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NAB Study Questions
NAB Study Questions
109
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11/23/2011
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Term
Was the Social Security Act the primary stimulus for the development of the Nursing Home Industry?
 Definition
True
Term
What was the original purpose of the Social Security Act?
 Definition
To provide a supplemental retirement income for working people and their dependents. Also, to provide Old Age Assistance (OAA), a form of public assistance to the needy who were age 65 or older and lived in the community.
Term
What year was the term "Nursing Home" coined?
 Definition
1936
Term
Were Nursing Homes federally regulated during the 1930's - 40's?
 Definition
No. By the late 40's many states had begun to regulate these facilities and there were many nursing home associations.
Term
The 1950 amendment to the Social Security Act gave what to the Nursing Home industry?
 Definition
Momentum
Term
The 1950 amendments to the SSA required states to establish a ______________ or ___________ for Nursing Homes. This gave official status nationwide to Nursing Homes or facilities providing long term care.
 Definition
Standard Setting or Licensing Agency
Term
The 1960 Kerr-Mills Act expanded their program by providing funds for what purpose?
 Definition
By providing funds for medical care of the aged.
Term
The 1960 Kerr-Mills act program required a _________ to ensure that funds went only to the health care of the needy.
 Definition
means test
Term
In 1965 the SSA was amended to establish ________ and __________; which is considered the biggest breakthrough for SSA.
 Definition
Medicare and Medicaid
Term
In 1965, the Medicare and Medicaid programs were assigned to the ________________.
 Definition
Health Care Finance Administration department of the U.S. Department of Health and Human Services.
Term
In 2001, Health Care Finance Administration was renamed _________________.
 Definition
The Centers for Medicare and Medicaid Services (CMS)
Term
CMS determines eligibility for ____________.
 Definition
Medicare
Term
_________ is essentially an insurance program for the elderly.
 Definition
Medicare.
Term
How is Medicare administered?
 Definition
By CMS, with assistance from the states.
Term
CMS determines eligibility, handles the funds, and certifies facilities and indiciduals who serve as ______________.
 Definition
providers of service
Term
The state surveys _____________ facilities to determine compliance with federal/state standards.
 Definition
Medicare
Term
_________ is a program that provides health care to the medically indigent.
 Definition
Medicaid
Term
________ involves a "means" test to determine that  __________ services only go to the qualified needy populuation.
 Definition
Medicaid
Term
_______ is primarily operated by the state which handles the funds, licenses, and certifies facilities for compliance with federal/state standards.
 Definition
Medicaid
Term
All standard of _______ are first approved by ______.
 Definition
Medicaid; CMS
Term
What were the last two major stimuli for nursing home industry development?
 Definition
Medicare; Medicaid
Term
Is it true that the 1950 amendments to SSA required states to establish a standard-setting or licensing agency, so each state up an official State Medicaid Agency.
 Definition
Yes. Federal/State standards were establishe to license several types of nursing facilities.
Term
________ identified a nursing facility which met state licensing standard to provide, on a regular basis, health related care and services to indiciduals who do not require hospital or SNF care, but whoe mental or physical condition requires services above the level of room and board and that can be provided only by and institution.
 Definition
Intermediate Care Facility (ICF)
Term
Efficective Oct. 1 of 1990, OBRA changed the name of the ICF to ____________.
 Definition
Nursing Facility (NF)
Term
The Omnibus Budget Reconciliation Act of 1987 (OBRA) is also referred to as ____________.
 Definition
the Nursing Home Reform Act.
Term
___________ is a nursing home that provides 24 hr/day skilled nursing services which cannot be provided in a facility other than a hospital.
 Definition
Skilled Nursing Facility (SNF)
Term
________ is a facility whose primary purpose is to provide health and rehabilitative services for mentally retarded indiciduals or persons with realted conditions, using a plan of care that includes professionally developed and supervised activities, experiences, or therapies. 
 Definition
Intermediate Care Facility - Mentally Retarded
Term
The objective of the services offered in an _____ is to maintain the optimal physical, intellectual, social, and/or vocational level at which the individual is presently or porentially capable of functioning.
