State NHA Exam

  1. The local mental health director or designee will reassess the certification of the Special Treatment Program how often? (72445)
    At least every 4 months.
  2. What are the fees for CNA certification?
    Initial Certification?
    • Initial $15.00
    • Renewal $20.00
    • Delinquency $10.00
    • Duplicate $5.00
  3. What is the required temperature at the manifold of the final rinse in a dish washing machine? (72347)
    180 Degrees Fahrenheit.
  4. What type of supervision is required for a physical therapy aid? (72407)
    Direct supervision from the physical therapist who is supervising the Physical Therapy unit.
  5. What is the required supply for medication in the unit dose system? (72373)
    Must have 24 hour supply for all patients and no more than 48 hours for all patients.
  6. What are the required minimum number of patients for a Special Treatment Program? (72445)
  7. How many hours of direct group or individual program service is required for each patient of a Special Treatment Program? (72445)
    A minimum average of 27 hours per week.
  8. Initial evaluation and assessment by the facility staff must be done within how many days? (72451)
    15 Days after admission or 30 days prior by the referring agency.
  9. In an emergency, a physical restraint may be applied under what circumstances? (72461)
    It may be applied if the patient is a danger to themselves or others and must have an order from a licensed health care practitioner acting within the scope of his/her professional licensure within one hour of the actual restraint and the order must be signed within 5 days.
  10. What is the time frame for a psychological evaluation and assessment after admission in a Special Treatment Program?
    • 45 Days.
    • Note: ICF says psychological and educational evaluation.
  11. A licensed psychiatric technician in a Special Treatment Program may do what? (72465)
    • Serve as a charge nurse and administer medications in an STP.
    • Note: A psych tech cannot serve as a charge nurse or administer medications in a SNF.
  12. Resident’s rights in a Special Treatment Program shall be prominently posted in the facility in what languages? (72453)
    English and Spanish.
  13. Orders for a restraint and/or seclusion, not in an emergency situation, shall be signed by the licensed health care practitioner acting within the scope of their licensure and renewed within
    what time frame? (72461)
    Every 24 hours.
  14. Drugs ordered STAT shall be administered within how many hours when the pharmacy is closed? (72355)
    2 Hours.
  15. A copy of the menu as served shall be kept on file for how long? (72341)
    At least 30 days.
  16. List the rights of patients in a Special Treatment Program. (72453)
    • 1) To wear their own clothes and to keep and use personal possessions.
    • 2) To have access to individual storage.
    • 3) To see visitors each day.
    • 4) To have reasonable access to a telephone, to make and receive
    • confidential calls.
    • 5) To have access to letter writing materials and to receive mail un-opened.
    • 6) To refuse shock treatments.
    • 7) To refuse lobotomy.
    • 8) And all other rights provided by law.
  17. Define Social Work Services. (72433)
    Services which assist staff, a patient and a patient’s family to understand and cope with a patient’s personal,emotional and related health and environmental problems.
  18. On premise food supply requirements for staple foods and perishable foods are what? (72349)
    At least one week (not 7 days) supply for staple foods and 2 days for perishables.
  19. Menus for regular and therapeutic diets shall be written and posted in the kitchen when? (72341)
    Written and posted at least one week in advance. Note: ICF says written one week in advance and posted at least 3 days in advance. (73333)
  20. Define supervision, direct supervision and immediate supervision? (72113)
    • Supervision does not require the immediate presence of the supervisor. Direct Supervision requires the supervisor to be in the same building and available. Immediate supervision requires
    • the supervisor to literally be present while the task is being
    • performed.
  21. How are glass thermometers disinfected? (72323)
    • Ten minutes in 70% Ethyl alcohol or 90% Isopropyl alcohol with
    • 0.2% iodine.
  22. What are the requirements for a CNA to remain current with their licensure? (71839)
    • State says continue to meet the 24 hours per year continuing education requirement and keep the certification up to date. Fed
    • regs say must re-take the original 75 hours of training and
    • competency. Note: Fed regs say that the required CNA training and competency is only 75 versus State who says 100 clinical
    • hours and 50 hours of theory/classroom. We always follow the most stringent rule. (F497)
  23. Define core curriculum. (71835)
    Means a description of each category of study within a program which covers the minimum knowledge and skills required for nurse assistants.
  24. CNA training program shall include what? (71835)
    • 100 Hours of supervised clinical training and 50 hours of theory.
    • Note: Theory hours assigned to each module are mandatory. Modules can be out of sequence but the theory hours assigned
    • to each module must stay the same. Note: F 497 says 75 hours of approved competency/program training is required.
  25. How often must a CNA license be renewed? (71839)
    Every 2 years.
  26. How long can a part time or full time nurse assistant be employed as a nurse assistant by a facility before they are certified? (71835)
    Within 4 months of employment he or she must be certified to continue employment in a facility.
  27. How many opportunities is a CNA given to take the examination and pass? (71837)
    A total of 3.
  28. Explain denial of rights. (72453
    • The attending Physician or Psychologist may deny a patient their rights for “good cause” except the right to refuse shock treatment
    • or lobotomy. The rights and/or limited rights being denied to the patient must also be documented in the patient health record.
  29. Milk dispensing devices need to be approved by who? (72349)
    The local Health Department. Note: ICF’s are only allowed to use approved milk dispensing devices with homogenized milk or they must serve an individual carton and they must open the carton in front of the resident. (73345)
  30. Signed drug orders shall be transmitted to the issuing pharmacy within how many hours and transmitted how? (72363)
    Within 48 hours either by a written prescription or an order form which produces a direct copy of the order or by fax
  31. Oxygen equipment shall be maintained as follows: Humidifier bottles changed how often? And what type of water is used? (72313)
    • Changed every 24 hours and used only distilled, demineralized or de-ionized water. Not ionized water. Note: ICF says vaporizer
    • bottles must be sterilized after each use and changed every 24 hours. Use only sterile distilled water.
  32. Social work services shall include but not be limited to the following. (72433)
    • 1) Interview and written assessment within five days of
    • admission.
    • 2) Involve the patient, the family, the MD and other
    • appropriate staff in developing a plan of care.
    • 3) Weekly progress notes.
    • 4) Monthly in-service for all shifts.
    • 5) Discharge planning.
  33. The dietetic manual is approved by who?
    Reviewed how often?
    And revised how often?
    • 1) Dietician and Patient Care Policy Committee.
    • Note: ICF says dietician only. (73329)
    • 2) Annually.
    • 3) At least every 5 years.
    • Note: ICF says “keep current.” (73329)
  34. What are the required services in a Skilled Nursing Facility?
    24 Hour in patient care and a minimum of services; physician, skilled nursing, pharmaceutical, activity program, dietary.
  35. Discontinued drugs shall be destroyed within how many days of the date the drug was discontinued? (72357)
    90 Days unless the drug was started again within the 90 days.
  36. What is the difference between drug administration and drug dispensing? (72045, 72047,72313,72353)
    Drug administration is done by the person actually preparing the dose and actually giving it to the patient i.e., a nurse. Drug dispensing is the packaging and labeling of medication i.e., the pharmacist.
  37. Define mechanically altered diet. (72065)
    Means a diet altered in texture.
  38. Define medication. (72067)
    • Means any chemical compound, remedy or non-infectious biological substance, the action of which is not solely mechanical, which may be administered to patients by any route as an aid in the diagnosis, treatment or prevention of disease or other abnormal condition, for relief of pain or
    • suffering, or to control or improve any psychological or pathological
    • condition. Note: Medications used for cosmetic purposes or other none medication
    • purposes not mentioned above are not considered “medications” in a SNF
    • environment.
  39. What type of milk shall be served?
    And processed according to who?
    • 1) Pasteurized grade A.
    • 2) Division 15 of the California Food and Agricultural Code.
  40. Changes to the menu must be noted where and how? (72341)
    • On the menu posted in the kitchen. Line out the old item, write
    • the reason for the change and write in the new replacement.
  41. What are the requirements of the facility for out-patient services
    such as PT, OT, ST or Audiology? (72401)
    • 1) Located as to minimize noise, odors, hazards and unsightliness to
    • facility patients.
    • 2) Out patients service units shall not traverse a nursing unit.
    • 3) Must have separate toilets for men and women.
    • 4) Drinking water facilities approved by DHS.
    • 5) Hand washing facilities with hot and cold water.
    • 6) Waiting area with space enough to seat the maximum number of
    • persons expected at any one time
  42. What is the minimum floor area requirement for PT and OT
    units? (72411)
    300 Square feet and no dimension less than 12 feet
  43. What is the requirement for exercise for a patient in a restraint?
    • No less than 10 minutes for every 2 hours in which the restraint
    • is applied.
  44. How often can a cycle menu be used?
    Must be revised?
