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Federal Nursing Home Administrator Exam
1. 1) OBRA asserts some separate committees can be folded into the quality
improvement/assurance committee. Safety, Pharmacy and which committee below can be added into QA/QI committee?: Infection Control
2. 2) Nursing homes are responsible for obtaining and providing dental care for residents.
Who usually pays for dental services?: The resident or a family member
3. 3) A facility is not allowed to charge a resident who is Medicaid and Medicare eligible
except for:: Co-pays
4. 4) You calculate the average percent of occupancy by:: Dividing the total census (occupied bed days) by
the total number of days, then multiply by 100
5. 5) Resident's rights should be explained to the resident and or family mem- ber:: Prior to
admission
6. 6) In case of an emergency, when no attending or back up physician is available, the
decision as to who will attend to the resident is to be made by the:: Administrator
7. 7) Federal law states that facilities must retain menus of food actually served for at
least:: 30 days
8. 8) A resident with a living will and DPOA specified she wants to receive heroic measures
if necessary. Six months later the resident requires CPR, but is now incompetent and the son request CPR be withheld. What is the right thing to do?: Provide the CPR
9. 9) A resident asks to see his chart. The doctor tells the nurse not to allow the resident
access to the chart. What do you do?: Tell the doctor the law gives the resident the right to view the medical records
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10. 10) Medical records belong to:: Facility
11. 11) When a resident passes away, the personal funds deposited with the
facility must be given to the resident's estate with a final accounting of the funds within:: 30 days
12. 12) The suffix "algia" refers to:: Pain
13. 13) Physical restraints must be removed:: Every two hours
14. 14) Depression is one of many psychological changes related to the aging process.
Others include the following except for:: Hearing loss
15. 15) "Nosocomal" refers to: Infection occurring inside the facility (institutionalized)
16. 17) A capital budget is mostly about:: Equipment and real estate
17. 18) Current debts are debts that are:: Due within one year
18. 19) A ledger is a complete listing of:: Accounts payable and receivable
19. 20) Which resource usually provides the least revenue for a nursing home?-
: Insurance
20. 20) Past due accounts should not exceed:: 5%
21. 21) All of the following are a cash expense except:: Depreciation
22. 22) A pro forma is primarily: A financial statement or prediction
23. 23) A function of management is controlling, which means:: Measuring outcomes
against benchmarks, then responding
24. 24) OBRA requires every facility to have:: A governing body - The Omnibus Reconciliation Act
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41. 41) Of the following, the task management performs that contribute most
effectively and positively to morale is:: Discipline consistently and fairly
42. 42) In a bargaining unit, only need to sign a card to
call a union election:- : 30 percent
43. 44) During an interview or on a job application, you may ask for all except:-
: Place of Birth
44. 45) To be eligible for FMLA, an employee must first work: 1250 hours in the last 12
months
45. 46) If an employee works 52 hours in one week at a rate of $7 per hour, what
would be the total gross salary?: $
46. 47) Fire safety regulations come primarily from:: LSC Life Safety Code
47. 48) The purpose of an enunciator panel is to:: Indicate the zone of a fire
48. 49) Generators must be checked: monthly
49. 50) Employee's Right to know refers to: Hazardous communications
50. 51) The primary fire - defense tools of a nursing home staff are:: Smoke barriers, corridor
walls, and resident rooms
51. 52) A maintenance program that saves time and money focuses on:: Preventive
maintenance
52. 53) Class C fires involve:: Electricity
53. PHYSICAL ENVIRONMENT ANT ATMOSPHERE:
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54. 54) Indoor temperatures: 71 - 81 degrees ferinhight
55. 55) Disaster plans: OBRA requirement for written plan
56. 56) Life Safety Code: Reasonably ensure the public protection from fire in public buildings
57. 57) MSDS: Information on potentially hazardous material
58. 58) OSHA: federal agency overseeing employee safety
59. 59) NFPA: establishes LSC
60. 60) Personnal Protective Equipment: gloves
61. 61) Preventative measures: time for schedules repairs
62. 62) Offer HBV: within 10 working days
63. 63) Smoke compartments: 200 feet or less
64. 64) Occupant loads for exit requirements:: one person per 120 sq ft of floor area in sleeping areas and
one person per 240 sq ft in treatment areas
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76. 75) Construct Validity: Extent to which a tool measures a trait important to job performance
77. 76) Line management: Performs personnel functioned, delegated authority to make decisions
78. 77) Skill Analysis: identification of attributes required to
79. 78) Task Analysis: review of job description
80. 79) Employee Handbook: Policies related to work conditions
81. 80) Career Path: Avenues for upward mobility within organization
82. 81) Progressive Discipline: Use of specific number and type of warnings
83. 82) Job description: list of duties and responsibilities
84. 83) COLA: Group of temporary workers
85. 84) Election for unionization: Conducted by NLRB
86. 85) FLSA: minimum wage
87. 86) Halo Effect: One trait colors all performance
88. 87) In-Out migration: Movements of workers in and out of geographic area
89. 88) Pool: Group of temporary workers
90. 89) Labor Market: geographic area of recruitment
91. 90) Union election: NLRB conducts; 50% plus 1 potential bargaining unit members VOTING wins
92. LEADERSHIP AND MANAGEMENT (23% - 35 questions):
93. 91) Strategic Planning: setting long term goals
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94. 92) Case mix: residents categorized by acuity
95. 93) Governing body: legally responsible for management
96. 94) Tactical planning: selecting goals for one year
97. 95) Management: achieve common goals thru organization
98. 96) Market segment: potential users of services
99. 97) Payor mix: residents categorized by payment type
100. 98) Rules: commands for action or non-action
101. 99) Procedures: required methods for handling activities
102. 100) Risk management: proactive means of anticipating problems
103. 101) Staff authority: advisory relationship with line management
104. 102) Forecasting: projects trends and needs which facility management must decide in future economic, social and
political environment expected and resources available.
