Assisted Living Regulations in New Jersey, Exams of Nursing

Download Assisted Living Regulations in New Jersey and more Exams Nursing in PDF only on Docsity! NJ CALA EXAM Aging in Place - Answer A process whereby individuals remain in their living environment despite the physical and/mental decline and growing needs for supportive services that may occur in the course of aging. ADLs (Activity of Daily Living) - Answer The functions or tasks for self-care, which are performed either independently or with supervision or assistance, such as: dressing, bathing, toileting, transfer, locomotion, bed mobility, and eating. Assisted Living - Answer A coordinated array of supportive personal and health services 24 hours per day, to residents who have been assessed to need these services including persons who require nursing home level care. It promotes resident self direction and participation in decisions that emphasize independence, individuality, privacy, dignity, and homelike surroundings. Bounded Choice - Answer Limits places on a resident's choice as a result of an assessment, in accordance with N.J.A.C. 8:36-5.18, which indicates that such resident's choices or preference place the resident or others at a risk of harm or lead to consequences which violate the norms of the facility or program or the rights of others. CPCH (Comprehensive Personal Care Home) - Answer A facility which is licensed by the Department of Health and Senior Services to provide room and board and to assure that assisted living services are available when needed, to four or more adults unrelated to the proprietor. Residential units in this type of facility have no more than two residents and have a lockable door on the unit entrance. CCRC (Continuing Care Retirement Community) - Answer A facility that has received a certificate of authority pursuant to the _________ and Financial Disclosure Act, N.J.S.A. 52:27D-300 et seq. Customized Resident Medication Package - Answer A unit-of-use package prepared by a pharmacist for a specific resident comprising a series of containers and containing two or more prescribed sold oral dosage forms, and so designed or labeled as to indicate the day and time, or period of time, that the contents within each container are to be taken. Guardian - Answer A person appointed by a court of competent jurisdiction to handle the affairs and protect the rights of any resident of the facility who has been declared a mental incompetent. This does not include a person affiliated with the facility, its operations or personnel, unless so ordered by the court. Health Care Service - Answer Any service provided to a resident of an assisted living or comprehensive personal care home that is ordered by a physician and required to be provided or delegated by a licensed, registered or certified health care professional. Hospice - Answer A program of palliative and supportive services provided to terminally ill persons and their families in the form of physical, psychological, social, and spiritual care. Managed Risk - Answer The process of balancing resident choice and independence with the health and safety of the resident and other persons in the facility or program. If a resident's preference or decision places the resident or others at risk and is likely to lead to adverse consequences, such risks or consequences are discussed with the resident, and, if the resident agrees, a resident representative, and a formal plan to avoid or reduce negative or adverse outcomes is negotiated, in accordance with the provisions of N.J.A.C. 8:36-5.18. Manage Risk Agreement - Answer The written formal plan developed in consideration of shared responsibility, bounded choice and assisted living values and negotiated between the resident and the facility or program to avoid or reduce the risk of adverse outcomes which may occur in an assisted living environment. Medication Administration - Answer A procedure in which a prescribed medication or biological is given to a resident by an authorized individual in accordance with all laws and regulations governing such procedures. Process of Medication Administration - Answer 1.) Removing an individual dose from a previously dispensed, properly labeled container (including a unit dose or unit-of-use container). 20 percent - Answer An assisted living facility shall indicate within 36 months of after licensure, at least ______________ of the facility's residents shall be individuals with nursing home-level care. This percentage shall be computed based upon the number of residents days per calendar year and may include direct admissions as well as maintained residents with nursing home-level of care needs. Biennially - Answer Each assisted living, comprehensive personal care home, and assisted living program will be assessed and inspected __________________. Survey Visits - Answer This may be made to a facility at any time by authorized staff of the Department . Such may include, but not limited to, the review of all facility documents and resident records and conferences with residents. Facility Licensure - Answer A licensure shall be granted for a period of one year or less as determined by the Department. Facility Licensure Renewal - Answer The license, unless suspended or revoked, shall be renewed annually on the original license date, or within 30 days thereafter as of the original licensure date. The facility will receive a request for renewal fee 30 days prior to the expiration of the license. A renewal license will not be issued unless the licensure fee is received by the Department. Surrender of Facility License - Answer The facility shall notify each resident, the resident's physician, and any guarantors of payment at least 30 days prior to the voluntary surrender of a license, or as directed under an order of revocation, refusal to renew, or suspension of license. In such cases, the license shall be returned to the Long-Term Care Licensing Program of the Department within 7 working days after the voluntary surrender, revocation, non-renewal, or suspension of license. CALA Qualifications - Answer 1.) 21 years or older; 2.) Possess a high school diploma or equivalent; 3.) hold a CALA or LNHA license. 2 Years - Answer An applicant for certification as an assisted living administrator shall sit for the Assisted Living Competency Examination within ____________ of successful completion of the assisted living training course. 3 Years - Answer An assisted living administrator certification shall be valid for a period of ____________ from date of issue. 