ALF Core Exam practice questions with correct answers, Exams of Nursing

Download ALF Core Exam practice questions with correct answers and more Exams Nursing in PDF only on Docsity! ALF Core Exam practice When outside temperatures are 65°F (18°C) or below, you must maintain a temperature of at least XX when residents are AWAKE.correct answeran indoor temperature of at least 72°F (22°C) shall be maintained AGENCYcorrect answerAgency for Health Care Administration AGING IN PLACEcorrect answerprocess of providing increased or adjusted services to a person to compensate for physical or mental decline that may occur with the aging process in order to maximize a person's dignity and independence and permit them to remain in a familiar, non institutional resident environment for as long as possible. ASSISTED LIVING FACILITYcorrect answerany building or residential facility provides housing, meals and one or more personal services for a period exceeding 24 hours to one or more adults who are not relatives of the owner or administrator. Residents do not require the 24-hour nursing. DEPARTMENTcorrect answerDepartment of Elderly Affairs EXTENDED CONGREGATE CAREcorrect answermeans acts beyond personal services / ADL's may be performed by persons licensed under part 1 chapter 464. TOTAL CARE PERSONAL SERVICES / ADL'scorrect answerdirect physical assistance or supervision of the activities of daily living, the self-administration of medication. Does not include transferring, medical, nursing, dental or mental health services. LIMITED NURSING SERVICEScorrect answerfor ALF residents who meet admissions criteria but do NOT require 24 hour nursing supervision. May include routine dressings, care of casts, braces and splints. When residents are asleep, what is the min inside temperature at night?correct answer68 degrees When the outside temperature is 90 degrees or less, what is the maximum inside temperature permitted?correct answerMaximum indoor temperature is 85 degrees with mechanical cooling devices When it is hotter than 90 degrees outside- what temp must remain inside at night and day?correct answer81. Maximum temperature allowed inside a resident space? As per EEC/ CEMP Hurricane Irma regulations.correct answer90 degrees maximum indoor temp allowed. What is the min sq ft required of living and dining space per resident if the facility is not comprised of apartments?correct answer35 sq ft Those facilities also serving as adult day care centers must provide an additional 35 sq ft of living space per adult day care client? true or falsecorrect answerTrue IF you also serve as an adult day care center how much extra space per resident must you have?correct answerextra 35 sq ft When calculating the minimum square footage requirements for living and dining space who else besides residents MUST be included?correct answerlive-in staff and family members must be included in the ratio. T/F ...ALF's must provide areas separate from bedrooms for activitiescorrect answerTrue how much usable floor space , not including closet or bathroom should be provided to a single occupancy?correct answer80 sq ft how much usable floor space , not including closet or bathroom should be provided to a double occupancy?correct answer60 sq ft per person. Total min 120 sqft In an ALF, how many toilets and sinks, and bathtubs must there be per person to accommodate all residents, live in staff and family members.correct answer1 sink: toilet per 6 people 1 bathtub per 8 people NEW for 2019 transportation; supplies; staffing; emergency equipment individual identification of residents; transfer or records; communication with families and responses to family inquiries. 429.41 (b) How long does a facility need to retain AHCA inspections?correct answer5 years How long does a facility need to retain resident contracts?correct answer5 years How long does a facility need to retain resident records?correct answer2 years T/ F? If you have 16 or less residents, you do not need to have an accessible phone?correct answerFalse! Must have an accessible phone available to all residents with at least one per floor if more than 17 residents. When should the initial fire safety evac capability be completed?correct answerwithin 6 months after the date of licensure to review the sprinklers and points of safety evacuation drills. How often must the drill be done by the local fire marshal or authority?correct answeronce a year How many fire drills must be done if you have sprinklers ?correct answer6 times a year- NEW FOR 2019 with a min of 2 drills when residents are asleep. What level back ground screening must any employee have that has ANY contact with a resident?correct answerLevel 2 AHCA background screening who are the key people:correct answerThe licensee holder, if an individual The administrator for day to day operation The financial officer Anyone who is a controlling interest any person who has a license that will be working with clients change of ownership- all funds on deposit, resident trust funds must be transferred to the applicant ? correct answeryes what is a conditional license?correct answerif the facility is found to have uncorrected violations that the community has not had a chance to correct If transfer or relocation is needed due to NON emergency reasons such as: adjudicated mentally incapacitated. how many days must the guardian be given?correct answer45 days in writing for a discharge notice Are facilities allowed to go over their resident capacity for a RESPITE care?correct answerNO , they are counted on the census What exception is there to this rule of not going over capacity?correct answeremergency shelter as long as it will not jeopardize the safety of any individual , needs can be met, facility reports it to the agency with 48 hours. maintains a log Advertising: is a telephone directory considered advertising ?correct answerNO what is contiguous propertycorrect answerfacility that consists of more than one building under one license must be on contiguous property- separated by no more than a two-lane street that traverses the property. A copy of the annual fire safety and sanitation inspection must be submitted how ofter to the central office and within how much time?correct answerannually, no later than 30 calendar days what agency is responsible for inspecting, food hygiene, biohazards waste and sanitary practices ?correct answerCounty health department; Department of Health F.S. vs F.A.C.correct answerFlorida statues= LAW; Florida Administrative Code = RULES who is responsible for fire safety?correct answerstate fire marshal or local authority having jurisdiction Baker Act training is done by?correct answerDCF Department of Children and Families who is responsible for inspection all license applicants and licensed facilities, core training and