Navigating the Complexities of Long-Term Care Facility Management, Exams of Leadership and Team Management

Download Navigating the Complexities of Long-Term Care Facility Management and more Exams Leadership and Team Management in PDF only on Docsity! NAB Exam with ANSWERS - Leadership & Strategy 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, because the mortgage is fully retired, the administrator will concentrate more on being effective than efficient since the quality indicators are all at or above the state's average. The owner would likely _____.A. Be pleasedB. Be distressedC. Be contentD. Praise the newly hired administrator - .......🔷ANSWERS🔷......✔✔ B. Be distressed. It is nearly always desirable to be efficient as well as effective. Under the Prospective Payment System (PPS), nursing facilities' reimbursed costs _____.A. Were about the same as previouslyB. Were more bundledC. Used an unbundled cost structureD. Were reimbursement for actual costs - .......🔷ANSWERS🔷......✔✔ B. Were more bundled. Medicare (and Medicaid) forced facilities to give more services for a single reimbursement rate than had been the case previously. PPS utilized an all-inclusiverate for Medicare Part A beneficiaries. In recent years, Medicare has _____.A. Allowed facilities to make a modest profitB. Shifted more costs onto nursing facilities C. Eased up on economic pressures previously placed on facilitiesD. Remained relatively unchanged in its reimbursement structure - .......🔷ANSWERS🔷......✔✔ B. Shifted more costs onto nursing facilities. Medicare, to cut its own costs, has required facilities to give more services under the Medicare reimbursement given. Both Prospective Payment System (PPS) and Patient Driven Payment Models (PDPMs) have utilized per diem or all-inclusive rates for reimbursement. The applicant for the administrator position in a facility near a large teaching hospital insists that, as before in his rural facility, if hired they would not let the Medicare reimbursement policies affect their case mix. This applicant _____.A. Should be hiredB. Is likely to succeed if hiredC. Can likely succeed in his goalD. Is out of touch - .......🔷ANSWERS🔷......✔✔ D. Is out of touch. Case mix in the typical rural facility is hard to manipulate and often predisposes the facility to accept all potential admissions. However, in the teaching hospital setting, the facility normally must maximize the number of Medicare rehabilitation residents to remain competitive and solvent. Monitoring and maximizing case mix today is a very important function of the administrator. The medical supplies provider tells the administrator of a facility that has not paid bills for the past three months but is now operating under a bankruptcy judge's approved plan for restructuring that no more deliveries will be made until past billsare fully paid. The medical supplies provider _____.A. Is smart to cut losses at that pointB. Does not understand how bankruptcy worksC. Will now likely get his past due bills paidD. Is farsighted - .......🔷ANSWERS🔷......✔✔ B. Does not understand how bankruptcy works. D. Placing themselves at risk - .......🔷ANSWERS🔷......✔✔ D. Placing themselves at risk. The administrator must get information from all levels of management to know what is going on. It is dangerous to rely solely on one person. Congress and the federal rule makers behave as if the facility will run successfully if Congress and the Centers for Medicare & Medicaid Services (CMS) can write enough rules. They are _____.A. IncorrectB. Correct, according to behavior theoryC. Pessimistic about the need for rulesD. Correct, according to emerging management theory - .......🔷ANSWERS🔷......✔✔ A. Incorrect. It is impossible and undesirable to try to write enough rules to make every facility function successfully. It is important to realize that not all facilities can run the same based on population, resident mix, niche of residents served, and many other factors. The administrator insists that a timely copy of all reports generated within the facility come across their desk before anyone signs them. The administrator is _____.A. Not rationalizing their management information systemB. Making appropriate and desirable requestsC. Exercising good judgmentD. Initiating an appropriate management information system - .......🔷ANSWERS🔷......✔✔ A. Not rationalizing their management information system. The administrator may have all reports made available to them but requiring that the administrator sees all reports before staff responsible for producing them signsoff on them would likely be dysfunctional for getting the facility's work done in a timely manner. Corporate sends a directive to its flagship facility administrator directing the administrator's attention more toward the outcome of resident care than the cost of resident care during the coming 12 months. Corporate is more concerned with _____ than with _____.A. Effectiveness/efficiencyB. Efficiency/effectivenessC. Expenses/inputsD. Expenses/throughput - .......🔷ANSWERS🔷......✔✔ A. Effectiveness/efficiency. Corporate wants that facility to have as nearly a deficiency-free inspection as possible and is willing to pay a little more for that year's performance to achieve this. 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 _____.A. Better resident care and possibly increased deficiency citationsB. Better resident care and decreased deficiency citationsC. No real improvement in resident care and decreased chartingD. Greater sensitivity to residents' needs and better documentation - .......🔷ANSWERS🔷......✔✔ A. Better resident care and possibly increased deficiencycitations. The residents may in fact get better care, but if it is not documented, the survey team has no real way to give credit for the care given. Give excellent care, but also document, document, document. Not documented, not done! The new social worker informs the head of nursing that admissions are all they have time for, and that nursing must monitor and document each resident's sociopsychological experiences. The new social worker is _____.A. Responding appropriately to prioritiesB. Achieving a better balance of assignments within the facility C. Responding inappropriatelyD. Likely to improve the case mix dramatically - .......🔷ANSWERS🔷......✔✔ C. Responding inappropriately. Current regulations should be reviewed with the social worker. Certain parts of theMinimum Data Set (MDS) are specifically the purview of the social worker, and they are expected to complete them. Today the twin forces of _____ and _____ are revolutionizing the delivery of healthcare.A. Technology/resident rightsB. Obamacare/resident data legislationC. New technology/best practices for careD. New inventions/rapid adoption of inventions - .......