3 Years - Answer At least once every ___________, on a schedule to be determined by the Department, an assisted living administrator shall file an application for renewal of current certification. 30 hours - Answer Complete at least ____________, of continuing education regarding assisted living concepts and related topics, as specified and approved by the Department of Health and Senior Services. Eligibility for Renewal - Answer 1.) Complete 30 hours of CEUs, 2.) Criminal History Background Check Lapse of Certification - Answer The applicant shall be required to complete 10 hours of continuing education credit for each year in which the certification was inactive in addition to the required 30 hours of continuing education for the last completed triennial certification period in which the applicant's certification was active. 40 Hours - Answer In order to be an assisted living administrator trainer, they must complete at least ____________ of the basic concepts etc. of assisted living. Administrator's Responsibilites - Answer 1.) Ensuring the development, implementation, and enforcement of all policies and procedures, including resident rights; 2.) Planning for, and administration of, the managerial, operational, fiscal, and report components of the facility; 3.) Ensuring that all personnel are assigned duties based upon their ability and competency to perform the job and in accordance with written job descriptions; 4.) Ensuring the provision of staff orientation and staff education; 5.) Establishing and maintaining liaison relationships and communication with facility staff and services and with residents and their families; 6.) Establishing and maintaining liaison relationships and communications with community hospitals, social services agencies, and mental health service agencies. Ombudsman - Answer An advocate who is an official in charge of representing the interests of the public by investigating and addressing complaints of maladministration or a violation of rights. Informed Consent in Different Languaes - Answer The resident has a right to refuse medication and treatment after the resident has been informed, in language that the resident understands, of the possible consequences of this decision. 30 Days - Answer The resident has the right to receive written notice at least ___________ in advance when the facility requests the resident's transfer or discharge, except in an emergency. This written notice shall include the name, address, and telephone number of the New Jersey Office of the Ombudsman for the Institutionalized Elderly, and shall also be provided to the resident's legally appointed guardian, if applicable, or, with the resident's consent, to the resident's family, ___________ in advance. Types of Services for ALF - Answer 1.) Assistance with Personal Care; 2.) Nursing; 3.) Pharmacy; 4.) Dining; 5.) Activities; 6.) Recreational; 7.) and Social Work services. Nursing Home Level Care Characteristics - Answer 1.) The resident requires 24/7 nursing supervision; 2.) The resident is bedridden for more than 14 days; 3.) The resident is consistently and totally dependent in four or more of the following activities of daily living: dressing, bathing, toilet use, transfer, locomotion, bed mobility, and eating; 4.) The resident has a cognitive decline severe enough to prevent the making of simple decisions regarding activities such as bathing, dressing, and eating and cannot respond appropriately to cueing and simple directions; 5.) The resident requires treatment of a stage 3 or 4 pressure sore or multiple stage two pressure sores; 6.) The residents requires than assistance with transfer; 7.) The resident is a danger to self or others; 8.) The resident has a medically unstable condition and/or has special health problems, and a regimen of therapy cannot be appropriately developed and implemented in the assisted living environment. 10 Percent - Answer A new or existing assisted living residence or comprehensive personal care home licensed on or after Sept. 1st, 2001, shall attain a level of occupancy by Medicaid-eligible persons of at least ______________ of its total bed complement within 3 years of licensure (for new ALFs) and shall maintain this level of Medicaid occupancy thereafter. In cases in which either the total bed complement or the total number of beds added in an existing facility is less than that amount, at least one bed shall be reserved for a Medicaid-eligible person. (p.34-35) Specialized Long-Term Care - Answer Residents who shall not remain in the assisted living residence or comprehensive personal care home and shall be transferred to a long-term care facility. Medicaid-Eligible Person - Answer An individual who has been determined as satisfying the financial eligibility criteria for medical assistance under the Medicaid program, and has been assessed as being in need of nursing home-level care, and has been approved by the Department for participation in a Federally approved waiver program for assisted living services. Maintenance of Records - Answer A register of residents are to be maintained, along with statistical data; such as resident census and facility characteristics shall be forwarded to the Department on request, in a format provided by the Department. Resident Interview - Answer This shall include at least orientation to the facility's or program's policies, business hours, fee schedule, services provided, residents rights, and criteria for admission and discharge. Documentation of this shall be included in the resident record. 15 Days - Answer If an applicant, after applying in writing, is denied admission to the assisted living residence, comprehensive personal care home, or assisted living program, the applicant and/or his or her family, guardian, or responsible person shall, upon written request, be given the reason for such denial in writing, signed by the administrator, within ____________ of the receipt of the written request. 