testing in all other matters regulated by this rule chapter?correct answerAHCA T/ F ...An ALF with a standard license can have a resident who requires 24 hour nursing supervision? correct answerFALSE unless the resident is under hospice care T/ F An ALF with a standard license can have a resident who needs more than just assistance with their ADL's?correct answerFALSE unless resident is under hospice care Florida Ombudsman Programcorrect answerwithin Dept. of Elder Affairs; volunteer advocacy group for residents; annual inspections and investigates complaints and does unannounced visits From which agencies must an ALF grant unrestricted access to the community?correct answerYou may ask for identification and MUST GRANT ACCESS -Anyone from the Department of Children and Families; Ombudsman; Dept of Elder Affairs; Medicaid fraud unit; Attorney General; Fire marshall; AHCA Penalty if an ALF fails to allow access to key governmental agencies?correct answerAHCA can impose a moratorium on new resident admissions by that ALF. how many days notice must a license give AHCA if they will be selling their facility ?correct answer60 days prior to transfer For advertising purposes what must be on the advertisement?correct answerAssisted living facility #55512 how often must a license be renewed?correct answerevery two years if you have more than 2 people being cared for on a 24 hour basis, do you have to have a license ?correct answeryes How much money/personal belongings can be kept on behalf of the resident?correct answer$500 personal funds /$ 500 in personal property NEW AS OF 2019 How many days after hiring a new employee must they have written notice that they have no communicable diseases?correct answer30 days , no early than 6 months prior How often is TB done?correct answerannually Community with 17 or more people, what must they have?correct answerwritten job descriptions and time sheets and level 2 back ground How often do you have to rescan for background?correct answerevery five years within how many days must you tell the agency if you change administrators?correct answer10days How many days can you serve as a administrator without having your license?correct answer90 days what is the max amt of facilities one can manage on one property?correct answer3 how many hours of continuing ed must u have and how often?correct answer12 hours every two years No staff member shall be in charge of a facility for a consecutive period of __days or more, or for a total of __days within a calendar year, without being an administrator or manager.correct answer21/ 60 can the administrators hours be counted as hours towards min?correct answeryes, as long as they are active in the day to day operations and are noted on the department schedule. how long must orientation be?correct answer2 hours in addition to 2 hours orientation you must have what other training?correct answer1 hour in-service training in infection control, including universal precautions, and facility sanitation procedures before providing personal care to residents. Employees that handle food must have what type and how much training?correct answer1 hour safe food handling practices when your staff completes their training, what must they do?correct answerKeep copies in their file with the following: Titlte of training program the subject matter training program agenda number of hours trainee's name, date and location Trainors name, signature and credentials (lic numb etc) how soon should a fire and safety evacuation capability be done for a new facility ?correct answer6 months how fast do you have to evacuate peoplecorrect answerthree minutes or less is prompt more than three no more then 13 is slow more than 13 impractical after 1996 what must all facilities have- except for those housing less than 8 people?correct answerfire sprinklers if you are 8 or fewer people and you are considered impractical to evacuate, do you have to install a fire sprinkler?correct answerYES if you do not have fire sprinklers, how often must you preform drills ?correct answermonthly or 12 a year a community that has sprinklers must have drills how often?correct answer6 a year , one every two months, - 2 of them must be conducted at night how often must you do elopement drillcorrect answer2 time a year what must be included in an emergency plan?correct answerprovision for all hazards provision for the care of those remaining during, provision for the care of those evacuated resident records, transportation, sheltering, supplies, staffing, emergency equipment and meds Identification of residents with alz disease, mobility limitation identification and coordination with the local emergency management agency post disaster activities identification of staff if the emergency management agency wants a change made to your plan when does it need to be turned back in?correct answer30 days how often do you send changes?correct answerannually can the facility provide shelter if it is over their occupancy number?correct answeryes in an emergency situation only as long as it is reported and life safety is not jeopardized, immediate needs of residents must be met. log must be kept what is considered a major incident?correct answerDeath, missing person, injury that requires a health care provider, fire, natural disaster, disruption of normal activities what is automatically defined as adverse?correct answerabuse, neglect, exploitation or if someone filed a report to the law enforcement, elopement how soon must an adverse incident be reported?correct answer1 busines day with 15 calendar days for the full report if a resident has a stage 2 wound, how long can they have that wound and remain in an ALF?correct answer30 days how many days do you have to refund deposit?correct answer45 days if facility fails to adhere to refund policy, how much can the agency charge the facility in a fine?correct answer3 times the amount due how often must a nursing assesment be done for sommeone under LNS?correct answermonthly MOR ?correct answerMedication observation record what must be on the MOR?correct answerknown allergies dose taken medication refused time taken health care provider missed dosage signature of person admistrating how many years must you keep a record of major adverse incidentscorrect answer2 years do you have to keep record of when a radon test was conducted?correct answeryes All completed survey, inspection and complaint investigation reports, and notices of sanctions and moratoriums issued by the agency must be kept for how many years?correct answer5 yrs The facility shall maintain the facility's written work schedules and staff time sheets as required for how long?correct answer6 months t/f Personnel records for each staff member shall contain, at a minimum, a copy of the original employment application