Dietician Qualifications and Assisted Living Facility Requirements, Exams of Health sciences

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NJ CERTIFIED ASSISSTED LIVING ADMINISTRATOR

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. Minimum PCA Staffing 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. Dietician Qualifications 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. Provision of Meals 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. Designation of a Food Coordinator 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. Responsibilities of Dietitians Written, dated menus shall be planned at least _________ days in advance for all diets. 14 days The same menu shall not be used more than once in any continuous __________ period. 7 day Menus, with changes or substitutes, shall be kept on file in the facility for at least _____________. 30 days 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. Supervision of Medication Administration _____________ solid and liquid dosage forms may be dispensed in a non unit-of-use or non unit-dose medication distribution system. OTC (Over the Counter) ______________ conventional bottles or concentrates may be dispensed in a non unit-of-use, non unit- dose, or conventional medication distribution system. Prescription Liquid Medications 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. Delegation to CMA. 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. 7 days 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. CMAs Cannot 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. Weekly 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. One Day Designation of Pharmacist 1.) Training of employees. 2.) Educating residents regarding medications. 3.) Establishing policies and procedures which ensure safe appropriate self-administration of medications. 4.) Reviewing medication administration records on ____________ basis, and at least ___________, inspecting all common areas of the facility or program where medication are stored or administered, documenting any problems and proposing solutions to these problems, and maintaining records of such inspections. Quarterly 1.) The storage area shall be kept locked when not in use. 2.) The storage area shall be used only for storage of medication and medical supplies. 3.) The key to the storage area shall be kept on the person of the employee on duty who is responsible for resident supervision. Storage and Control of Medications Discontinued or expired medications shall be destroyed within _____________ in the facility, or, if unopened and properly labeled, returned to the pharmacy for credit, if allowable, and in conformance with N.J.A.C. 13:39 and other State and Federal laws, codes, and regulations.

30 days All ________________________________ in the facility shall be witnessed and documented by two individuals, each of whom shall either be the administrator, the registered professional nurse, the licensed practical nurse, or the provider or consultant pharmacist. Medication Destruction Residents shall have the opportunity to organize and participate in a ______________________ that presents the resident's concerns to the administrator of the facility. Resident Council The facility shall arrange for the provision of social work services to residents who require them, by social workers licensed. Each social worker shall be licensed or certified by the New Jersey State Board of Social Work Examiners in accordance with N.J.A.C. 13:44G and N.J.S.A. 45:15BB. Social Worker Emergency medical services shall be available to or arranged for residents requiring these services. The facility shall develop a written plan for arranging for emergency transportation of residents for medical care and returning them to the assisted living residence. Emergency Medical Services At least _______ employee trained in cardiopulmonary resuscitation (CPR) and the Heimlich maneuver shall be available in the facility at all times. The facility shall have an automatic external defibrillator (AED) on site. At least _______ employee trained in the use of the AED shall be available in the facility at all times. One The facility shall develop written emergency plans, policies, and procedures which shall include plans and procedures to be followed in case of medical emergencies, power failures, fire, and natural disasters. The emergency plan shall be filed with the Department and the Department shall be notified when the plans are changed. Copies of the emergency plans shall also be forwarded to other agencies in accordance with State and municipal laws. Nothing in these rule shall supersede or imply non- compliance with the Uniform Fire Act or Uniform Fire Code, N.J.A.C. 5:70, or NFPA 101. Emergency Plan and Procedures The facility shall conduct at least one drill of the emergency plans every _____________. Month The 12 drills shall be conducted on a rotating basis, to ensure that _______drills occur during each working shift on an annual basis. 4 The facility shall maintain documentation of all drills, including the date, hour, description of the drill, participating staff, and signature of the person in charge. In addition to the drills for emergencies due to