30 Days - Answer Written notification of by the administrator shall be provided to a resident and/or his or family, guardian, or designated responsible person, of a decision to involuntarily discharge the resident from the facility or program. Such involuntary discharge shall only be upon grounds contained in the facility's or program's policies and procedures and shall only occur only if the resident has been notified and informed of such policies in advance. The notice of discharge shall be given at least __________ in advance and shall include the reason for discharge and the resident's right to appeal. This _________ advance notice shall not apply if the discharge is for reasons in accordance with the criteria specified at N.J.A.C. 8:36-5.1(d) (such as an emergency situation). A copy of the notice shall be entered into the resident's record. Notification Requirements - Answer 1.) The resident acquires an acute illness requiring medical care. 2.) Any serious accident, criminal act or incident occurs which involves the resident and results in serious harm or injury or results in the resident's arrest or detention. 3.) The resident is transferred from the facility. 4.) The resident expires. Interpretation Services - Answer The facility or program shall demonstrate the ability to provide a means to communicate with any resident admitted who is non-English-speaking and/or has a communication disability, using available community or on-site resources. Referral & Transfer Agreements - Answer Each licensed assisted living residence and comprehensive personal care home shall maintain written referral and/or transfer agreements with at least one licensed acute care hospital in New Jersey, at least one licensed State, county, or private psychiatric hospital in New Jersey, and with at least one licensed New Jersey long-term care facility. A written agreement with an acute care hospital with licensed adult psychiatric beds in New Jersey shall enable compliance with psychiatric hospital component of the requirement. Financial Arrangements - Answer Upon admission and at the time of any changes in charges, inform the residents in writing, of any and all all fees for services provided and charges for supplies routinely provided by the facility. The facility shall also inform the resident of the costs of supplies which are specially ordered. At the resident's request, this information may be provided instead to the resident's family, guardian, or responsible person. Personal Needs Allowance - Answer The administrator or his or her representative shall develop a policy and procedure for handling the monthly _______________________ for each resident who receives SSI or other forms of public assistance. Every administrator to whom resident's personal funds are entrusted shall maintain written records, such as a ledger, including the date each payment was received, the amount of payment, the date of each disbursement, the amount of each disbursement, the reason for each disbursement and to whom each disbursement was made. It shall not be commingled with any other facility operating account and shall be deposited into an interest bearing account. 72 hours - Answer Each resident shall receive his or her personal needs allowance within ____________ of the receipt of the check by the administrator. Financial Power of Attorney - Answer The resident or, if the resident is not competent, the resident's representative with ________________________, shall sign to acknowledge receipt of funds, goods or services purchased with such funds at the time of disbursement. 14 days - Answer Upon admission, each resident shall receive an initial assessment by a RN to determine the resident's needs. If this initial assessment indicates the resident has general needs, a general service plan shall be developed within ____________ of the resident's admission. General Service Plan - Answer 1.) The resident's need, if any, for assistance with ADLs. 2.) The resident's need, if any, for assistance with recreational and other activities. 3.) The resident's need, if any, for assistance with transportation. 30 days - Answer Within ____________ prior to admission to the assisted living residence, comprehensive personal care home, or assisted living program, a physician, advanced practice nurse or physician assistant shall specify in writing that the resident is appropriate for this level of care to have a health service plan. Physician and Dentist - Answer At the time of admission, arrangements shall be made between the administrator and the resident, guardian, or responsible person regarding the _______________and ______________ to be called in case of illness, or the individual to be called for a resident who, because of religious affiliation, is opposed to medical treatment. 14 days - Answer If the initial assessment of N.J.A.CC. 8:36-7.1(a) indicates that the resident requires health care services, a health care assessment shall be completed within __________ of admission by RN using an assessment instrument available from the Department, or an assessment instrument adopted by the facility or program, equivalent to the instrument available from the Department, and which meets the requirements. Health Care Assessment - Answer 1.) Need for assistance with ADLs. 2.) Cognitive patterns. 3.) Communication/hearing patterns. 4.) Vision Patterns. 5.) Physical functioning and structural problems. 6.) Continence. 7.) Psychosocial well-being. 8.) Mood and behavior problems. 9.) Activity pursuit patterns. 10.) Disease diagnoses. 11.) Health conditions and preventative health measures, including, but limited to, pain, falls, and lifestyle. 12.) Oral/nutritional status. 13.) Oral/dental status. 14.) Skill conditions. 15.) Medication Use* 16.) Special treatment and procedures. CMA (Certified Medical Assistant) - Answer Certified as a CNA, CHHA, or PCA; Successfully completion of medication administration training coursed approved by the Department; Successful completion of a Department of Health and Senior Services approved standardized examination regarding medication administration for PCAs. An oral examination shall not substitute for the written component of this examination. 2 years - Answer Medication aide certification shall be valid for a period of ___________ from the date of issue. At least once every __________, on a schedule to be determined by the Department, a medication aide shall file an application for renewal of current certification. 30 hours - Answer In order to be eligible to renew for a current certification, the medication aide have completed at least _________ of continuing education, seminars, or in-service training every two year certification period. This includes continuing education for review of the fundamental principles of medication administration, the skills and knowledge necessary for the task of medication administration, and topics of current drug use relevant to the elderly. 