with references furnished and verification of freedom from communicable disease including tuberculosis.correct answertrue t/f You need to include documentation of the appointment of a health care surrogate, guardian, or the existence of a power of attorney in the resident records and include it with the emergency plan.correct answerfalse A copy of the facility's resident elopement response policies and procedures should be :correct answerin the admission policy If the resident's possessions are not claimed within ??? days after notification, the facility may dispose of them. The contract shall also specify any other conditions under which claims will be made against the refund due the resident. Except in the case of death or a discharge due to medical reasons, the refunds shall be computed in accordance with the notice of relocation requirements specified in the contract. However, a resident may not be required to provide the licensee with more than 30 days' notice of terminationcorrect answer45 days how many days prior can an assessment have been done for placement?correct answer60 days how soon do we have to have 1823 form?correct answer30 days after placement if a governmental agency places someone can the assessment be completed after move in?correct answerno, before move in... not more than 30 days prior If Cares agency places someone can their assessment be used?correct answeryes can a community go over capacity to house someone on an emergency basis?correct answeryes- if part of the CEMP and is sheltering for another evacuated community how often must a face to face assessment be done for continued residency?correct answer3 years or after a significant change if a resident is terminaly ill, how can they stay in the facility?correct answeran interdiciplinary care plan with hospice must be completed in the facilty and added to their file how many days notice must be given to a resident that no longer meets criteria?correct answer45 days what tempt should stuffed meats be cooked tocorrect answer165 Reheated food must be cooked to what temp?correct answer165 how many inches above the floor must food be keptcorrect answer6 inches how many days of supply of non-perishable food must a facility have on hand ?correct answer3 days What temp should left overs be cooked tocorrect answer165 =no more than how many hours shall elapse between the end of an evening meal and beginning of a morning mealcorrect answer14 how far in advance must menus be posted to residentscorrect answerone week do ear nose and eye medicine need to be kept separate?correct answeryes when a medication is discontinued , what do you have to do?correct answerwrite date and doctor that diconuted and write discontinued, keep separate from their other meds separate, discontinued drawer can you reuse a script if doctor reorders it?correct answeryes when you dispose of meds do you have to make note in residents file?correct answeryes Can an ALF with a standard license provide wound care?correct answerNO. unless ALF holds an ECC or LNS license What are prohibited conditions at the time of Admission?correct answerartificial airway mgmt BUT CPAP or biped allowed; tube feeding; monitoring of blood gases; post surgical drainage tubes; wound van devices; administration of blood products; 24 hour nursing supervision Can a resident be on hospice and be admitted to an ALF?correct answerYes as long as the resident meets admission criteria Residents must have a face to face medical exam completed and recorded on the AHCA 1823 form when?correct answerat the time of admission, at least every three years and whenever there is a significant change If a potential resident has a stage 2 pressure sore, what must occur?correct answerThe resident may contract with a third party provider to care for the pressure sore AND the sore must show healing improvement in 30 days otherwise a discharge notice must be given to the resident. For continued residency, a resident can be dialysis in an ALF with a standard license under what circumstances?correct answeronly if the dialysis or IV therapy is NOT administered in the ALF. T/ F If an ALF has an LNS license, a resident with IV therapy administered in the facility may be admitted and continue to reside in the ALF if this is agreeable to the ALF?correct answerTRUE Whose responsibility is it to ensure that there resident's needs can be met within an ALF?correct answerthe Administrator Is an ALF required to assist residents and give reminders if needed with set up appointments and transportation to medical dental and nursing and mental health appointments?correct answerYES T/ F The assistance of more than one person to help a resident transfer is prohibited.correct answerFALSE; two person transfers are allowed in an ALF. A terminally ill resident who exceeds the residency criteria may remain in an ALF under what circumstances?correct answerIf the resident is on hospice and continued residency is agreeable to the resident and facility. Min age to be admitted to an ALF?correct answer18 years old. No kids in an ALF Admission criteria to an ALF?correct answerNo communicable disease, HIV is ok, can perform ADL's with assistance if needed Is emptying a catheter or osmotic bag permitted in a standard license ALF?correct answerYES this is considered a toileting ADL. For residents placed by DCF, Department of Children and Family services, an 1823 must be completed by when?correct answerWithin 30 days prior to admission For residents placed in an ALF by DCF, Department of Children and Family services, under a temporary EMERGENCY, an 1823 must be completed by when?correct answer30 days post admission ok. What is a substitute for an initial 1823?correct answerthe CARES assessment done by the department of elder affairs. What the timeframe to complete an 1823?correct answer60 days pre-admission through 30 days post admission. Is assistance with a CPAP machine allowed in an ALF?correct answerYES Is assistance with tube feeding allowed in an ALFcorrect answerNO Is intravenous therapy allowed to be performed within a standard license ALF?correct answerNO The health assessment / 1823 must be completed by?correct answera physician, a physician's assistant or an advanced registered nurse practitioner What qualifies as a significant change for a resident that would prompt a new medical examination/ 1823?correct answerany sudden weight gain or loss; enrolling on hospice; How many days can resident be bedridden in a standard license ALF?correct answer7 days All elopements are considered to be adverse incidents and they must be...correct answerreported to AHCA within 1 day When must residents be assessed for an elopement risk?correct answerwithin 30 days of admission by a health care or mental health provider. If already noted on the 1823 then that meets the