Deck 5: Dialysis

Question 1

Dialysis is a procedure necessary to maintain the life of a person whose liver has failed.

Answer 1

False

Question 2

ESRD networks treat patients by providing hemodialysis services.

Answer 2

False

Question 3

Dialysis patients see the following caregivers at regular intervals: physicians, nurses, soci al workers, and dietitians.

Answer 3

True

Question 4

A freestanding dialysis facility that is accredited by The Joint Commission is deemed to meet federal requirements and does not have to be surveyed by the state.

Question 5

Peritoneal dialysis uses the patient's thoracic cavity to filter out wastes

Question 6

Each dialysis patient is assigned to a primary care provider who alone is responsible for the performing a comprehensive assessment and developing a plan of care.

Question 7

The Forum of ESRD Networks has developed a medical record model outlining recommended practices for medical record documentation in ESRD facilities.

Question 8

A person with end-stage renal disease can become eligible for Medicare on the basis of the ESRD diagnosis.

Question 9

In general, dialysis facilities have been slow to adopt electronic health records.

Question 10

One of the major responsibilities of an ESRD network is to evaluate and resolve patient grievances.

Question 11

The retention period for clinical information on dialysis patients, according to federal statute, is ten years.

Question 12

Both dialysis and kidney transplant are forms of renal replacement therapy (RRT).

Question 13

The Kidney Disease Outcomes Quality Initiative (KDOQI) includes the development of clinical practice guidelines; CMS has incorporated some of the outcome measures from these guidelines into their clinical performance measures projects.

Question 14

Patients who have kidney transplants generally have lower survival rates, a poorer quality of life, and higher overall medical costs than patients on dialysis.

Question 15

In ___________, the patient's blood circulates outside his or her body through an artificial kidney that removes metabolic wastes and helps to maintain homeostasis.

A) artificial renal function
B) hemodialysis
C) CAPD
D) CCPD

Question 16

In health care facilities that accept Medicare patients, a(n) __________ survey would be the only type of survey conducted by a regional office of the Centers for Medicare and Medicaid Services.

A) routine
B) accreditation
C) validation
D) licensure

Question 17

Which of the following has a contract with CMS to assess the quality of care rendered to ESRD patients?

A) ESRD network
B) transplantation surgeon
C) National Committee for Quality Assurance (NCQA)
D) Accreditation Association for Ambulatory Health Care (AAAHC)

Question 18

Although not the preferred clinical term, irreversible stage 5 chronic kidney disease is denoted by the term _______________ in many federal publications.

A) dialysate dependence
B) BUN depression
C) CAPD
D) ESRD

Question 19

Select the best answer or combination of answers: Renal replacement therapy (RRT) includes ______________.

A) peritoneal dialysis
B) hemodialysis
C) kidney transplant
D) a and b, but not c
E) a, b, and c

Question 20

Select the best answer or combination of answers: A dialysis facility is an entity that _________________.

A) provides outpatient maintenance dialysis services
B) provides home dialysis training and support services
C) performs kidney transplants
D) a and b, but not c
E) a, b, and c

Question 21

Which dialysis modality is the most prevalent in the United States?

A) in-center hemodialysis
B) home hemodialysis
C) continuous ambulatory peritoneal dialysis
D) continuous cycling peritoneal dialysis

Question 22

In ______________________________ the patient is able to perform his or her own dialysis almost anywhere because very little special equipment is required and the patient dialyzes three or four times a day at home or at work.

A) hemodialysis
B) self-hemodialysis
C) continuous cycling peritoneal dialysis (CCPD)
D) continuous ambulatory peritoneal dialysis (CAPD)

Question 23

Which of the following types of caregivers would be most likely to see the in-center dialysis patient at every treatment?

A) social worker
B) dietitian
C) physician
D) dialysis technicia

Question 24

The Conditions of Coverage require that each dialysis facility implement a data-driven performance improvement program that utilizes indicators or performance measures associated with improved health outcomes and with the identification and reduction of medical errors. This program is known as_______________________________ .

A) Clinical Performance Measures (CPM) Project
B) Renal Management Information System (REMIS)
C) Quality Assessment and Performance Improvement (QAPI)
D) Consolidated Renal Operations in a Web-enabled Network (CROWNWeb)

Question 25

Which of the following is a document prepared by the interdisciplinary team that evaluates the patient in at least thirteen required areas?

A) Patient assessment
B) Plan of care
C) Interdisciplinary progress notes
D) Clinical performance measures

Question 26

Unstable dialysis patients should be reassessed by the interdisciplinary team at least ________.

A) daily
B) weekly
C) monthly
D) annually

Question 27

The timeline for completion of the comprehensive patient assessment and initial implementation of the plan of care is within _____________________.