6 Months - Answer An applicant for medication aide certification shall sit for the standardized examination within __________ of successful completion of an approved medication administration training course. Minimum PCA Staffing - Answer The facility shall provide on the premises at all times (per building) the following minimum numbers of employees: 1.) At least one awake PCA in accordance with N.J.A.C. 8:36-9.1(a). 2.) At least one additional employee. Dietician Qualifications - Answer The dietitian shall possess a bachelor's degree from an accredited collage or university with a major area of concentration in a nutrition-related field of study, and one year of full-time professional experience or graduate-level training in nutrition. Provision of Meals - Answer The assisted living residence or comprehensive personal care home shall provide dining services to meet the daily nutritional needs of residents, directly in the facility. Designation of a Food Coordinator - Answer The facility shall designate a food service coordinator who, if not a dietitican, functions with scheduled consultation from a dietician. When meals are prepared in the facility, the food service coordinator or designee shall be present in the facility. The food service coordinator shall ensure that dining services are provided as specified in the dining portion of the health care plan. Responsibilities of Dietitians - Answer If indicated, according to residents' needs, a dietitian shall be responsible for providing resident care, including, but not limited to, the following: 1.) Assessing the nutritional needs of the resident. If indicated, preparing the dietary portion of the health care plan on the basis of the assessment, providing dietary services to the resident as specified in the dietary portion of the health plan, reassessing the resident, and revising the dietary portion of the health care plan. Each of these activities shall be documented in the resident's record; and 2.) Providing nutritional counseling and education to residents. 14 days - Answer Written, dated menus shall be planned at least _________ days in advance for all diets. 7 day - Answer The same menu shall not be used more than once in any continuous __________ period. 30 days - Answer Menus, with changes or substitutes, shall be kept on file in the facility for at least _____________. Supervision of Medication Administration - Answer 1.) The facility or program shall document the provision of training (received from the RN or licensed pharmacists, and documented) to each employee who has been designated to provide resident supervision of self-administration of medications. 2.) The facility or program shall document any instances where medications are not taken in accordance with the prescribers orders. 3.) The facility shall keep a record of all prescribed medications for which the resident is receiving supervision of medication administration. OTC (Over the Counter) - Answer _____________ solid and liquid dosage forms may be dispensed in a non unit-of-use or non unit-dose medication distribution system. Prescription Liquid Medications - Answer ______________ conventional bottles or concentrates may be dispensed in a non unit-of-use, non unit-dose, or conventional medication distribution system. Delegation to CMA. - Answer If the appropriate delegation is made, and in accordance with the facility's policies and procedures and all applicable State and Federal laws and regulations, the CMA may: i.) Administer medications through the routes of oral, ophthalmic, otic, inhalant, nasal, rectal, vaginal, topical, and by the percutaneous endoscopic gastrostomy (PEG) (g-tube) tube route of administration; ii.) Administer any prescription or OTC medication according to regulations; iii.) Administer regularly scheduled medications, including prescription, OTC, and Schedule II-V medications; iv.) Administer "PRN" or as needed medication, OTC, and Schedule II-V. 7 days - Answer CMAs can adminster "PRN" or as needed prescription, OTC and Schedule II-V medications EXCEPT that residents receiving the following medications shall be assessed by the RN at least once every ______________: 1.) Residents receiving PRN Schedule II narcotic analgesics. 2.) Residents receiving Schedule III-IV narcotic analgesics. 3.) Residents receiving Schedule III-IV central nervous system agents. CMAs Cannot - Answer 1.) Administer any injection other than pre-drawn properly packaged labeled insulin. 2.) Calculate a medication dosage. 3.) Pre-pour medication for more than one resident at a time. 4.) Contact prescribers for changes in medication, to clarify an order, or contact the pharmacist for questions regarding a dispensed medication. 5.) Administer bolus doses of enteral feedings, or stop and/or start an existing enteral feeding pimp or gravity-fed system. Weekly - Answer At least ____________ a RN shall review and sign off on any modifications or additions to the MAR that were made by the CMA under the RN's delegation. One Day - Answer Registered professional nurses and pharmacists who participate in certification medication aide training shall attend a Department offered ___________ Train-the-Trainer Medication Aide Workshop prior to providing such training to a Certified Medication Aides. Quarterly - Answer Designation of Pharmacist 1.) Training of employees. 2.) Educating residents regarding medications. Fire Extinguishers - Answer These shall be hung conspicuously, kept easily accessible, shall be visually examined monthly and shall be recorded on a tag which is attached to it. It shall also be inspected and maintained in accordance with manufacturers' and applicable NFPA requirements and N.J.A.C. 5:70. Each shall be labeled to show the date of such inspection and maintenance. 10 years - Answer All resident records shall be maintained for a period of _______________ after the discharge of a resident from the assisted living residence, comprehensive personal care home, or assisted living. 