assessment requirement. Activities need to be offered how frequently at a min in an ALF?correct answer12 hours per week, with activities at least 6 days per week T/ F An ALF must document changes in the service provision to residents including changes in the method of medication administration?correct answerTRUE T/ F An ALF must provide assistance with scheduling doctors visits?correct answerTRUE T/ F A standard license ALF must provide administration of medications?correct answerFALSE; only an LNS licensed ALF with a nurse can administer doctor prescribed medications. T/ F An ALF must provide total assistance with feeding.correct answerFALSE; feeding a resident is permitted but "total" feeding is considered an ECC ADL. When a resident experiences a significant change, the ALF must...correct answerobtain a new 1823 completed by a health care provider A facility's elopement policies and procedures must cover...correct answerhow staff with conduct an immediate search of the facility's premises. person centered care for residents with memory impairments includescorrect answerrecognition that person is not diminished. How long must all advertising be kept?correct answer2 years How is an ALF identified on advertising?correct answer"Assisted Living Facility #13075" Can someone receive rebates or split fees or kickbacks for referring a resident?correct answerNO- those are all considered patient brokering Can someone receive compensation for referring a Medicaid resident?correct answerNO- medicaid is a gov't program and no referral fees/ commissions can be earned on this type of resident. Is it ok to pay a resident if they refer and friend or family member?correct answeryes Can an ALF deny a resident admission on the sole basis of that resident receiving optional state supplements (OSS)?correct answerNO. At the time of admission, a resident who is receiving hospice services may be admitted as long as...correct answerthe resident meets the admission criteria T/ F A resident being admitted to an ALF may be receiving hospice services.correct answerTRUE as long as the resident meets the admission criteria. What is the admission criteria in an ALF?correct answerAdmission criteria is based on the ALF's license, rates, services and accommodations avail to residents; obligations and expectations of residents to the ALF as disclosed in the handbook (ex. alcohol and medication storage.) Who can complete an 1823?correct answerDoctor, physician assistant or advanced registered nurse practitioner Can a licensed nurse complete an 1823?correct answerNO- must be an RN; advanced registered nurse practitioner or physician or physician assistant. T/ F Residents must provide 60 days notice prior to moving out.correct answerFALSE- only 30 days notice required. What must be included in a bed hold policy?correct answera provision with addresses the termination of the bed hold if the resident is unable to return to the community. A resident contract must include?correct answerAn assesment prior to admission= face to face examination with a 100% complete 1823 (no blanks) and that the resident will be re-assessed every 3 years or when a significant change occurs. Security deposits must be kept...correct answerin a Florida banking institution Do contracts need to include monthly rates?correct answerYES, with detail specifically on the community's services and accommodations included in the rates. What must be included in a resident contract?correct answerrates, services and accommodations; 30 days notice for any rate increases; rights duties and obligations of residents; refund policy, bed hold policy; any extra services and the corresponding rates. Include any fees schedules ex. levels of care $$$. What is the ALF procedure for storing security deposits and advanced rent?correct answermust be in FL banking institution; kept separate from facility funds; may not be shown as assets on a financial statement; must notify the resident in writing whiten 30 days when the funds are being held with the name and address of the depository. What is considered an apartment?correct answer= kitchen/ kitchenette + bathroom How long must resident contracts be kept?correct answer5 years Pro-rated funds must be calculated based oncorrect answerthe termination date What is the termination date?correct answerthe date that the unit is cleared of all personal resident belongings Must refunds be pro-rated?correct answerYES When are refunds mandatory?correct answerWhen a resident is discharged, transferred or dies What is the rate an ALF can charge to store a residents belongings?correct answerMax 20% of the unit cost with 14 day advance notice to the resident that a storage charge will be levied. After 45 days, the ALF can dispose of the belongings. How must time does a community have to issue a resident refund?correct answer45 days What is the penalty if a community refuses to issue a refund?correct answerAn AHCA fine of 3 x amount owed to the resident. How often must a resident assessment be done in an ECC?correct answerannually on form DH 1896 Can a resident contract be executed with a resident 30 days prior to admission?correct answerNO, contracts must be executed AT THE TIME of admission. T/ F After admission, the medical examination report must be recorded on the AHCA 1823?correct answerTRUE T/ F residents who are placed by DCF on a emergency basis are exempt from having the health assessment completed for up to 30 days after admission?correct answerTRUE Admission packets must include house rules?correct answerYES What are ALF house rules?correct answerresident resp; alcohol and tobacco polices; medication storage requirements; elopement and response to an elopement; abuse neglect and exploitation; admin and If resident funds are misused what is the penalty?correct answer3rd degree FELONY What happens to resident funds if the resident passes away with no will?correct answerThe community must hold those funds for the residents estate in an interest bearing account until probate is finished. If probate does not occur within 2 years, then those funds are transferred to the Health Care trust fund administered by AHCA. The community may not keep these funds. When must a community notify AHCA if they are declaring bankruptcy, foreclosure or facing eviction? correct answerWithin 10 days of receiving a court order. What is the penalty, if a community fails to report that they are declaring bankruptcy, foreclosure or facing eviction?correct answerConsidered a 2nd degree MISDEMEANOR Where should resident funds and property be held for safekeeping?correct answerin a Florida banking institution. A POA, Power of Attorney is also called...correct answeran Attorney-in-Fact Who/ what is considered a controlling interest of an ALF?correct answerAnyone or entity that holds 5% or more