105. 103) Bench Marking: improve business by comparing with best practice of others
(standards from which you measure)
106. 104) Upper-Level management: responsible for the overall functioning of the facility, normally interacting
directly with the Board of Directors and/or owners.
107. 105) Middle-Level management: report to upper-level while interacting with lower-level (DON)
108. 106) Lower-level management: directly supervise the staff who do the actual work
109. 107) Line Position (Authority):: empowered by administrator to make decisions for organization (DON can
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114. 112) Burden of proof: obligation of person bringing action
115. 113) Liable: written defamation
116. 114) Slander: verbal defamation
117. 115) Malice: intentional doing of wrongful act
118. 115) Tort: a wrong: legal duty owed, breached, and harm occured
119. 116) Worker Comp:: responsible for injuries occurring at work
120. 117) Scope of Employment:: range of employee activities (resident services by omission or commis- sion)
121. 118) Governing:: exercise authority
122. 119) Advisory:: not binding
123. 120) Stewardship:: accumulation and use of assets
124. 121) Planning and monitoring:: goals and progress
125. 122) Determining Facility Objectives:: measurable, verifiable, and attainable
126. 123) Governing Body:: Approval of P & P
Approval of budget Selection and Appraisal of Administrator
127. FINANCE (14% - 21 questions):
128. 124) Accounting Equation: Assets = Liabilities + Capital
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129. 125) Accounts payable: Amounts owed by facility
130. 126) Balance Sheet: Statement showing solvency
131. 127) Solvency: the ability of a corporation to meet its long term fixed expenses and to accomplish long-term expansion
and growth
132. 128) General ledger: Summaries entries in each journal for accounting period
133. 129) Cost Center: Organizational unit whose costs are separately accumulated
134. 130) Accrual: Record revenue when entered; expenses when incurred
135. 131) Functional Accounting: Recording aggregated data for related activities
136. 132) Aggregated: formed by the conjunction or collection of particulars into a whole mass or sum; total; combined
137. 133) Contractual Discount: Uncollectible difference between charges and third party payor agree- ments
138. 134) Depreciation: spreading of cost of capital assets over useful life
139. 135) Operating Statement: total revenues - total expenses =net income (loss)138)
140. 136) Working Capital: Current assets - current liabilities
141. 137) Entity Concept:: The facility, its records and monies are separate from owners. Ensuring
consistency in accounting through full ownership disclosure.
142. 138) On-Going Concern:: The facility will continue to operate INDEFINITLEY
143. 139) Consistency:: The accounting reports will be prepared in the same way year to year to allow the facility to
compare history to determine risks, and allow for clarity
144. 140) Full Disclosure:: All information must be shown in financial records accurately reflecting the financial standing
of the facility
13 / 26 receipts, billing, accounts payable (purchases), cash disbursements, payroll, general.
156. 152) General:: non-repetitive entries. Used to make adjustments to conform to accrual system.
157. 153) Double entry:: two entries for each transaction DEBIT and CREDIT
158. 154) General Ledger:: summary of all debits and credits contained in all the journals for the time period.
1. Continuous balance for each account monthly
2. Basis for "trail balance"
159. 156) Financial Statement:: summary of all transactions made in a particular time period and their ettect on the
finances of the facility.
160. 157) Handling Cash: Two person procedure; one receives by opening mail or taking in person; the other prepares
bank deposit
161. 158) Collections: policy for delinquent bills. MUST BE CONSISTENT with all payment types; in not facility could be
charged with fraud.
162. 159) Payroll: largest expense (50-70% of operational) controlled by administration
separate bank account
163. 160) Residents' Accounts (Trust fund): Legally must provide Safe
for cash and valuables Separate accounting Interest Bearing - amounts over $50.