A) 10 calendar days after admission to the dialysis facility or 4 outpatient hemodialysis sessions
B) 30 calendar days after admission to the dialysis facility or 13 outpatient hemodialysis sessions
C) 90 calendar days after admission to the dialysis facility or 37 outpatient hemodialysis sessions
D) 180 calendar days after admission to the dialysis facility or 75 outpatient hemodialysis sessions

Question 28

Federal regulations explicitly state that the patient or designee must sign one of the following documents or the document should explain the reason that the signature was not provided. To which of the following documents does this regulation apply?

A) history and physical
B) discharge summary
C) progress notes
D) plan of care

Question 29

The fundamental payment in Medicare's reimbursement system for dialysis facilities is made on a _______________.

A) per diem basis
B) per treatment basis
C) monthly capitation basis
D) diagnosis related group basis

Question 30

Which of the following is NOT a case-­mix adjustment factor in Medicare's prospective payment system for dialysis facilities for dialysis facilities?

A) body surface area
B) body mass index
C) procedures
D) age

Question 31

Which of the following applies with regard to co-morbidity adjustments in the Medicare prospective payment system for dialysis facilities?

A) There are only a few (less than 20) categories of conditions that qualify as co-morbidities.
B) There are a significant number (over 100) of categories of conditions that qualify as co-morbidities.
C) There are numerous (more than 1,000) categories of conditions that qualify a co-morbidities.
D) There are no co-morbidity adjustments in the Medicare prospective payment system for dialysis facilities.

Question 32

When a dialysis patient is transferred to another facility, federal regulations require that all requested medical record information be transmitted to the receiving facility within __________.

A) one working day
B) five working days
C) two weeks
D) one month

Question 33

The best source of data on kidney transplants is available from the ______________.

A) CROWNWeb reporting system
B) Forum of ESRD Networks
C) Centers for Disease Control
D) United Network for Organ Sharing

Question 34

One effect that the quality incentive program could have on Medicare payments to dialysis facilities is that ______________________.

A) payments to high-performing facilities may be increased by as much as 5%
B) payments to facilities that do not meet performance standards may be reduced by as much as 2%
C) payments to facilities significantly below performance standards may be denied
D) all of the above

Question 35

_____________________ is a gradual loss of kidney function classified into five stages, with mild loss of kidney function in the early stages and severe or total loss in the later stages.​

Question 36

The _____________________ is an ongoing project of CMS implemented through the ESRD networks to measure and report the quality of renal dialysis services provided under the Medicare program.

Question 37

__________________________________ is an Internet-based software application from CMS and is the required method by which dialysis facilities submit data about patients and facility operations.​

Question 38

_____________________________ is a form of peritoneal dialysis in which the patient is able to dialyze herself three or four times per day without special assistance and a minimum amount of equipment.​

Question 39

___________________________________ is a form of peritoneal dialysis in which the patient uses a cycler machine to dialyze once a day for nine or ten hours, generally while sleeping.​

Question 40

_____________________ is a solution used to filter products across a semipermeable membrane by the process of diffusion.​

Question 41

________________ is the process of artificially removing metabolic end products and water across a semipermeable membrane by diffusion.​

Question 42

A(n) ____________________________ stimulates the bone marrow to make red blood cells and is used to treat and prevent anemia, a common complication of chronic kidney disease in patients on dialysis.​

Question 43

Organizations that have contracted with the Centers for Medicare and Medicaid Services (CMS) to assess the quality of care rendered to ESRD patients and to collect and analyze ESRD data are known as _________________.​

Question 44

________________________ is a calculated value that serves as a means of measuring the adequacy of dialysis (i.e., a way to determine whether the patient is dialyzing long enough or often enough to remove sufficient waste and excess fluid from the body).​

Question 45

__________________________ is the process of cleansing the blood as it circulates through an artificial kidney machine outside the patient's body.​

Question 46

____________________________ is a type of dialysis in which the patient's abdominal cavity is filled with a solution (dialysate), and the semipermeable membrane across which the products diffuse is the patient's own peritoneal membrane. The fluid containing the wastes is later withdrawn from the peritoneal cavity.​

Question 47

_____________________________ is any treatment that replaces kidney function. The treatment may be some type of dialysis or it may be kidney transplantation.​

Question 48

A survey conducted by a regional office of the CMS to determine whether the surveys being conducted by state agencies (or other groups) are appropriately assessing the facility's operations is known as a _______________________________.​

Question 49

With regard to frequency of reassessment, stable dialysis patients must be reassessed at least ________________.​

Question 50

Describe the difference between continuous ambulatory dialysis and continuous cycling peritoneal dialysis?

Question 51

Describe any three of the thirteen items that a dialysis record comprehensive assessment should include according to federal regulations.?

Question 52

?Describe three of the eight items a dialysis plan of care must include according to federal regulation.

Question 53

Describe what requirements must be met for a person with ESRD to be eligible for Medicare coverage.​

Question 54

Describe what a Quality Assessment and Performance Improvement (QAPI) Program should include.​