ownership interest in the community. When a controlling interest is involved as a defendant or petitioner in a bankruptcy or foreclosure what must happen?correct answerthe agency, AHCA must be notified in 10 days Can a community owner/ administrator or staff service as a resident's guardian?correct answerNO Can a community owner/ administrator or staff service as a resident's trustee?correct answerNO Can a community owner/ administrator or staff service as a resident's conservator?correct answerNO Can a community owner/ administrator or staff service as a resident's Power of Attorney?correct answerYES Can a community owner/ administrator or staff service as a resident's Attorney-in-Fact?correct answerYes, another word for POA DOES AN ALF HAVE TO HAVE LIABILITY INSURANCEcorrect answerYES, at all times even if no claims pending. Does an ALF need to have a recognized accounting system?correct answerYES If ALF provides safekeeping of resident money or property, then these 3 rules apply.correct answerquarterly statements with detailed income and expense reports; monthly statement if the ALF Admin is the POA; within 30 days of receiving a security deposit, the ALF must inform the resident in writing of the banking institution and the the address. If a resident receives OSS payments and the ALF is the representative payee, how much does the surety bond need to be?correct answerTWICE the OSS payment + TWICE the supplemental security income SSI + TWICE the social security disability income SSDI. 59A-36.013 (3) (b) T/ F Upon the issuance of a new or continuance of a surety bond the agency must be notified.correct answerTRUE. Annually AHCA must be notified of any changes to the surety bond including a new bond or the continuance. Who can teach the class to unlicensed staff to train them on assistance with the self-administration of medication for residents?correct answerlicensed pharmacist or a registered nurse A Medication storage policy is mandatory in an ALF? T/ F?correct answerTRUE. An ALF must have a written policy on the central storage of meds and must provide this information to residents upon admission to the community. Is an ALF responsible if a resident refuses their meds?correct answerYES. All med refusals must be documented and reported to the health care provider. If a resident misses a medication dose what should the ALF do?correct answerNotify the resident health care provider and document the missed dose and the outreach in the resident file. When should a health care provider be notified about a medication and a resident?correct answerWhen med is refused; a side effect occurs; nausea, vomiting, dizziness; altered state of consciousness; med goes in and comes out whole in stool- not digested? Can unlicensed staff put medications in a resident's mouth?correct answerNO T/ F Unlicensed trained staff may assist a resident to lift medication to their moth by placing a hand under the resident's hand and guiding the medication to the mouth.correct answerTRUE Can unlicensed trained staff break scored or crush tablets?correct answerYES only if have health care provider's order and must be a medication that can be crushed or broken. (ex. not a long lasting med with a slow-release coating that is destroyed if med is crushed.) Can unlicensed trained staff assist with topical medications?correct answerYes, the resident must be involved- i.e. can lift their shirt or hold their pant leg up. Do staff have to wash hands before wearing gloves?correct answerYES Do staff have to wash hands AFTER removing gloves?correct answerYES When applying a medical patch to a resident, what must be noted?correct answerOn the patch directly, it must be written, the date the patch was placed and initials of the caregiver. What are residents medication options in an ALF?correct answerBased on the health care provider's feedback, a resident may self administer, require assistance or a nurse may administer. Who can administer meds in an ALF?correct answerOnly a nurse; not a trained unlicensed staff member trained in self-administration of medication. Who can change a prescription label?correct answera licensed pharmacist What must be on a prescription label?correct answerPharmacy name, resident name; doctors name; drug name; dose; strength; expiration date; date dispensed; refills; auxiliary labels; special instructions; pharmacy phone number What is an auxiliary label?correct answersmaller labels, sometimes brightly colored, with additional instructions for medication administration How are medications managed in a community for a resident?correct answerThe resident self- administers; the resident receives assistance with self administered medications; the licensed nurse administers. Can residents be forced to take their medications?correct answerNO- residents may not be compelled to take medications. Must contact health care provider if they refuse. Can family members fill a resident's pill organizer?correct answerYes Can unlicensed trained staff fill a residents' pill organizer?correct answerNO Who can fill a resident's pill organizer?correct answerNurses and family members If nurse fills pill organizer for a resident that self administers medications what is the procedure?correct answerNurse obtains medications. fills organizer; returns medications to storage; DOCUMENTS day/time organizer was filled. Can private duty aides hired by a resident assist with medications?correct answerNO Can unlicensed trained staff assist with anti-embolism stockings?correct answerYES- unlicensed trained staff can assist with applying and removing stockings Can unlicensed trained staff assist with oxygen?correct answerYES- but NOT titration. Can apply nasal cannulas. Can unlicensed trained staff assist use judgment or discretion when assisting with the self administration of medications?correct answerNO! the terms judgement and discretion indicate that vital signs and the residents condition must be interpreted and evaluated which is beyond the scope of an unlicensed trained staff person. A nurse must be involved. Can unlicensed trained staff assist with PRN medication?correct answerYes, only if requested by a competent resident who self-administers PRN medications must be...correct answerwritten with specific parameters that include the when applicable and not to exceed limitations. For unlicensed trained staff, does assistance include help with suppositories?correct answerNO- no meds may be assisted to be self administered by unlicensed trained staff that are rectal, urethral or vaginal preparations. OTC medications must have what documentation?correct answerresidents name, manufacturers instructions for use or the healthcare providers instruction for use. CAN A RESIDENT WHO SELF ADMINISTERS use A PILL ORGANIZERcorrect answeryes When does a resident need a