48 hours - Answer The register shall be kept up-to-date at all times. Admissions, discharges and discharge destination, and other changes shall be recorded within ____________. Residents' Individual Records - Answer 1.) The resident's completed admission application and all records forwarded to the facility; 2.) The resident's name, last name, date of birth, name and address of sponsor or interested agency, date of admission, date of discharge (and discharge destination) or death, the name, address and telephone number of physician to be called, and the name, address and of nearest relative, guardian, responsible person, or interested agency, together with any other information the resident wishes to have recorded; 3.) A copy of the resident's advanced directive, if applicable; and 4.) A copy of the resident's general service plan and/or health service plan, if applicable. Record of Death - Answer 1.) Promptly notify a family member, guardian, or other designated person of the death of the resident. Notification shall be made at the time of the occurrence, and the time between the resident's death and notification shall not exceed one hour; and 2.) Including in the resident's record written documentation from the physician of the date and time of death, the name of the person who pronounced the death, disposition of the body, and a record of notification of the family. The administrator or administrator's designee shall include in the record of notification of the family confirmation and written documentation of that notification. 3.) A physician, registered nurse or paramedic may make a determination and pronouncement of death in accordance with N.J.A.C. 13:35-6.2(d) and (e). Ventilation - Answer Means of _______________shall be provided in accordance with the Uniform Construction Code, N.J.A.C 5:23, either by windows or by mechanical ________________ for every habitable room. Means of ________________ shall be provided for every bathroom or water closet (toilet) compartment. ________________ shall be provided either by a window with an openable area or by mechanical _______________. 44 inches - Answer The width of passageways, aisles and corridors shall have a minimum of ___________ of clear space. Smoke Detectors - Answer These shall be provided in all residents' bedrooms, living rooms, and "studio apartment" units, whether or not the facility contains a comprehensive automatic fire suppression system throughout. 150 square feet - Answer Residential units occupied by one person shall have minimum of ______________ of clear and usable floor area. This excludes closets, bathroom, kitchenette, hallways, corridors, vestibules, alcoves, and foyers (unless the Department grants such a request). 80 additional square feet - Answer In units occupied by more than one resident, there shall be a minimum of ______________________ for an additional occupant. Two - Answer No residential unit in an assisted living shall be occupied by more than ________ individuals. 230 square feet - Answer Total amount of clear and usable floor area for two person occupied assisted living residence. Lockable Residential Units - Answer Residential units shall be lockable by the occupant(s). All residential units shall be accessible by means of a master key or similar system which is available at all times in the facility, and available at all times for use by designated staff. 30 square feet - Answer The facility shall provide a minimum of ___________ per resident of community spaces for dining and for active and passive recreation. One - Answer Each assisted living facility shall provide at least ________ non-commercial washer and dryer to be used exclusively for the residents' personal items. One hour - Answer When a commercial type laundry equipment is utilized, it shall be installed in a separate laundry room. The remainder of the shall be protected from the laundry room by fire separation assemblies of a least ___________ rated construction. Administration and Public Areas - Answer 1.) A grade level barrier-free entrance, sheltered from the weather and able to accommodate wheelchairs shall be provided, and shall include a reception and information counter or desk and waiting space for eating. 2.) Space for private interviews shall be provided. 3.) An individual mailbox for each resident shall be provided. 4.) General or individual offices for records, administrative and professional staff shall be provided. 5.) Space shall be provided for storing employee's personal possessions. 6.) Separate space shall be provided or storage of office supplies, sterile or pharmaceutical supplies, and housekeeping supplies. 7.) A room(s) for examination and treatment of residents, which is adequate for an overnight stay and include toilet facilities, may be provided. The room shall have a minimum floor area of 100 square feet, excluding space for vestibule, toilet and closet. The room shall contain a lavatory or sink equipped for hand-washing, a work counter, storage facilities, and a desk, counter or shelf for writing. 100 square feet - Answer A room(s) for examination and treatment of residents, which is adequate. The room shall have a minimum floor area of __________________, excluding space for vestibule, toilet and closet. The room shall contain a lavatory or sink equipped for handwashing, a work counter, storage facilities, and a desk, counter or shift for writing. Sounding Devices - Answer If self-locking doors are used at the main entrance and other entrances which open onto a roof or balconies, they shall be equipped with a sounding device, such as a bell, buzzer, or chime, which is in operating condition. The sounding device shall be affixed to the outside of the door or to the adjacent exterior wall for use in the event that a person is unable to enter the building, and shall ring an area staffed 24 hours a day. 3 degrees Fahrenheit - Answer For central kitchens, thermometers which are accurate to within _______________ shall be kept in a visible location within refrigerators, freezers, and storerooms used for perishable and other items subject to deterioration. Household and Cleaning Products - Answer All household and cleaning product used by facility staff shall be identified, labeled, and secured. All poisonous and toxic materials shall be identified, labeled, and N.J.A.C. 8:36 - Answer Regulations: Standards for Licensure of Assisted Living Residences, Comprehensive Personal Care Homes, and Assisted Living Programs. N.J.A.C. 8:43E - Answer General Licensure Procedures and Enforcement of Licensure Regulations Commissioner - Answer Refers to the Commissioner of the New Jersey Department of Health and Senior Services. Curtailment - Answer An order by the Department which requires a licensed health care facility to cease and desist all admissions and readmissions of patients or residents to the facility or affected service. Deficiency - Answer A determination by the Department of one or more instances in which a State licensing regulation or