    • 1) No less than 3 weeks.
    • 2) Quarterly.
  45. Storage of non-legend drugs at bedside shall meet the following.
    • 1) Shall prevent access by other patients.
    • 2) Document the use of medications and quantity of
    • medications supplied in the patient health record.
    • 3) Must have a physicians’ order.
  46. Physician history and physical evaluation is required within what
    time frame? (72303)
    72 Hours following admission or 5 days prior to admission.
  47. What is the time frame for approving a request for a change in curriculum of a certified nursing assistant program? Also known as program flexibility. (71831)
    • Minimum 30 days.
    • Medium 45 days.
    • Maximum 60 days.
  48. What is needed to qualify for an STP services approval by the Department of Mental Health (DMH)? (72445)
    Minimum of 30 patients who have been approved and determined to be in need of STP services by the local mental health director or designee.
  49. Define physical restraint. (72082)
    • Means any physical or mechanical device or material attached or
    • adjacent to a patient’s body that the patient cannot remove
    • easily, which has the effect of restricting the patient’s freedom of
    • movement.
    • Note: A physical restraint is not the same as a treatment
    • restraint or postural support.
  50. What is the process for washing utensils not using mechanical
    means? (72347)
    • Wash in minimum temperature of 110 degrees F with soap or
    • detergent and rinsed in hot water and disinfected by one of the
    • following: Immersion for 2 minutes at 170 degrees F or 30
    • seconds at 180 degrees F or in water containing bactericidal
    • chemical approved by the Department of Health.
  51. Drugs required to be stored at room temperature shall be stored
    between what? (72357)
    Between 59 degrees F and 86 degrees F.
  52. What are the requirements for the supervisor of housekeeping and laundry service? (72621)
    Experience and training.
  53. What is the floor area requirement for speech pathology/speech
    therapist? (72431)
    There are no specific requirements except to “meet the need.”
  54. Drug destruction records shall be retained for how long? (72371)
    3 Years.
  55. What is the ratio requirement for instructor to student in the CNA
    program? (71828)
    1 Instructor for every 15 students.
  56. Drugs requiring refrigeration shall be stored within what temperatures? (72357)
    Between 36 degrees F and 46 degrees F.
  57. Plumbing and drainage requirements are regulated by what?
    Part 5, Title 24 California Administrative Code, Basic Plumbing.
  58. Itemized food purchases are kept for how long? (72341)
    1 Year.
  59. What are the requirements for rooms accommodating patient’s
    with infectious diseases? (72321)
    • 1) Ventilation for the outside.
    • 2) Separate toilets.
    • 3) Separate hand washing facility.
    • 4) Separate soap dispenser.
    • 5) Individual towels.
    • Note: ICF says the patient must be transferred but
    • must also follow the same guidelines while they
    • are waiting to be transferred. (73531)
  60. Oral and rectal thermometers shall be stored how? (72323)
    Separately in clean labeled containers and fitted lids
  61. What is the required room temperature for the facility and patient
    rooms? (73611)
    71 to 81 degrees. Note: SNF/STP (72609) Patients room
  62. The Program Director in a Special Treatment Program must be
    approved by who? And shall be one of the following. (72467)
    • 1) Department of Mental Health.
    • 2) Physician, Psychologist, RN, LVN, Psych Tech, Art
    • Therapist, Dance Therapist, Music Therapist, Occupational
    • Therapist, Recreational Therapist, Social Worker or
    • another discipline approved by DMH.
  63. What are the requirements for a Program Director of a Special
    Treatment Program? (72467)
    • 2 Years experience in a mental health setting of which 1 year
    • was in Program Development in a mental health setting.
  64. A Special Treatment Program shall provide interdisciplinary staff
    per patient as follows. (72465)
    • 1) 49 or less certified patient’s equal 24 hours per week of
    • professional staff time.
    • 2) 50 to 69 certified patient’s equals 32 hours per week.
    • 3) 70 to 99 certified patient’s equals 48 hours per week.
    • 4) 100 plus of certified patient’s equals 72 hours per week.
  65. The Program Director in a Special Treatment Program shall not be the following. (72467)
    The Director of Nursing, Charge Nurse or facility Administrator.
  66. The Medical Director shall do what? (72305)
    • 1) Liaison between Administrator and attending physician.
    • 2) Review and evaluate administrative and patient care
    • Policies and Procedures.
    • 3) Consultant to the DON.
    • 4) Reviewing employee pre-employment and annual health
    • examination reports.
  67. Drugs ordered STAT during normal pharmacy hours shall be administered within what time frame? (72355)
    1 Hour.
  68. Storage of legend drugs at bedside shall meet the same conditions of non-legend drugs and shall in addition. (72357)
    Be limited to sublingual or inhalation forms of emergency drugs.
  69. Food temperature requirements are what? (72343)
    • 1) 45 Degrees F or below.
    • 2) 140 Degrees F or above.
    • Note: Fed says the danger zone is 41-135.
    • See F-Tag 371.
  70. The Activity Program must at a minimum consist of what types of individual, small and large group activities in order to meet the
    needs and interest of all patients? (72381)
    • 1) Social activities.
    • 2) Indoor and outdoor activities.
    • 3) Activities away from the facility.
    • 4) Religious activities.
    • 5) Opportunity for patient’s to participate in the planning
    • and implementation of the program.
    • 6) A creative activity.
    • 7) Educational activity.
    • 8) Exercise activity.
    • 9) Activities must be offered daily.
  71. What are the requirements to be head of the Activity Program?
    • 1) 2 Years experience in a social or recreational program within the
    • past 5 years of which 1 year was full time in an activity program in a
    • health care setting or
    • 2) Be an Occupational Therapist, Art Therapist, Music Therapist, Dance
    • Therapist, Recreational Therapist or Occupational Therapist
    • Assistant or
    • 3) Receive 36 hours of training approved by DHS and receive
    • consultation from Recreational Therapist, OT or OTA who has 1 year
    • experience in a health care setting.
    • Note: ICF says the same except on #3 no consultation is needed.
    • (73385)
  72. List the things that an Activity Leader at a minimum shall do. (72381)
    • 1) Develop, implement and supervise Activity Program.
    • 2) Plan and conduct in-service at least annually.
    • 3) Coordinate Activity Program and other patient services.
    • 4) Maintain a list of patients who are not able to participate in activities.
    • 5) Post activity calendar in large print.
    • 6) Request and maintain equipment.
    • 7) Develop and maintain contacts with community agencies.
    • 8) Develop and implement activities for patients unable to leave their
    • rooms.
    • 9) Maintain quarterly progress notes.
    • 10) Maintain current record of type and frequency of activity
    • and names of patient’s participating.
  73. Controlled drugs are regulated by who? (72369)
    • The Federal Comprehensive Drug Abuse Prevention Control Act
    • of 1970.
  74. Refrigerator at the nursing station must meet the following Standards. (72325)
    • 1) Located in clean area not subject to contamination.
    • 2) 45 Degrees F or below for chilling.
    • 3) 0 Degrees or below for freezing.
    • 4) Contain accurate thermometer.
  75. Special Treatment Program provide what therapeutic services? (72443)
    Pre-vocational preparation and pre-release planning.
  76. In a Special Treatment Program what are the general areas of service provided to mentally disordered persons with special needs? (72443)
    • 1) Self-help skills
    • 2) Behavioral adjustment.
    • 3) Interpersonal relationships.
  77. What are the services provided in a Special Treatment Program?
    • 1) Self-help skills training.
    • 2) Behavioral intervention training.
    • 3) Interpersonal relationships.
    • 4) Pre-vocational preparation services.
    • 5) Pre-release planning.
  78. What services are provided in behavioral intervention training?
    • 1) Behavior modification.
    • 2) Re-motivation therapy.
    • 3) Patient government activities.
    • 4) Group counseling.
    • 5) Individual counseling.
  79. What services are provided in interpersonal relationships training? (72445)
    • 1) Social counseling.
    • 2) Educational and recreational therapy.
    • 3) Social activities.
  80. What services are provided in pre-vocational training? (72445)
    • 1) Home making.
    • 2) Work activity.
    • 3) Vocational counseling.
  81. List 5 types of drugs that are to be administered within 4 hours of the time ordered. (72355)
    Anti-infectives, analgesics, anti-nausea, anti-diarrheal, Anti- agitation or any other medication needed to treat severe discomfort.
  82. Who approves the emergency supplies? (72377)
    • Patient Care Policy Committee or Pharmaceutical Committee.
    • Note: ICF says Patient Care Policy Committee. There is not Pharmaceutical Committee. (73375)
  83. Physical Therapy Assistants must have what type of supervision? (72407)
  84. Special Treatment Program provides a service to what type of patient? (72443)
    Chronic psychiatric impairment and whose adaptive functioning is moderately impaired.
