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SMQT COMPREHENSIVE TEST PAPER 2026
COMPLETE SOLUTIONS
โ What is Tardive dyskinesia. Answer: abnormal, recurrent, involuntary movements that typically present as lateral movements of the tongue or jaw, thrusting, chewing, frequent blinking, brow arching, grimacing, and lip smacking. May be irreversible โ Significant weight loss in 1 month. Answer: 5% weight loss โ Severe weight loss in 1 month. Answer: greater than 5% weight loss โ Significant weight loss in 3 months. Answer: 7.5% weight loss โ Severe weight loss is 3 months?. Answer: greater than 7.5% weight loss โ Significant weight loss in 6 months?. Answer: 10% weight loss โ What are signs and symptoms of digoxin toxicity?. Answer: anorexia, nausea ,vomiting, visual changes, cardia arrhythmia, low heart rate
โ When must a Gradual Dose reduction (GDR) occur?. Answer: Within the first year in which a resident is admitted or med is prescribed the facility must attempt a GDR in two separate quarters (with at least one month in between the attempts) unless clinically contraindicated. โ Severe weight loss in 6 months. Answer: greater than 10% weight loss โ When finalizing the sample. Answer: what do you do if other residents are marked FI for the complaint allegation care area?,sample 3 residents for the care area. โ What residents are system selected?. Answer: any offsite selected with at least one care area marked FI, any resident a surveyor marked as include in sample, any identified abuse concern from IP or history of abuse citation or allegation since last survey. โ What areas are reviewed for non-interviewable residents ?. Answer: Pressure ulcers, dialysis, infections, nutrition, falls in last 120 days, ADL decline, low risk B&B, unplanned hospitalization, elopement, change of condition in last 120 days.
โ Which residents are included in the survey shell?. Answer: 1. Offsite selected who make up 70% of the sample
- Residents with at least 1 MDS in the last 120 days
- Residents for closed record review โ What is the CASPER report?. Answer: Certification and Survey Provider Enhanced Reporting โ What items are required upon entrance. Answer: 1. Census excluding bed holds
- Matrix for new admits in the last 30 days
- Alphabetized list of resdients
- List of resident who smoke โ When screening residents. Answer: what other concerns should you pay attention to?,resident behavior, staff-resident interactions, resident grooming and cleanliness, strong urinary odors, evidence of abuse or neglect โ How many compliant/FRI residents are in the initial pool?. Answer: 5 residents โ What types of residents must you include in the initial pool?. Answer: 1. who smokes
2 dialysis 3.Hopsice
- Ventilator
- TBP โ What are the types of interview status?. Answer: 1. intervieable 2.Noninterviewable 3.Refused
- Unavailable
- Out of facility. โ What should you do if a resident halts the interview midway?. Answer: Attempt to complete later, if you can't, leave the rest blank, complete RO/RR then mark the resident as complete. โ What is the definition of Jeopardy?. Answer: A providers noncompliance has caused, or is likely to cause, serious injury, harm, impairment or death. โ What system provided information should be discussed at the end of Day 1 meeting?. Answer: 1. were any offsite selected residents d/c?
- Was each newly admitted resident listed on the matrix screened by a team member?
โ When finalizing the sample you must ensure that a surveyor is assigned to which residents?. Answer: every resident in the sample, additional complaint/fri residents, non sampled unnecessary medication review residents โ What are the 9 mandatory facility tasks. Answer: 1. Beneficiary Protection Notification review 2.Dining observation
- Infection control
- Kitchen
- Medication Administration
- Medication Storage
- QAA/QAPI
- Resident Council Meeting
- Sufficient and Competent Nurse Staff โ What 3 task are assigned to all surveyors?. Answer: Dining observation, infection control, sufficient and competent nurse staff. (One surveyor is assigned primary responsibility for completion of each task) โ Which facility tasks are triggered tasks?. Answer: Environment, Personal Funds, Resident Assessment
โ 483.24. Answer: Quality of Life- pertains to all care and services provided. Facilities must provide necessary care and services to attain or maintain highest practicable physical, mental, and psychosocial well being. โ 483.25. Answer: Quality of Care-facility must ensure residents receive care and treatment in accordance with professional standards of practice, person centered care and resident choice โ What is included on a baseline care plan?. Answer: Initial goals based on admission orders MD orders and dietary orders Therapy and social Services PASARR โ What is a PASARR. Answer: Pre-Admission Screening and Resident review - screening to ensure that the facility coordinates with the appropriate, State designated authority, to ensure that individuals with a mental disorder, intellectual disability or a related condition receive care and services in the most integrated setting appropriate to their needs. โ What pathway is used to investigate QOC concerns that have no pathway?. Answer: General CE pathway
Need to expand sample to r/o SQC? Status of information for complaint/FRI Pertinent findings Work left to complete Need to adjust workload Whether 3 resident rep interviews are done Concerns indicative of system failure โ What is the importance of record review?. Answer: Determine how negative outcomes are r/t the facilities failure to provide adequate care Determine if the facility has enabled the resident to reach their highest practicable level โ What is reviewed during the Infection Control task?. Answer: All surveyors observe for breaks in infection control throughout the survey. Assigned surveyor reviews IPCP, AB Stewardship, and the influenza/pneumococcal vaccination (5 residents), sample of 3 staff including at least 1 that was COVID 19 positive, and 3 residents for TBP(1 covid + or suspected) as well as screening, testing and reporting of COVID 19
โ What is reviewed for compliance with the Antibiotic Stewardship program?. Answer: 1. AB use protocol on prescribing
- Protocols to determine if AB is indicated
- A process for review of AB use by prescribers
- Protocols to ensure resident are prescribed the appropriate AB
- A system for feedback reports โ What are the factors in determining Noncompliance. Answer: 1. specific action or lack of action relative to requirement
- Practice the facility implemented or failed to implement
- what the facility did or di not do to cause the noncompliance
- The actual or potential outcome that resulted from the noncompliance. โ What factors should you consider in determining severity when harm has occured ?. Answer: Is the harm at the level of serious injury, impairment or death? did the resident experience a negative psychosocial outcome? how did the facility practice in question cause, contribute, or perpetuate the harm? โ What factors should you consider in determining severity when the is no actual harm?. Answer: how likely is it that a resident could suffer harm, impairment, death or compromise/deterioration?