🔷ANSWERS🔷......✔✔ C. New technology/best practices for care. We are seeing new technologies presenting themselves almost daily to assist in resident care. The advent of shared best practices among providers has allowed fora much higher level of care to be provided in the facility. For the nursing facility setting, the new capacities to monitor residents' health offer dramatic new opportunities to improve _____. (Mark all that apply)A. Quality of lifeB. LongevityC. Infection control techniquesD. Chronic disease management - .......🔷ANSWERS🔷......✔✔ ALL OF THE ABOVE New technology coupled with best practices for care allow for the capacity to improve chronic disease management, quality of life, longevity, and other unique possibilities in the nursing facility. New legislation such as the _____ has allowed nursing facilities the ability to leverage new technologies and electronic health records to provide improved care. Giving every employee the space to innovate at least a little; listening to residents and acting on their ideas; and wandering around with residents, staff, and suppliers are examples of the difficult-to-achieve _____.A. Long-range goalsB. Short-range goalsC. Commonsense, obvious goalsD. Typical facility approach - .......🔷ANSWERS🔷......✔✔ C. Commonsense, obvious goals. Peter's management model discusses these items which are all part of the "blinding flash of the obvious"; however, we must realize that not all employees hold these skills. As administrators, we can help them reach this level. In a facility of 120 beds, the administrator _____ personally perform each of the management tasks.A. Need notB. ShouldC. Over a month willD. Over a year will - .......🔷ANSWERS🔷......✔✔ A. Need not. Whereas the administrator should be assigning the tasks in the facility, it is impossible for them to perform them all. The administrator must rely on middle- and lower-level managers to get this job done and to report any concerns they havein their abilities to carry out their own management tasks. A licensed person responsible for formulating and enforcing policies that will be applied to an entire facility is thought of as a(an) _____.A. Upper-level managerB. Senior administratorC. Board memberD. Owner - .......🔷ANSWERS🔷......✔✔ A. Upper-level manager. The administrator is upper-level management, and they are also the individual whois ultimately responsible for formulating policies that are applied to the entire facility. The staff person for whom both upward and downward communication skills are the MOST necessary is the _____.A. Staff development coordinatorB. Director of nursingC. Nursing supervisorD. Assistant administrator for personnel - .......🔷ANSWERS🔷......✔✔ B. Director of nursing. The director of nursing must be skilled in upward and downward communication, as they are responsible for reporting to upper-level management and for interacting with lower-level management. When the director of nursing makes an effective policy decision without consulting the administrator that impacts all nursing personnel, the administrator should _____.A. Be pleasedB. Nevertheless, be somewhat concernedC. Counsel with the director of nursing about chain of commandD. Begin the search for a new director of nursing - .......🔷ANSWERS🔷......✔✔ A. Be pleased. The administrator should expect a middle-level manager such as the director of nursing to make policies for managers reporting to them. However, a word of caution is necessary here. In today's regulatory environment, it is important for policy to be verified against regulations, which is a job that ultimately rests with the administrator. In the typical nursing facility, the decision-making process is _____ establishment oflower, middle, and upper levels of management.A. Noticeably more complicated than the simple B. Normally accomplished by theC. Successful if the ownership ensures effectiveD. Rendered relatively uncomplicated through - .......🔷ANSWERS🔷......✔✔ A. Noticeably more complicated than the simple. Today's facility is challenged with many regulations, constant change, and many outside stakeholders who have interest in the facility. The administrator must consider all the forces acting on the nursing facility to make decisions. Effective decisions often require the input of any stakeholder that they will impact. Decisions made by persons on the staff to whom the administrator has delegated line authority are, in the final analysis, regarded as decisions by _____.A. The ownersB. The board of directorsC. The administratorD. The department head holding such line authority - .......🔷ANSWERS🔷......✔✔ C. The administrator. Decisions by those who have been given line authority by the administrator hold the same weight as if the administrator made those decisions themselves. When a nurse practitioner (NP), who is more highly qualified than the director of nursing, gives orders to nurses in the hallways, the director of nursing should feel _____.A. ReaffirmedB. UnderminedC. That quality of care is being reinforcedD. That a useful support system is functioning - .......🔷ANSWERS🔷......✔✔ B. Undermined. The NP, usually a consultant in the facility, has only a staff position. The NP shouldonly be making decisions regarding the care of their residents. If the NP were to give direct orders to the staff, these employees would simply become confused and B. A high level of healthcare for all citizensC. More healthcare than any nation can affordD. Affordable healthcare for all - .......🔷ANSWERS🔷......✔✔ C. More healthcare than any nation can afford. Our technologic capabilities today far exceed what they did even 10 years ago. We can deal with very serious disease processes very quickly, as we learned with COVID-19. However, we have yet to "feel" the financial burden for providing such technologically advanced care yet. The staff in nursing facilities, over the next two decades, will likely _____.A. Experience culture shockB. Be reduced in staff/resident ratiosC. Become accustomed to a predictable core businessD. Remain committed to the facility, lowering turnover - .......🔷ANSWERS🔷......✔✔ A. Experience culture shock. The staff we hired years ago is much less adept than what we see coming from hospital nurses. Nursing facilities have typically been behind in technology by many years. However, today that hospital technology is expected for use in the nursing facility, which is having to rapidly change to meet the current needs of our residents and referral sources. This will invariably cause some culture shock among current nursing staff as they round the learning curve to update their knowledge. For the facility of today to survive, we will need to embrace _____ and _____.A. Old thinking/outdated knowledgeB. New ways of thinking/willingness to changeC. New thinking/slow changes to meet new requirementsD. Quick communications/reluctance to make changes - .......