applicable provisions of the 2000 edition of the Life Safety Code of the National Fire Protection Association (NFPA). The Life Safety Code is available for inspection at the Office of the Federal Register Information Center, Washington, D.C.
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How must a facility explain to the resident his/her rights, and the rules of conduct for residents in the facility?
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Both orally and in writing in a language the resident understands
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Can a resident of a facility work at the facility?
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Yes, if the resident agrees to and it is in the care plan
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A nursing home is at capacity with 58 residents; how many monthly hours of dietary consultation must they have at a minimum?
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8 hours monthly The facility must ensure a qualified dietitian is available as frequently and for such time as is necessary to assure each resident a diet that meets the daily nutritional and special dietary needs of each resident, based upon the acuity and clinical needs of the resident. The facility must ensure that monthly dietary consultant hours are provided, at a minimum, as follows: (1) facility population: 60 residents or under – eight hours; (2) facility population: each additional 30 residents or fraction thereof – four hours.
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Resident bedrooms must measure at least ___ square feet per resident in multiple resident rooms and ___ square feet for single resident rooms
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80; 100
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What group gives recommendations for facility lighting?
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Illumination Engineering Society of North America
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Auxiliary buildings located on the site within ____ of the main licensed structure and which contain hazardous operations or contents, must meet the same requirements for safety as the main licensed structure
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20 feet
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Heating and air conditioning must be designed and installed in accordance with NFPA 90A and Heating, Ventilating, and Air-Conditioning Guide created by who?
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American Society of Heating, Refrigeration, and Air-Conditioning Engineers (ASHRAE)
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The DON may serve as charge nursing when there is an average daily occupancy of how many residents?
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60 or fewer
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Who is responsible for developing a policy to avoid injuries to residents and nurses involved in lifting, moving, transferring, and repositioning residents?
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The Quality Assessment and Assurance Committee
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Medicaid-certified facilities must keep financial records re: purchases made on a residents’ behalf for how long?
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3 years and 90 days with a contract (or for 3 years after the end of the federal fiscal year in which services were provided if there was a provider agreement/contract with no specific termination date in effect)
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Hilltop Park has just admitted Mike, a 15 year old male to the facility. What must the facility NOT send to the local education agency (LEA)?
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Diet menu
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How many unannounced visits during a licensing period will DHS invite a citizen advocate to accompany them during a licensing inspection?
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2 visits
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There must be at least one approved, readily accessible fire hydrant within how many feet of the facility?
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300 feet
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Golden Acres just got a deficiency in their dietary dept because they didn’t keep records properly. How long should they retain the menus for?
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At least 30 days
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What is the minimum amount of lighting in a resident bedroom?
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10 foot candles
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Corridors must be equipped with handrails that are how far from the floor?
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33-36 inches from the floor
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If a facility has no other policy, how long at minimum should a facility keep the daily posted nurse staffing data?
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2 years
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If DADS decides to revoke a facility’s license at some point, how long after receiving the certified letter stating such action, does the licensee holder have to request a hearing?
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30 days
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Brentwood Nursing Facility must have written policies that include plans for promoting ___________ and _________________
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Self-care and independence
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Nurse aide in-service training is derived from what?
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Nurse aide performance reviews
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The facilities Medical Director is responsible for what?
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Implementation of resident care policies
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What is incorrect regarding resident personal funds?
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A facility can require that a resident deposit their personal funds with the facility
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Resident bedrooms must be able to accommodate how many people?
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No more than 4
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If a facility provides blood bank transfusion services, they must meet the requirements for laboratories specified by what?
answer

CFR 493
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A facility must assist residents with obtaining routine and __________ dental care
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24 hour emergency
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Rolling Meadows Nursing Home has Tiffany, an unlicensed nursing student, working the evening shift during the weekends. Can Tiffany administer medications to the residents?
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Not until she is fully licensed
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If a nourishing snack is provided at bedtime, and the residents agree, what is the maximum length of time allowed between evening meal and morning meals?
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16 hours
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Which of the following would not be considered an activity of daily living?
answer

Cook
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If a resident has been admitted with a Class A injury, can they refuse treatment for the injury?
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Yes A resident has the right to refuse treatment, to formulate an advanced directive, and to refuse to participate in experimental research. If the resident refuses treatment, the resident must be informed of the possible consequences.
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Mr. & Mrs. Thorne have been married for 37 years and both have been admitted to the Sleepy Hollow Nursing Facility. Mrs. Thorne would like to share a room with Mr. Thorne; is this allowable?
answer

Yes, if both people agree to the arrangement
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A nursing facility that has multiple floors and 201 to 350 resident beds on floors other than the main entrance floor or where the major inpatient services are located, must have how many elevators?
answer