  85. How often must the Special Treatment Program submit a written description to the Department of Mental Health? (72449)
  86. Patient’s placed in restraint and/or seclusion shall be observed by qualified personnel how often? (72463)
    • At least every half hour.
    • Note: ICF says the same. (73407)
  87. Program staff in a Special Treatment Program shall receive ongoing, planned academic and on the job in service education how often? (72469)
    At least 1 hour per week.
  88. Initial assessment by a licensed nurse shall begin when? (72311)
    At the time of admission and completed within 7 days after admission.
  89. If a facility is devoted entirely to the care of the mentally disordered there shall be at least one ________ on duty on all 3 shifts 7 days a week. (72465)
    RN or LVN.
  90. Drugs and food stored in the same refrigerator shall be kept how? (72357)
    Closed containers and clearly labeled “drugs.”
  91. Drug order records shall be kept how long? (72365)
    At least 1 year.
  92. List the services provided in Self Help Skills training. (72445)
    • 1) Personal care and use of medications.
    • 2) Money management.
    • 3) Use of public transportation.
    • 4) Use of community resources.
    • 5) Behavior and impulse control.
    • 6) Frustration tolerance.
    • 7) Mental health education.
    • 8) Physical fitness.
  93. Interdisciplinary professional staff in a Special Treatment Program shall be composed of at least two of the following.
    • Psychologist, Social Worker, Occupational Therapist,
    • Recreational Therapist, Art Therapist, Dance Therapist, Music
    • Therapist and any other discipline approved by the Department.
    • Note: Must have a minimum of 1 year of experience or training
    • in mental health setting.
  94. What are the administrative policies governing administration and management in a Certified Nursing Assistant Training Program? (71828)
    • 1) A job description for the Licensed Nurse Program Director who is the
    • instructor including duties, responsibilities and limitations.
    • 2) Organizational chart.
    • 3) Method of monitoring instructors.
    • 4) Ratio of students to instructor.
    • 5) How to handle absenteeism and process to make up the time.
  95. What are the optional services in a SNF? (72401)
    P.T., O.T., S.T., Speech Pathology, Audiology, Social Work Services and Special Treatment Program.
  96. Records for schedule II drugs shall be reconciled how often?
    And retained for how long? (72369)
    • 1) Daily.
    • 2) 1 Year.
    • Note: Fed says “periodic reconciliation”. We
    • reconcile the narcotic log per shift because it
    • only makes sense that the 3-11 shift cannot
    • sign off or reconcile medications that were
    • given during the 7-3 shift.
  97. Who is allowed to receive verbal orders for drugs and treatments? (72361)
    • 1) Licensed Nurse.
    • 2) Psych Tech. STP only.
    • 3) Pharmacist.
    • 4) Physician.
    • 5) Physician’s Assistant/Nurse Practitioner under the supervision of a
    • Physician.
    • 6) Respiratory Therapist for Respiratory care only.
    • Note: ICF says only licensed nurse or pharmacist can receive verbal
    • orders. (73353)
  98. Within what time frame must verbal orders be signed by the prescriber? (72361)
    • Within 5 days.
    • Note: ICF says within 48 hours. (73353)
  99. Name 3 types of Social Workers. (72437
    • 1) Licensed Clinical Social Worker licensed by California Board of
    • Behavioral Science Examiners.
    • 2) Social Work Assistant-B.A. degree in related field with supervision
    • from a “Social Worker.”
    • 3) Social Work Aide- staff receiving orientation, on the job training and
    • supervision by “Social worker” or Social Work Assistant.
  100. What are the requirements of the Dietetic Service Supervisor?
    • 1) Qualified Dietician.
    • 2) Or BA degree in Food and Nutrition with one year experience in Dietetic Service
    • in a health care institution
    • 3) Or a graduate of a Dietetic Tech or Assistant Training Program approved by the
    • American Dietetic Association
    • 4) Or Board Certified Dietary Manager with 6 hours of in-service
    • 5) Or appropriate college degree and Board Certified Dietary Manager with 6 hours
    • of in-service
    • 6) Or 90 hours of a State approved program in food service supervision
    • 7) Or military experience in food service supervision and management equivalent
    • to the above # 3 or # 4
    • Note: ICF says full time training and experience. (7334
  101. What are the requirements to be a Dietician? (72037)
    • Refers to Business and Professions code which says the following:
    • Registered or eligible for registration by the American Dietetic Association.
  102. Define Intermediate Care Bed Classification. (72053)
    Patients requiring skilled nursing care on a less then continuous basis.
  103. List the appropriate licensure and/or certification for the following:
    1) Pharmacist. (72081)
    2) Physical Therapist. (72083)
    3) Physician’s Assistant. (72087)
    4) Podiatrist. (72089)
    5) Recreation Therapist. (72093)
    6) Registered Nurse. (72095)
    7) Speech Pathologist. (72107)
    • 1) Licensed by the California Board of Pharmacy.
    • 2) Licensed by the Physical Therapy Board of California.
    • 3) Certified by the Physician’s Assistant Committee of the Medical Board of
    • California.
    • 4) Licensed by the Board Pediatric medicine.
    • 5) Registered or eligible by the California Board of Park and Recreation Personnel or
    • The National Therapeutic Recreational Society.
    • 6) Licensed by the California Board of Registered Nursing.
    • 7) Licensed by the Speech Language Pathology and Audiology and Hearing Aid
    • Dispensers Board or an individual with an M.A. Degree with authorization to
    • practice with supervision.
    • Note: ICF says must be a licensed Speech Pathologist only. (73109)
  104. Patient Care Policy Committee shall be composed of at least
    who? (72525)
    • A physician
    • Administrator
    • DON
    • Pharmacist
    • Activity Leader
    • And a representative of each required service.
    • Note: ICF says one physician, administrator, supervisor of health
    • services and other appropriate personnel. (73521
  105. Each facility must have Administrative Policies and Procedures for at least the following: (72521)
    • 1) Personnel-job descriptions, orientation, staff development, employee
    • benefits, verification of credentials, health and grooming.
    • 2) Patient admission, leave of absence, transfers, out on pass and discharge.
    • 3) Discrimination for admissions and discharges.
    • 4) Health records.
    • 5) Must be able to provide care.
    • 6) Reporting unusual occurrences.
  106. What are the number of hours required for a DSD for a hundred plus bed facility with in-service and orientation only? (71829)
    93 Hours per month.
  107. What are the number of hours required for a DSD for a 60 to 99 bed facility with in-service and orientation only? (71829)
    54 Hours per month
  108. What are the number of hours required for a DSD for a 1 to 59 bed facility with in-service and orientation only? (71829)
    26 Hours per month.
  109. What are the number of hours required for a DSD for a 100 plus bed facility with in-service, orientation and pre-certification program? (71829)
    40 Hours per week.
  110. What are the number of hours required for a DSD for 60 to 99 bed facility with in-service, orientation and pre-certification program? (71829)
    30 Hours per week.
  111. What are the number of hours required for a DSD for 1 to 59 bed facility with in-service, orientation and pre-certification program?
    20 Hours per week.
  112. What are the qualifications for the DSD? (71829)
    • 1) Licensed Nurse with 1 year experience in Patient Care in Long Term Care
    • and 1 year experience planning, implementing and evaluating educational
    • programs in nursing or
    • 2) 2 Years experience as a Licensed Nurse of which 1 year was providing
    • direct patient care in a Nursing Facility and 24 hours of continuing
    • education courses taken within 6 months of employment and copy sent to
    • the DHS and a copy available on site
  113. The physical Therapy service unit shall include the following equipment: (72409)
    • 1) Parallel bars.
    • 2) Full view mirror.
    • 3) Overhead pulley and weights.
    • 4) Set of training stairs.
    • 5) Treatment table enclosed by cubicle curtain for privacy.
    • 6) Availability of wheelchairs, walkers, canes and crutches.
  114. The Administrator shall be responsible for only one SNF unless all of the following conditions are met: (72513)
    • 1) Must be owned by the same governing body.
    • 2) They are all within one hour traveling time in the same geographic
    • area.
    • 3) No more than 3 facilities of a total of no more than 200 beds.
    • 4) In the Administrator’s absence, a responsible adult must be
    • designated to carry out responsibilities.
  115. Affiliation agreements, contracts and written arrangements shall
    include what? (72511)
    • 1) Description of service to be provided
    • 2) Financial arrangements.
    • 3) Methods by which services will be provided.
    • 4) Conditions of termination.
    • 5) Time frame of affiliation.
    • 6) Effective date.
    • 7) Date agreement was signed.
