Test An Overview of-risk Management in Long-Term Care: Middle Management General Purpose: To provide middle management personnel with knowledge of common malpractice issues and risk management strategies for long-term care facilities. Learning Objectives: After completing this educational activity and taking the post-test, you should be able to: 1. Recognize the importance of reducing liability risk in long-term care facilities. 2. Identify recent legislation and regulatory statutes that affect long-term care facilities. 3. Select documentation and standards of care for occurrences that increase liability risk for long-term care facilities. 4. Distinguish costs, penalties, and sanctions associated with citations, lawsuits, and high-risk occurrences that increase liability Post-test Instructions: After viewing the presentation or reading the learning materials associated with this activity, complete the following test by filling out the answer sheet. Please select the best answer to each multiple-choice question. There is only one correct answer. You must achieve 70% to pass and to earn credit. Question #1 relates to the following scenario: The Petrikko family is visiting the Red Bush Hill Nursing Home to decide if they will move their mother here from her current home in an assisted living facility. The daughter tells the director of nursing that she reviewed quality measure (QM) evaluations of the nursing home on the Internet. The director of nursing explains that the Centers for Medicare and Medicaid Services (CMS) evaluate the nursing home and provide a report card that includes a grade. CMS scores the facility based on a number of QMs. The information provided in the report card is then placed online for public viewing. The media uses the QM scores and each facility s report card grades to determine the ranking of nursing homes. This ranking is also published for the general public. 1. The legislation that requires a report card be completed when grading long-term facilities is the A. Freedom of Information Act. B. Nursing Home Quality Initiative (NHQI). C. Omnibus Budget Reconciliation Act (OBRA). D. Corporate Manslaughter and Corporate Homicide Act 2007. Question #2 relates to the following scenario: The middle manager at Day Lilies Nursing Home is not aware of legislation that governs nursing homes. The manager unknowingly breaches the laws. The financial consequences of this breach lead to bankruptcy of the facility. All the middle managers have to advise the staff of the upcoming closure of the facility. The staff is told that they will all be unemployed by the end of next week.
2. Consequences of breaching OBRA legislation include A. termination of CMS provider agreements. B. removal of all residents from the facility. C. administrative penalties as high as $100,000 per day. D. incarceration of all facility administrators and management personnel. Question #3 relates to the following scenario: Alfred, the maintenance employee who usually changes the facility s gas tanks, is not at work today. The maintenance director must delegate this task to another employee. 3. Which employee should be assigned to the task of oxygen gas tank connection? A. Ben, a maintenance employee who attended a gas tank training program. B. Daniel, a security guard who used to work as a gas tank delivery driver. C. Cathy, a nursing assistant who once watched Alfred switch the gas tanks. D. Emily, who transports those residents who use individual oxygen tanks. Questions #4 through #6 relate to the following scenario: The food service director of Red Bush Hill Nursing Home is notified that a resident, Mr. D, is having difficulties swallowing his food. The food service director discusses this situation with the nursing staff and learns that Mr. D has lost weight in the past week. 4. To further assess Mr. D s eating difficulties, a referral is made for a consultation with a A. physical therapist. B. occupational therapist. C. ear, nose, and throat physician. D. speech-language pathologist. 5. Mr. D is diagnosed with dysphagia. His new plan of care includes all of the following except A. finger foods. B. bland pureed foods. C. small portion meals. D. high calorie supplements. 6. Despite interventions addressing his dysphagia, Mr. D continues to lose weight. It is important to document this weight loss in Mr. D s medical record to notify A. his dentist. B. his family members. C. the facility s risk manager. D. the Academy of Nutrition and Dietetics.
Questions #7 and #8 relate to the following scenario: Mrs. F has dementia and has been combative and aggressive. Last night, she injured her roommate. Her physician requests an evaluation with a psychiatrist. In the meantime, he prescribes a new medication to address the aggression. While waiting for the medication to take effect, family members have given consent for physical restraints during non-direct supervision at nighttime. 7. When a restraint is being used for a resident, it is important for the middle manager to monitor documentation of all of the following except A. release times. B. care plan for restraints. C. rationale for restraint use. D. intake/output flow sheets. 8. The middle manager reinforces with the staff that Mrs. F s restraint can be removed A. when she is sleeping. B. for supervised toileting needs. C. whenever she requests the restraint to be removed. D. for her to spend unsupervised time with other residents. Question #9 relates to the following scenario: The director of environmental services provides educational programs for the staff on reduction of hospital acquired infections (HAIs). One resident, Ms. I, is in isolation because of the recent onset of a contagious illness. During the staff educational training session, the director reviews various ways to reduce the risk of spreading infections within the facility and from health care workers to residents. 9. To assist with the enforcement of the best practice for limiting HAIs, which of the following does the director make available to the staff? A. latex gloves. B. hand sanitizer. C. masks and gowns. D. disinfectant sprays. Question #10 relates to the following scenario: The director of nursing enforces the policies and procedures of medication administration. One of these policies includes the Red Rule regarding identification of residents prior to providing the medication. 10. The Red Rule requires that, prior to medication administration, the nurse A. use two identifiers for the resident. B. recheck the medication dosage with another nurse. C. verify the room, bed number, and resident s full name. D. ask the resident which medications she takes to verify the correct medications.