3 At least three (one of which must be hospital-type) elevators must be installed where 201 to 350 resident beds are located on floors other than the main entrance floor or where the major inpatient services are located on a floor other than those containing resident beds. Elevator service may be reduced for those floors which provide only partial inpatient services
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Unless another schedule is specified, how often must a resident’s physician’s orders be reviewed?
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At least every 60 days
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Rapid response teams can visit long-term care (LTC) facilities identified through the Department of Aging and Disability Services what?
answer

Early warning system
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Can a resident self-administer their own drugs?
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Yes, if the interdisciplinary team has determined the practice is safe. This will be reviewed periodically.
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Ma and Pa’s nursing facility was just informed that it needs to offer its resident the pneumococcal vaccine. Which residents does it need to offer this vaccine to?
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To those that are 65 years or older or those that are candidates because of chronic illness
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If an employee that while at work is at risk of contacting potentially infectious material or blood declines the Hepatitis B vaccine at first, does the facility have to offer them the vaccine at a later date if the employee decides he/she wants to receive it?
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Yes (A) The facility’s policy regarding hepatitis B vaccinations must address all circumstances requiring vaccinations and include a method to identify employees at risk of directly contacting blood or potentially infectious materials. (B) The facility must offer all of the employees identified in subparagraph (A) of this paragraph hepatitis B vaccinations within 10 days of employment. If the employee initially declines the hepatitis B vaccination but at a later date, while still at risk of directly contacting blood or potentially infectious materials, decides to accept the vaccination, the facility must make the vaccination available at that time.
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What is the minimum allowable room between beds?
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3 feet or 36 inches
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If a facility finds that one of its employees has a communicable disease, the facility must prohibit that employee from what?
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Direct contact with residents or their food
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How often must a facility performance performance reviews of the nurse aides?
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Every 12 months
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An incident that appears to be of a serious nature can be investigated under the direction of which of the following?
answer

The Administrator
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Dr. Nama seems to be late for all of her scheduled visits to the nursing home. How late can Dr. Nama be and still have her visits be considered timely?
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10 days A physician visit is considered timely if it occurs not later than ten (10) days after the date the visit was required
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When testing the emergency generators EVERY WEEK, how long should the generators run for under the full load?
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30 minutes
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How often does a facility need to have an inspection by the local fire marshal?
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At least annually
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Keeneland just received another bad survey result. Does Keeneland need to make the results of this survey available to the residents?
answer

Yes, they must always make survey results available to the residents
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Ms. Rich, the facility administrator, has received a subpoena for the medical records of Mr. York, a resident in the facility. What should Ms. Rich do now?
answer

Comply with the terms of the subpoena and send Mr. York’s medical records. (2) Except as provided in paragraph (3)(B) of this section, the resident may approve or refuse the release of personal and clinical records to any individual outside of the facility. (3) The resident’s right to refuse release of personal and clinical records does not apply when: (A) the resident is transferred to another health care institution; (B) record release is required by law
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Which type of drugs have their own separate record?
answer

Schedule II, III, and IV
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If the clinical records supervisor is not a registered RHIA or RHIT, how often must they have a consultation from a registered RHIA or RHIT?
answer

At least every 180 days The facility must designate in writing a clinical records supervisor who has the authority, responsibility, and accountability for the functions of the clinical records service. The clinical records supervisor must be: (1) A registered health information administrator (RHIA) or registered health information technician (RHIT); or (2) An individual with experience appropriate to the scope and complexity of services performed as determined by the Texas Department of Human Services, and who receives consultation at a minimum of every 180 days from an (RHIA) or (RHIT).
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Mrs. Aaron, a new resident at Green Pastures Nursing Facility, has just been admitted. How often should she expect to have visits from her physician?
answer

At least once every 30 days for the first 90 days, and at least once every 60 days thereafter
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How long can a facility use an individual as a nurse aide prior to completing their nurse aide training?
answer

Four (4) months
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Prior to removing equipment or features of a building that may now be in excess, a facility must get approval from who?
answer

Life safety features and equipment that have been installed in existing buildings which are now in excess of that required by the Life Safety Code must continue to be maintained or may be completely removed if prior approval is obtained from the Texas Dept of Human Services (DHS)
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What does OBRA stand for what, and which year is most often referred?
answer

Omnibus Budget Reconciliation Act of 1987
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How does a facility decide what are a particular residents ADL’s?
answer

(!) Activities of Daily Living; based on the comprehensive assessment of the resident
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DAD’s Rapid Response Team has just visited Happy Trails Nursing Facility 5 days after the wait period required after a survey. How long was that wait period?
answer

60 days – (b) Rapid response teams may visit facilities that request DADS assistance. A visit under this subsection may not occur before the 60th day after the date of an exit interview following an annual or follow-up survey or inspection
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As far as heating and coolness in a facility, what needs to be the standard given to all residents?
answer