    • 8) Signatures of all parties (Administrator and Vendor)
  116. A provision of pharmaceutical services is to provide the following
    equipment and supplies: (72377)
    • 1) Refrigerator with an accurate thermometer.
    • 2) Lockable drug cabinets, drawers, closets or rooms.
    • 3) Drug service trays and/or carts.
    • 4) Drug preparation counter area and convenient water
    • source.
    • 5) Reference materials.
  117. The DON may serve as the charge nurse for the distinct part for
    a total license capacity of _________? (72465)
    59 Beds or less.
  118. The following consumer information shall be conspicuously posted in a location accessible to the public. (72503)
    • 1) Name and license number and date of employment of the current
    • administrator.
    • 2) A listing of all services and special programs provided.
    • 3) The current and following week’s menu.
    • 4) A notice that the facility’s written admissions and discharge policies are
    • available upon request.
    • 5) Most recent survey and related plan of correction.
    • 6) Name and address of all previous owners.
    • 7) List all other facilities owned by the same person or entity.
    • 8) Pending action to revoke the facility license.
    • 9) Name, address and telephone number of the local DHS.
    • Note: See F-Tag 156 for Federal posting requirements.
  119. The records for each in service shall include: (72517)
    • 1) Name and title of presenter.
    • 2) Date of presentation.
    • 3) Title of subject presented.
    • 4) Description of content.
    • 5) Signatures of those attending.
    • Note: Records kept for 4 years.
  120. What is the required nursing staff supervision for a distinct part of a Special Treatment Program? (72465)
    • A full time (40 hours per week) RN, LVN, or Licensed Psych
    • Tech on the day shift responsible for supervision of the distinct
    • part. Shall also have 1 year experience in an STP program or will
    • participate in facility in-service program.
  121. List the dollar value of bonds required for a facility to handle the
    following amounts of resident’s money: (72217)
    1) $750.00 or less.
    2) $751.00 to $1,500.00.
    3) $1,501.00 to $2,500.00
    4) Over $2,500.00.
    • 1) $1,000.00 Bond.
    • 2) $2,000.00 Bond.
    • 3) $3,000.00 Bond.
    • 4) Raise in increments of $1,000.00.
    • Example: To handle $3,000 of resident’s
    • money would require a $4,000.00 bond.
    • Note: ICF says the same except list a minimum of $25 or more
    • per patient or $500 or more for all patients. (73241)
  122. How many days must the Administrator be absent before the
    licensee shall appoint an acting Administrator? (72501)
    30 Consecutive days.
  123. Each facility shall have an ongoing educational plan for all
    personnel of at least the following: (72517)
    • 1) Problems and needs of aged, disabled, chronically and acutely ill patients.
    • 2) Prevention and control of infections.
    • 3) Interpersonal relationships and communications skills.
    • 4) Fire prevention and safety.
    • 5) Accident prevention and safety measures.
    • 6) Confidentiality of patient info.
    • 7) Patient dignity and patient privacy.
    • 8) Patient rights and civil rights.
    • 9) Signs and symptoms of cardio pulmonary distress.
    • 10) Chocking prevention and intervention.
  124. Employee personnel records shall include the following: (72533)
    • 1) Full name.
    • 2) Social Security #.
    • 3) Professional license registration #.
    • 4) Employee classification.
    • 5) Info on past employment and qualifications.
    • 6) Date employment began.
    • 7) Date of termination.
    • 8) Documented evidence of orientation to the facility.
    • 9) Performance evaluation.
    • Note: Retain these records for 3 years following the termination
    • date.
  125. When a patient is transferred to another facility the following shall be entered into the patient’s health record: (72519)
    • 1) The date, time and condition of the patient and the reason for the transfer.
    • 2) Inform the patient, the patient’s guardian or authorized representative of the transfer with documentation of a written or telephone acknowledgement.
  126. Infection Control Committee shall be composed of who? (72525)
    • 1) Physician.
    • 2) Nursing.
    • 3) Administration.
    • 4) Dietetic.
    • 5) Pharmaceutical.
    • 6) Activities.
    • 7) Housekeeping.
    • 8) Laundry.
    • 9) Maintenance.
  127. Patient Care Policy Committee shall establish policies governing
    the following services: (72525)
    • 1) Physician.
    • 2) Dental.
    • 3) Nursing.
    • 4) Dietetic.
    • 5) Pharmaceutical.
    • 6) Health Records.
    • 7) Housekeeping.
    • 8) Activities and other services provided by the
    • facility.
  128. Patient Care Policies and Procedures shall include but not be limited to: (72523)
    • 1) Physician Services.
    • 2) Nursing Services.
    • 3) Infection Control.
    • 4) Dietary Services.
    • 5) Pharmaceutical.
    • 6) Activity Program.
    • 7) Housekeeping services.
  129. Hot water must be kept between…(73649)
    • Not less than 105 Degrees F and not more than 120 Degrees F.
    • Note: SNF refers to Title 24 for hot water temperatures which
    • states the same as for ICF. (72651)
  130. Taps with water temps higher than 125 degrees F or more shall
    • Identified by a warning sign with 2 inch letters.
    • Note: SNF refers to Title 24 which states the same as
    • for ICF. (72651)
  131. Water for human consumption from an independent source is
    subjected to…(72651)
    • Bacteriological analysis by the local Health Department, State
    • Department of Health or local Licensed Commercial Lab at least
    • every 3 months. Copy of most recent report available for
    • inspection.
    • Note: ICF says the same. (73649)
  132. All screens must be what size and screen doors must be
    approved by who? (73657)
    • 1) 6 Mesh per centimeter or 16 mesh per inch.
    • 2) Approved by the State Fire Marshall.
    • Note: SNF refers to Title 24 which says the same as
    • ICF. (72659)
  133. What is the minimum requirement of a signal system? (73631)
    • 1) Visible in the corridor above the patient’s room.
    • 2) Audible signals and light indicating the room.
    • 3) Must have a reset button in the room where the call
    • originated unless there is a 2 way voice system.
    • Note: SNF refers to Title 24 which says the same as ICF.
    • (72631)
  134. Static pressure drop (air filters) shall be maintained…(72639)
    • 1) Written record of inspection cleaning or replacement.
    • 2) Description of filters originally installed.
    • 3) The efficiency rating by ASHRAE (American Society of Heating
    • Refrigeration and Air Conditioning Engineers).
    • 4) Change the filters according to the recommendation by the
    • manufacturer.
    • 5) After cleaning or replacement, visually inspect fans when they are on
    • and off using flashlight.
    • 6) Keep certifications from equipment service companies.
    • Note: ICF says the same. (73637)
  135. What are the required committees in a SNF? (72525)
    • 1) Patient Care Policy Committee.
    • 2) Infection Control Committee.
    • 3) Pharmaceutical Committee.
    • Note: ICF only require Patient Care Policy Committee.
    • (73521)
  136. Administrative Policy and Procedures shall be reviewed how
    often? Revised? And approved in writing by who? (72521)
    • 1) At least annually.
    • 2) As needed.
    • 3) The Governing Body or Licensee and Medical
    • Director.
    • Note: ICF says reviewed and revised annually,
    • and approved by the Patient Care Policy
    • Committee. (73519 & 73521)
  137. The Pharmaceutical Service Committee shall meet how often?
    At least quarterly.
  138. The Pharmaceutical Service Committee shall be composed of
    the following: (72525)
    • 1) Pharmacist.
    • 2) DON.
    • 3) Administrator.
    • 4) And one physician.
  139. Patient Care Policy Committee shall meet at least how often?
    • Annually.
    • Note: ICF says the same. (73521)
  140. Infection Control Committee shall meet how often? (72525)
  141. The Administrator shall notify the Department of an unusual
    occurrence within what time frame? (72513, 72541)
    • 24 Hours.
    • Note: ICF says the same. (73539)
  142. List the survey process. (OBRA Appendix P)
    • Task #1 Off site survey prep Oscar/Casper report #3 facility
    • compliance for the last 4 surveys and report #4 is the last survey in
    • comparison to state and regional averages.
    • Task #2 is entrance conference.
    • Task #3 is initial tour.
    • Task #4 is sample selection.
    • Task #5 is information gathering.
    • Task #6 is information analysis.
    • Task #7 is exit conference.
  143. What are the lighting requirements in a SNF? (72653)
    • 30 Foot candles in reading areas and work areas. All other areas, including
    • exits, entrances, stairways, ramps, corridors and storerooms, must have 20
    • foot candles of light.
    • Note: ICF says 30 lumens in reading/work areas, 10 lumens in the rest of
    • the room and 5 lumens in the exits, entrances, stairways, ramps, corridors
    • and storerooms. (73651)
  144. What are the requirements for employee health examination and health records? (72535)
    • 1) All employees including licensee if working in the facility must have
    • health exam.