🔷ANSWERS🔷......✔✔ B.New ways of thinking/willingness to change. Survival for the facility today requires new ways of thinking, behaving, motivating, and communicating. Survival also requires the ability and willingness to change. Plans can be said to be statements of the _____.A. Hopes of the administratorB. Hopes of the ownershipC. Prediction of the next steps neededD. Organizational goals of the facility - .......🔷ANSWERS🔷......✔✔ D. Organizational goals of the facility. Plans allow us to provide an integrated decision system that establishes the framework for facility activities. Plans are statements of the organizational goals ofthe facility. A major advantage associated with carefully developed plans is making it possible to _____.A. Control the futureB. Not repeat past mistakesC. Compare what happens to what was predictedD. Compare what happens to past experiences - .......🔷ANSWERS🔷......✔✔ C. Compare what happens to what was predicted. Plans allow for a prediction basis for facility decision makers to cope with the future. Carefully developed plans make it possible to compare what happens to what was expected to happen. This allows for quality improvement and a means to improve operations where necessary. When external conditions change, plans _____.A. Should remain in placeB. Can be altered to meet the changed conditionsC. Should be monitored, but not radically alteredD. Are of decreased value - .......🔷ANSWERS🔷......✔✔ B. Can be altered to meet the changed conditions. The only thing we can guarantee in the industry is change. When external conditions change, our plans need to change to meet the new conditions and changing requirements. The observation about the idea that "if it ain't broke, don't fix it" is _____.A. That this is functionally valuable conventional wisdomB. That if it ain't broke today, it will be tomorrowC. That too few managers understand this good adviceD. That this is a solid insight one can depend upon - .......🔷ANSWERS🔷......✔✔ B. That if it ain't broke today, it will be tomorrow. Change happens so quickly in nursing facilities that what is acceptable and correctone day might not be the next. As such, it is easy to see that just because something is correct today, it might not be tomorrow, when regulations or requirements change. The approach to planning known as SWOT refers to focusing on _____.A. Strengths, weaknesses, occupancy level, and threatsB. Strategies, weaknesses, opportunities, and threatsC. Strengths, weaknesses, opportunities, and threatsD. Statistics, work options, opportunities, and trends - .......🔷ANSWERS🔷......✔✔ C. Strengths, weaknesses, opportunities, and threats. SWOT refers to strengths, weaknesses, opportunities, and threats. This is widely used in business for many purposes, including planning, marketing, and many others. In general, government purposes and the facility goal of providing high-quality care are _____.A. Diverging in recent yearsB. The sameC. DifferentD. Difficult to assess meaningfully - .......🔷ANSWERS🔷......✔✔ B. The same. C. An industry standardD. A way to seek out opportunities and act upon them - .......🔷ANSWERS🔷......✔✔ B. A mistake. Administrators who are not engaged in their community do not understand what is happening within it. They cannot be innovative or knowledgeable; thus, not going into the community is a mistake. When one accepts the idea that change is a permanent part of life, _____.A. Life becomes more uncontrollableB. Life becomes less comfortableC. Uncertainty proliferatesD. One can take advantage of new opportunities - .......🔷ANSWERS🔷......✔✔ D. One can take advantage of new opportunities. When we embrace change, we can much more clearly see opportunities which mayexist for us both in our careers and in our facilities. Organizing is the first step in implementation of a(an) _____.A. Challenge to the workersB. PlanC. Organizational chartD. Organizational reorganization - .......🔷ANSWERS🔷......✔✔ B. Plan. Organizing is the first step in the implementation of a plan. It is the process of translating plans into combinations of money, materials, and people. What the worker does, how the worker does it, what aids are necessary, what is accomplished, and what skills are needed are parts of a _____.A. Job familyB. Job reviewC. Needs assessment D. Job analysis - .......🔷ANSWERS🔷......✔✔ D. Job analysis. Job analysis is where an administrator studies a job, its importance to other jobs, the qualifications for a job, and the conditions under which the job is performed. It can be argued that all nursing facility administrators organize their facility according to _____.A. Local requirementsB. The owners' needsC. Some theory of organizationD. The same theory of organization - .......🔷ANSWERS🔷......✔✔ C. Some theory of organization. The administrator generally applies some theory of organization to their facility. This assists in their behaviors and their daily decision-making. An organized or complex whole, an assembling or combining of things or parts forming a complex or single whole, best describes the _____.A. Systems conceptB. Organizational theory conceptC. Complexity conceptD. Organizational chart concept - .......🔷ANSWERS🔷......✔✔ A. Systems concept. A system is defined as an organized or complex whole, an assembling or combiningof things or parts forming a complex or single whole. A primary advantage of systems theory is that it serves as a tool for making sense of the world by making clearer _____.A. How people interactB. Interrelationships within and outside the organizationC. Interrelationships among the staff D. Interactions between staff and residents and their responsible parties - .......🔷ANSWERS🔷......✔✔ B. Interrelationships within and outside the organization. Systems theory is a tool for making sense out of our world by clarifying the organization's interrelationships. The administrator uses systems theory to determine the relationship between the facility and the larger outside community. In essence, what nursing facilities do is use money to hire staff and provide materials needed to _____.A. Give resident careB. Show profitabilityC. Achieve conformity to regulationsD. Meet owner requirements - .......🔷ANSWERS🔷......