Comfortable and safe temperature levels. Facilities initially licensed or certified after October 1, 1990, must maintain temperature ranges of 71-81° F.
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Upon completing a residents assessment, how long after does a facility have to be ready to transmit data to CMS?
answer

7 days (B) Transmitting data. Within seven (7) days after a facility completes a resident’s assessment, a facility must be capable of transmitting to DADS information for each resident contained in the MDS in a format that conforms to standard record layouts and data dictionaries, and that passes standardized edits defined by CMS and DADS
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Who is CMS?
answer

Centers for Medicare and Medicaid Services
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Longhorn Convalescent is having a job fair, they must NOT employ anyone who has:
answer

(A) Found guilty of abusing, neglecting, or mistreating residents by a court of law; or (B) have had a finding entered into the State nurse aide registry concerning abuse, neglect, mistreatment of residents or misappropriation of their property
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When checking for proper lighting, how high off the floor should the person be checking?
answer

30 inches – Illumination requirements for these areas apply to lighting throughout the space and should be measured at approximately 30 inches above the floor anywhere in the room
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The Activities Director minimum qualifications are:
answer

(B) eligible for certification as a therapeutic recreation specialist, therapeutic recreation assistant, or an activities professional by a recognized accrediting body, such as the National Council for Therapeutic Recreation Certification, on October 1, 1990; or (2) has two years of experience in a social or recreational program within the last five years, one of which was full-time in a patient activities program in a health care setting; or (3) is a qualified occupational therapist or occupational therapy assistant; or (4) has completed an activity director training course approved by any state
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Electrical and Lighting systems must conform to what standards?
answer

Electrical and illumination systems must be designed and installed in accordance with NFPA 70 and the Lighting Handbook of the Illuminating Engineering Society (IES) of North America
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For new facility construction, what is the fee DADS charges for expedited Life Safety Code and physical plant inspections on single level and multilevel – per bed?
answer

Plant Inspection Fees: Single story $30 per bed Minimum: $3,600 Multiple story $36 per bed Minimum: $4,500
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Emergency generators must be able restore service within how long?
answer

The emergency lighting must be automatically in operation within 10 seconds after the interruption of normal electric power supply
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How long must a facility retain menu’s for?
answer

30 days A list of residents receiving special diets and a record of their diets must also be kept in the dietary area for at least 30 days
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How often must the facility give a statement to a resident regarding any funds the facility may be holding for the resident?
answer

As requested and Quarterly
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How often must a facility dispose of medications of residents that are deceased or the medication has expired?
answer

Quarterly Medications of deceased residents, medications that have passed the expiration date, and medications that have been DC’ed must be securely stored and reconciled. These medications must be disposed of according to federal and state laws or rules on a quarterly basis
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The nurse’s station must be equipped to receive calls from residents in what locations?
answer

(a) A nurse’s station must be equipped to receive resident calls through a communication system from: (1) resident rooms; and (2) toilet and bathing facilities
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It has come time for Mr. Adrian Beltre, a new resident at Hop-a-Long Nursing Facility, is about to have his first quarterly assessment. Will the facility use the same instrument in the quarterly assessment as it used during the comprehensive assessment?
answer

No, they will use the quarterly assessment instrument provided by DADS and approved by CMS. This must happen at least once every three months
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A resident’s ADL’s (Activities of Daily Living) are derived from what?
answer

The comprehensive assessment (1) Activities of daily living (ADLs). Based on the comprehensive assessment of the resident, the facility must ensure that: (A) a resident’s abilities in activities of daily living do not diminish unless the circumstances of the individual’s clinical condition demonstrate that diminution is unavoidable
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The Quality Assessment and Assurance Committee must meet how often?
answer

Quarterly (1) Meets at least quarterly to identify issues with respect to which quality assessment and assurance activities are necessary
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Qualifications for a qualified speech-language therapist are:
answer

(i) is a Texas licensed speech-language pathologist; or (ii) meets the educational requirements for licensed and has accumulated, or is in the process of accumulating, the supervised professional experience (the internship) required for license
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A qualified audiologist therapist is:
answer

(i) is a Texas-licensed audiologist; or (ii) meets the educational requirements for license and has accumulated, or is in the process of accumulating, the supervised professional experience (the internship) required for license
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Resident bedrooms can accommodate no more than how many residents?
answer

No more than four (4)
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For a facility of 60 or fewer residents, how many hours of dietary consultation must they have?
answer

At least 8
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What is PASARR?
answer

Pre-Admission Screening and Annual Resident Review
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In the event a facilty must close voluntarily, how soon must the facility notify it’s residents?
answer

RULE §19.1921 General Requirements for a Nursing Facility (d) In the event any facility ceases operation, temporarily or permanently, voluntarily or involuntarily, notice must be provided to the residents and residents’ relatives or responsible parties of closure. (1) If the closure is voluntary, notice to residents’ relatives or responsible parties must be in writing, not later than one week after the date on which the decision to close is made.
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Every registered nurse, LVN, and nurse assistant, must each year receive at least 1 hour training on caring for what type of people?
answer