    • 2) Exam must be 90 days prior to employment or within 7 days after.
    • Must have clearance for both TB and disease.
    • 3) Must be yearly.
    • 4) If TB test is positive, must do 14” X17” chest X-Ray.
    • 5) Health records must be kept for 3 years after termination.
    • Note: Fed (Equal Opportunity Act) says must be kept separate of
    • personnel file.
  145. How are scheduled II drugs stored?
    Records kept for how long? (72369)
    • 1) In a separate locked cabinet unless in a unit dose system
    • on scheduled basis.
    • 2) Records are kept for 1 year separate of other records
    • unless using a unit dose system.
  146. How do you handle communicable diseases in an ICF? (73531)
    • 1) You don’t. You must transfer the patient to an appropriate
    • placement ASAP.
    • 2) While waiting for the transfer, an ICF must follow the same
    • regulations as in a SNF.
  147. Drugs can be returned to the issuing pharmacy under what circumstances? (72371)
    • 1) They must be sealed.
    • 2) Cannot violate any State or Federal regulation.
    • 3) Cannot be a schedule II, III, or IV.
    • 4) Identified by a lot or control number.
    • 5) A separate log must be kept with signatures of the facility RN
    • returning the medications and signatures of the receiving pharmacist.
    • 6) Log must be kept for 3 years.
    • Note: ICF says the same. (73369)
  148. Schedule II, III, IV drugs shall be destroyed by the facility in the
    presence of who? Documented how? Log…(72371)
    • 1) Pharmacist and RN employed by the facility.
    • Note: ICF says the same. (73369)
    • 2) Patient name, strength, amount, date destroyed, prescription.
    • 3) Signature of pharmacist and RN.
    • 4) Kept in a separate log or patient health record for 3 years.
  149. Drugs that are not schedule II, III, IV shall be destroyed in the
    presence of who? Documented how? Log…(72371)
    • 1) Pharmacist or licensed nurse employed by the facility.
    • 2) Must have 1 other witness.
    • 3) All signatures required.
    • 4) Log kept for 3 years. Kept in a separate log or patient health record
    • for 3 years.
    • 5) Log the same details as foe schedule II, date destroyed, prescription
    • #, etc.
    • Note: ICF says pharmacist or RN plus 2 witnesses. (73369)
  150. List the license categories. (73054)
    • 1) General Acute Care Hospital.
    • 2) Acute Psychiatric Hospital.
    • 3) Skilled Nursing Facility.
    • 4) Intermediate Care Facility.
  151. What regulations govern the physical plant?
    (Article 6 Physical Plant)
    • Title 24.
    • Note: Title 24 is referenced often throughout SNF, STP and ICF
    • sections for physical plant repair guidelines.
  152. When must the Department be notified of any construction,
    remodeling or alterations? (72605)
    • Within 5 days of the commencement of any construction.
    • Note: ICF says the same. (73607)
  153. What are the licensing fees? (72203)
    • SNF says:
    • 1) 1-49 beds = $948.00 plus $13.00 per bed.
    • 2) 50-99 beds = $1,186.00 plus $13.00 per bed.
    • 3) 100+ beds = $1,540.00 plus $13.00 per bed.
    • ICF says:
    • 1) 1-59 beds = $948.00 plus $13.00 per bed.
    • 2) 60-99 beds = $1,186.00 plus $13.00 per bed.
    • 3) 100+ beds = $1,540.00 plus $13.00 per bed.
    • Note: These fees have been removed and they now refer to Health & Safety
    • Code. SNF (72203 & ICF 73208)
  154. How many days after a discharge must a patient’s chart be
    closed? And how many years must the record be kept after
    discharge? And how many years after minor’s discharge must
    the record be kept? (72543)
    • 1) 30 Days.
    • 2) 7 Years. (Really 10 years).
    • 3) 1 Year after 18 years old and never less than 7.
    • Example: 11 year old minor discharged. The record must be kept until
    • they are 19 years old even though that is more than 7 years, must be
    • kept longer in order to meet the 1 year after 18 requirement.
  155. How many in-service hours are required? (71839)
    • 24 Hours a year or 48 hours every two years.
    • Note: Fed reg says 12 hours per year. (F 497)
  156. What are the requirements regarding a public telephone?
    • A SNF is required to have a public telephone. The
    • exception is a separate building with 6 or less ambulatory
    • patients.
    • Note: ICF says the same. (73621)
  157. How many hours are there of orientation and how is it broken
    down? (71833)
    • 1) 16 Hours.
    • a) First 8 hours- tour, patient population, daily routine, used of
    • equipment, call cord and system, disaster and unusual occurrence
    • and intro to patient care.
    • b) Second 8 hours (within 32 hours)- administrative structure,
    • organizational chart, services offered, role, and personnel policies
    • and procedures.
    • Note: ICF leaves it to the facility to create the orientation
    • program/policy and procedures. (73317)
  158. What is included in the personnel Policies and Procedures section of the orientation program? (71833)
    • 1) Philosophy of care.
    • 2) Patient’s rights.
    • 3) Legal and ethical issues.
    • 4) Direct patient care- transferring, bathing, positioning,
    • turning.
    • 5) Comfort and environment.
    • 6) Federal and State regulations.
    • 7) Choking (CPR/First Aid certification).
    • 8) A signed performance evaluation.
  159. What are the qualifications for the Staff Developer? (DSD) (71829)
    • 1 Year as an RN or LVN providing direct patient care with 1 year
    • experience planning, implementing and evaluating educational plan or 2
    • years full time experience with 24 hours of continuing education within 6
    • months of employment and a copy of the transcript must be sent to the
    • department and a copy available on site
  160. What is the requirement for the storage of food being stored in
    the kitchen in regards to the flooring? (72343)
    • Must be “off the floor”.
    • Note: ICF says all food must be stored at least 12” off the
    • floor. (73337)
  161. What is the requirement in notifying the department of defaced or
    destroyed health records? (72543)
    • The department must be notified in writing within 3
    • business days.
    • Note: ICF says immediately and in writing. (73543)
  162. Define: (72701)
    1) Substantial probability.
    2) Serious physical harm.
    3) Direct relationship.
    4) Class “C” violation.
    • 1) The likelihood that an event is real and substantial.
    • 2) Bodily injury resulting in a literal loss of a body part or reduced
    • capacity to use/function either temporary or permanent or loss of
    • internal function resulting in a temporary or permanent reduction in
    • physical, mental capacity or shortened life.
    • 3) Significant risk is created.
    • 4) Violation of a statute or regulation relating to the operation or
    • maintenance of the facility with only minimal relationship to the
    • health, safety or security of the patients.
  163. What are the regulations for pest control? (72637)
    • Facility must be rodent and vermin free.
    • Note: There are no specific requirements just do it!
  164. What are some basic regulations/requirements of housekeeping
    department? (72621)
    • 1) Must have daily, weekly and monthly schedules and policy and
    • procedures posted.
    • 2) Supplies available.
    • 3) Must use commercial germicide.
    • 4) Mop head must be changed daily.
    • 5) Environment must be safe, clean, orderly, attractive and kept free of
    • odors.
    • 6) Janitor closets must be cleaned and be locked when not in use.
  165. What are some basic requirements for patient rooms and physical plant? (72609)
    • 1) They must be labeled on the outside of the door by number, letter or
    • both for identification.
    • 2) Rooms cannot be locked unless they are an approved seclusion
    • room in a psychiatric facility.
    • 3) Fences, yards, exits and doors cannot be locked without DHS
    • approval.
    • 4) Rooms with ambulatory patients must be labeled “Reserved for
    • Ambulatory Patient” with half inch lettering
  166. What special needs groups cannot be accepted to a SNF or ICF
    unless their special needs can be met in an approved STP or
    special disability services unit? (73391 & 72443)
    • 1) Development disabled.
    • 2) Substance abuse-alcohol or drug.
    • 3) Mentally disordered.
    • Note: Residents with the above special needs cannot be admitted to a
    • SNF or ICF unless the SNF or ICF have the STP or special disability
    • services unit required and necessary to meet the need.
  167. What are the requirements for soiled linen? (72623, 72627)
    • 1) Policies and procedures for soiled linen must be posted in
    • the laundry area.
    • 2) Must be stored and transported in closed containers.
    • 3) No odor and no cross contamination.
    • 4) Soiled linens must be labeled “soiled”.
  168. Back flow preventers (vacuum breakers) are maintained according to who? (72651)
    Part 6 Title 24 of the California Administrative Code.
  169. What are the requirements for clean linen? (72623,72625)
    • 1) Policy and Procedures for clean linens must be posted in
    • the laundry area.
    • 2) Must be stored and transported in a covered unit.
    • 3) Must have at least 3 complete bed changes for facility bed
    • capacity.