✔✔ A. Give resident care. Inputs consist of money, people, and materials. We utilize these inputs to provide outputs. One of the most important outputs is resident care. The resident care that is given by the facility (i.e., the output) _____.A. Is usually goodB. Can range from good to unacceptableC. Achieved cures for the residentsD. Meets federal and state requirements - .......🔷ANSWERS🔷......✔✔ B. Can range from good to unacceptable. The work that facilities do (caring for residents) is an output. This output can range from good to bad when it comes to resident care. The function of surveyors is to ensure that only good care is occurring. The administrator uses _____ as the guidelines to compare the output with the expected results.A. The facility's policies and plans of actionB. Goals Typically, the output of the nursing facility as a system becomes the input for _____.A. Psychiatric hospitalsB. Managed care organizationsC. Health maintenance organizationsD. Home health or hospice agencies - .......🔷ANSWERS🔷......✔✔ D. Home health or hospice agencies. Each system has an output that needs to be plugged in elsewhere. The output of the hospital is the nursing facility, the output of the nursing facility is home health,and so forth. The entropy process is considered a universal law of nature that all organisms _____.A. Can grow indefinitelyB. Move toward deathC. Can expandD. Can expand if more inputs are available - .......🔷ANSWERS🔷......✔✔ B. Move toward death. The entropic process is a universal law of nature that all organisms move toward death. As a general characteristic of organizations, it has been argued that, in general, organizations seek to _____.A. GrowB. Maintain their current sizeC. Shrink as neededD. Be flexible in adapting to change - .......🔷ANSWERS🔷......✔✔ A. Grow. Organizations tend to grow with time. Organizations tend to maximize the ratio of imported to expended energy; thus, they can continue to grow. Once in place, organizations become creatures of habit and develop a tendency to _____ change.A. EmbraceB. ResistC. Build onD. Create - .......🔷ANSWERS🔷......✔✔ B. Resist. Organizations become creatures of habit and develop a tendency to resist change. This can be referred to as an "organizational hardening of the arteries." The MOST predictable response of a nursing facility experiencing a "disruptive employee" is to _____.A. Hold an in-serviceB. Counsel with the employeeC. Let the employee goD. Contact the Equal Employment Opportunity Commission (EEOC) and ask for action - .......🔷ANSWERS🔷......✔✔ C. Let the employee go. When a facility is faced with internal or external situations that force change, it can become countered by employees looking to retain their old patterns and modesof operation. A typical (not necessarily appropriate) response would be for the facility to terminate the employment relationship. When a nursing facility chain goes from being the leader to being behind the pack, this can likely be attributed to _____.A. Bullheadedness of top managementB. OverconfidenceC. Lack of enthusiasmD. A deep reservoir of outmoded attitudes and policies - .......🔷ANSWERS🔷......✔✔ D. A deep reservoir of outmoded attitudes and policies. Nursing facilities and chains can fall from leadership to trailing the pack. Productivity studies attribute this to "a deep reservoir of outmoded attitudes and policies." The real purpose of systems thinking is to _____.A. Empower people to introduce organizational changeB. Ensure that the current adjustments remainC. Tutor employees in how the organization is arrangedD. Achieve conformity to the organizational chart - .......🔷ANSWERS🔷......✔✔ A. Empower people to introduce organizational change. The purpose of systems is to empower, not control people. It is to liberate staff to experiment with new ways to meet resident needs, not to tie them down. Staffing is hiring the _____ person for the right job in an organization.A. Most qualifiedB. LicensedC. Best interviewedD. Right - .......🔷ANSWERS🔷......✔✔ D. Right. Staffing is hiring the right person for the right job in an organization. There are an indefinite number of variables to consider when pursuing a hiring action. The success of the nursing facility depends upon adequate _____. Today, this includes meeting specific mandates and regulations to meet resident needs.A. StaffingB. ManagingC. DirectingD. Policy making - .......🔷ANSWERS🔷......✔✔ A. Staffing. D. Director of nursing's - .......🔷ANSWERS🔷......✔✔ C. Administrator's. The nursing facility administrator is expected to make decisions ethically. Ethical practices throughout the facility are the administrator's responsibility, especially among all caregiving staff. Organizations that thrive over an extended period depend on having _____.A. Large profit marginsB. Charismatic leadershipC. Consistent leadershipD. Effective leaders - .......🔷ANSWERS🔷......✔✔ D. Effective leaders. Organizations that thrive over an extended period depend upon influential leaders. These are persons who have foresight combined with an ability to guide the organization to take advantage of the opportunities the future offers. Compared to defining the concept deciding, defining the concept leading is _____.A. Less difficultB. More difficultC. Just as difficultD. Researched and understood - .......🔷ANSWERS🔷......✔✔ C. Just as difficult. Just as a satisfactory description of deciding is elusive, so is a sufficient descriptionof leading. Democratic, authoritarian, and laissez-faire are _____.A. Types of leadership stylesB. Outmoded models for today's leadersC. Discounted todayD. Types of political positions - .......🔷ANSWERS🔷......✔✔ A. Types of leadership styles. There are various leadership styles, which include democratic, authoritarian, and laissez-faire. A supervising staff member whom the administrator might MOST want to provide leadership by walking around (LBWA) is the _____.A. ReceptionistB. Charge nurseC. Director of nursingD. Director of housekeeping - .......🔷ANSWERS🔷......✔✔ C. Director of nursing. LBWA expects the administrator to walk around and observe things in the facility, such as staff interactions with residents, quality of care, and other potential concerns. This information collected by the administrator becomes actionable when presented to the director of nursing for their attention and correction. An effective administrator does NOT overrule middle-level managers UNLESS _____.A. They personally disagreeB. Harm could resultC. Management has specifically addressed that situationD. Rules are not being fully observed - .......🔷ANSWERS🔷......