 Definition
ICF/MR
Term
Hospitals that developed nursing beds that were licensed as a SNF and/or NF and have a nursing home license separate from the hospital's license are called ____.
 Definition
Free Standing
Term
The state Medicaid agency conducts a certification survey of ____________ facilities using essentially the same standards as for Medicaid.
 Definition
Medicare
Term
Some Hospitals developed nursing beds that were a distinct part of the hospital, required to meet all federal/state standards, but were licensed under the hospital's license.
 Definition
True. This is called DISTINCT PART.
Term
Hospitals operating fewer than 100 beds could have a limited number of beds certified for use as acute or LTC beds. These are called _________.
 Definition
Swing Beds
Term
A ___________ Nursing Facility is one not certified for nor participating in Medicare or Medicaid.
 Definition
Nonparticipating
Term
Do Nonparticipating facilities accept only private pay or insurance cases?
 Definition
Yes
Term
_____ does the certification and assigns the provider number of facilities.
 Definition
CMS
Term
The __________ must be used by the facility in all correspondence, billing and other operational actions.
 Definition
Provider Number
Term
No funds are ever distributed unless the ________ is included.
 Definition
Provider Number
Term
The building of any participating nursing home and any major renovation must have prior approval of the _____________________ and usually the State Fire Marshall.
 Definition
state Medicaid agency
Term
Congress amended the SSA in _________ to include Section 1122. It allowed the federal government to withhold Medicare and Medicaid funds from a hospital, nursing home or other health care facility if prior approval was not obtained from the official state health planning agency.
 Definition
1972
Term
The ___________________ sought to put into one package all of the federal government's interests in health care matters.
 Definition
Planning and Resource Development Act
Term
The Planning and Resource Development Act of 1975 required each state to set up a ______________. 
 Definition
State Health Planning and Development Agency
Term
What does SHPDA stand for?
 Definition
State Health Planning and Development Agency
Term
The _____________ developed a "State Health Plan" guideline for reviewing the need for additional facilities based on population and health care facility statistics.
 Definition
SHPDA
Term
The primary purpose of ____________ and the State Health Plan was to prevent the overbuilding of health care facilities and the duplication of highly specialized, expensive equipment.
 Definition
Section 1122 of SSA
Term
Referred to as the state health plan and approved by CMS, each state may establish its own ___________ and set its own standards on new construction eligible for Medicare and Medicaid.
 Definition
needs review program
Term
Under the section 1122 agreement of SSA, as a measure of control, unapproved facilities could not participate in _______ or _________.
 Definition
Medicare or Medicaid
Term
In October 1987, the federal government ________ its Section 1122 of SSA agreements with the states and abolished the requirement for a State Health Plan.
 Definition
terminated
Term
Certified facilities are permitted to develop a private pay wing of the NF to be used by private pay residents. This may provide a wider variety of services and is called a ________________.
 Definition
Luxury Wing
Term
In 1972, representatives of several state boards of examiners, namely Florida, Louisiana, Oklahoma, South Dakota, and Texas, organized the National Association of Boards of Examiners of ______________________.
 Definition
Nursing Home Administrators
Term
One of the initial purposes of the NAB association was to conduct research and make recommendations on questions of common interest to long-term care administrators' examination and licensing boards and to licensing authorities of the states, commonwealths, district, and territories of the U.S.
 Definition
True
Term
One of the initial purposes of the NAB association was to study and recommend professional and educational standards for LTC administrators in order to promote and protect public health and welfare.
 Definition
True
Term
One of the initial purposes of the NAB association was to cooperated in obtaining uniformity of the laws, rules, regulations, and procedures concerning state boards of examiners and/or licensing authorities in order to create efficiency for those recieving licenses as LTC administrators.
 Definition
True
Term
One of the initial purposes of the NAB association was to consider, establish and maintain a uniform code of ethics and standards of professional conduct and practice for boards of examiners and/or licensing authorities of LTC administrators.
 Definition
True
Term
One of the initial purposes of the NAB association was to work toward reciprocal endorsement and/or recognition of LTC administrator licenses by the licensing boards and authorities of the states, commonwealths, district, and territories of the U.S.