    • 4) Must have sufficient wash cloths to meet the need.
    • 5) Must be labeled “clean”.
    • 6) Must be in good repair.
  170. What are the requirements for solid waste containers? (72645)
    • 1) Movable bins must be approved by local health department
    • 2) Must have tight fitted lids.
    • 3) Must be in good repair.
    • 4) Must be leak proof.
    • 5) Must be rodent proof unless stored in an enclosure.
    • 6) All containers except for movable bins must have external handles.
    • 7) Putrescible waste must be emptied at least every 4 days.
  171. What are the regulations for the use of medical gases? (72649)
    1) Piped oxygen is tested and regulated by the National Fire Protection Association Bulletin.2) Must be written reports for initial installation, changes to the system and integrity breaches.3) Cannot transfer gases from cylinder to cylinder.
  172. What are the basic guidelines for a citation review conference?
    • 1) Licensee has the right to bring legal counsel or anyone else.
    • 2) The department representative who issued the citation should
    • attend.
    • 3) The conference shall be informal.
    • 4) Neither party shall record, subpoena witnesses or cross examine.
    • 5) May only present willing witnesses.
  173. List the medical gases. (72649)
    • Carbon Dioxide, Cyclopropane, Ethylene, Helium,
    • Nitrous Oxide, Oxygen, Helium- Oxygen mixtures
    • and Carbon Dioxide-oxygen mixtures.
  174. What are the requirements for equipment in the facility? (72637)
    • 1) Must meet OSHA requirements.
    • 2) Portable electrical medical equipment must be 3 pronged
    • and equipped for 110 to 120 volts. 60 Hertz current.
    • 3) Cord must be integral part of the equipment.
  175. What are some requirements in the laundry area? (72623)
    • 1) Must be separate storage for clean and soiled linen.
    • 2) Must have hand washing and toilet facilities close by.
    • 3) Separate carts clearly labeled “soiled linen” and “clean linen.”
    • 4) Carts must be made of washable materials.
    • 5) Written procedures for storage, transportation and the handling of
    • clean and soiled linens must be posted.
  176. What are the requirements for the emergency system? (72641)
    • 1) Generator must provide back up for minimum of 6 hours.
    • 2) In an emergency, the following is required to continue operation:
    • Lighting, signals, alarms, medical equipment and any other function
    • that is necessary.
    • 3) Generator must automatically turn on within 10 seconds of a power
    • failure.
    • 4) Generator must be tested every 14 days on full load capacity for a
    • minimum of 30 minutes and a log must be kept.
    • Note: Diesel generators per manufacturers recommendations.
  177. Special Treatment Program must have the following areas:
    • 1) Dining.
    • 2) Recreational.
    • 3) Program.
    • 4) Indoor.
    • 5) Outdoor .
    • Note: Indoor or outdoor areas may not be shared with
    • another program. Designated for STP only
  178. In an ICF telephone orders can be received by who? And signed by the prescriber when? (73313)
    • 1) Licensed nurse or pharmacist
    • 2) 48 Hours.
    • Note: SNF says 5 days. (72361)
  179. What are the nurse staffing requirements in an ICF? (73319)
    • 1) Less than 100 beds needs an RN or LVN 8 hours per day, day shift
    • only 7 days a week.
    • 2) 100 + beds needs an RN 8 hours per day-day shift only 7 days a
    • week. In addition also need an RN or LVN 4 hours per day 7 days
    • per week day shift only for each 50 beds or portion of in excess of
    • 100.
    • 3) Must have nursing personnel day and night.
    • 4) Minimum of 1.1 nursing hours per patient day
  180. How often are physician visits required in an ICF? (73303)
    • At least every 60 days. Note: SNF says every 30 days. (72307)
    • Federal regs say every 30 days for first 90 days then every 60
    • days thereafter. (F387)
  181. Who can administer medications in an ICF? (73313)
    • Personnel who have completed a State approved training
    • program in medication administration.
    • Note: SNF says licensed nurse only. (72313)
  182. What are the required services in an ICF? (73301)
    • 1) Activities.
    • 2) Physician.
    • 3) Intermittent Nursing.
    • 4) Pharmaceutical.
    • 5) Dietary
  183. Who reviews the medications in an ICF? (73313)
    • RN or pharmacist every month.
    • Note: SNF says only pharmacist every month.
    • (72375)
  184. Unusual occurrences: (72541)
    1) Definition.
    2) Time frame for reporting.
    3) The method of reporting.
    4) Retaining records.
    5) Reporting fire or explosion
    • 1) Epidemic outbreaks, poisonings, fires, major accidents, death from
    • unnatural causes or any other occurrence that threatens the welfare, safety
    • or health of patient’s visitors or personnel.
    • 2) Within 24 hours by phone or telegraph.
    • 3) Confirmed in writing.
    • 4) In the facility for one year.
    • 5) Also report to local fire authority or in the limited areas the State Fire
    • Marshall.
  185. What are the requirements for speech pathology, audiology
    progress notes in an ICF? (73479)
    • Progress notes must be written at least monthly.
    • Note: SNF says weekly. (72423)
  186. How often must a social worker write progress notes in an ICF?
    • Monthly.
    • Note: SNF says weekly. (72433)
  187. What is the square footage per bed in a single room and a multi-bedroom?
    • 1) 110 square foot for a single bed room.
    • 2) 80 Square foot per bed in a multi bed room.
  188. Patient Care Policy Committee in an ICF must include who? And
    be reviewed how often? (73521)
    • 1) 1 Physician, the administrator, the supervisor of
    • health services and other disciplines as needed.
    • 2) Annually.
  189. ICF annual reports to DHS are due when? (73541)
    • On or before February the 15th of each yaer. Must be on
    • correct forms discussing matters requested by the
    • department
  190. A receiver submits a written report to the department including
    the following: (72805)
    • 1) Physical condition of the plant including the deficiencies affecting the
    • facility operation and recommendations of the current physical
    • condition and the capability of the continuing long term care.
    • 2) Assessment of the facilities probability of meeting State standards
    • within four months or an alternate date approved by the Department.
    • 3) Number of patients remaining and number of patients transferred
    • during the receivership.
    • Note: This chapter 3.5 which his literally a half a page is not
    • listed to be on the test but is good information to know.
  191. In issuing a written citation to correct the alleged violation the
    department will include at least the following: (72709,73715)
    • 1) The seriousness of the violation.
    • 2) Number of patients affected.
    • 3) Available equipment and/or personnel needed to correct the
    • problem.
    • 4) An estimate of time needed for delivery and installation of needed
    • equipment to make the correction.
    • 5) Plus the same as is on card #192.
  192. A written citation shall include at least the following:
    (72709, 73715)
    • Refers to Health & Safety Code 1423 (a) for the same information as is on
    • card #191 in addition to the below information.
    • 1) Description of violation and the area it occurred.
    • 2) List of residents affected and a list of residents with potential to be
    • affected.
    • 3) If all residents are affected, specify in writing, no list of names
    • required.
    • 4) Specify the shortest reasonable time to make correction.
  193. Define a class A,B and C violation: (73702,73705,73709)
    • 1) A is imminent danger.
    • 2) B is a direct or immediate relationship.
    • 3) C is minimal relationship.
    • Note: SNF (72703) for Class “A” Violation & (72705)
    • for Class “B” violation is currently repealed and
    • pending.
  194. Class A violation shall be corrected when? And the civil penalty for a class A is what? (73717)
    • 1) Immediately unless time is given by the department.
    • 2) Not less than a $1,000.00 and not more than $5,000 per
    • violation.
  195. In fixing the civil penalty to an A violation the following are
    considered: (72711)
    • 1) The gravity of the violation.
    • a) The degree of substantial probability.
    • b) The severity of serious harm most likely to result or did result.
    • c) The extent the regulations were violated.
    • 2) Good faith.
    • 3) Previous violations.
  196. What are the civil penalties for a class B violation? (73717)
    • Not less than $50.00 and not more than $250.00 for each
    • violation. Note: A separate civil penalty of $50.00 for each day
    • beyond the set completion date for each (A or B violation).
  197. What are the requirements in a SNF regarding smoking? (72507)
    • Both ICF & SNF require supervision and or periodic supervision for
    • smokers. They both also require signs marking open flamed areas and
    • oxygen areas. The difference between SNF & ICF is that SNF requires
    • designated “smoking” and “non-smoking” areas. (ICF 73509)
  198. Who is in charge of re-stocking the emergency supply kit after
    the seal has been broken? (72377, 73375)
    The Pharmacist within 72 hours and will also re-seal the kit.
  199. Who approves the pharmaceutical emergency supplies for each
    nursing station? (72377)
    • Patient Care Policy Committee or Pharmaceutical Service
    • Committee.