Federal certification regulation has been violated. Department - Answer Refers to the New Jersey Department of Health and Senior Services. Division - Answer Refers to the Division of Health Care Systems Analysis, New Jersey Department of Health and Senior Services. Facility - Answer The entity which has been issued a license to operate a health care facility pursuant to N.J.S.A. 26:2H-1 et seq. For the purposes of this chapter, this includes ambulance and invalid coach services. Immediate and Serious Threat - Answer A deficiency or violation that has caused or will imminently cause any time serious injury harm, impairment, or even death to residents or patients of the facility and therefore requires immediate corrective action. Patient - Answer An individual under the medical and nursing care and supervision of a licensed health care facility. Resident - Answer An individual residing in a licensed health care facility and under the supervision of that facility for the purpose of receiving medical, nursing, and/or personal care services. Survey - Answer The evaluation of the quality of care and/or the fitness of the premises, staff, and services provided by a facility as conducted by the Department and/or designees to determine compliance or non-compliance with applicable State licensing regulations, statutes, or Federal Medicare/Medicaid certification regulations or statutes. 10 business days - Answer At the conclusion of a survey or within ______________ thereafter, the Department shall provide a facility with a written summary of the factual findings used as a basis to determine that a licensure violation has occurred, and a statement of each licensure regulation to which the finding of deficiency relates. Following completion of the survey, an acute care facility may contact the Inspections, Complaints and Compliance Program and a long term care facility may contact the Long Term Care Assessment Survey Program to request an informal review of deficiencies cited. The request must be made in writing within _______________ of the receipt of the written survery findings. The plan of correction shall be submitted within ______________ of the facility's receipt of the notice of violations, unless the Department specifically authorizes an extension for cause. Where deficiencies are the subject of informal dispute resolution pursuant to N.J.A.C. 8:43E-2.3, the extension shall pertain only to the plans of correction for the deficiencies under review. Suspension of a license - Answer The Commissioner may order the summary suspension of a license of a health care facility or a component or distinct part of a facility upon a finding that violations pertaining to the care of patients or to the hazardous or unsafe conditions of the physical structure pose an immediate threat to the health, safety, and welfare of the public or the residents of the facility. Except in the case of life-threatening emergency, the notice shall provide the facility with a 72-hour period from receipt to correct the violations and provide proof to the Department of such correction. If the Department determines the violations have not been corrected, and the facility has not filed notice requesting a hearing to contest the notice of suspension within 48 hours of receipt of the Commissioner's notice pursuant, then the license shall be deemed suspended. Upon the effective date of the suspension, the facility shall cease and desist the provision of health care services and effect an orderly transfer of patients. If the facility requests a hearing within 48 hours of receipt of the Notice of Proposed Suspension of License in accordance with N.J.S.A. 26:2-H-14, the Department shall arrange for an immediate hearing to be conducted by the Commissioner and a final agency decision shall be issued within 48 hours by the Commissioner. Pain - Answer An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Pain Rating Scale - Answer A tool that is age cognitive and culturally specific to the patient or resident population to which it is applied and which results in an assessment and measurement of the intensity of pain. Pain Treatment Plan - Answer A plan based on information gathered during a patient/resident pain assessment, that identifies the patient's/resident's needs and specifies appropriate interventions to alleviate pain, to the extent feasible and medically appropriate. Pain Assessment Procedure - Answer A facility shall formulate a system for assessing and monitoring patients'/residents/ pain using a pain rating scale. Pain should be assessed at minimum upon admission, on the day of a planned discharge, and when warranted by changes in a patients'/residents' condition, self-reporting of pain and/or evidence of behavioral cues indicative of the presence of pain. If pain is identified, a pain treatment plan shall be developed and implemented within the health care facility or the patient/resident shall be referred for treatment or consultation. Pain and Home Health Care Services - Answer In the case of individuals receiving home health care services, assessment shall coincide with a visit by staff of the home health service agency and assessment on the day of discharge is not required if the individual has been admitted to an inpatient or residential health care facility and discharge from the home health service agency takes place after the admission. Staff Education and Training Programs - Answer 1.) Orientation of new staff to the facility's policies and procedures on pain assessment and management. 2.) Training of staff in pain assessment tools; behaviors potentially indicating pain; personal, cultural, spiritual and/or ethnic beliefs that may impact a patient's/resident's perception of pain; new equipment and new technologies to assess and monitor a patient's/resident's pain status. 3.) Incorporation of pain assessment, monitoring and management into the initial orientation and ongoing education of all appropriate staff. 4.) Patient/resident rights. 