Deck 10: Long-Term Care

Question 1

Who determines how long-term care facilities are reimbursed under the Medicaid program?

A) The individual state agency through state legislation
B) The individual state agency through state legislation.
C) The federal Medicaid Bureau
D) Congress

Answer 1

The individual state agency through state legislation

Question 2

Developed by an interdisciplinary team, the ________________________ includes measurable objectives and timetables to meet a resident's medical, nursing, mental, and psychosocial needs.

A) comprehensive resident assessment
B) case mix group
C) standard of care
D) care plan

Answer 2

care plan

Question 3

The ____________________________ (is/are) a core set of screening and assessment elements, including common definitions and coding categories forming the foundation of the comprehensive resident assessment of residents in long-term care facilities, such as skilled nursing facilities (SNFs).

A) care area assessment summary
B) standard survey elements
C) minimum data set
D) care plan

Answer 3

minimum data set

Question 4

Which of the following provide(s) structure for assessing social, medical, and psychological problems by providing a systemized method of reviewing key components of the minimum data set and directing caregivers to evaluate causes, interrelationships, and particular strengths that affect development of the care plan?

A) resource utilization guidelines
B) care area assessment process
C) federal survey requirements
D) risk contract assessment

Question 5

When a care area is triggered, the long-term care interdisciplinary team documents the outcome of the assessment process for that particular care area and ___________________.

A) the expected resource utilization group into which the resident's stay will fall
B) culture change issues to be addressed before the next OBRA assessment
C) their decision regarding care planning for a particular problem or need
D) a comprehensive assessment for each care area every 14 days.

Question 6

Medicare Part A coverage is limited in that a long-term care resident must first qualify with a minimum of a _____ hospital stay.

A) 100-day
B) 60-day
C) 300-day
D) 3-day

Question 7

The duration of skilled nursing facility Medicare Part A coverage is limited to the need for daily skilled care up to a maximum of _____ days per spell of illness.

A) 100
B) 30
C) 60
D) 3

Question 8

The resource utilization group (RUG) that applies to a given resident is based on __________________.

A) the principal and up to 10 additional diagnosis codes
B) all diagnosis codes and procedures codes
C) documentation of care areas triggered
D) the minimum data set

Question 9

The phrase private payin the long-term care setting denotes payment by _______________.

A) the individual or family
B) commercial insurance
C) Medicare or Medicaid
D) a managed care plan

Question 10

In long-term care, CPT codes are used most commonly to bill for:

A) Medicare Part A services
B) Medicare Part B services
C) Medicaid day care programs
D) Medicaid institutional services

Question 11

Which of the following is a facility in which the majority of patients are regarded as permanent residents?

A) hospital skilled nursing unit
B) skilled nursing facility
C) nursing facility
D) adult day care

Question 12

Which of the following would initiate a complaint investigation in response to a hotline call concerning alleged abuse or neglect?

A) Centers for Medicare & Medicaid Services
B) Federal Bureau of Investigation
C) The Joint Commission
D) state licensing agency

Question 13

According to federal regulations, the care plan should be completed within _______ of the comprehensive assessment.

A) 24 hours
B) 7 days
C) 30 days
D) 3 months

Question 14

An agreement between an HMO and CMS to provide services to Medicare beneficiaries under which the health plan receives a monthly payment for enrolled Medicare members and must then provide all services needed is called a(n) ____________________________.

A) resource utilization guarantee
B) enrollment agreement
C) capitation agreement
D) risk contract

Question 15

CMS provides free software for entering and transmitting MDS assessment data. This software is called ________________.

A) MDS calculator
B) RUG calculator
C) RAVEN
D) SNFware

Question 16

Standard surveys of long-term care facilities are unannounced and conducted at least every 15 months.

Question 17

Contracted providers, such as physical therapists, bill Medicare directly for their services to residents in a skilled nursing facility.

Question 18

Long-term care patients are commonly called residents.

Question 19

Most LTC facilities are accredited by The Joint Commission.

Question 20

Substantial noncompliance and substandard quality of care findings at a long-term care facility can result in fines of up to $10,000 per day.

Question 21

A care area may be triggered by data entered on the minimum data set (MDS) and if so, the interdisciplinary team must document the outcome of their assessment process for that care area.

Question 22

In long-term care facilities such as nursing facilities, records are generally audited for completeness only at the resident's death or discharge.

Question 23

Resource utilization groups (RUGs) comprise a case-mix methodology based solely on diagnosis and procedure codes submitted on Medicare bills.

Question 24

When the state agency receives notification of a complaint about a long-term care facility, the result is an investigation of the facility.

Question 25

The medical program for the indigent is called Medicare.

Question 26

​The __________________________________ is a form providing a location for documentation of the care area(s) that have triggered from the MDS and the decisions made during the assessment process regarding whether or not to proceed to care planning

Question 27

______________________________ are generated from specific resident responses for one or a combination of MDS elements and identify residents who have or are at risk for developing specific functional problems and require further assessment.​

Question 28

​_______________________________ are fines levied by the federal government against providers who are found to be in substantial noncompliance with federal regulations.