prescription from a health care provider for an OTC med?correct answerWhen the nurse provides assistance or administration of that med. T/ F Orders for OTC meds are required anytime the resident has their mediations administered.correct answerTRUE Can an ALF have bulk stock supply of OTC meds?correct answerYes, only if the OTC meds are centrally sorted; labeled with medication name, date of purchase and notice that med is part of ALF stock supply. How are medications managed for a resident if they are going to miss a med pass?correct answerthe ALF may provide the medication to the resident if they self administer, a family member or a friend. Are chemical restraint medications permitted in an ALF?correct answerNO. Any medications that have a side effect or may serve as being a chemical restraint must be reviewed annually by the health care provider. T/ F Chemical restraints may be used in an ALF with a health care provider's order.correct answerFALSE - no drug may deliberately be used to physically limit, restrict or deprive mobility or movement and is used for discipline or convenience and not required for the treatment of medical symptoms. How should discontinued medications be handled?correct answerkeep separate from current medications; mark as discontinued, dispose of in 30 days When should discontinued medications be disposed?correct answerWithin 30 days When should abandoned medications be disposed?correct answerWithin 30 days- return to pharmacy, dispose within community with a witness; document the disposal T/ F When a resident moves out of the facility, the ALF must return the residents' medications to the resident , family or guardian.correct answerTRUE Sample medications must have...correct answeroriginal manufactures packaging, doctors name, residents name, date dispensed. What is the protocol if sample medications are missing manufacturers instructions or there are different instructions per the doctor?correct answerNeed doctor's name; resident's name, date dispensed, name and strength of drug; directions for use, expiration date A resident returns from the doctor with sample medications that have the manufacturers instructions for use. The medications must be labeled with...correct answerthe practitioner's name, date dispensed, resident's name When must food safety training be complete based on hire date?correct answerwithin 30 days of hire and keep on file for 3 years How long can a community operate without a CFPP if the CFPP leaves?correct answer90 days to get CFPP and come into compliance Where must a sink be located for hand washing?correct answerWithin 20 ft of food prep area with clear signage to wash hands, 100 degree water temp and garbage can. What is a good hand washing technique?correct answer20 seconds with a cleaning compound with clean running warm water. Is nail polish allowed in kitchen / food prep?correct answerOnly if hands are gloved. No artificial nails are permitted. Are open beverage containers allowed in the kitchen/ food prep area?correct answerNo, must be covered to prevent bugs. What is the physical plant standard for food prep areas and the kitchen?correct answersmooth walls and floors to easily clean; covered shatterproof lighting; 50' candles for knife and grinder area; 20' candles for under counter; No AC air vents above food steam tables; must be able to catch dead bugs with mesh or mechanical air curtain if the kitchen door is open. Garbage must have tight fitting lids and no mess on surrounding floors. Must have pest control services contracted; mop sink must be separate with floor drain and space for mop to air dry between uses away from food. How can a thermometer be calibrated?correct answerWith ice water at 32 degrees What are dishwashing standards?correct answerHot water level as recommended by the manufacturer of equipment being used. NEW RULE 2019 How far off the floor should food be stored?correct answer6 inches The best way to defrost food iscorrect answerrefrigerator Do not store food:correct answerNear chemicals or cleaning supplies In restrooms In locker rooms In janitor closets In furnace rooms Under stairways or pipes Temps for cooking food- summarycorrect answer135 fruits 155 ground mechanical meats 165 stuffed meats; any leftovers- can only reheat once and then toss. Eggscorrect answerpasteurized eggs must be served immediately once cooked; non pasteurized eggs may be used only in baking and must be used 30 min after breaking. All stored must be labeled with?correct answerdate of preparation and date to discard; Mandatory cooling temps and timescorrect answerGet foods from 135 degrees to 70 degrees in 2 hours Get foods from 135 degrees to 41 deg in 6 hours How long can food out of safe temp range?correct answerno more than 4 cumulative hours including thawing, preparation, serving and cooling. Safe food tempscorrect answer135 or hotter; 41 degrees or colder Daily food serving standards in an ALF per resident?correct answerat a min: 2 or more protein servings of 6oz each 6-11 bread starches 3-5 veg 2-4 fruit 2+ milk, fats, oils, sweets and water Must have standardized recipes if have how many residents?correct answer16 or more How many times can leftovers be re-heated?correct answerone time only 1 to 165 degrees held for 15 seconds. Temperature logs may be required for:correct answerfridges; dishwashers, cooking What is the rule for therapeutic diets?correct answerMust be done in accordance with healthcare providers orders. Not just on a request. When doing men substitutions, what is the protocol?correct answerlike items should be substituted for like items; example baked chicken instead of tilapia as protein. How should menus be planned?correct answerBased on resident preference and input. Why do utensils for plating need measurements?correct answerTo ensure uniform standards of plating and correct amounts as prescribed by the dietitian How often are menus reviewed by the dietician?correct answerannually As the chef, you decide to serve a different side. When if at all should this be documented?correct answerPRIOR to serving the meal Menus should be planned at least how far in advance?correct answer1 week How long should served menus be kept on file?correct answer6 months When must a new hire have a free from communicable disease clearance from a health care provider? correct answerwithin 30 days of beginning employment When must a TB test be done for a new hire?correct answerwithin the last 6 months and submitted within 30 days of beginning employment. How long must work time schedules be kept on file?correct answer6 months Who must have a level 2 AHCA background screening?correct answerAny employee that has access to residents, resident funds, resident living areas, a controlling interest, financial officer; the licensee, contractors who work more that 20 hours/ week and provide personal care services. What are staff training requirements for direct care staff BEFORE providing care to residents?correct answerBEFORE providing care all direct care staff MUST: 1 hour in service on infection control incl. universal precautions and facility sanitation and or blood borne pathogens. What are staff training requirements for direct care staff WITHIN 30 DAYS of employment?correct answer1 hour inservice on reporting adverse incidents; facility emergency procedures including chain of command and staff roles in an emergency evacuation; if the employee is not core trained; 1 additional hour of training in resident rights in an ALF and recognizing abuse neglect and exploitation. 