Alzheimers
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The director of nursing may serve as a charge nurse only when the facility has an average daily occupancy of ____ or fewer residents.
answer

60 or fewer. – The director of nursing may serve as a charge nurse only when the facility has an average daily occupancy of 60 or fewer residents.
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The definition of Involuntary Seclusion is:
answer

Separation of a resident from others or from his room against the resident’s will or the will of the resident’s legal representative. Temporary monitored separation from other residents will not be considered involuntary seclusion and may be permitted if used as a therapeutic intervention as determined by professional staff and consistent with the resident’s plan of care.
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In the event of an electrical interruption and the facility must use batteries until service is restored, how long must the batteries be capable of sustaining power?
answer

1.5 hours – Emergency electrical services by generator or battery must be provided to comply with the provisions of the National Fire Protection Association (NFPA) 70. Battery systems must be capable of sustaining power for a duration of at least 1.5 hours.
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After filing a phone report of abuse, the facility must conduct an investigation. A written report of the investigation must be sent no later than how many days after the oral report?
answer

A facility owner or employee who has cause to believe that the physical or mental health or welfare of a resident has been or may be adversely affected by abuse, neglect, or exploitation caused by another person must report the abuse, neglect, or exploitation. (1) The person reporting must make the telephone report immediately on learning of the alleged abuse, neglect, exploitation, conduct, or conditions. (2) The facility must conduct an investigation of the reported act(s). A written report of the investigation must be sent no later than the fifth working day after the oral report.
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If restraints are used for a treating a residents medical condition, they must be released how often?
answer

Every two hours for a minimum of 10 minutes, and the resident repositioned
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All facilities must send the Texas Department of Human Services a report of the deaths of all persons residing in the facility within how many working days after the last day of the month in which the resident death occurs.
answer

10 working days
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Typical ADL’s include?
answer

(i) bathe, dress, and groom; (ii) transfer and ambulate; (iii) toilet; (iv) eat; and (v) use speech, language, or other functional communication systems;
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1) Certain requirements are specific to Medicaid-certified facilities and are so designated. The Medicaid-specific requirements apply to all residents, including, but not limited to:
answer

Private pay, Medicaid applicants and recipients, VA patients, and Medicare recipients, who are admitted to and reside in a Medicaid-certified facility or a Medicaid-certified distinct part of a facility.
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“Mental/psychological abuse” is defined as what?
answer

Mistreatment within the definition of “abuse” not resulting in physical harm, including, but not limited to, humiliation, harassment, threats of punishment, deprivation, or intimidation.
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In the event of an emergency and loss of electrical power to the facility, the fuel storage must be capable of running the generators for how long?
answer

For at least 4 hours. – Emergency service to receptacles and equipment may be a delayed automatic connection. Receptacles connected to emergency power must be of a uniform and distinctive color. Stored fuel capacity must be sufficient for not less than 4-hours operation of required generators
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Licenses expire every ___ years
answer

Two
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(b) General information required. An applicant must file with DADS an application which contains: (1) for initial applications and change of ownership only, evidence of the right to possession of the facility at the time the application will be granted, which may be satisfied by the submission of applicable portions of a lease agreement, deed or trust, or appropriate legal document. (2) a certificate of good standing issued by who?
answer

the Comptroller of Public Accounts
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(a) During the license term, a license holder may not increase capacity without approval from the Texas Department of Human Services (DHS). The license holder must submit to DHS a complete application for increase in capacity and the fee required. If DHS approves the increase, what happens next?
answer

(b) Upon approval of an increase in capacity, DHS will issue a new license.
question

If DADS decides to exclude a person from eligibility for a license, that exclusion must be for at least how many years?
answer

2 years. (a) DADS, after providing notice and opportunity for a hearing, may exclude a person from eligibility for a license if the person has substantially failed to comply with the rules in this chapter. Exclusion of a person must extend for at least two years, but not more than ten years. During the period of exclusion, the excluded person is not eligible to be a license holder or a controlling person of a license holder.
question

In the event that a facility decides to voluntarily close, how much time must be given to it’s residents for relocation?
answer

(1) If the closure is voluntary, notice to residents’ relatives or responsible parties must be in writing, not later than one week after the date on which the decision to close is made, giving at least 30 days notice for relocation after receipt of notice.
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For medications that are self-administered by a resident, how must they be stored?
answer

(d) Self-administered medications may be kept in a locked cabinet in the resident’s room. When medications are self-administered, the facility remains responsible for medication security, accurate information, and medication compliance.
question

Emergency generators must be installed in accordance with what 2 NFPA standards?
answer

