Download SMQT EXAM SCRIPT 2026 PRACTICE SOLUTION BUNDLED and more Exams Nursing in PDF only on Docsity!
SMQT EXAM SCRIPT 2026 PRACTICE
SOLUTION BUNDLED
◉ What factors drive decisions on severity? Answer: residents condition whether staff followed P&P duration of event facility and staff response to the problem impact on the resident (condition after the event) ◉ What does Widespread scope refer to? Answer: The entire population, not a subset, not a hall, but ALL ◉ 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 ◉ 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) ◉ 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. ◉ What is 483.60 Answer: Kitchen-store, prep, distribute food under sanitary conditions to prevent food-born illness. F ◉ What is the danger zone? Answer: above 41degress or below 135 degrees ◉ What are the 3 types of contamination Answer: Biological, chemical, physical ◉ 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.
◉ What should a medication administration observation include? Answer: 25 opportunities variety of residents, staff on different shifts and units Variety of routes (PO, SC, ophthalmic etc.) ◉ What does a med observation assess for? Answer: MD orders- reconcile observed meds with the MD orders manufacturers specifications professional standards verify med expiration date ◉ How do you calculate med error rate Answer: number of errors /opportunities X 100 ◉ F 759 Answer: 5% or more medication error rate ◉ F760 Answer: Significant medication error ◉ What is a significant medication error? Answer: error which causes the resident discomfort or jeopardizes health and safety
◉ F 921 Answer: Safe, functional, sanitary environment-if triggered, no need to complete entire pathway-on complete applicable section ◉ Sections of Environmental Pathway? Answer: accommodation of need, call system, sound, temp, lighting, clean equipment in good repair, water temp, bed/bath linens clean-in good repair, pest control, ventilation, handrails, other concerns ◉ What is the square footage of a single room? Answer: 100 square feet ◉ What is the square footage of a multiple room? Answer: 80 square feet per resident ◉ What is a comfortable temperature? Answer: 71-81 degrees ◉ How should privacy curtains be hung? Answer: Must be hung from the ceiling and extend around the bed to provide total visual privacy. ◉ What is the window requirement for residents rooms? Answer: Must have an outside window or outside door in every sleeping room, sill height must not exceed 36 inches above the floor.
has more than 1 surveyor identified and validated the same concern? Make a list of the concerns that facility should be aware of/. ◉ 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 ◉ What is Extent? Answer: prevalence or frequency ◉ What is universe Answer: total number affected or at risk from deficient practice ◉ What is disputed in and IDR Answer: Provider can dispute factual accuracies with state agency ◉ What is disputed in an IDDR Answer: Provider can dispute with an entity separate from the state agency when CMPs are imposed
◉ What is a Formal Appeal? Answer: An appeal heard with Administrative Law Judge. Both sides use lawyers, it is adversarial. CMS and provider are subject to cross-examination. If either side is unsatisfied with results it can be appealed to the DAB (Departmental Appeals Board). ◉ What is Judicial Review Answer: A provider may request (CMS may not) if unsatisfied with DAB. ◉ During a formal appeal, does CMS have the responsibility of showing why the provider should have enforcement? Answer: Yes ◉ 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.
- bruises around the breast or genital area or suspicious injuries Answer: Failure to protect from abuse triggers? ◉ 1. lack of timely assessment of individuals after injury
- lack of supervision for individual with known special needs
- failure to carry out dr orders
- repeated occurrences such as falls which place the individual at risk of harm without intervention
- access to chemical and physical hazards by individuals who are at risk
- access to hot water of sufficient temperature to cause tissue injury
- non functioning call system without compensatory measures
- unsupervised smoking by an individual with a known safety risk
- lack of supervision of cognitively impaired individuals with known elopement risk
- failure to adequately monitor individuals with known severe self-injurious behavior
- failure to adequately monitor and intervene for serious medical/surgical conditions
- use of chemical./physical restraints without adequate monitoring
- improper feeding/positioning of individual with known aspiration ri Answer: Failure to prevent neglect triggers?