3 hours in resident behavior and needs and providing assistance with daily living. Which staff must receive an in-service on resident elopement?correct answerALL STAFF within 30 days of hire will receive an inservice training on resident elopement and will be provided a copy of the ALF's policies and procedures for an elopment. Who must participate in resident elopement drills?correct answerAll direct care staff and Administrator How often are elopement drills?correct answertwice a year HIV/AIDScorrect answerAll staff must complete the one-time education course for HIV AIDs within 30 days of hire. Documentation of compliance must be maintained. Staffing based on censuscorrect answer0-5 residents = 168 staff hours/ week 6-15 = 212 16-25 = 253 26-35 =294 36-45 = 335 46-55 = 375 56-65 = 416 66-75 = 457 76- 85 = 498 86-95 = 539 95+ = Add 42 hours for every 20 residents greater than 95 When are job descriptions mandatory?correct answerWhen an ALF is licensed for 17 or more beds When must an ALF remove employees from background screening roster?correct answerWithin 10 days of a change in employment Who must complete Alzheimer's 1 training and by when?correct answerAll staff that interact with MC residents on a daily basis. Training must be complete within 3 months/ 90 days of beginning employment Who must complete Alz 2 training, how long and by when?correct answerAll MC DIRECT CARE staff within 9 months of employment for a total of 4 hours What additional training does MC direct care staff need?correct answerAn additional 4 hours of continuing education in dementia every year. Summary of Alz 1. Alz 2 and additional training requirementscorrect answerAlz 1: All MC staff who interact on daily basis within 3 months @ 4 hours Alz 2: Direct care staff within 9 months @ 4 hours Continuing education - dementia training mandatory for Direct Care staff every year @ 4 hours If only "incidental contact" with MC residents- what is training?correct answerMust receive written info within 3 months of employment How long to keep work schedules and staff time sheets?correct answer6 months pre-service orientation must address at a minimumcorrect answerresident rights If Administrator of ECC ALF, what are the training requirement?correct answerCore trained with passing test + 4 hours on ECC within 3 months of becoming administrator of an ECC. 4 hours continuing education every 2 years + 4 hours What are ECC Direct care staff training requirements?correct answer2 hours within 6 months; What are LMH Direct care staff training requirements?correct answer6 hours within 6 months by DCF approved materials; 3 hours continuing ed every 2 years provided by Administrator or online T/ F A level 2 background screening can be done after a person has been hired and started work.correct answerFALSE - a level 2 background screen must be done BEFORE employment If an administrator or manager is going to be absent from a community more than 21 consecutive days, what is the procedure?correct answerA person who has met the administrator or manager requirements must be appointed in writing to be in charge of the facility Do newly hired staff need to provide free from communicable disease paperwork before starting?correct answerNo. Staff have 30 from beginning employment to provide free from communicable disease information. who is in charge of the responsible operation of an ALF and resident care until ownership is transferred? correct answerThe transferor What must a transferor provide to residents?correct answera statement which shows the amount and type of resident funds that were held by the ALF and are getting credited to the resident. What must be posted in a public area for all visitors and residents?correct answerIn a min of 14 point font: telephone numbers for long term care ombudsman, disability rights florida, the agency consumer hotline and florida abuse hotline. Do residents each need their own phone?correct answerNo. One phone per floor is mandatory for a building licensed for 17+ residents. Must have easy phone access with privacy available. What are the min mandatory visiting hours in an ALF as per the resident bill of rights?correct answer9am-9pm Do residents have the right be outdoors?correct answerYes, the right to be outdoors with supervision with access to regular exercise What is the penalty of a resident is not given the full 45 day discharge notice by an ALF?correct answerAHCA may fine the community $2,500 if a proper discharge notice of 45 days is not given to a resident. Can a resident work in exchange for free room and board in an ALF?correct answerNo. A resident if they work in an ALF must be compensated at least min. wage. Are residents allowed to complain about an ALF?correct answerYes, residents have the right to present grievances without reprisal (i.e. get kicked out of ALF) to a rep from longterm care ombudsman and to make recs about the policies and procedures in an ALF. Are residents allowed to share a room with their spouse in an ALF?correct answerYes When can a half bed rail be used in an ALF?correct answerOnly with written informed consent of the resident or the resident representative AND be ordered by the health care provider AND reviewed annually by the health care provider. Statute of Limitationscorrect answer2+ or - yrs from the incident date to a max of 4 yrs. Unless the act was concealed or misrepresented then unto 6 yrs max. When can civil actions to enforce resident rights be enacted against an ALF? 429.29correct answerIF the claimant can prove with a preponderance of evidence that... *The ALF owed a duty to the R *The ALF breached the duty to the R *The duty breach =loss, injury, death or damage to R *R sustained loss, injury, death or damage as result of the breach. durable power of attorneycorrect answerdocument that allows an agent to represent a resident patient for healthcare needs. Can a guardian over-ride a durable POA?correct answerNO. The durable POA takes precedence over a guardian. Can a memory care resident elect a durable POA?correct answerNo. A durable POA can only be appointed by a