    • Note: ICF says Patient Care Policy Committee only. (73375)
  200. Emergency drug supplies in a SNF shall meet the following
    requirements: (72377)
    • 1) Legend drugs shall not be stored in the emergency supply unless except under the
    • following conditions:
    • a) Injectables shall be limited to a max of 3 single doses or 1 container of the smallest
    • multi dose vial. Must be sealed and in unused containers in
    • b) Sublingual or inhalation drugs shall be limited to single sealed containers of the
    • smallest available size.
    • c) No more than 6 emergency drugs in solid or oral dosage form or suppository form
    • for anti-infective, anti-diarrheal, anti-nausea, or analgesic use may be stored if in
    • sealed containers. Not more than 4 doses of any one drug may be stored.
    • 2) Emergency drug supply shall be stored in a portable container sealed with a
    • tamper proof seal. DON or Charge Nurse will notify the pharmacist when the seal
    • has been broken. Drugs used from the kit shall be replaced within 72 hours and
    • released by the pharmacist. Each nursing station must have an emergency drug
    • supply kit.
  201. What is the 2 hour rule? (72313)
    • Medications cannot be administered more than 2 hours after the
    • dose has been prepared. Doses shall be administered within 1
    • hour of the prescribed time unless otherwise indicated by the
    • prescriber and medications can only be administered by the
    • person who prepared them.
    • Note: ICF says the same. (73313)
  202. What is a stop order policy? (72359)
    • Drugs may be administered in the absence of a specific duration
    • of therapy on a licensed prescribers new drug order if the facility
    • applies its stop order policy for such drugs. The prescriber shall
    • be contacted prior to discontinuing therapy as established by
    • stop order policy.
    • Note: ICF says the same. (73357)
  203. Emergency drug supplies in an ICF shall meet the following
    requirements: (73375)
    • 1) Emergency legend drugs must be on at least 1 nursing station.
    • 2) The seal must be broken in the presence of a physician, pharmacist or licensed
    • nurse.
    • 3) Supply kit must be checked at least monthly by the pharmacist.
    • 4) If the seal is broken, the supervisor of health services must notify the pharmacist
    • and the pharmacist must replace the drugs and re-seal the kit within 72 hours.
    • 5) Legend drugs shall be limited to a max of 3 single doses in either sealed ampules
    • or vials of any 1 emergency drug. If emergency drugs are not available in
    • parenteral form a supply of the drug in inhalation or sublingual form may be
    • maintained in the smallest sealed manufacturer’s package. No other oral legend
    • drugs may be stored.
  204. What is the protocol for bowel and bladder management?
    • 1) Written assessment by a licensed nurse within 2 weeks after admission for an
    • incontinent resident to determine the patient’s ability to participate in a B & B
    • retraining program.
    • 2) Care plan for B & B training.
    • 3) Weekly written evaluations by a licensed nurse of patient progress in B & B
    • retraining program.
    • 4) Fluid intake and output shall be recorded for each patient as follows:
    • a) If ordered by the physician.
    • b) For a patient with an indwelling catheter.
    • 1) Intake and output evaluated weekly and included in weekly progress notes.
    • 2) After 30 days re-evaluate the need to continue recording intake and output.
    • Note: ICF does not require bowel and bladder management. (73315)
  205. Postural support versus physical restraint. (72319)
    • Postural support means a method other than an orthopedic brace used to
    • assist patients to achieve proper body position and balance. These
    • methods are not considered restraints. Treatment restraints may be used
    • for the protection of the patient during treatment and diagnostic procedures
    • such as IV therapy or catheterization procedures and may be applied for no
    • longer then the time required to complete the treatment. No restraints with
    • locking devices shall be used or available for use in a SNF.
  206. The attending physician shall be notified of the following: (72311)
    • 1) Admission of patient.
    • 2) Any adverse changes.
    • 3) Any unusual occurrence involving the patient.
    • 4) Any changes in weight of 5lbs or more within a 30 day period unless
    • the physician says in writing otherwise.
    • 5) Any negative reaction to a medication or treatment.
    • 6) Any error in the administration of a medication or treatment.
    • 7) The inability to obtain or administer prescribed treatment to a patient.
  207. Can separate premises owned by the same owner use the same
    license? (72207)
    • No they cannot. Separate premises must have separate
    • licenses.
  208. Define agency. (71801)
    • A private school, organization or individual approved by the
    • department to provide a continuing education course and a
    • certification training program for nurse assistance.
  209. Define clinical training. (71803)
    • The portion of the orientation program and the certification
    • training program which includes instruction and demonstration
    • on a patient of the patient care skills by a Director of Staff
    • Development or other competent instructor.
  210. Define gross negligence. (71811)
    • Means the failure of a person to exercise any care or the
    • exercise of so little care that it is apparent that the person is
    • indifferent to the consequences of his or her conduct and to the
    • welfare of others.
  211. Define an hour in an organized learning experience. (71813)
    50 Minutes
  212. Define continuing education. (71805)
    • Means provision of structured courses for certified nurse
    • assistants by an agency, a public educational institution or in a
    • health care setting other than the nursing facility where the
    • certified nursing assistant is employed.
  213. What are the rules regarding personal medications in a SNF?
    • Medication brought in by any means for a patient upon admission must be
    • examined and identified by the patient’s physician or the facility pharmacist. The
    • exception is drugs transferred from other licensed health facilities by any agent of
    • the patient or pharmacy. They do not need to be examined by a physician or
    • pharmacist.
    • Note: ICF says all medications brought in for a new admission must be examined
    • by the patient’s physician or a facility pharmacist. (73363)
  214. How often shall a disaster drill (external disaster) be held by a
    facility? (72553)
    • 6 Month intervals for all shift and written report kept in the facility of each drill.
    • Note: ICF says twice a year. (73549)
  215. Fire and internal disaster drills shall be how often? (72553)
    • Quarterly and on all 3 shifts.
    • Total of 12 times per year.
    • Note: ICF says the same. (73551)
  216. What is the nursing staffing requirement for a SNF? (72329.1)
    • 1) 59 or less beds RN or LVN on all shifts. No DON.
    • 2) 60 to 99 beds RN or LVN on all shifts plus DON 5 days a week 8 hours a day. The
    • DON cannot serve as a charge nurse.
    • 3) 100 plus beds RN on all shifts plus DON. The DON cannot serve as a charge
    • nurse.
    • Note: There must be sufficient nursing staff to provide a minimum daily average of 3.2
    • nursing hours per patient day.
    • Example: The total number of hours worked by direct care staff divided by the number
    • of patients. 288 employee hours for the 24 hour day divided by 80 patients for the day
    • = 3.60 hours of nursing care per patient per day. Note: See section 72329.1 (3) (a) (b)
    • (c) (d) for more info on “direct caregiver” and licensed nursing staffing per shift.
  217. What is a drawing account? (72529)
    • An account that holds less than $500 of residents money on sight and
    • available to the resident on the day of the request. All monies are tracked
    • with vouchers, receipts, debits, credits and balance filed in chronological
    • order. Records are maintained in the facility for a minimum of 3 years after
    • the date of the last transaction. The account can never be less than zero.
    • Note: ICF says the same (73357). Fed says less than $50 and less than
    • $100 for short term Medicare residents.
  218. What is a Demand Trust Account? (72529)
    • An account that holds resident’s money in a bank outside of the facility. The
    • amount must be over $500.00 (Fed regs say over $50.00 and $100 for Medicare
    • patients F-Tag 159). All banking records relating to these funds will be maintained
    • in the facility for a minimum of 3 years from the date of transaction. Checks to this
    • account must be identified as a patient trust fund account and clearly printed on
    • each patient’s trust account checks and bank statements. All outstanding checks
    • for 45 days or more shall be maintained on a separate list and reflected on the
    • most recent bank statement. Patient’s funds maintained in a financial institution
    • shall be deemed to be entrusted to the facility if the licensee or any agent or
    • employee thereof is an authorized signatory to the set account.
    • Note: ICF says the same (73557)
  219. How long after a patient is discharged or deceased must the
    advance rent be returned to the patient, heir, legatee or personal
    representative? (72531)
    • 2 Weeks (not 14 days) after the discharge or death.
    • Note: ICF says the same except only after death not after
    • discharge or death. (73558)
  220. When shall money and valuables of a patient that have been
    entrusted to the licensee and kept within the facility be returned
    to the patient or authorized representative? (72529)
    • Immediately upon request or discharge with a signed receipt.
    • Note: ICF says the same. (73557)
  221. Within what time frame must monies in a demand trust account
    be given to the resident or resident representative upon request?
    • Within 3 normal banking days.