Question #11 relates to the following scenario: Trent is a 60-year-old male visiting his 92-year-old father at Red Bush Hill Nursing Home. Trent helps his dad walk to the dining room. While ambulating with his dad, Trent slips on a throw rug on the tile floor. An ambulance is called and Trent is taken to the hospital for assessment of his possible injuries. 11. To implement a facility-wide fall prevention program, it is imperative that A. middle managers decide which program will be used. B. the initial cost is tax deductible and has a low start-up fee. C. staff, residents, and family members are all educated about the program. D. residents try using the program to see if they like it before it is initiated. Question #12 relates to the following scenario: A few months later, the middle manager is advised that Trent is suing Red Bush Hill Nursing Home because of his fall. The lawsuit states that the nursing home was at fault for having an unsecured throw rug on a tile floor. This is a known fall hazard. Trent wins the lawsuit and is awarded compensation. The result is a payment to the plaintiff of $500,000. 12. Which of these is a result of increased litigation brought against nursing homes? A. decreased interest in large nursing home facility care B. decreased number of staff working at facilities C. increased malpractice insurance rates D. increased desire among older adults to hire private caregivers
Enrollment Form An Overview of-risk Management in Long-Term Care: Middle Management Test Code: LAMM0513a Instructions: Please complete Part 1: Enrollment to provide essential information to create your educational record and to report to licensing boards (if applicable). Your site coordinator will provide you with the facility ID and your user name. Then complete Part 2: Test Answers by darkening one circle to indicate the correct response to each question. You are also required to provide feedback by completing Part 3: Evaluation. After completing this form, please return it to your site coordinator to have your test submitted for processing. Results will be sent to the site coordinator within 4 weeks of submission. For customer support and accreditation questions, please call: 1 (800) 787-8985 Part 1: Enrollment Facility Name Last Name User Name Facility Number First Name Role: Allied Health (RD, PT, OT, RT, SW, etc.) Nursing (CNA, LPN/LVN, RN, etc.) Non-clinical support role. Please specify your job title: Credit Type: Continuing education is available for the following professions. Please select one. Nursing PT OT License: All Florida licensees and District of Columbia nurses: please provide license information for reporting to CE Broker. State of license (1) License # License Type (abbreviation) State of license (2) License # License Type (abbreviation) Part 2: Test Answers Darken one circle for your answer to each question. a b c d a b c d a b c d 1. 5. 9. 2. 6. 10. 3. 7. 11. 4. 8. 12. Part 3: Evaluation (Please note: There are 2 pages /17 questions.) 1. Rate to what extent you were able to meet objective 1. (1- lowest, 5- highest, NA- not applicable) NA
2. Rate to what extent you were able to meet objective 2. (1- lowest, 5- highest, NA- not applicable) NA 3. Rate to what extent you were able to meet objective 3. (1- lowest, 5- highest, NA- not applicable) NA 4. Rate to what extent you were able to meet objective 4. (1- lowest, 5- highest, NA, not applicable) NA 5. Was evidence provided to substantiate material presented? 6. Were personal experience and observation the primary source of information? 7. Rate to what extent did the program content relate to the learning objectives? (1- lowest, 5- highest) 8. Rate the effectiveness of the independent study learning method. (1- lowest, 5- highest) 9. Rate the contribution of this course to your overall knowledge of the subject. (1- lowest, 5- highest) 10. Rate your overall degree of satisfaction with this course. (1- lowest, 5- highest) 11. Rate the degree that you believe this course was objective and free from bias. (1- lowest, 5- highest) 12. Was a commercial product promoted? 13. If yes, did you feel that product promotion was the sole purpose of the course? 14. Rate your level of expertise in this subject prior to this course. (1- lowest, 5- highest) 15. Rate the educational level of the content. Basic Intermediate Advanced 16. Comments: 17. What future topics would you like to see offered for continuing education?