NFPA 37 and NFPA 99;
question

Resident bedrooms that accommodate 3 or more residents must not exceed 50% of the total capacity unless approved by the Texas Dept. of Human Services (DHS).
answer

(1) Bedrooms must: (A)accommodate no more than four residents. The total number of beds in ward rooms with three or more beds must not exceed 50% of the total facility capacity in existing facilities unless approved by the Texas Department of Human Services (DHS).
question

Bedrooms must not be less than how many feet in the smallest dimension?
answer

10 feet. (4) The width and length of bedrooms and the arrangement of furniture must assure appropriate resident circulation, especially in relation to emergency evacuation and to usual wheelchair movement. Bedrooms should not be less than 10 feet in the smallest dimension.
question

What is a therapeutic diet?
answer

A diet ordered by a physician as part of treatment for a disease or clinical condition, in order to eliminate, decrease, or increase certain substances in the diet or to provide food which has been altered to make it easier for the resident to eat.
question

How often must each facility must conduct, review, and assess the facilities current risk classification according to the CDC Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health Care Settings.
answer

Annually – (1) Tuberculosis. (A) The facility must conduct and document an annual review that assesses the facility’s current risk classification according to the current CDC Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health Care Settings.
question

Heating, ventilating, and air-conditioning must be designed and installed in accordance with what two groups standards?
answer

(3) Heating, ventilating, and air-conditioning systems must be designed and installed in accordance with NFPA 90A and the Heating, Ventilating, and Air- Conditioning Guide of the American Society of Heating, Refrigeration, and Air-Conditioning Engineers (ASHRAE).
question

An application for renewal will be considered timely is it received in DADS’ Licensing and Credentialing Section, Regulatory Services Division within how many days after the postmark?
answer

15 days. (c) If the application is postmarked by the submission deadline, the application will be considered timely if received in DADS’ Licensing and Credentialing Section, Regulatory Services Division within 15 days after the postmark.
question

When a resident is being discharged, the physician has how long to sign all the order for discharge?
answer

Within 20 workdays of being notified by the facility of the discharge (4) write, sign, and date a physician’s discharge summary within 20 workdays of being notified by the facility of the discharge.
question

A change of ownership license is only a temporary license that is good for how many days?
answer

90 days. (e) A change of ownership license is a 90- day temporary license issued to an applicant who proposes to become the new operator of a nursing facility that exists on the date the application is submitted.
question

As part of Self-Determination, the resident has the right to:
answer

Self-determination and participation. The resident has the right to: (A) choose activities, schedules, and health care consistent with the resident’s interests, assessments, and plans of care; (B) interact with members of the community both inside and outside of the facility; and (C) make choices about aspects of the resident’s life in the facility that are significant to the resident.
question

When a facility performs an investigation of an alleged violation such as abuse, how soon must the results of the investigation be reported to the state survey agency?
answer

The results of all investigations must be reported to the administrator or his designated representative and to other officials in accordance with Texas law (including to the state survey and certification agency) within five workdays of the incident, and if the alleged violation is verified, appropriate corrective action must be taken.
question

A facility must have a full-time qualified social worker if they have how many beds or more?
answer

120 or more. (a) The facility must provide medically- related social services to attain the highest practicable physical, mental, or psychosocial well-being of each resident. See also §19.901 of this title (relating to Quality of Care) for information concerning psychosocial functioning. (1) A facility with more than 120 beds must employ a qualified social worker on a full-time basis.
question

How many hours of continuing education must an Activities Director have each year?
answer

8 Hours. Activity directors must complete eight hours of approved continuing education or equivalent continuing education units each year.
question

For a facility with 50 residents, how many hours of Dietary consultation must they have?
answer

(a) The facility must ensure a qualified dietitian is available as frequently and for such time as is necessary to assure each resident a diet that meets the daily nutritional and special dietary needs of each resident, based upon the acuity and clinical needs of the resident. The facility must ensure that monthly dietary consultant hours are provided, at a minimum, as follows: (1) facility population: 60 residents or under – eight hours;
question

Menu’s must be prepared how far in advance?
answer

(a) Menus must: (1) meet the nutritional needs of residents in accordance with the recommended dietary allowances of the Food and Nutrition Board of the National Research Council, National Academy of Sciences; (2) be prepared at least one week in advance
question

When can the Director of Nursing serve as a charge nurse?
answer

When there are 60 or fewer residents. (C) The director of nursing may serve as a charge nurse only when the facility has an average daily occupancy of 60 or fewer residents.
question

How many months worth of Resident Assessments must a facility keep in a patients Active Record?
answer

The last 15 months. (4) Use. A facility must maintain all resident assessments completed within the previous 15 months in the resident’s active record and use the results of the assessments to develop, review, and revise the resident’s comprehensive plan of care as specified in §19.802 of this title (relating to Comprehensive Care Plans).
question