 Definition
True
Term
Each state and the District of Columbia are _______ to appoint one representative to the NAB Board of Governors upon payment of state membership dues. 
 Definition
eligible
Term
Section 1902 of the SSA as amended in 1965 _______ nursing home administrators to be licensed by the states.
 Definition
required
Term
Each state must license through its healing arts provisions or appoint a _____________________ that is required to develop, impose and enforce standards of licensing, monitor their performance, issue, revoke, or suspend licensing/licenses, and conduct studies and investigations that will help to improve standards.
 Definition
board of examiners
Term
In all states it is a crime, usually a ________, to represent oneself as a nursing home administrator without being duly licensed. 
 Definition
misdemeanor
Term
Medicare patients are classified into groups according to ___________.
 Definition
diagnosis
Term
The payment for services at a flat rate depending on a diagnosis and without regard to the length of stay for a Medicare patient, is called a ______________.
 Definition
DRG or Diagnosis Related Group
Term
___________ is placing a renewed emphasis on quality of life in the nursing home setting.
 Definition
Culture Change
Term
Embracing such programs as the _____________, as well as physical plants that incorporate neighborhood concepts and even near-revolutionary facilities is a current trend.
 Definition
Eden Alternative
Term
NF administrators are eperiencing an ever-growing request for ______________.
 Definition
private rooms
Term
____________ is promoted by private enterprise. Units are constructed with needs of the elderly in mind - w/c access, sturdy and stable furniture, good lighting, tight security, etc...
 Definition
Retirement Housing or Senior Apartments
Term
___________________ provide additional services to those offered retirement housing. Is considered a major threat to the Nusing Home occupancy rates.
 Definition
Assisted Living units
Term
___________________ provide a full spectrum of living options, including retirement homes that range from efficiency apartments to garden homes, assisted living units, and nursing homes.
 Definition
Continuing Care Retirement Center (CCRC)
Term
_______________, are accessory dwellings within or attached to a home. Usually have a bedroom, bath, kithchen and living area with a separate entrance.
 Definition
Accessory Apartments
Term
_____________ are temporary modular homes that can be placed on single family property, perhaps in the back yard of a family member.
 Definition
ECHO (Elders Cottage Housing Opportunity) Housing
Term
____________ involves someone or several people living with an elderly person sharing his/her home and various household chores.
 Definition
Shared Housing
Term
___________ or ___________ usually involves a large house where residents have their own bedrooms, meals are usually provided as well as housekeeping services.
 Definition
Congregate Housing or Group Homes
Term
___________ provide meals, laundry, transportation, and other services to an elderly person on a fee basis.
 Definition
Foster Homes
Term
__________ is a licensed adult care facility that is operated for the purpose  of providing LTC to at least 5 persons in a community-integrated setting.
 Definition
Enriched Housing
Term
The federal government supports and encourages development of home care and community services that serve as ________ to nursing facility placement.
 Definition
Alternative Care
Term
Facilities that provide care usually between the hours of 8 am and 5 pm.
 Definition
Adult Day Care
Term
Are Day Care Facilities, Non-emergency medical transportation, Home Health, Meals on Wheels, Sitting Services, Hospice Care, Rehab Services and Programs of All Inclusive Care for the Elderly (PACE) examples of alternative care options for the elderly?
 Definition
Yes.These are examples of alternative care options for the elderly population.
Term
_____________________ has developed into an expansive program that provides transportation to and from medical, dental, and other healthcare providers.
 Definition
Non-emergency medical transportation
Term
_________ is an assisted living service provided to the homebound. It provides a variety of health care services such as nursing care, personal care and rehabilitative services.
 Definition
Home Health
Term
_____________ delivers nutritious meals to many homebound. This program is usually operated by a local Council on Aging which may offer other services.
 Definition
Meals on Wheels
Term
__________ is the philosophy and practice of caring for the dying. It is based on the concept that death is a natural and inevitable part of life and at some point the focus should be on enhancing whatever life remains rather than battling illness and warding off death.