competent resident. Is it mandatory for a resident to have a DNRO?correct answerNo, a resident has choice the right to choose whether they want to be recuscitated. An ALF canNOT make a resident sign or not sign a DNRO as a condition of admission. What is the penalty for NOT reporting resident abuse or neglectcorrect answer2nd degree MISDEMEANOR What is the penalty for making false claim/ report of resident abuse or neglect?correct answer3rd degree FELONY Is an ALF a mandatory reporter for suspected abuse or neglect?correct answerYes An ALF must encourage resident care to includecorrect answerallowing a resident to participate in the community to achieve the highest possible level of autonomy and independence. How long must an ALF keep resident RECORDS?correct answer2 years How long must an ALF keep resident CONTRACTS?correct answer5 years What is admission / discharge log?correct answerAn ALF keeps records of all residents admitted and discharged including names; dates' locations coming from and going to and if a stage 2 pressure sore present at either admit or discharge. How long must an ALF keep fire safety inspections?correct answer2 years How long must an ALF keep health safety sanitation inspections?correct answer2 years How long must an ALF keep AHCA inspections, survey results, complaints, moratorium notices?correct answer5 years Do residents getting assistance with ADL's need to be weighed?correct answerYES. Every 6 months Can an ALF be a representative payee for a competent resident?correct answerNO. If a resident is competent than an ALF canNOT be a representative payee. The resident must receive the funds as designated from OSS, Social Security, VA or Railroad as originally intended. Must respite residents be noted an facility's admission/ discharge log?correct answerYES When must an ALF file a liability claim report?correct answerOnly where there is a month with a liability claim against the facility. No claim, then no report needed. When is a receiver appointed by AHCA?correct answerWhen a facility doesn't have enough money to provide care for residents. When are re-licensure surveys conducted by AHCA?correct answerBiennially; 2 years What must a resident receive in order to be noted as LMH resident in a LMH facility?correct answerResident must receive OSS, optional state supplementation, social security income, SSI social security disability income SSDI How does an ALF keep track of LMH residents?correct answeron admission and discharge log with note of who is LMH resident. When can an ALF admit a LMH resident?correct answerAn ALF may admit an LMH resident only AFTER receiving licensing as an LMH. How can ALF confirm that a mental health resident is a LMH resident?correct answerObtain copy of Alternate Care Certification for OSS form Written verification from social security admin A statement from mental health care provider or case manager Who can do an Appropriate Placement Assessment for a mental health resident in an ALF?correct answerPsychiatrist; clinical psychologist, clinical social worker; psychiatric nurse or someone supervised by any of these people. How can an ALF obtain an Appropriate Placement Assessment for a mental health resident?correct answerDischarge statement from state mental hospital completed in past 90 days Completed 1823 Completed Alternate Care Certification for OSS form What must an LMH ALF complete within 30 days of admission?correct answerVerify that resident is receiving SSDI or SSI AND OSS Obtain Appropriate Placement Assessment Dev. Community Living Support Plan Obtain Cooperative Agreement When must a community living support plan be completed and updated?correct answerwithin 30 days of admission OR within 30 days of receiving the Appropriate Placement Assessment whichever is LATER. Must be updated annually or if significant change in behavioral health. Who must sign the community living support plan?correct answerresident, administrator or designee, resident's case manager When does a community living support plan need to be updated?correct answerWhen a resident experiences a significant change; Must update 1823 at the same time. Community Living Support Plancorrect answermeans a written document prepared by a mental health resident and the resident's mental health case manager in consultation with the administrator of an assisted living facility with a limited mental health license or the administrator's designee. A copy must be provided to the administrator. The plan must include information about the supports, services, and special needs of the resident which enable the resident to live in the assisted living facility and a method by which facility staff can recognize and respond to the signs and symptoms particular to that resident which indicate the need for professional services. What must be complete within 72 of admission of LMH resident?correct answerAppropriate Placement Assessment * Community Living Support Plan Cooperative Agreement *Must show doc requesting this form and good faith effort to obtain info incl. name, title, phone number of who was requested and keep in resident file. How often do nursing assessment need to be done for LNS residents?correct answerMonthly Do logs need to be kept of who is receiving LNS services and types of services?correct answerYes When must an 1823 be complete for an ECC resident?correct answerBEFORE admission to an ECC (this is different than a standard license ALF!!) How often must an 1823 be updated for an ECC resident?correct answerAnnually or if significant change Can a resident be a "total care" under ECC license?correct answerYes, an ALF with an ECC license can admit and retain residents who require total care with their ADL's. Can a non-weightbearing, "total" transfer resident be admitted to an ECC?correct answerNO. Upon admission, an ECC resident must be able to transfer with assistance. 1+ caregiver assistance is ok When must an ECC service plan be completed?correct answerWithin 14 days of admission and updated quarterly How long must advertising be kept?correct answer2 years What can ECC do?correct answertotal care with ADL's nursing assessments- at admission and monthly service plans- at admission and quarterly What principles must an ECC follow?correct answerShared responsibility and managed risk shared responsibilitycorrect answermeans exploring the options available to a resident within a facility and the risks involved with each option when making decisions pertaining to the resident's abilities, preferences, and service needs, thereby enabling the resident and, if applicable, the resident's representative or designee, or the resident's surrogate, guardian, or attorney in fact, and the facility to develop a service plan which best meets the resident's needs and seeks to improve the resident's quality of life.