    • Note: ICF says the same. (73557)
  222. In the event of a death when must money and valuables of a
    patient which have been entrusted to the licensee be
    surrendered to the responsible party of the executor of the estate
    in exchange for a signed receipt? (72529)
    • Within 30 days following the death of a resident except in a
    • coroner or medical examiner case.
    • Note: ICF says the same. (73557)
  223. What happens if a patient dies with no heir? (72529
    • A written notice within 5 working days will be given by the facility
    • to the public administrator of the county and a copy shall be
    • available in the facility for review.
    • Note: ICF says the same. (73557)
  224. How often must residents receive a financial statement reflecting
    their financial transactions? (72529)
    At least quarterly
  225. The functions of the Infection Control Committee shall include
    but not be limited to: (72525)
    • 1) Establishing, reviewing, monitoring and approving policies and
    • procedures for investigating, controlling and preventing infections in
    • the facility.
    • 2) Maintaining, reviewing and reporting statistics of the number, types,
    • sources and locations of infections within the facility.
  226. What is the difference between legend drugs and non-legend
    drugs? (72357)
    • Legend drugs are narcotics and/or prescription drugs and nonlegend
    • drugs are everything else.
  227. What does it mean to mingle funds? (72529)
    • Never at any time is any resident’s money to be mixed with any
    • other money especially with facility money. It must remain
    • completely separate and exact at all times.
    • Note: ICF says the same. (73557)
  228. What is the standard admission agreement? (72516)
    • 1) The licensee shall use the California Standard Admission Agreement for skilled
    • nursing and intermediate care facilities form CDPH 327 (05-11) as the sole
    • contract admission between residents and the licensee.
    • 2) The licensee shall not alter this agreement without the prior written authorization of
    • the department.
    • 3) No resident or legal representative shall be required to sign any other document as
    • a requirement for admission into the facility or as a condition of continued stay.
    • 4) Any arbitration agreement shall be separate from the standard admission
    • agreement and shall contain in a prominent place in bold face font of not less than
    • 12 point type.
    • “Resident’s shall not be required to sign this arbitration agreement as a
    • condition of admission to this facility and cannot waive the ability to sue for a
    • violation of the resident bill of rights.”
    • Note: ICF says the same. (73518)
  229. How many days shall a skilled nursing facility afford the patient a
    bed hold? (72520)
    • 7 Days.
    • Note: ICF says the same. (73504)
  230. What are the regulations for a bed hold? (72520)
    • 1) Upon transfer to a general acute care hospital the patient or representative shall
    • notify the skilled nursing facility within 24 hours if the patient or representative
    • wants the 7 day bed hold.
    • 2) Any patient who exercises the bed hold option shall be liable to pay reasonable
    • charges not to exceed the facility daily rate for bed hold days.
    • 3) The facility shall not be required to maintain the bed hold if the patient’s attending
    • physician notifies the SNF in writing that the patient stay in the hospital is expected
    • to exceed 7 days.
    • 4) Patient or representative must be informed in writing of the right to exercise the
    • bed hold provision upon admission and transfer.
    • 5) A licensee who fails to meet these requirements shall offer to the patient the next
    • available bed appropriate for the patient’s needs.
    • 6) Does not apply to patients only covered by Medicare.
    • Note: ICF says the same except for #6. (73504)
  231. How many meals shall be served in a day? (72335)
    • Not less than 3 meals shall be served daily and with not more
    • than a 14 hour span between the last meal and the first meal of
    • the following day. Fed says: 16 hours when substantial
    • nourishments have been served in the evening.
  232. What information is on a resident’s dietary profile card? (72335)
    • Each resident has a profile card indicating diet order, likes,
    • dislikes, allergies to foods, diagnosis and instructions or
    • guidelines to be followed in the preparation of food for the
    • patient.
    • Note: ICF does not require a profile card. (73325)
  233. Who receives and records verbal dietary orders? (72335)
    • Qualified dietitian and shall be signed by the prescriber within 5
    • days.
  234. What are the required hours for a dietitian in the facility? (72351)
    • Full time, part time or consultant. If the dietician is not employed
    • full time then a full time dietetic supervisor must be employed.
    • Note: ICF has no such requirement. (73343)
  235. What are some kitchen rules? (72351)
    • 1) Work schedules by job titles and weekly time schedules by job titles shall be
    • posted.
    • 2) Employee’s street clothing shall be stored in a closed area separate from food or
    • items used in food service.
    • 3) Kitchen sinks shall not be used for hand washing. Must have separate hand
    • washing facilities.
    • 4) Persons’ other than dietetic service personnel shall not be allowed in the kitchen
    • unless necessary to do their job.
    • 5) Smoking is not permitted.
    • 6) Sufficient staff shall be employed.
    • 7) All foods are labeled and dated in tight fitted containers.
    • 8) Kitchen shall be ventilated to maintain comfortable working conditions, remove
    • odors, fumes and prevent excessive condensation.
  236. What are the requirements of the Director of Nursing? (72327)
    • 1) Shall be a registered nurse and shall be employed 8 hours
    • a day on the day shift 5 days a week.
    • 2) Shall have at least 1 year of experience in nursing
    • supervision within the last 5 years.
    • 3) DON can serve only 1 facility at any one time.
  237. When is an orientation program complete? (71833)
    • When there is an orientation schedule, a lesson plan and a core
    • curriculum
  238. Bed pans and urinals shall be sanitized only by one of the
    following methods: (72323)
    • 1) Submerged in boiling water for a minimum of 30 minutes.
    • 2) Autoclaving at 15 pounds pressure and 250 degrees F for
    • 20 minutes.
    • 3) Gas sterilization.
    • 4) All disposables shall not be re-used.
  239. What changes must be reported to DHS? (72211)
    • 1) Changes in information provided pursuant to the health and safety code within 10
    • days of such changes in writing.
    • 2) When a change of administrator occurs the Department must be notified within 10
    • days in writing by the licensee. Shall include the name and license # of the new
    • administrator.
    • 3) Notified within 10 days in writing of any change of the mailing address of the
    • licensee. Must include new mailing address.
    • 4) Department shall be notified within 10 days in writing by the licensee of any
    • changes of a principal officer. Must include the name and business address of the
    • new officer.
    • 5) Any decrease in license bed capacity shall require notification by letter to the
    • department and shall result in the issuance of a corrected license.
  240. Physicians assistants working under a physician’s supervision,
    perform only those selected diagnostic and therapeutic tasks
    identified in…(72303)
    • The scope of their professional licensure as a health care
    • practitioner.
    • Note: Refer Title 16 of the California Administrative Code.
  241. Records of hours and dates worked by all employees must be
    available during what time frame? (72533)
    • Most recent 12 months.
    • Note: ICF says most recent 6 months. (73527)
    • Note: Must be kept on site or centrally located and
    • available upon request.
  242. A permanent log of the temporary held services employed in the
    facility shall be kept for 3 years and shall include the following:
    • 1) Employee ‘s full name.
    • 2) Name of the temporary health services personnel agency.
    • 3) Professional license and registration # and date of
    • expiration.
    • 4) Verification of health status.
    • 5) Record of hours and dates worked.
  243. Who is in your Quality Assurance Committee per State
    • State do not require a QA Committee. Fed regs do. Fed says
    • must have a DON, a physician and 3 other facility staff in QA
    • Committee. Must meet quarterly. Focus is primarily on clinical
    • issues. (F520)
  244. What are the requirements for a Social Worker? (F 251)
    • A 120 plus bed facility must have a qualified Social Worker with
    • a BA in Social Work or Human Services with one year of
    • supervision in health care as a Social Worker working directly
    • with individuals.
  245. Each licensed bed shall have the following: (72613)
    • 1) Clean comfortable bed with adequate mattress, sheets,
    • pillow, pillow case and blankets all in good repair.
    • 2) A bedside table, chair, over bed table and reading light all
    • in good repair.
    • Note: ICF says the same but does not require and over
    • bed table and the arm chair must be “comfortable”. (73615)
  246. When must the Department be notified of a new DSD? (71829)
    In writing within 30 calendar days of employment
  247. Who notifies the Pharmacist when the emergency supply seal is
    broken and supplies need to be replaced? (72377)
    • DON or Charge Nurse.
    • Note: ICF says Supervisor of Health Services. (73375)
  248. How often must an in-service program be renewed? (71847)
    • 1) Submitted to the Department every 2 years for renewal.
    • 2) The Department must be notified no later than 30 days
    • prior to any changes in the program and/or program staff.
  249. What are the required nursing hours per patient, per patient day
    in a SNF, ICF? STP? (72329.1,73319,72329)
    • 1) 3.2
    • 2) 1.1
    • 3) 2.3
  250. What is a medication error? (F332-F333)
    What is a medication error? (F332-F333)
Card Set
State NHA Exam
Title 22, OBRA