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SMQT TEST STUDY GUIDE 2026 QUESTIONS
WITH COMPLETE SOLUTIONS
โ The TC must complete which tasks during offsite prep? Answer: Create/export shell from ACO Import shell into ASE-q Add team members Complete offsite prep screen Make unit assignments Make mandatory task assignments print documents Share offsite prep with team โ What documents are printed by the TC during offsite prep? Answer: 1 matrix with instructions 1 entrance conference worksheet 3 beneficiary worksheets โ What is the purpose of the initial pool process? Answer: To briefly screen all residents and observe, interview and complete initial record review.
โ When should you share data? Answer: At the end of each day and when the team composition changes. โ What must be done prior to Sample Selection Answer: The completed I.P data is shared and the TC confirms that the data is complete. โ What are the 7 LTSCP steps? Answer: 1. Offsite prep
- Facility entrance
- Initial Pool Process
- Sample Selction 5.Investigation
- Ongoing and other survey activities
- Potential Citations โ Name 3 antipsychotics Answer: Thorazine (chlorpromazine) Haldol (haloperidol) Abilify (aripiprazole) Clozaril (clozapine) Zyprexa (olanzapine) Latuda (lurasidone) Seroquel (quetiapine) Risperdal (risperidone) โ Indications of unnecessary medication include? Answer: Excessive dose excessive duration without adequate monitoring
โ What is Medication-induced Parkinsonism? Answer: Syndrome of symptoms like Parkinson's โ tremor Answer: shuffling gait, slowness of movement, expressionless face, drooling, postural unsteadiness and rigidity of muscles. โ What is dystonia? Answer: acute, painful, spastic contraction of muscle groups (commonly the neck, eyes and trunk) that often occurs soon after initiating treatment. โ What is Neuroleptic Malignant Syndrome (NMS)? Answer: Syndrome related to the use of antispychotics that presents with a sudden onset of diffuse muscle rigidity, high fever, labile blood pressure, tremor, and cognitive dysfunction. Potentially fatal if not treated immediatley, including stopping the offending medication. โ What is serotonin syndrome? Answer: Serious clinical condition resulting from overstimulation of serotonin receptors. Commonly related to the use of SSRI's, SNRI's, triptans, and antibiotics. Restlessness, hallucinations, confusion, loss of coordination, fast heartbeat, rapid changes in blood pressure, increased temperature, overactive reflexes, NV&D. 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 What is the survey process based on? Answer: Person centered care, resident centered outcomes, QOC and QOL. โ What are the components of a deficiency statement? Answer: 1. regulatory reference
- deficient practice statement 3.relevance facts and findings โ When should you export the survey shell from ACO? Answer: Export the shell as close to the survey as possible but no more than 5 business days before. โ When should you contact the RAI coordinator? Answer: If the number of residents is unreasonable after exporting the survey shell 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
โ How many residents does the system select for unnecessary medication review? Answer: 5 โ What should you ask for if Abuse is being investigated based on a history of abuse as noted on offsite prep screen? Answer: Ask facility for all allegations of abuse since the last survey. โ What should you consider when adding residents when the sample size is not met? Answer: Residents with the most concerns Residents with concerns R/T QOL and RR Residents selected for unnecessary med review prior survey and complaint results underrepresented areas of facility. โ What is investigated when more than 5 complaint/fri residents are added to the sample? Answer: You will only investigate for the allegation 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 When should you use "Resident Notes" Answer: when you have information about the resident you would like to have for all care areas โ What must you do prior to observing resident care? Answer: Have consent from the resident or resident rep., and facility nurse staff must be available during the observation. โ How should you determine who to interview? Answer: Use the critical element pathway โ What do you do if an interviewee says you cannot use the information they reveal? Answer: You cannot use the revelation but you can investigate the issue with other residents โ Can an interviewee's identity be revealed if the facility appeals a cited deficiency and the deficiency is baed on information from the interview? Answer: Yes โ What should be discussed at end of day 1 team meeting? Answer: Any newly identified harm or IJ concerns? 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
โ What is the psychosocial outcome grid? Answer: guide designed to identify each residents psychosocial response to noncompliance as the basis for determining psychosocial severity of a deficiency โ What is reasonable person concept? Answer: Used when a resident's psychosocial outcome may not be readily determined through the investigative process. The team should determine the severity of the psychosocial outcome that the deficient practice would have had on a reasonable person in a similar situation. โ 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) โ What does Widespread scope refer to? Answer: The entire population, not a subset, not a hall, but ALL 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
variety of residents, staff on different shifts and units Variety of routes (PO, SC, ophthalmic etc.) โ 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 โ How do you calculate med error rate Answer: number of errors /opportunities X 100 โ F 759 Answer: 5% or more medication error rate โ F760 Answer: Significant medication error โ What is a significant medication error? Answer: error which causes the resident discomfort or jeopardizes health and safety 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