✔✔ B. Harm could result. The job of the administrator is to empower the middle-level manager to make appropriate decisions for the facility. The effective administrator does not overrule the middle-level manager unless harm could result from the decision being made. The best time for the administrator to introduce change in the facility is when _____.A. Everyone is ready for itB. It is clear to all that the situation demands itC. It will improve the bottom line D. They do not have to - .......🔷ANSWERS🔷......✔✔ D. They do not have to. The best time to introduce change is when none needs to happen. Business as usual is no longer possible in the industry. It is necessary to develop the capacity to implement change as an ongoing basis of managing a facility. For every successful decision the administrator makes, _____.A. The administrator is praisedB. Recognition comes from those affectedC. They may experience two or three wipeoutsD. Ownership is grateful - .......🔷ANSWERS🔷......✔✔ C. They may experience two or three wipeouts. No administrator makes the right decision every time. For every successful decision an administrator makes, they can likely expect two or three wipeouts. One reason for the administrator NOT to give all their attention to the most immediate opportunity is that _____.A. Corporate is unlikely to approveB. Change costs too much energyC. Better opportunities may also existD. It may not be what it seems - .......🔷ANSWERS🔷......✔✔ C. Better opportunities may also exist. It is important to pay attention to the most immediate opportunity, but it is more important to pay attention to what is coming as well. If one does not consider the future by focusing on only the present, they can potentially miss better opportunities that exist. The best time to begin a move toward introducing a change into a facility is when _____.A. Change is still on the horizonB. Change is imminent Operational use of existing structure is the responsibility of _____ management.A. Upper-levelB. Middle-levelC. Lower-levelD. Functional - .......🔷ANSWERS🔷......✔✔ B. Middle-level. The middle-level manager is responsible for implementing the administration's policies by devising ways to put them into action within the facility. This level of management translates the broader institutional policies by developing more specific ones to control employee behavior. The acts of the _____ leader are typically unexamined.A. AcceptedB. VeneratedC. CharismaticD. Fully established - .......🔷ANSWERS🔷......✔✔ C. Charismatic. The acts of charismatic leaders are typically unexamined. Their followers do not scrutinize their actions as they would those of their immediate supervisors. A valuable goal for each administrator is to deliver short-term results while securing _____.A. New friendsB. High-level supportC. Long-term viabilityD. Medium-term goals - .......🔷ANSWERS🔷......✔✔ C. Long-term viability. In times of crisis and change, when people are confused about what to do, ordinaryleadership must rise to the level of strategic leadership. The trick is to deliver short-term results while securing long-term viability. When one can motivate someone to do something they would not otherwise do, oneis said to be wielding _____.A. Undue influenceB. Self-controlC. PowerD. Excessive influence - .......🔷ANSWERS🔷......✔✔ C. Power. Power is the ability to control the behavior of others. A person has power when they can make other people do what they want them to. The administrator's ability to award or withhold a year-end bonus represents _____ power held by the administrator.A. PunishmentB. OverarchingC. FinancialD. Reward - .......🔷ANSWERS🔷......✔✔ D. Reward. Administrators are given reward power to induce or persuade employees or residents to do what the administrator asks. If the administrator has the authority to award or withhold a year-end bonus, they have reward power. Fear that the administrator may write a negative report and place it in one's personnel file represents the administrator's _____ power.A. ExpertB. PersonnelC. ControllingD. Punishment - .......🔷ANSWERS🔷......✔✔ D. Punishment. The employee believes that a manager has the ability (and inclination) to punish unacceptable behaviors. The ultimate punishment power is firing an employee, but there are many intermediate or less drastic means. Use of punishment power is usually a last resort, after other types of power have failed. Two types of power available to all staff members are _____.A. Legitimate and rewardB. Punishment and rewardC. Referent and rewardD. Expert and referent - .......🔷ANSWERS🔷......✔✔ D. Expert and referent. Expert and referent power are available to all members of the staff. Referent power depends on personal and group characteristics and is conferred by peers in the organization. Peer influence is often more readily accepted than influence fromsuperiors. Generally, it is better if an administrator can possess and exercise _____ power.A. Expert and referentB. Charismatic and punishmentC. Expert and punishmentD. Legitimate and punishment - .......🔷ANSWERS🔷......✔✔ A. Expert and referent. It is important to note that expert and referent power, as present in the facility, adds to the power of organizationally given rewards and punishments because the organization cannot confer expert and referent power. Promoting referent power isa more robust action than giving power based on rewards and punishments. Communication is the exchange of information and the transmission of _____.A. MeaningB. Memos of documentationC. FaxesD. Internet messages - .......🔷ANSWERS🔷......✔✔ A. Meaning. Communication is the exchange of information and the transmission of meaning. The closer one gets to the organization center of control, the administrator's office,for example, the _____.A. More pronounced the emphasis is on the exchange of informationB. Less important constant information exchange becomesC. Less necessary written reports becomeD. More comfortably the administrator can operate - .......🔷ANSWERS🔷......✔✔ A. More pronounced the emphasis is on the exchange of information. Communicating is at the heart of the management process. The closer a person gets to the organizational center of control, the more pronounced the emphasis is on exchanging information. The charge nurse who remembers the words of praise from the director of nursing but ignores the criticisms also received from the director of nursing illustrates a barrier to communication known as _____.A. Selective hearingB. Subgroup allegianceC. Status distanceD. Agenda carrying - .......🔷ANSWERS🔷......✔✔ A. Selective hearing. Individuals tend to listen to what they want or expect to hear, thereby filtering out the unpleasant and receiving only selective messages. This is known as selective hearing, a barrier to communication. A nurse assistant realizes that another nurse assistant is sleeping much of the night shift but decides not to report them. This illustrates _____.A. Differences in knowledge levelB. Subgroup allegianceC. Status distanceD. The filter effect - .......