fire, the facility shall conduct at least one drill per _________ for emergencies due to a disaster other than fire, such as storm, flood, other natural disaster, bomb threat, or nuclear accident (a total of 12 drills). Year All staff shall participate in at least one drill ______________, and select residents may participate in drills. Annually The facility shall request of the local fire department that at least one joint fire drill shall be conducted _______________. Upon scheduling a joint fire drill, the facility shall notify first aid and civil defense agencies of this drill and shall participate in community-wide disaster drills. Annually The facility shall test at least one _______________ each month of the year and maintain documentation of test dates, location of each tested, persons testing the alarms, and its condition. Manual Pull Alarm 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. Fire Extinguishers 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. 10 years The register shall be kept up-to-date at all times. Admissions, discharges and discharge destination, and other changes shall be recorded within ____________. 48 hours 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. Residents' Individual Records

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). Record of Death 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 _______________. Ventilation The width of passageways, aisles and corridors shall have a minimum of ___________ of clear space. 44 inches 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. Smoke Detectors 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). 150 square feet In units occupied by more than one resident, there shall be a minimum of ______________________ for an additional occupant. 80 additional square feet No residential unit in an assisted living shall be occupied by more than ________ individuals. Two Total amount of clear and usable floor area for two person occupied assisted living residence. 230 square feet 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.

Lockable Residential Units The facility shall provide a minimum of ___________ per resident of community spaces for dining and for active and passive recreation. 30 square feet Each assisted living facility shall provide at least ________ non-commercial washer and dryer to be used exclusively for the residents' personal items. One 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. One hour 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 lavat Administration and Public Areas 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. 100 square feet 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. Sounding Devices

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. 3 degrees Fahrenheit 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 stored in a locked cabinet or room. The telephone number of the poison control center shall be conspicuously posted in the facility. Household and Cleaning Products During the heating season, the temperature in the facility shall be kept at minimum of ____________ during the day (between sunrise and sunset). 72 degrees Fahrenheit During the heating season, the temperature in the facility shall be kept at minimum of ____________ during the night. 68 degrees Fahrenheit During warm weather conditions, the temperature within the facility shall not exceed _____________. 82 degrees Fahrenheit According to current regulations, the temperature of the hot water used for bathing and handwashing shall be at least _________________. 95 to 120 degrees Fahrenheit This shall be stored in a ventilated, vermin proof-area, separate from other supplies, and shall be stored, sorted, rinsed, and laundered only in areas specifically designed for those purposes. It shall be stores, transported, collected, and delivered in a covered laundry bag or cart. Laundry carts shall be in good repair, kept clean, and identified for use when either clean or soiled laundry. Soiled Laundry The facility shall develop, implement, and review at least _______________, written policies and procedures regarding infection prevention and control. Written policies and procedures shall be consistent withe the Centers for Disease Control publications and OSHA standards. Annually The facility shall document evidence of ___________ vaccination against influenza for each residents, in accordance with the General Recommendations on Immunization of the Advisory Committee on Immunization Practice of the CDC. Influenza vaccines for all residents accepting the vaccine shall be completed by November 30th of each year. Residents admitted after this date, during the flu season and up to February 1, shall as medically appropriate, receive influenza vaccination prior to or on admission unless refused by the resident. Annual