5.) Implementation of the plan shall include records of attendance for each program. Continuous Quality Improvement - Answer This facilities program shall include a systematic review and evaluation of pain assessment, management, and documentation practices. The facility shall develop a plan by which to collect and analyze data in order to evaluate outcomes or performance. Data analysis shall focus on recommendations for implementing corrective actions and improving performance. Safety with Sharps and Needles - Answer All facilities shall purchase, for use by health care workers only, available sharp devices containing integrated safety features or available needleless devices designed to prevent needle stick injuries. In cases where there is no available sharp device containing integrated safety features or needleless device, for a specific patient use, faciltiies shall utilize the appropriate sharp device that is available for that specific patient use, including any sharp device which employs Managed Risk Agreements - Answer _________________________ should only be utilized when it has been determined that the residents decision may lead to adverse outcomes. Fire extinguishers - Answer ____________________ shall be hung conspicuously, kept easily accessible, and results of exam recorded on tag and attached. Designee Assigned for Resident Supervision - Answer The storage area for medications that are not self- administered must be kept locked when not in use and the key shall be kept by: 72 hours - Answer A resident with short-term post-operative pain has a prescription order for Darvocet 100mg by mouth every four hours prn for 7 days. In this case the RN must reasses for least every _____________. Call the RN - Answer The CMA is changing Mrs. Jones wound dressing and observices that there is a significant amount of drainage on the dressing and a foul odor. The CMA should first: 40 degrees - Answer Cold food must be served at a temperature of ____________. RN - Answer The administration of medication remains the responsibility of the RN. 10 hours - Answer The adminstrator shall annually participate in at least _________ of continuing education regarding assisted living concepts and related topics as specified and approved by the DOH or Nursing Home Administrators Licensing Board. Registered Professional Nurse - Answer The initial resident assessment must be performed by a: 72 hours - Answer A reportable event requires notification of the Department immediately by telephone and in writing with _________. Resident Activities - Answer _________________ must be planned, diversified, and available for groups or individuals. Discharge Records - Answer ___________________ should include the destination of residents who are discharged. 60 cubic feet - Answer The number of air exchanges per hour within the designated smoking room shall be equivalent to the number necessary to achieve ______________ per minute per smoker. 14 days - Answer Written dated menus shall be planned at least _________ in advance for all diets. Substitutions - Answer Any changes or _____________ in menus shall be posted or provided in writing to each resident. 30 days - Answer Menus shall be kept on file in the facility for ________________. Liabilities - Answer Accounts payable are considered to be: Balance Sheet - Answer To view revenue and expenses at a given point in time, one would look at the ____________ Cash Flow - Answer One of the top reasons for failure of Assisted Livings is due to poor ______________ RN - Answer The initial assessment should be completed by the ____________. Abuse - Answer A willful mental attach on a resident is considered to be _____________. Hazardous Materials - Answer ____________________ must be locked at all times. 10 business days - Answer A plan of correction must be submitted within __________________. More than 14 days - Answer A health service plan should be developed for a resident requiring health service needs for ____________________. once per shift quarterly - Answer Fire drills must be conducted at least ______________________. Prevent Infections - Answer Standard precautions are put in place to _______________. Prevent Spread of Infection - Answer Laundry should be kept covered so as to ______________________________. Documenting - Answer _________________ in a resident's medical record at change of condition is done so as to accurately show that the staff is aware of changes and occurrences with the resident. Emergency Plan - Answer A copy of the facility's _______________ shall be provided to the DHSS and forwarded to other agencies as required by state and local laws N.J.A.C. 8:36-14.2. A Living Will and Advanced Directives - Answer Documents indicating end-of-life choices are called DNR - Answer A resident's legal guardian has the right to sign a _________ on behalf of the resident. Do Not Resuscitate - Answer DNR stands for Family Medical Leave Act - Answer FMLA stands for HIPAA - Answer ________________ is in place to provide for confidentiality of resident's records. Current Year - Answer The OSHA log 300 is used to track employee work related injury or illness incidents from the _________________. Involuntary Discharge - Answer An ___________________ must include the name and number of the Ombudsman. arranged - Answer The facility must provide ________________ resident transportation to and from health care services out the facility. True - Answer True or False: The designated alternate does not have to be certified or licensed. HIV - Answer Universal precautions are needed for residents who have _________ disease. Handwashing - Answer What is the best for ordinary infection control? Rabies - Answer This disease is a reportable, communicable disease. OSHA - Answer An agency that oversees work-related accidents/incidents and medical waste. Mantoux Test - Answer 2 Step Tuberculosis Test Material Safety Data Sheet - Answer MSDS stands for CDC - Answer This agency provides guidelines for infection prevention and control. 3 Step Test - Answer Hepatitis B requires what kind of test? NFPA - Answer An agency that oversee life safety code. Medical Waste - Answer Syringes, blood soaked bandages, and needles are considered to be ______________. 80 feet - Answer Space required for one person in CPCH 50 feet - Answer Space required for additional person in CPCH 60 days - Answer Time prior to admission a physician, nurse practitioner or physician assist can authorized a resident as appropriate for assisted living. November 30th - Answer Date by which resident must have flu shot. If they move in after this date, they must have their flu shot by February. 5 - Answer ______ units of tuberculin in Mantoux Test 180 degrees - Answer Dishwasher Water Temperature 140 degrees - Answer Washing Machine Water Temperature 180 degrees - Answer Clothes Dryer Temperature 8 percent - Answer Percentage of glass windows in assisted living residence 21 - Answer Minimum age of administrator 4 days - Answer Supply on food required on hand 10 percent - Answer Percentage of any sickness in which the state much of notified. one - Answer Number of required CPR/AED trained personnel on-site. 18 inches - Answer Items should be store __________ from ceiling. 