Question 29

Under Medicare's ________________ provisions, a skilled nursing facility is responsible for billing the entire package of care that residents receive during a stay, with certain specified exceptions such as physicians' professional services.​

Question 30

The _______________________________ is a person-centered philosophy that creates a more homelike environment for residents of a nursing facility by providing individuals with privacy and the ability to make choices similar to what they would experience were they living in their own homes.​

Question 31

​___________________________ are a schedule of assessments performed for a nursing facility resident at admission, quarterly, annually, whenever the resident experiences a significant change in status, and whenever the facility identifies a significant error in a prior assessment.

Question 32

​__________________________ is a transitional type of care that represents a level of service that is less intensive than traditional acute care but more goal oriented and resource intensive than what is generally regarded as skilled nursing care.

Question 33

Match each description with the correct item

- Ability to bathe, dress, groom, transfer and ambulate, toilet, eat, use speech, languages, etc.

A) Standard survey
B) Culture change movement
C) Activities of daily living
D) Care area triggers

Question 34

Match each description with the correct item

- Clinically relevant information about an individual that identifies specific problems and forms the basis for individual care planning

A) Standard survey
B) Culture change movement
C) Activities of daily living
D) Care area triggers

Question 35

Match each description with the correct item

- A periodic, resident-centered inspection that gathers information about the quality of service furnished in a facility to determine compliance with the requirements of participation in the Medicare and Medicaid programs

A) Standard survey
B) Culture change movement
C) Activities of daily living
D) Care area triggers

Question 36

Match each description with the correct item

- A person-centered philosophy that creates a more home-like environment for residents of a nursing facility

A) Standard survey
B) Culture change movement
C) Activities of daily living
D) Care area triggers

Question 37

Match each description with the correct item

- Residents who need constant oversight and supervision in activities of daily living

A) Respite care
B) Short-term patients
C) Permanent residents, special care
D) Permanent residents receiving nonskilled care
E) Permanent residents, skilled care

Question 38

Match each description with the correct item

- Designed to care for residents diagnosed with conditions such as Alzheimer's

A) Respite care
B) Short-term patients
C) Permanent residents, special care
D) Permanent residents receiving nonskilled care
E) Permanent residents, skilled care

Question 39

Match each description with the correct item

- Residents receive frequent skilled care from licensed professionals

A) Respite care
B) Short-term patients
C) Permanent residents, special care
D) Permanent residents receiving nonskilled care
E) Permanent residents, skilled care

Question 40

Match each description with the correct item

- Residents, length of stay is less than 100 days

A) Respite care
B) Short-term patients
C) Permanent residents, special care
D) Permanent residents receiving nonskilled care
E) Permanent residents, skilled care

Question 41

Match each description with the correct item

- Short stay to provide relief to primary caregivers of the frail elderly

A) Respite care
B) Short-term patients
C) Permanent residents, special care
D) Permanent residents receiving nonskilled care
E) Permanent residents, skilled care

Question 42

Match each description with the correct item

- Physical presence in the long-term care facility is limited

A) Registered nurses
B) Licensed practical nurses
C) Occupational therapists
D) Activities staff
E) Licensed physicians
F) Nursing assistants
G) Certified medication technicians
H) Social services

Question 43

Match each description with the correct item

- Coordinate long-term daily care and hold supervisory positions

A) Registered nurses
B) Licensed practical nurses
C) Occupational therapists
D) Activities staff
E) Licensed physicians
F) Nursing assistants
G) Certified medication technicians
H) Social services

Question 44

Match each description with the correct item

- Predominant licensed caregivers in the long-term care setting

A) Registered nurses
B) Licensed practical nurses
C) Occupational therapists
D) Activities staff
E) Licensed physicians
F) Nursing assistants
G) Certified medication technicians
H) Social services

Question 45

Match each description with the correct item

- Provide daily care needs to long-term care residents

A) Registered nurses
B) Licensed practical nurses
C) Occupational therapists
D) Activities staff
E) Licensed physicians
F) Nursing assistants
G) Certified medication technicians
H) Social services

Question 46

Match each description with the correct item

- In some states, can assume responsibilities to lessen the load of licensed nursing professionals.

A) Registered nurses
B) Licensed practical nurses
C) Occupational therapists
D) Activities staff
E) Licensed physicians
F) Nursing assistants
G) Certified medication technicians
H) Social services

Question 47

Match each description with the correct item

- Make arrangements for adaptive equipment, clothing, and financial assistance.

A) Registered nurses
B) Licensed practical nurses
C) Occupational therapists
D) Activities staff
E) Licensed physicians
F) Nursing assistants
G) Certified medication technicians
H)Social services

Question 48

Match each description with the correct item

- Responsible for assessing the therapeutic recreational needs and preferences of each resident and developing an individualized program.

A) Registered nurses
B) Licensed practical nurses
C) Occupational therapists
D) Activities staff
E) Licensed physicians
F) Nursing assistants
G) Certified medication technicians
H) Social services

Question 49

Match each description with the correct item

- Often independent contractors rather than employees

A) Registered nurses
B) Licensed practical nurses
C) Occupational therapists
D) Activities staff
E) Licensed physicians
F) Nursing assistants
G) Certified medication technicians
H) Social services

Question 50

​Describe respite care in the long-term care setting.

Question 51

During a standard survey for a long-term facility what does substandard quality of care mean?​

Question 52

List three items that should be included in a long-term care patient's care plan.?

Question 53

​Describe two circumstances in which a facility may transfer or discharge a resident involuntarily.

Question 54

List the three criteria for determining if a long-term resident has experienced a significant change in condition.?

Question 55

List three typical items on a long-term care audit form.?