The facility shall document evidence of vaccination against pneumococcal disease for all residents who are 65 years of age or older. The facility shall provide or arrange for pneumococcal vaccination of residents who have not received this immunization, prior to or on admission unless the resident refuses offer of the vaccine. Pneumococcal Disease Provided the following information: 1.) The number of licensed and unlicensed staff providing direct care to residents diagnosed with Alzheimer's and related disorders. 2.) The activities that specifically directed towards residents disagnosed with Alzheimer's and related disorders, including but not limited to, those designed to maintain the resident's dignity and personal identity, enhance socialization and success, and accomodate the cognitive and functional ability of the resident. 3.) The frequency of the activities. 4.) The safety policies and procedures and any security monitoring system that is specific to residents diagnosed with Alzheimer's and related disorders. Services for Residents with Alzheimer's/dementia Assisted living facilities are permitted to accept short-term residents who regular caregivers are participating in a respite care program. Respite Defined as any individual, paid or unpaid, who provides regular in-home care for an elderly, disabled, or cognitively impaired person. Caregiver The facility shall establish a written plan for a quality improvement program for resident care. The plan shall specify a timetable and the person(s) responsible for the quality improvement program and shall provide the ongoing monitoring of staff and resident care services. Polices and produces should be reviewed annually. The administrator shall implement measures to ensure that corrections or improvements area made. Quality Improvement Program 1.) The facility shall develop policies and procedures that support a restraint-free environment for all residents. 2.) The use of any restraining devices shall be based on an assessment and shall require a physician, advanced practice nurse, or physician assistant order. 3.) The least restrictive device shall be used, in compliance with the prescriber's order. 4.) A specific plan of care shall be developed for the use of any restraining device. Use of Restraints Regulations: Standards for Licensure of Assisted Living Residences, Comprehensive Personal Care Homes, and Assisted Living Programs.

N.J.A.C. 8:

General Licensure Procedures and Enforcement of Licensure Regulations N.J.A.C. 8:43E Refers to the Commissioner of the New Jersey Department of Health and Senior Services. Commissioner 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. Curtailment A determination by the Department of one or more instances in which a State licensing regulation or Federal certification regulation has been violated. Deficiency Refers to the New Jersey Department of Health and Senior Services. Department Refers to the Division of Health Care Systems Analysis, New Jersey Department of Health and Senior Services. Division The entity which has been issued a license to operate a health care facility pursuant to N.J.S.A. 26:2H- et seq. For the purposes of this chapter, this includes ambulance and invalid coach services. Facility 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. Immediate and Serious Threat An individual under the medical and nursing care and supervision of a licensed health care facility. Patient 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. Resident 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.

Survey 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 reso 10 business days 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 des Suspension of a license An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Pain 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 Rating Scale 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 Treatment Plan 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 Assessment Procedure 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. Pain and Home Health Care Services 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. Staff Education and Training Programs 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. Continuous Quality Improvement 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 non-integrated, add-on safety features, until such time as appropriate sharp device containing integrated safety features becomes available. Safety with Sharps and Needles This does not apply to 1.) Physicians; 2.) Volunteers; 3.) Employees who volunteer to work overtime; 4.) Employees of assisted living facilities that are licensed in accordance with N.J.A.C. 8:36 and who receive room and board as a benefit of employment and reside at the facility on a full-time basis; 5.) Employees who assume on-call duty; 6.) Employees participating in a surgical or therapeutic interventional procedure that is in progress, when it would be detrimental to the patient if the employee left. However, the case of elective procedures, the rules do apply if the procedure was scheduled such that the length of time ordinarily required to complete the procedure would exceed the end of the employee's schedule shift; 7.) Employee not involved in direct patient care activities or clinical services.

Mandatory Overtime A situation characterized by long standing vacancies in that portion of the facility's master staffing plan applicable to the work unit of an employee who files a complaint where such vacancies are the result of open positions that continually remain unfilled over a period of 90 days or more despite active recruitment efforts. Chronic Short Staffing Time spent by an employee who is not currently working on the premises of the place of employment, but who is compensated for availability, or as a condition of employment has agreed to be available, to return to the premises of the place of employment on shore notice if the need arises. On-call Time An employer shall not discharge or in any other manner discriminate against an employee because such employee has made any complaint to his or her employer, including the employer's representative; to the Comissioner of Labor; or to the State agency that licenses the facility where the employee works that the employee has been required to work overtime in contravention to the provisions in the in N.J.A.C. 8:43E. Employee Complaint A written plan which includes in-services programs and on the job training. Staff Education Plan A physician specializing in treatment of diseases of aging. Geriatrician A written document that can aid the resident to protect their rights to accept or refuse medical care if they become mentally or physically unable to communicate them. Advance Directive This warming device must never be used in an assisted living facility. Portable Heaters This is the least effective in guarding against infection against bloodborne pathogens. Antibiotics Corridor widths must have clear space of at least _____________ in CPCH's. 36 inches A written summary of the duties and responsibilities of a job. Job Description The square footage of community space in an assisted living facility for 100 residents.