🔷ANSWERS🔷......✔✔ B. Subgroup allegiance. In subgroup allegiance, each one of the subgroups in the organization demands allegiance from its members. Within each group, tangible and intangible rewards are given, so communication is interpreted within each subgroup's goals and needsrather than from the viewpoint of the organization. The medication nurse thought they understood what the pharmacist had just said about the side effects of a medication, but found the technical jargon used by the pharmacist to be intimidating. This illustrates _____.A. Differences in knowledge levelB. The language barrierC. Status distanceD. The filter effect - .......🔷ANSWERS🔷......✔✔ B. The language barrier. Doctors and nurses speak "medicalese." Pharmacists speak another language entirely. If one employee does not understand what is being said or is intimidated by what is being communicated to them by others, this illustrates the language barrier. The charge nurse decided not to write up an incident on their shift because four incidents had already been written up that week on the shift. This illustrates _____.A. Differences in knowledge levelB. Subgroup allegianceC. Self-protectionD. The filter effect - .......🔷ANSWERS🔷......✔✔ C. Self-protection. Persons often fail to communicate information that might reflect poorly on them, their friends, or the organization. This illustrates self-protection as a barrier to communication. One of the impediments to accomplishing loyalty to facility goals is that the facility can never count on any individual employee's _____.A. Undivided attentionB. Personal tastes C. DemandsD. Reasonable expectations - .......🔷ANSWERS🔷......✔✔ A. Undivided attention. Administering a nursing facility is a complicated process. One of the impediments to developing loyalty to facility goals is that the organization can never count on the individual employee's undivided attention. This division of attention is called partial inclusion or the segmental involvement of people in the job role. Dignity has been interpreted by states' examiners _____.A. With wide variationsB. Fairly consistentlyC. Differently depending on the section of the countryD. With excellent consistency - .......🔷ANSWERS🔷......✔✔ A. With wide variations. As with many regulations, there are wide variations of interpretation of them despite interpretive guidelines. Norms are justified by _____, which are more generalized statements about behavior expected from staff members.A. AttitudesB. Attempts to connect C. employeesValuesD. Organizational ideas - .......🔷ANSWERS🔷......✔✔ C. Values. Norms are justified by values, which are more generalized statements about the behavior expected from staff members. Values furnish the rationale for the normative requirements. Treating all residents with respect is best described as a _____.A. RoleB. NormC. Value A. With full informationB. By the well-qualified nurseC. At the lowest level possibleD. At the middle-level of management - .......🔷ANSWERS🔷......✔✔ C. At the lowest level possible. The concept of delegation is permitting decisions to be made at the lowest possiblelevel. Such authority is given to middle-level and lower-level managers, allowing them to make decisions for the organization as appropriate. How people relate to each other in the organization and the overall style or feel of an organization are referred to as _____.A. Corporate meaningB. The value systemC. The corporate cultureD. The personnel handbook mission statement - .......🔷ANSWERS🔷......✔✔ C. The corporate culture. Corporate culture is the overall style or atmosphere of a facility. The corporate culture governs how people relate to each other in the organization. When the board of directors gives equal authority to manage the facility to the medical director and the administrator, the board has ignored the _____ concept.A. Short chain of commandB. UtilityC. DelegationD. Unity of command - .......🔷ANSWERS🔷......✔✔ D. Unity of command. Unity of command is accountability to only ONE supervisor. This case outlines accountability to TWO different individuals, which would cause confusion and delay in the facility. The principle that there should be as few levels of management between the chief administrator and the rank and file as possible is the _____.A. Short chain of commandB. Intervening levelsC. Effective middle levels of managersD. Maximum use of managers - .......🔷ANSWERS🔷......✔✔ A. Short chain of command. Short chain of command asserts that there should be limited management levels between the chief administrator and the rank and file. It minimizes communication and the potential for misunderstanding. The administrator who pays attention to the size of the various departments, centralization and decentralization, span of control, and short chain of command is paying attention to _____.A. Being a good managerB. Being effectiveC. The concept of balanceD. What is occurring in the facility - .......🔷ANSWERS🔷......✔✔ C. The concept of balance. Advocates for the principle of balance assert that there must be harmony between size of departments, standardization of procedures, centralization and decentralization services, span of control, and short chain of command. Continual surveillance is necessary to maintain balance among all these concerns. The administrator who begins with the nursing assistants' ideas then moves upward through the director of nursing's ideas and does so for each department is utilizing the concept of _____.A. Management information systemsB. Lowest to highestC. Respect for the individual workerD. Management by objectives - .......🔷ANSWERS🔷......✔✔ D. Management by objectives. Management by objectives meaningfully involves the lowest level employees and managers in recommending organizational goals to shift power upward. This is an excellent example of a way to include stakeholders in administrative decision-making. The administrator tells the admissions director to drop the daily reporting and to report only on days the census drops below 90%. The administrator is utilizing the _____ concept.A. Program Evaluation and Review Technique (PERT)/Critical Path Method (CPM)B. DelegationC. Management by objectivesD. Management by exception - .......🔷ANSWERS🔷......