What is considered a “behavioral emergency”?
answer

A behavioral emergency is a situation in which severely aggressive, destructive, violent, or self-injurious behavior exhibited by a resident: A) poses a substantial risk of imminent probable death of, or substantial bodily harm to, the resident or others; B) has not abated in response to attempted preventive de-escalatory or redirection techniques; C) could not reasonably have been anticipated; and D) is not addressed in the resident’s comprehensive care plan.
question

What is an “Admission MDS assessment”?
answer

An MDS assessment that determines a recipient’s initial determination of eligibility for medical necessity for admission into the Texas Medicaid Nursing Facility Program.
question

A qualified dietitian is one who is qualified based upon either:
answer

(A) registration by the Commission on Dietetic Registration of the American Dietetic Association; or (B) licensure, or provisional licensure, by the Texas State Board of Examiners of Dietitians. These individuals must have one year of supervisory experience in dietetic service of a health care facility.
question

Sam Whitelow, a resident at Running Rivers SNF, has a Comprehensive Care Plan that must include measureable short and long-term _____ and _______
answer

Objectives and Timetables. (a) A facility must develop a comprehensive care plan for each resident that includes measurable short-term and long-term objectives and timetables.
question

A resident has the right to participate in what, regarding their stay in a nursing facility?
answer

Plan of Care You have a right to: (10) participate in developing a plan of care, to refuse treatment, and to refuse to participate in experimental research;
question

The Department of Aging has staff based in regional offices that may make unannounced visits any time, day or night. These people are called what?
answer

Quality-of-care monitors. The Department of Aging and Disability Services (DADS) uses an early warning system to detect conditions that could be detrimental to the health, safety, and welfare of residents. (1) Quality-of-care monitors are based in regional offices and monitor long-term care (LTC) facilities on visits that may be announced or unannounced and may occur on any day and at any time, including nights, weekends, and holidays.
question

If a resident requires physical therapy in the treatment plan, but the facility does not provide physical therapy, what does the facility need to do, if anything?
answer

The facility must locate physical therapy by an outside provider. (1) provide the required services; or (2) obtain the required services from an outside resource, in accordance with §19.1906 of this title (relating to Use of Outside Resources), from a provider of specialized rehabilitative services.
question

The Diet Manual must not be older than?
answer

5 Years. (c) The facility must ensure that a current diet manual, approved by the facility dietitian or the consultant dietitian, is readily available to dietary service personnel and the supervisor of nursing service. To be current, the diet manual must be no more than five years old.
question

How often must a facility perform performance reviews of the nurse aides?
answer

The facility must complete a performance review of every nurse aide at least once every 12 months
question

If an applicant is determined to be eligible and in need of nursing facility care, what is the effective date of vendor coverage? Is it the date the individual entered the facility, the date of application, or the date the need for nursing facility care was established?
answer

Which ever is the latest. If an applicant is determined to be eligible and in need of nursing facility care, the effective date of vendor coverage is either the date the individual entered the facility, the date of application, or the date the need for nursing facility care was established, whichever date is the latest.
question

Interest on civil money penalties accrue at what rate?
answer

Interest on civil money penalties accrues at the rate of 10% from the date specified in Code of Federal Regulations §488.442 until paid.
question

How must a facility inform a resident of their rights?
answer

Orally and in Writing. (a) The facility must inform the resident, the resident’s next of kin or guardian, both orally and in writing, in a language that the resident understands, of the resident’s rights and all rules and regulations governing resident conduct and responsibilities during the stay in the facility.
question

Resident rooms are designed to accommodate no more than how many residents?
answer

No more than 4 residents. (4) Resident rooms. Resident rooms must be designed and equipped for adequate nursing care, comfort, and privacy of residents. (A) Bedrooms must: (i) accommodate no more than four residents;
question

For Resident Assessments of (minors) children, what should be included that is not included for adults?
answer

Parents or Guardians. (A) Pediatric assessments should be performed by licensed facility staff experienced in the care and assessment of children. Parents or guardians should be included in the assessment process. The potential for community transition should be discussed with the parents or guardians whenever an assessment occurs.
question

The automatic fixed fire extinguishment system that is mounted in the kitchen range hoods must be inspected and serviced at least every _____ months.
answer

(g) A facility must ensure that a person licensed by the State Fire Marshal’s office inspects and services automatic fixed fire extinguishment systems mounted in kitchen range hoods at least once every six months in accordance with NFPA 96. The facility must maintain, onsite, a written and signed report of the inspection and service performed. The facility must keep the hood, exhaust ducts, and filters clean and free of accumulated grease.
question

(2) Additional Requirements for facilities or distinct parts of facilities that are certified for Medicare-only participation are in?
answer