3000 square feet If mechanical ventilation is used in a CPCH, there shall be a least _______ air exchanges per hour. 2 Debt owed to creditors are listed in the chart of accounts as Accounts Payable The __________ involvement regards fire protection. NFPA A natural response to loss and disappointment. Depression A ________________ is negotiated in order to balance flexibility and responsibility. Managed Risk Agreement _____________________ is the most effective with minimizing the risk of harm to an assisted living resident. Accurate Assessment of Risks Related to Choices The concept of ______________ may place limits on facility staff, limit resident choice based on assessed risks, and place responsibility for resident choice on resident's, staff, and family. Bounded Choice _________________________ should only be utilized when it has been determined that the residents decision may lead to adverse outcomes. Managed Risk Agreements ____________________ shall be hung conspicuously, kept easily accessible, and results of exam recorded on tag and attached. Fire extinguishers 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: Designee Assigned for Resident Supervision 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 _____________. 72 hours 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:

Call the RN Cold food must be served at a temperature of ____________. 40 degrees The administration of medication remains the responsibility of the RN. RN 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. 10 hours The initial resident assessment must be performed by a: Registered Professional Nurse A reportable event requires notification of the Department immediately by telephone and in writing with _________. 72 hours _________________ must be planned, diversified, and available for groups or individuals. Resident Activities ___________________ should include the destination of residents who are discharged. Discharge Records 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. 60 cubic feet Written dated menus shall be planned at least _________ in advance for all diets. 14 days Any changes or _____________ in menus shall be posted or provided in writing to each resident. Substitutions Menus shall be kept on file in the facility for ________________. 30 days Accounts payable are considered to be: Liabilities To view revenue and expenses at a given point in time, one would look at the ____________

Balance Sheet One of the top reasons for failure of Assisted Livings is due to poor ______________ Cash Flow The initial assessment should be completed by the ____________. RN A willful mental attach on a resident is considered to be _____________. Abuse ____________________ must be locked at all times. Hazardous Materials A plan of correction must be submitted within __________________. 10 business days A health service plan should be developed for a resident requiring health service needs for ____________________. More than 14 days Fire drills must be conducted at least ______________________. once per shift quarterly Standard precautions are put in place to _______________. Prevent Infections Laundry should be kept covered so as to ______________________________. Prevent Spread of Infection _________________ 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. Documenting 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. Emergency Plan Documents indicating end-of-life choices are called A Living Will and Advanced Directives A resident's legal guardian has the right to sign a _________ on behalf of the resident. DNR

DNR stands for Do Not Resuscitate FMLA stands for Family Medical Leave Act ________________ is in place to provide for confidentiality of resident's records. HIPAA The OSHA log 300 is used to track employee work related injury or illness incidents from the _________________. Current Year An ___________________ must include the name and number of the Ombudsman. Involuntary Discharge Staff must use soap to wash their hands and must scrub for at least ________________. 20 seconds A resident who is not interested in eating should be _________________. offered alternatives The menus are reviewed and signed off by the ___________________. Dietician Resident records shall be accessible at all times to ________________ State Surveyors ____________ shall be always made available to residents. Snacks Fire extinguishers shall be examined ________________. monthly The ____________________ must be inspected based on manufacturer recommendations. Fire Sprinkler System Another medical term for stroke. CVA High blood pressure is a result of ______________. Hypertension