✔✔ D. Management by exception. Management by exception is the practice of examining operational results for the facility and only bringing issues to the attention of the administrator when they represent substantial differences from what is budgeted or expected. Mapping out time estimates for the completion of each step in renovating a wing isusing _____.Program Evaluation and Review Technique A. (PERT)/Critical Path Method (CPM)B. DelegationC. Management by objectivesD. Management by exception - .......🔷ANSWERS🔷......✔✔ A. Program Evaluation andReview Technique (PERT)/Critical Path Method (CPM). PERT or CPM are project management concepts. These tools can show the relationship among activities that make up a project. Activities can be mapped out with time estimates for completion of necessary steps, which is a critical path to facilitating resource allocation in the facility. The federal government is increasingly establishing clinical practice guidelines for caregiving in the nursing facility setting. These clinical practice guidelines represent what is believed to be best practices in caregiving. Examples of such guidelines are checklists and the INTERACT tools. Translating goals into clearly stated policies, identifying appropriate measures, and stating limits to deviation are some of the requirements for _____.A. Improving managementB. Effective control of qualityC. Getting ahead of competitorsD. Managing for results - .......🔷ANSWERS🔷......✔✔ B. Effective control of quality. There are nine conditions that must be met for effective control of quality to be observed: translate goals into policies and plans of action; identify appropriate measurements; set limits to deviations from the goals of plans of action; disseminate information to appropriate staff in useful form; take management action when limits are exceeded or quality is not achieved; take corrective actions utilize systematic evaluation and renewal of control measures; ensure managementsupports functional and valued quality control mechanisms so they remain effective; and keep limitations of the scope and capabilities of the quality control system in mind. Getting information in a useful form to staff at appropriate levels, stating policies of actions to be taken when limits are exceeded, and taking corrective actions are some of the requirements for _____.A. Improving managementB. Effective control of qualityC. Getting ahead of competitorsD. Managing for results - .......🔷ANSWERS🔷......✔✔ B. Effective control of quality. There are nine conditions which must be met for effective control of quality to be observed: translate goals into policies and plans of action; identify appropriate measurements; set limits to deviations from the goals of plans of action; disseminate information to appropriate staff in useful form; management action must be taken when limits are exceeded or quality is not achieved; corrective actions must be taken; systematic evaluation and renewal of control measures; functional and valued quality control mechanisms must be supported by management to remain effective; and keep limitations of the scope and capabilitiesof the quality control system in mind. Physicians diagnose and treat resident illnesses; administrators diagnose and treat_____ illnesses.A. StaffB. CorporateC. OrganizationalD. Epidemic - .......🔷ANSWERS🔷......✔✔ C. Organizational. Physicians diagnose and treat resident illness much like administrators diagnose and treat organizational illness or organizational pathologies. Administrators are organizational diagnosticians who manage the nursing facility by using judgments based on their interpretation of presenting organizational symptoms. When an administrator studies and determines what is believed to be a problem adversely affecting the nursing facility, the administrator is engaged in a study of _____.A. Human natureB. What motivates employeesC. Organizational pathologyD. Organizational attitudes - .......🔷ANSWERS🔷......✔✔ C. Organizational pathology. Organizational pathology is the study and diagnosis of what is believed to be a problem adversely affecting the nursing facility. Managers have always sought to achieve quality control in their organizations and _____.A. Clear successes have been attained across the boardB. The need for such control is a subject of controversyC. This remains an elusive aspect of managing D. This is largely a thing of the past since the turn of the century - .......🔷ANSWERS🔷......✔✔ C. This remains an elusive aspect of managing. Managers have always sought to achieve quality control in their organizations, but this remains one of the more elusive aspects of successful management. Ensuring that all the organizational arrangements believed to be needed are in place puts the emphasis on _____ as a quality measure.A. StructureB. ProcessC. OutcomeD. Productivity - .......🔷ANSWERS🔷......✔✔ B. Process. Inspecting for process ensures that all the organizational arrangements to accomplish the required work are in place. This set of processes is what the systems model describes as the processor. Focusing on the results of the effort made and the measurable impact on resident care places the emphasis on _____ as a quality measure.A. StructureB. ProcessC. OutcomeD. Productivity - .......🔷ANSWERS🔷......✔✔ C. Outcome. The outcome is the result of the efforts made, measured by impacts on the nursing facility resident. Outcome focuses on measuring whether residents enjoy a high quality of life, fully enjoy the residents rights established by Congress, and receive high-quality nursing and medical care. Quality, argued Deming, comes from _____.A. Constant inspectionsB. A low rework rate A. Can rarelyB. CanC. Never isD. Always can - .......🔷ANSWERS🔷......✔✔ B. Can. Benchmarking studies other corporations' very best practices and seeks any better practices as sufficient to justify a benchmarking effort. When Deming warned not to simply copy others' efforts when benchmarking, he was advocating _____.A. A new approach to benchmarkingB. Less benchmarkingC. Improved benchmarkingD. Adapting, rather than copying, benchmarked ideas - .......🔷ANSWERS🔷......✔✔ D. Adapting, rather than copying, benchmarked ideas. Deming warned that it is a hazard to copy blindly. He believed in adapting over adopting and that understanding the theory behind the benchmarked process is more likely to lead to successful extrapolation. The approach in total quality of management of placing responsibility with the workers who produce a service is sometimes known as _____.Source managementOutsourcingQuality at the sourceWorker involvement - .......🔷ANSWERS🔷......✔✔ C. Quality at the source. To achieve total quality, responsibility for high-level service or products lies with the producing workers. This worker commitment is called quality at the source. Employee empowerment in decision-making, use of teams, and use of individual responsibility for services characterizes _____. A. Management by qualityB. Resource maximizationC. Total quality managementD. Benchmarking - .......