164. 161) Cost Per Patient Day =: Total cost/census days
165. RESIDENT CARE & QUALITY OF LIFE (35% - 52 questions):
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166. 162) Nursing Assistant Training: 75 hour course and exams plus continuing in service
167. 164) Excess Disability: Avoidable Dysfunction
168. 165) PASAAR: Insures appropriate treatment for MR/MI population
169. 166) Function: Focus of Rehab
170. 167) Pharmacist: Monthly drug review/Audits
171. 168) Basis for Menu: Basic 4 plus recommended daily allowances
172. 168) Nursing Assistants: Provide most direct care
173. 169) OBRA ^87: Conditions to participate in Medicare and Medicaid
174. 170) MDS: Comprehensive Assessment within 14 days of admission
175. 171) Physician Extenders: Nurse Practitioner, Clinical Nurse Specialist or Physician Assistant
176. 172) Licensed Nurse: Charge Nurse on each tour of duty
177. 173) Time between Super and Breakfast: 14 hours
178. 174) RN Coverage: 8 consecutive hours, 7 days per week
179. 175) Frequency of Activities: 7 days per week during hours requested
180. 176) Frequency of Doctor Visits: Every 30 days for first 90 days, then every 60 days
181. 177) Access to records: 24 hours of request
182. 178) Care Plans: 21 days after admissions
183. 179) Required in service for CENA: 12 hours per year
16 / 26 Meat: 4 oz Milk: 2 cups
199. 195) Quality Assurance Committee: DON, a physician, and 3 other staff members
A. Care plan
B. Infection Control
C. Pharmacy Committee
D. Safety Committee
200. 196) Administration: A. License
B. Compliance with standards and regulations
C. Governing body
D. Nurse Aide Training
E. Medical Director
F. Laboratory Services
G. Radiology Service
H. Clinical Services
I. Disaster Plan
J. Transfer Agreement
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K. Quality assurance
L. Disclosure
201. The most likely cause of for series of bankruptcies among larger nursing home
chains around the year 2000 was: Paying too much for acquisitions in 1998 and 1999
202. In a chance conversation with the owner of an eight-facility chain, the newly hired
administrator for the oldest facility in the chain indicates that, since the mortgage is fully retired, he will concentrate more on being effective then efficient since his Quality Indicators are all at or above his state's average. The owner would likely: Be distressed
203. Occupancy of Facility A has been a steady 70% since Prospective Payment System
was introduced. Two weeks ago, a new 120-bed equally equipped facili- ty opened several blocks away. The facility A administrator tells the admissions counselor to continue the usual recruitment approach. The chain owners ought to: Seek a new administrator
204. Bankruptcy among larger nursing home chains prior to 2000: Were highly unusual
205. Under the Prospective Payment System, nursing facilities reimbursed costs-
: Were never bundled
206. In recent years Medicare has: shifted more cost onto nursing facilities
207. The nurse newly promoted to director of nurses (DON) insist on giving four RN
hours of patient care each day on the Alzheimer's wing in the 175-bed facility. The administrator should: Seek a new DON
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215. The candidate for administrator said she used a variety of administrative styles,
but could't say exactly which she would use in every circumstance. The interviewer should be: favorable impress
216. The candidate for
administrator indicated that she consistently choose the charismatic style of leadership. This should the interviewer.: Alert
217. Th
e cost of providing subacute care to nursing home residents : Is perhaps triple that of more typical patient
218. The nurse supervisor who had just been appointed DON announced at the first
department head meeting that she had circulated a memo among the nurses that only formal communications were to be allowed in the nursing department. The administrator should: Anticipate problems
219. The department head was not surprised to learn that the employee had only
heard his positive comments to the employee and ignored his criticism. The department head's grasp of the communication process is: Appropriate
220. The administrator routinely accepted as his nearly exclusive information source
the director of nursing's positive reports on how nursing was going well. The administrator is: Placing him at risk
221. Periodic shortage of nurses available for nursing home employment
: Is likely to remain for the foreseeable future
222. Congress and the Federal rule makers behave as if the facility will run
successfully if congress and CMS can write enough rules. They are: Incorrect
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223. When the administrator notices the DON seeks to turn many duties as possible
over to housekeeping, the administrator should conclude that the DON is: Behaving normally
224. The administrator insist that a timely copy of all reports generated within the
facility come across her desk before anyone signs them. The administrator is : Not rationalizing her managemnt information system
225. The administrator notices that incident reports are being
insufficiently filled out, but does nothing, believing that the situation will likely correct itself. The administrator is : Failing to control ettectively
226. Corporate sends a directive its flagship facility administrator, directing the
administrator's attention more towards outcome of resident care than cost of resident care during the coming 12 months. Corporate is more concerned with than with .: Effectiveness/efficiency
227. The long term care sector receiving
increased funding and attention from the federal government is the .: Home health care sector
228. The concept that nursing homes should be
reimbursed by states for their actual costs was part of the : Hatch Amendment
229. The intense
health care cost-shifting efforts among providers such as Medicare, Medicaid and local governments is : Likely to continue
230. Worried about the level of actual resident care being achieved in the facility,
the administrator directs the nurses to spend less time charting and more time focusing on the effectiveness of care being given to residents. The likely result will be : Better resident care,