Chapter 42, Code of Federal Regulations, §§483.5- 483.75. OBRA
question

What are “Barrier precautions”?
answer

Precautions including the use of gloves, masks, gowns, resuscitation equipment, eye protectors, aprons, faceshields, and protective clothing for purposes of infection control.
question

Every facility must keep a supply of how much Staple Food?
answer

(f) The dietary department must keep a seven-day supply of staple foods.
question

Water in the kitchen for sanitizing must be what degrees Fahrenheit?
answer

(5) The kitchen must have an adequate supply of hot and cold water. Hot water for sanitizing purposes must be 180 degrees Fahrenheit.
question

In order to verify staffing, assurance of emergency egress, resident care, medication security, food service or nourishments, sanitation, and other items, a number of inspections take place between what times?
answer

5pm and 8am (1) In order to ensure continuous compliance, a sufficient number of inspections will be conducted between the hours of 5:00 p.m. and 8:00 a.m. in randomly selected institutions. This cursory after-hours inspection will be conducted to verify staffing, assurance of emergency egress, resident care, medication security, food service or nourishments, sanitation, and other items as deemed appropriate. To the greatest extent feasible, any disruption of the residents will be minimal.
question

When a resident has a communicable disease, the facility must immediately report what to who?
answer

The residents name to the city health officer or county health officer or whoever has jurisdiction. (4) The name of any resident with a reportable disease as specified in 25 Texas Administrative Code §§97.1 – 97.14 (relating to Control of Communicable Diseases) must be reported immediately to the city health officer, county health officer, or health unit director having jurisdiction, and appropriate infection control procedures must be implemented as directed by the local health authority.
question

If a person is being referred to a court for guardianship, the facility must perform a:
answer

(a) A facility will perform a Capacity Assessment for Self Care and Financial Management for persons who will be referred to a court for guardianship if the person:
question

How much time can elapse between the evening meal and breakfast?
answer

16 hours. (d) When a nourishing snack is provided at bedtime, up to 16 hours may elapse between a substantial evening meal and breakfast the following day, if a resident group agrees to this meal span and a nourishing snack is served.
question

A facility must retain the records of those who have completed a state approved training course for Paid Feeding Assistants. What is the minimum content that should be on those records?
answer

The date and location of the course, Trainer’s name, and a statement that the course was completed successfully. (b) Maintenance of records. The facility must maintain a record of all individuals used by the facility as paid feeding assistants who have successfully completed the state- approved training course for paid feeding assistants. At a minimum, documentation must include the date and location of the course, the name of the trainer, and a statement that the course was successfully completed.
question

Can unlicensed personnel administer drugs?
answer

Yes. (1) Methods and procedures. The facility may permit unlicensed personnel to administer drugs, but only under the general supervision of a licensed nurse. The unlicensed individual must be a nursing student, a medication aide student, or a medication aide with a current permit issued by the Texas Department of Human Services.
question

How does a facility decide on the content for the Nurse-Aides In-service training?
answer

Regular in-service education. The facility must complete a performance review of every nurse aide at least once every 12 months, and must provide regular in-service education based on the outcome of these reviews. The in-service training must: (A) be sufficient to ensure the continuing competence of nurse aides, but must be no less than 12 hours per year; (B) address areas of weakness as determined in nurse aides’ performance reviews and may address the special needs of residents as determined by the facility staff.
question

A facility must keep a supply of how much Perishable Food?
answer

2 Days worth. (f) The dietary department must keep a seven-day supply of staple foods and a two-day supply of perishable foods at all times. The facility is allowed the flexibility to use food on hand to make substitutions at any interval as long as comparable nutritional value is maintained.
question

How often does a residents drug regimen need to be reviewed?
answer

Monthly (4) Drug regimen review. (A) The drug regimen of each resident must be reviewed at least once a month by a licensed pharmacist. The consultant pharmacist’s drug regimen review must be maintained in the resident’s clinical record.
question

When a residents self-administers drugs, can they keep the drugs in their room?
answer

(d) Self-administered medications may be kept in a locked cabinet in the resident’s room. When medications are self-administered, the facility remains responsible for medication security, accurate information, and medication compliance.
question

Passenger elevators must be inspected how often?
answer

Every 6 months. Passenger elevators and escalators must be inspected by a qualified agent at least every six months. Freight elevators must be inspected every 12 months.
question

Resident bedrooms must have at least one ____ to the outside and a floor that is?
answer

(4) Resident rooms. Resident rooms must be designed and equipped for adequate nursing care, comfort, and privacy of residents. (A) Bedrooms must: (vi) have at least one window to the outside; and (vii) have a floor at or above grade level.
question

The Nursing Home Administrator is required to work at least how many hours a week?
answer

40 hours a week. (b) The facility must operate under the supervision of a nursing facility administrator who is: (1) licensed by the Texas Board of Nursing Facility Administrators; (2) responsible for management of the facility; and (3) required to work at least 40 hours per week on administrative duties
question