🔷ANSWERS🔷......✔✔ .C. Total quality management. Employee empowerment in decision-making, the use of teams in the organization, individual responsibility for services, and customer service are characteristics of most total quality management effort services The role of innovator is _____.A. Best assigned to the administratorB. Available to all employeesC. A skill employees can developD. Best taught in in-services - .......🔷ANSWERS🔷......✔✔ B. Available to all employees. The manager is not necessarily the innovator but does have the task of ensuring that innovation occurs within the organization. To best achieve this goal, the manager should encourage interdisciplinary development of the change, including stimulating others to develop innovations. One writer suggests that managers should _____ specific objectives that will guide the organization over an extended period.A. Avoid trying to set out too manyB. EncourageC. AssignD. Insist on - .......🔷ANSWERS🔷......✔✔ A. Avoid trying to set out too many. The effective manager has difficulty setting specific long-term objectives because the external environment changes continually, and organizational strategies must constantly adapt. Innovation can be expected _____.A. From all levels in a nursing facility chainB. Primarily from upper-level managementC. Primarily from ownershipD. From middle-level well-trained staff who can update their skills - .......🔷ANSWERS🔷......✔✔ A. From all levels in a nursing facility chain. Innovation requires constant awareness of the environment, and to be innovative isto respond flexibly to these changes. Not all innovations work but continuing to promote staff suggestions and accountability will continue to produce new innovations from all levels Google's Android and Apple's iOS have facilitated unprecedented development of _____.A. CommunicationB. AppsC. SoftwareD. Future possibilities - .......🔷ANSWERS🔷......✔✔ B. Apps. Google and Apple have facilitated the unprecedented development of apps affecting not only medicine and science but also finance, energy, retail, transportation, and everyday life Due to new technologies, healthcare provided by nursing facilities will be increasingly _____.A. Uni-levelB. MultilayeredC. Error proneD. Totally comprehensive - .......🔷ANSWERS🔷......✔✔ B. Multilayered. Facilities are getting to the point of multiple technologies being able to provide care for the same thing. This level of redundancy, or multilayering, will continue with new innovations in healthcare, pushing our care to a new level. A marketing strategy includes selecting a target market or markets. A concern with niche marketing is that finding a niche must be done carefully. Niches are often _____ in practice.A. Easy to identifyB. Difficult to put togetherC. Opposed by ownershipD. Cost prohibitive - .......🔷ANSWERS🔷......✔✔ D. Cost prohibitive.Niches that may be a great idea might also be cost prohibitive in practice. Many niche markets have reimbursements that are lower than the cost of service. MOST facilities choose a _____, which is the set of all product lines and items the facility intends to offer.A. Product mixB. Market segmentC. Market mixD. Niche - .......🔷ANSWERS🔷......✔✔ C. Market mix. Most facilities choose a market mix, which is the set of all product lines and items the facility intends to offer. Services cannot be touched, sat in, or driven like a car; thus, the services we offer in nursing facilities are _____.A. InconsistentB. InseparableC. InventoryD. Intangible - .......🔷ANSWERS🔷......✔✔ D. Intangible. Services cannot be touched, sat in, or driven like a car; thus, the services we offer in nursing facilities are intangible. Potential residents cannot directly experience the healthcare they will receive before entering the facility. The steps of problem recognition, information search, alternative evaluation, purchase decision, and post-purchase evaluation are, in marketing texts, identified as the steps in _____.A. Consumer decision-makingB. Facility market segmentation decisionsC. Healthcare marketing practicesD. Government rule making - .......🔷ANSWERS🔷......✔✔ A. Consumer decision-making. Consumer decision-making is characterized by problem recognition, information search, alternative evaluation, purchase decision, and post-purchase evaluation. Factors such as general appearance of the facility, absence of odors, and the appearance of the residents may be those factors about which the decision maker may not be consciously aware while visiting a facility into which to place a relative.These are referred to as _____ factors.A. KeyB. SpecialC. UsualD. Subliminal - .......🔷ANSWERS🔷......✔✔ D. Subliminal. Subliminal perceptions are factors the decision maker is not consciously aware of, such as the facility's general appearance, absence of odors, friendliness of staff, and appearance of residents Cognitive readiness, affective readiness, and behavioral readiness are _____.A. Elements of a complex marketing theoryB. The steps in marketingC. The goals of advertisingD. Often not cost effective - .......🔷ANSWERS🔷......✔✔ C. The goals of advertising. The purpose of advertising is to motivate the target audience to move through the three buyer readiness states (cognitive, affective, and behavioral advertising) toward the actual use of facility services Which staff should normally talk to the press?A. The marketing personB. The administratorC. Only the ownerD. Any qualified and knowledgeable persons - .......🔷ANSWERS🔷......✔✔ B. The administrator. Good relations with the local news outlets will benefit the facility in inevitable times of crisis. Policies must be established as to what staff members may give press interviews. Generally, all staff are required to refer press persons to the administrator _____ prohibit(s) the exchange or offer of exchange of anything in value to induce the referral of business which is reimbursable by federal health programs.A. Stark lawsB. Fair use doctrinesC. Federal anti-kickback statutes (AKS)D. The Affordable Care Act - .......🔷ANSWERS🔷......✔✔ C. Federal anti-kickback statutes (AKS). The federal AKS prohibit the exchange or offer of exchange of anything of value to induce (or reward) the referral of business which is reimbursable by federal healthcare programs. Examples of such kickbacks include financial incentives for referrals, free or low rent office space, excessive compensation for medical directorships, waiving co-payments, questionable cost sharing by hospice companies, and a myriad of other considerations