In order to properly solve a problem, the Administrator must first _________________________. Understand the Problem According to OSHA standards, the Hepatitis B vaccination must be made available to all employees who have reasonably anticipated occupation blood exposure within ______________ of assignment. 10 working days In accordance with assisted living regulations related to ____________________ operation, each assisted living residence and CPCH must establish and implement a written work plan that includes scheduled assignment, frequency of cleaning specific area, and frequency of cleaning and maintain equipment. Housekeeping Rates of this infection are higher for persons over 65 than any other age group. Pneumonia In accordance with regulations, soiled laundry shall be stored in a ventilated area which is also ___________________. Vermin-proof The distance between fire extinguishers should be not more than ____________ for type A. 75 feet The distance between fire extinguishers should be not more than ____________ for type B and type C. 50 feet Another term for exit. Egress A written document that includes issue of concern, resident preference and choices, identification of possible or probable consequences , alternate options, final agreement and decision if agreement will be re-evaluated at a later date. Managed Risk Agreement A _____________________ has the following components: material safety data sheets, inventory of solutions containing toxic chemicals, and hazardous locations within the facility and treatment areas. Hazard Communication Plan Medical records of employees who were exposed to ________________ must be kept for length of employment plus 30 years. Bloodborne Pathogens A person appointed voluntarily through the decision of the elderly person or resident.

Power of Attorney In assisted living, electrical inspections must be conducted _________. yearly A ___________ is a planning and a controlling device used to establish both financial and operational goals for a certain period. budget The facility must provide ________________ resident transportation to and from health care services out the facility. arranged True or False: The designated alternate does not have to be certified or licensed. True Universal precautions are needed for residents who have _________ disease. HIV What is the best for ordinary infection control? Handwashing This disease is a reportable, communicable disease. Rabies An agency that oversees work-related accidents/incidents and medical waste. OSHA 2 Step Tuberculosis Test Mantoux Test MSDS stands for Material Safety Data Sheet This agency provides guidelines for infection prevention and control. CDC Hepatitis B requires what kind of test? 3 Step Test An agency that oversee life safety code. NFPA

Syringes, blood soaked bandages, and needles are considered to be ______________. Medical Waste Space required for one person in CPCH 80 feet Space required for additional person in CPCH 50 feet Time prior to admission a physician, nurse practitioner or physician assist can authorized a resident as appropriate for assisted living. 60 days Date by which resident must have flu shot. If they move in after this date, they must have their flu shot by February. November 30th ______ units of tuberculin in Mantoux Test 5 Dishwasher Water Temperature 180 degrees Washing Machine Water Temperature 140 degrees Clothes Dryer Temperature 180 degrees Percentage of glass windows in assisted living residence 8 percent Minimum age of administrator 21 Supply on food required on hand 4 days Percentage of any sickness in which the state much of notified. 10 percent Number of required CPR/AED trained personnel on-site.

one Items should be store __________ from ceiling. 18 inches How much clearance of combustible materials should there be? 18 inches The percentage of weight loss in a month that unintentional that should be brought to the attention of the RN. 5 percent 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. 16 hours 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. 14 hours No breakfast before _____________ unless requested. 7:00am No more than ____________ of waiting for assistance in eating once tray is delivered. 15 minutes If out more than ________ with communicable disease, have to have note from physician. 3 days Training records specific to blood borne pathogens must be kept for __________ from date of training 3 years Exterior glazed area is equal __________ of clear area. 8 percent 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. 60 days A current ____________ shall be available to the dining service personnel and to the nursing service personnel. diet manual

At least ________ meals shall be prepared and service daily to residents. 3 Freestanding residential health care facilities which were either licensed or certificate of need approval on or before December 20, 1993. Comprehensive Personal Care Homes (CPCH) When serving clams, the metal tags should be kept at the facility for _____________. 30 days PRD stands for Per Resident Day RCA stands for Root Cause Analysis This details anything that could harm a resident such as toxic chemicals. It details each toxic chemical/item with what's in it, how to treat it, etc. It should be kept with the maintenance department but accessible to all staff in the facility. Safety Data Sheet Rescue Alert Others Confine Extinguish/Evacuate R.A.C.E. _________________ are treated or "hired" as if they were employees. Volunteers CIPID stands for Choice, Independence, Privacy, Individuality, and Dignity These are changes as a result of genetic program contained in each cell that leads to the diminished function and death of the organ and eventually the organism as a whole. Cellular Senecent Chemical bonding between organic molecules in the body causes increases stiffness, chemical instability and insolubility of connective tissue and DNA. DNA repair decreases as the cell ages. Cross-Link Genetic Theory With age, the ability if the immunologic system to quantitatively and qualitatively produce antibodies diminishes.