◉ 1. Application of chemical/physical restraints without clinical indication
- Presence of behaviors by staff such as threatening or demeaning resulting in displays of fear, unwillingness to communicate and recent or sudden changes in behavior by individuals
- Lack of interventions to prevent individuals from creating an environment of fear Answer: Failure to protect from psychological harm triggers? ◉ 1. Administration of medication to an individual with a known history of allergic reaction to that medication
- Lack of monitoring and identification of potential serious drug interaction, side effects, and adverse reactions
- Administration of contraindicated medications
- Pattern of repeated medication errors without intervention
- Lack of diabetic monitoring resulting or likely to result in serious hypoglycemia or hyperglycemic reaction
- Lack of timely and appropriate monitoring required for drug titration Answer: Failure to protect from undue adverse medication consequences and/or failure to provide medications as prescribed triggers ◉ 1. Food supply inadequate to meet the nutritional needs for the individual
- high number of serious blood reactions
- incorrect cross match
- lack of monitoring Answer: Failure to safely administer blood products and safely monitor organ transplantation triggers? ◉ 1. nonfunctioning or lack of emergency equipment and/or power source
- smoking in high risk areas
- incidents such as electrical shock, fires
- ungrounded/unsafe electrical equipment
- widespread lack of knowledge of emergency procedures by staff
- widespread infestation by insects/rodents
- lack of functioning ventilation, heating, or cooling system placing individuals at risk
- use of non-approved space heaters in resident or patient areas
- improper handling/disposal of hazardous materials, chemicals and waste
- locking exit doors in a manner that does not comply with NFPA 101
- obstructed hallways and exits preventing egress
- lack of maintenance of fire or life safety systems
- unsafe dietary practices resulting in high potential for food borne illnesses Answer: Failure to provide safety from fire, smoke
and environment hazards and/or failure to educate staff in handling emergency situations triggers? ◉ Answer: Failure to provide initial medical screening, stabilization of emergency medical conditions and safe transfer for individuals and women in active labor....not really applicable to the long term care side so I chose not to include it. ◉ a situation in which the providers noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident Answer: What is the definition of Immediate Jeopardy? ◉ the WILLFUL infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish Answer: What is the definition of abuse? ◉ failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness Answer: What is the definition of neglect? ◉ 1. only ONE INDIVIDUAL needs to be at risk
- SERIOUS HARM, INJURY, IMPAIRMENT, OR DEATH does NOT HAVE TO OCCURE BEFORE CONSIDERING immediate jeopardy. Requires HIGH potential for those outcomes.
- protection
- reporting/response Answer: Key components to prevent abuse and neglect? ◉ Entity compliance and noncompliance
- When an entity complies with the requirements applicable to the survey conducted, the form CMS-2567 should consist of an explicit statement that the entity is in compliance.
- If an entity does not comply with one or more applicable requirements, the form CMS-2567 includes corresponding citations of noncompliance Answer: Principles of Documentation # ◉ Using Plain Language
- The deficiency citation is written clearly, objectively and in a manner that is easily understood. Answer: Principles of Documentation # ◉ Components of a Deficiency Citation
- regulatory reference
- deficient practice statement
- relevant findings Answer: Principles of Documentation # ◉ Relevant onsite correction of findings
- if during the survey the entity corrects the situation that resulted in the deficiency, a determination of "not met" must be documented on the 2567. The entity may indicate its corrections in the right-hand column of the 2567. During IJ, if the facility initiates corrective actions that abate a finding for IJ, follow the guidance in appendix Q Answer: Principles of Documentation # ◉ Interpretive Guidance
- the deficiency citation explains how the entity fails to comply with the regulatory requirements, not the interpretation of those requirements. Answer: Principles of Documentation # ◉ Citation of State or Local Code Violations
- state code are not cited on the 2567 Answer: Principles of Documentation # ◉ Cross-References
- Cross referencing from one citation to another is acceptable, but each deficiency must stand by itself Answer: Principles of Documentation # ◉ Condition of Participation Deficiencies
- COP (requirements with which an entity must comply in order to participate in the programs) citation includes deficient practice statements and findings to support the determination of
- The needy elderly
- Blind
- Disabled individuals receiving cash assistance under the Supplemental Security Income Program
- Certain infants and low-income pregnant women
- At the option of the State, other low-income individuals with medical bills that qualify them as categorically or medically needy. Medicaid is a state program that provides medical services to clients of the state public assistance program and, at the State's option, other needy individuals. Medicaid also augments the hospital and nursing facility (NF) services mandated under Medicaid. States may decide on the amount, duration, and scope of additional services, except that care in institutions primarily for the care and treatment of mental health ◉ Clinical Laboratory Improvement Amendments (CLIA) Answer: Signed into law in 1988, CLIA regulations include federal standards applicable to all U.S. laboratory facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CDC, in partnership with the CMS and FDA, supports the CLIA program and clinical laboratory quality.
- The Centers for Disease Control & Prevention is responsible for the CLIA studies, convening the Clinical Laboratory Improvement Amendments Committee (CLIAC) & provides scientific & technical support to CMS.
- A laboratory is defined as any facility that performs laboratory testing on specimens derived from humans for the purpose of providing information for the diagnosis, prevention, treatment of disease, or impairment of, or assessment of health.
- CLIA covers approximately 175,000 laboratory entities.
- The Food & Drug Administration (FDA) is responsible for test categorization.
- The Divisi ◉ Title XVIII of the Social Security Act Answer: Title XVIII (18) established regulations for the Medicare program. The Chapter also provides insurance coverage for hospital, post-hospital, home health services, and hospice care for the aged and disabled. regardless of income or health status.