โ How do you classify the severity when the evidence includes incidents of varying severity and cope?. Answer: Classify the deficiency at the highest level of severity.Ex. 1 resident severity level 3, there were widespread finding of same deficiency at severity level 2 - classify as severity level 3-scope isolated โ How do you determine SQC. Answer: Deficiency designated under CoP 1 or more def. that poses IJ A pattern of, or widespread def. at severity level 3 A widespread deficiency a severity level 2 (F,H,I,J,K, or L) โ What does the Beneficiary Protection Notice Review verify?. Answer: verify notification to resident when Med A ends- SNF-ABN and NOMNC verify the facility billed medicare within the required time frame after the resident requested a demand bill verify that the facility did not bill the resident while a decision was pending. โ What is the danger zone?. Answer: above 41degress or below 135 degrees
โ What are the 3 types of contamination. Answer: Biological, chemical, physical โ What is Critical Control Point (CCP). Answer: a specific point, procedure, or a step in food preparation and serving at which control can be exercised to reduce, eliminate, or prevent the possibility of a food safety hazard. Cooking ,cooling, holding, reheating โ What temperature should hot foods be held at?. Answer: 135 degrees or higher โ What temperature should cold foods be held at?. Answer: 41 degrees or lower โ What temperature should food be re-heated to?. Answer: 165 degrees for 15 seconds within 2 hours โ Should ABHS be used in food Service ?. Answer: No โ What is the purpose of medication administration observation?. Answer: Verify that the facility meets the requirements of error rate
โ What amount of money must be kept in an interest bearing account?. Answer: $ โ When must a facility notify a Medicaid resident of the amount of money in their account?. Answer: When the account reaches $200 of the eligibility limit. โ How can the software help determine the new admissions?. Answer: Any residents on the alphabetical list from the facility that are not in the software should be the admissions in the last 30 days โ When should QAPI/QAA task be completed?. Answer: At the end of the survey โ What should be discussed at End of Day meetings?. Answer: were offsite concerns validated? were new systemic concerns validated? has more than 1 surveyor identified and validated the same concern? Make a list of the concerns that facility should be aware of/. โ What does an Extended Survey further evaluate?. Answer: Physician services (483.30)
Nursing Services (483.35) Administration (483.70) QAPI (483.75) Infection Control (483.80) if applicable Training (483.95) if applicable Resident Assessment (483.20) if def. in QOC triggered โ What is universe. Answer: total number affected or at risk from deficient practice โ What area trigger an extended survey?. Answer: Residents rights
Abuse 483. QOL 483. QOC 483. Behavioral Health 483. Pharmacy 483. Administration 483. Infection Control 483. โ How many hours upon Oral or Written request does a facility have to provide clinical records excluding weekends and holidays. Answer: 24
โ Annual assessments must be done every. Answer: 12 months โ Review of assessments occur. Answer: every 3 months or quarterly โ Comprehensive care plan must be developed within how many days after completion of what. Answer: Within 7 days after completion of the MDS Assessment โ How often should a physician visit?. Answer: Every 30 days for 90 days and then every 60 days โ Timely MD visits occur. Answer: within 10 days after the visit was required โ MD services are required. Answer: 24/ โ Drug reviews occur. Answer: once a month โ CNA's should have how many hours of inservice training every year. Answer: 12 hours per year
โ QA committee members. Answer: DON, MD and 3 staff โ Clinical records are kept for how long. Answer: 5 years after discharge (3 years for a minor after discharge) โ QA meets every. Answer: 3 months or quarterly โ How many months of resident assessments must be kept in the residents chart?. Answer: 15 months โ What are narrow therapeutic drugs?. Answer: These are drugs where a level of the drug is measured in the blood. The level of the drug determines if it will work or not. โ What are some narrow therapeutic drugs. Answer: Digoxin, phenytoin, carbamazepine, theophylline โ For narrow therapeutic drugs when the drug level is too low what happens. Answer: Drug will not work โ For narrow therapeutic drugs when the drug level is too high what happens. Answer: Typically side effects occur like nausea, vomiting, dizziness