Autoimmune Theory Organs have a fixed amount of energy available and they wear out. Residual damage resulting from stress accumulates, and the body no longer is able to resist the stress and dies. Slow virus or ordinary virus is present in the body and may play a part in the aging process. Stress and Viral Theories Those who stay active and manage strinkage of their world and substitute activities in their life accordingly to changes in life circumstance will obtain optimal age. Activity Theory Aging is dependent on the aging person's personalty type, the ability to adjust to stress, and on his or her social milieu remaining stable over the life span. People become more individual as they age. Therefore, the person's lifestyle and personality will be reflected in old age as it is in younger years. Continuity Theory Emphasizes the concept of motivation and human needs. One such theory is that Maslow's theory of basic needs. It is arranged in a hierarchy of physiologic needs, safety and security, love and belonging, self-esteem, and self-actualization. Persons move between the levels, and are always striving towards the higher needs. The older person should eventually become full self-actualized. Meaning fulfilled in self-creativity, relationships with friends, family, and society. Human Needs Theory A decline in physiologic capacities of functions that occur in an organism with the passage of time that eventually lead to death. It includes those changed that occur in any cell or organ system as a function of time, independent of any external or pathologic influences. Aging A pathologic or abnormal state found in any cell, organ, organ system in a unit of time or extending over many units of time. Resulting in a disturbance in function or structure of any part, organ, or system of the body. Disease Freezer temperature should be _________ Fahrenheit (within 3 degrees) 0 degrees Refrigerators should be between ______________ Fahrenheit (within 3 degrees) 41 degrees An exterminator should visit the facility every ____________ for effective and safe controls to minimize and eliminate the presence of rodents, roaches, and other vermin in the facility. 30 days

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. two If the air conditioner is down and the facility exceeds ____________ an evacuation is required. 88 degrees Any accident that results in death or the hospitalization of _______________ is considered to be a reportabled event with OSHA. 5 or more employees Reportable events to OSHA should be reported within ___________. 8 hours Reportable events to OSHA should retain records for ____________. 5 years MSDS stands for Materials Safety Data Sheet The dietitian shall spend an average of ___________ per resident each month providing dietary services in the facility. 15-20 minutes Dietary services personnel shall be present for a period of at least ___________ each day. 12 hours An average of ____________ of resident activities staff time per resident per week shall be devoted to resident activities. 45 minutes Resident activities shall be scheduled for ________ days each week. 7 There should be at least _________ resident activities during the evenings each week. 2 At least __________, a listing of all scheduled activities shall be posted in a conspicuous place in the facility. weekly standing out so as to be clearly visible

conspicuous The biggest expenses for an assisted living budget includes: Salaries, Raw Food, and Utilities/Supplies What are the three types of budgets? Operational Budget, Capital Budget, and Cash Budget 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. Accounting Liabilities + Equity = Assets Assets - Equity = Liabilities Assets - Liabilities = Equity This is the term associated with increasing assets, decreasing liabilities, and owner's equity, increasing expenditures and decreasing revenues. Debit The is term associated with decreasing assets, increasing liabilities and owner's equity, decreasing expenditures, and increasing revenues. Credit Revenue - Expenses = Profit divided by Loss This equation determines the financial of an organization. Net income/loss is equal to

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the difference of revenue and expenses. Net income or profit is then credited to ____________________, while a net loss is debited. Retained Earnings __________________ 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. Retained Earnings