Specialized Services are physical, occupational, and speech therapy evaluations and services provided to eligible Medicaid recipients identified by?
answer

Specialized Services are physical, occupational, and speech therapy evaluations and services provided to eligible Medicaid recipients identified by the Preadmission Screening and Resident Review (PASARR) team
question

If a resident enters (admits) and leaves(departs) a facility on the same day, does DAD’s pay for any of that day?
answer

Yes, the whole day. (1) If entrance and departure are on the same day, and the recipient does not enter another Title XIX facility on that day, DADS pays for the entire day.
question

Golden Cross Skilled Nursing needs 5 members for their Quality Assessment and Assurance committee. They currently have a physician, an LVN, and 2 nurse aides, who are they missing?
answer

The Director of Nursing. a) The facility must maintain a Quality Assessment and Assurance Committee consisting of: (1) the director of nursing services; (2) a physician designated by the facility; and (3) at least three other members of the facility’s staff.
question

A facility must have a minimum of how many days supply of nonperishable staple foods?
answer

7 days. (k) Food storage areas. (1) Food storage areas must provide for storage of a 7- day minimum supply of nonperishable staple foods and a 2-day supply of perishable foods at all times.
question

Except when a nourishing snack is provided at bedtime, there must be not more than ___ hours between a substantial evening meal and breakfast the following day.
answer

14
question

How many hours does the consultant pharmacist have to devote to pharmaceutical services?
answer

There is no specific amount of time as long as the review of drug regimen, etc. is sufficient to meet the needs of the residents Regulation says: The number of hours per month the consultant pharmacist devotes to the pharmaceutical services for ordering, storage, administration, disposal, recordkeeping (documentation) of drugs and medications, and drug regimen review must be sufficient to meet the needs of the residents.
question

The facility must provide wheelchair access into the building by use of ramps and curb breaks, and Ramps must not slope more than ____ unit(s) of rise to ____unit(s) of run.
answer

Ramps must not slope more than 1:12 (one unit of rise to 12 units of run)
question

The maximum room temperature for food storage must not exceed __ degrees Fahrenheit at all times. The measurement must be taken at the ____-____ level.
answer

85° F; five-foot
question

The fire alarm system must be designed so that whenever the general alarm is sounded by activation of any device (such as manual pull, smoke sensor, sprinkler, or kitchen range hood extinguisher), the following must occur automatically:
answer

(1) smoke and fire doors which are held open by approved devices must be released to close; (2) air handlers (air conditioning and/or heating distribution fans) serving three or more rooms or any means of egress must shut down immediately; (3) smoke dampers must close; and (4) the alarm-initiating-device location must be clearly indicated on the fire alarm control panel(s) and all auxiliary panels.
question

Manual pull stations (re: fire alarms) must be provided where?
answer

At all exits, living rooms, dining rooms, and at or near the nurse stations
question

Sewage must be discharged into a state-approved sewerage system or the sewage must be collected, treated, and disposed of in accordance with applicable ________ rules and regulations.
answer

Texas Natural Resource Conservation Commission
question

Resident-use hot water must be reliably controlled, such as by thermostatic or mixing valves, to not exceed ____ degrees Fahrenheit and not less than ___ degrees Fahrenheit at each fixture
answer

110°; 100°
question

Linen must be washed, dried, stored, and transported in a manner which will _______
answer

produce hygienically clean linen.
question

Occupied resident rooms must be cleaned and put in order at least _____
answer

daily
question

Mirrors and dispensers for persons with disabilities must be no higher than _________ above the floor.
answer

40 inches
question

Extinguishers in resident corridors must be spaced so that travel distance is not more than ________
answer

75 feet
question

When resident bedrooms are more than __________ from the nurses station and the adjacent corridors are not observable from the station by direct line of sight, an auxiliary station must be established and used
answer

150 feet
question

Doors within the means of egress must not be equipped with a latch or lock which requires the use of a key or tool to open from the inside of the building. A _______________ must be provided with ______________________, or other simple type of releasing device with an obvious method of operation, even in darkness.
answer

latch or other fastening device on a door; a knob, handle, panic bar
question

Supply systems must assure an adequacy of hot and cold water. An average rule-of-thumb design for hot water for resident usage (at 110 degrees Fahrenheit) is to provide ____________________ in addition to kitchen and laundry use.
answer

6-1/2 gallons per hour per resident
question

How many Alzheimer’s patients are allowed within a facility?
answer

No greater number of residents must be kept in the certified area than is authorized by the certificate. Allowable number of residents. Each certificate must specify the maximum allowable number of residents to be cared for at any one time in the certified area. No greater number of residents must be kept in the certified area than is authorized by the certificate.
question

Vendor payment will be made at periodic intervals but not less than ________________ for services rendered during the previous billing period.
answer

once per month

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