18 inches - Answer How much clearance of combustible materials should there be? 5 percent - Answer The percentage of weight loss in a month that unintentional that should be brought to the attention of the RN. 16 hours - Answer Up to __________ may elapse between a substantial evening meal and breakfast the following dat if the following conditions are met: a resident group agrees to this meal plan and a nourishing bedtime snack is served. 14 hours - Answer Meals shall be scheduled in such a way that no more than 14 hours elapse between a substantial evening meal and breakfast the next morning. 7:00am - Answer No breakfast before _____________ unless requested. 15 minutes - Answer No more than ____________ of waiting for assistance in eating once tray is delivered. 3 days - Answer If out more than ________ with communicable disease, have to have note from physician. 3 years - Answer Training records specific to blood borne pathogens must be kept for __________ from date of training 8 percent - Answer Exterior glazed area is equal __________ of clear area. 60 days - Answer The facility, within ____________ of establishing an account, shall notify the resident, in writing, of the name of the bank or investment company holding the funds and the account number. diet manual - Answer A current ____________ shall be available to the dining service personnel and to the nursing service personnel. 3 - Answer At least ________ meals shall be prepared and service daily to residents. two - Answer Fire extinguishers: there shall be a minimum of ________ extinguishers in the basement, at least one on each floor of the building, and as required in kitchen areas. 88 degrees - Answer If the air conditioner is down and the facility exceeds ____________ an evacuation is required. 5 or more employees - Answer Any accident that results in death or the hospitalization of _______________ is considered to be a reportabled event with OSHA. 8 hours - Answer Reportable events to OSHA should be reported within ___________. 5 years - Answer Reportable events to OSHA should retain records for ____________. Materials Safety Data Sheet - Answer MSDS stands for 15-20 minutes - Answer The dietitian shall spend an average of ___________ per resident each month providing dietary services in the facility. 12 hours - Answer Dietary services personnel shall be present for a period of at least ___________ each day. 45 minutes - Answer An average of ____________ of resident activities staff time per resident per week shall be devoted to resident activities. 7 - Answer Resident activities shall be scheduled for ________ days each week. 2 - Answer There should be at least _________ resident activities during the evenings each week. weekly - Answer At least __________, a listing of all scheduled activities shall be posted in a conspicuous place in the facility. conspicuous - Answer standing out so as to be clearly visible Salaries, Raw Food, and Utilities/Supplies - Answer The biggest expenses for an assisted living budget includes: Operational Budget, Capital Budget, and Cash Budget - Answer What are the three types of budgets? Accounting - Answer The outgrowth of an organization's needs for a standardized system or recording, monitoring, and using financial data that follows generally accepted policies and procedures on a consistent basis. Assets - Answer Liabilities + Equity = Liabilities - Answer Assets - Equity = Equity - Answer Assets - Liabilities = Debit - Answer This is the term associated with increasing assets, decreasing liabilities, and owner's equity, increasing expenditures and decreasing revenues. Credit - Answer The is term associated with decreasing assets, increasing liabilities and owner's equity, decreasing expenditures, and increasing revenues. Profit divided by Loss - Answer Revenue - Expenses = the difference of revenue and expenses. - Answer This equation determines the financial of an organization. Net income/loss is equal to ___________________ Retained Earnings - Answer Net income or profit is then credited to ____________________, while a net loss is debited. Retained Earnings - Answer __________________ are the accumulated profits and losses of an organization since its inception. Any distribution of owner's equity to owners, partners, or shareholders comes from this. Cash Basis of Accounting - Answer ________________ provides for the recognition of revenue at the moment revenue is received, and the recognition of expenditures at the time that payment was made. Accrual Basis of Accounting - Answer ____________________ provides for the recognition of revenue at the time revenue is earned, and the recognition of expenditures at the time the expense was incurred. (Example: Monthly Budgeting Purposes) Financial Statements - Answer A financial statement is a summary of an organization's financial data in generally accepted formats. Balance Sheets, Income Statement, Statement of Cash Flows - Answer What are the three basic financial statements? Balance Sheet - Answer The _________________ summarizes the assets, liabilities, and owner's equity of the organization. The report is called such because the assets must total the sum of the liabilities and the owner's equity. The date of it is stated "as of the date" indicating that is not a reflection of a specific time period. Income Statement - Answer The ________________ summarizes the result of operation of an organization. The report matches expenses against revenue; therefore, it is often referred as a profit and loss statement. The statement is dated "for the period", sine it reflect the activity from a specific beginning date to a specific ending date. Statement of Cash Flow - Answer The _______________ is a report that reconciles the cash balance at the beginning of the period with the cash balance at the end of the period. It provides an accountability of the sources of funds and the uses of accounting: cash and accrual. The date of the reports is "for the period" since it covers a specific beginning date and ending date. Trial Balance - Answer A _______________ is a summary listing of an organization's accounts and their respective balances in numerical order according to the charts of accounts. Its indicated both debit and