 Definition
Hospice Care
Term
____________ are available for for those residents that have just been d/c'd from the hospital, especially for strokes, fractures, and post-surgical stays.
 Definition
Rehabilitative Services
Term
____________ is a unique capitated managed care benefit featuring a comprehensive medical and social service delivery system in a adult-day care center that is supplemented with in-home servicces and with referral opportunities to other appropriate settings for the frail and elderly. Participant must be > 55 years old, live a ______ district, and qualify for nursing home services as certified by the appropriate state agency.
 Definition
Program of ALL Inclusive Care for the Elderly (PACE)
Term
A significant trend in health care delivery that has a major impact on the Nursing Home industry is  _____________ _____________.
 Definition
Managed Care
Term
"__________ __________ is a complex system that involves the active coordination of, and the arrangement for, the provision of health services and coverage of heath benefits."
 Definition
Managed Care
Term
There are _____ distinct types of Managed Care.
 Definition
two
Term
Name the two distinct types of managed care:
 Definition

HMO: Health Maintenance Organizations &

PPO: Preferred Provider Organizations
Term
Name three revenue sources that are used by facilities to make up for accrued Medicaid losses:
 Definition
Private Pay, Medicare & Managed Care.
Term
The American Health Care Association declared the industry as one in __________.
 Definition
crisis
Term
The three areas causing crisis in the nursing home industry are:
 Definition

1. Losses accrued due to Medicaid reimbursement issues.

2. A fast growing elderly population, combined with dwindling public finances.

3. Staffing Shortages
Term
The cost of recruitment and retention is estimated to exceed the four billion mark ________.
 Definition
annually
Term
The direct cost to the facility due to turnover of direct-care employees alone is _______ to be $2500 per employee.
 Definition
estimated
Term
There are over ________ vacant nursing positions in nursing homes on a daily basis.
 Definition
100,000
Term
Turnover ratios exceed ____ for all nurse staff positions and over ______ for CNA positions.
 Definition
50% & 70%
Term
The Bureau of Labor Statistics predicts a percent increase in the _______ for long-term care employees during the first decade of this century. Equating to an addtional 800,000 jobs in an industry that is already struggling to meet current demands.
 Definition
demand
Term
There is no continuum of predictable behavior or of the aging process itself, so the elderly group cannot and should not be ___________.
 Definition
stereotyped
Term
For every elderly person in a nursing home, there are approximately 1.4 people in the community with equal degrees of ________.
 Definition
disability
Term
T or F? Attitudes toward the aging vary widely from culture to culture.
 Definition
True
Term
The ________ is both psychological and physiological.
 Definition
aging process
Term
There is an expectation of certain behavioral and attitude ____________ as an individual ages, according to the theory of physchological aging.
 Definition
changes
Term
In regard to physcological aging, a person who does not show expected changes as they age is considered __________.
 Definition
exceptional
Term
_______ phsychological changes include slowed memory retrieval, difficulty handling change, resistance to change and depression.
 Definition
Normal
Term
__________ phsychological changes include marked memory loss, confusion and a loss of judgement.
 Definition
Abnormal
Term
Dementia, delusions, and hallucinations represent ____________ thought processes.
 Definition
pathological
Term
_________ _________ considers physical defects associated with deterioration of tissues or organs, resulting in diminished vitality of body processes.
 Definition
Physiological aging
Term
It is imperative to train staff to _____________ normal and abnormal characteristics of aging.
 Definition
recognize
Term
A characteristic often ____________ is reduced resilience and the ability to relate to new stimuli.
 Definition
overlooked
Term
T or F? The loss of familiar stimuli, contact with family and freinds, health, and mobility may be accompanied by sorrow, anger, feelings of worthlessness, disappointment, fear and depression.
 Definition
True
Term
In the nursing facility depression may be _______ for dementia since the resident is slow, complains of poor memory, and is withdrawn.
 Definition
mistaken
Term
Depression may be ____________ because the person presents physical complaints instead of dysphoria, restlessness, pacing and agitation.
 Definition
overlooked
Term
T or F? The aged often have chronic and degenerative disorders that may preven their return to independent community living.
 Definition
True
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