Dave's Notes Flashcards
1
Q
Doc notified if weight change of
A
5lbs in 30 days
2
Q
Menu cycle at least
A
3 weeks revise Q 90 days
3
Q
Treatment restraints to be used ONLY
A
for the time required to complete the treatment.
4
Q
Soft ties, seat belts, spring release trays or cloth vests are restraints UNLESS
A
used for “postural support”
5
Q
All patients to be assisted and encouraged to maintain the
A
“highest level of self care and independance”
6
Q
Patient call lights to be answered
A
promptly
7
Q
Humidifier bottles change and sterlize
A
Q24 hours fill only with sterile distilled, deionized or demineralized water.
8
Q
Dentist inservice for staff
A
annually
9
Q
Care plans revised
A
quarterly
10
Q
Food service supervisor requires
A
90 hour course
11
Q
Drugs destroyed in
A
90 days
12
Q
Drugs at room temp
A
59F - 86F
13
Q
Initial assesment finished within
A
within 7 days
14
Q
Minimum dishwashing temp
A
110F
15
Q
Utensils clean
A
170F 2 minutes, 180F 30 Sec
16
Q
Autoclaving
A
250F for 20 minutes
17
Q
Persishable foods stored
A
below 45 or over 140
18
Q
Non Perishable food
A
1 week, staples 2 days
19
Q
Sanitize washbasins
A
30minutes boiling water or autoclave or gas sterilization: NOT with chemicals
20
Q
Employee health records kept
A
3 years
21
Q
CNA certificate renewal costs
A
$20
22
Q
CNA orientation time requirements
A
16 hours in first 40 worked (first 8 MUST be before providing care)
23
Q
1 hour of learning experience is
A
50 min
24
Q
Drug DESTRUCTION records kept
A
for 3 years
25
Drug ORDER records kept
for 1 year
26
Glass thermometers cleaned
70% alcohol 10 min
27
Drugs ordered stat given within
1 hour given in 2 hours max
28
Diet Manual reviewed
annually revised Q 5years
29
Handicap parking space width
13' wide
30
Test Ice
every month
31
Test drinking water
every 3 months
32
Lighting in room
20 ft candles
33
Lighting for reading
30ft candles
34
Bedhold lasts
7 days
35
Nurses progress notes updated
as neccessary
36
Prepaid room and board returned within
2 weeks from dc
37
Patients money returned within how many days after death
30 days of death
38
Unusual occurrences report within
24 hours keep one year
39
Patient Care Policy comittee reviewed
annually
40
Patient records keep
7 years (title 22) 5 years OBRA
41
Notify DHS of construction within
5 days
42
Autoclave thermometer check
weekly
43
Test Autoclave
monthly
44
Curtains located
18" below sprinklers
45
Windows no higher than
36"
46
Hand rails between
34" and 38" high
47
Handicap parking width
13' wide
48
Medicaid fraud unit info
must be posted (HCFA office info not required
49
Minimum RN hours
8 per day
50
Drugs brought in check with
DOC and Pharmacist
51
Written Manual required for
HVAC
52
Surveyors review upon entrance
Facility Characteristics, QI profile, Resident Level Summary
53
Admission eval completed
5 days prior-48 hours after admit
54
Weights taken
monthly
55
Bug Screens
16 wires per square inch
56
CNA training complete
in 4 months
57
Water over 125F must have
warning sign 2" letters
58
Hot water temperature between
105F and 120F
59
100+ beds must have RN
at all times (not DON)
60
Generator must come on
in 10 seconds and run 6 hours
61
PCP committee includes
DON, Activities, Admin, pharmacist and at least one physician
62
Isolation bed ratio
1:35
63
Medical Director
liason between admin and MD's
64
Storing of NON-legend drugs at bedside
original container, recorded in chart, amount recorded - NOT ordered by prescriber
65
Convert utility room to office
DHS approval required
66
Admin policy and procedures from
governing body
67
Extended survey follows
standard survey
68
Oxygen equipment needs
3 prong hospital grade plug
69
Temperature of pipes regulated by
title 24
70
Non contested citations, facility pays
25% in 4 days
71
Not in compliance in 6 months
23 day fast track to term
72
Not in compliance in 3 months
Denial of payments for new admissions
73
Survey can come
at any time
74
Self administration of drugs determined
by IDT
75
Bowel and bladder management within
2 weeks of admit
76
Notify DHS of change in Administrator within
10 days
77
ADMIN can oversee
3 buildings up to 200 beds IF same company
78
Trained and competent non licenced staff can give
medicinal baths and shampoo, non legend cream or ointment to intact skin, and laxative suppositories
79
Audiology can be
an optional service
80
Phone not req'd if
less than 6 beds all ambulatory
81
Minimum info on ID band
name and facility name
82
No mingling of funds between
facilities
83
Health Records can leave the facility for
storage after discharge
84
3 req'd committees
PCP, Infection control and Pharmacy
85
ADMIN or designee screens
patients for admit
86
Change of physician requires
review of orders for care and treatment
87
Final responsibility for care in ICF
MD
88
Final responsibility for care in SNF
ADMIN
89
Signed orders sent to pharmacy
in 48 hours
90
Therapuetic diet manual approved by
dietician & PCP
91
Unit dose medication supply on hand
min 24hrs max 48hrs supply
92
All nurses need
CPR training
93
Patients financials reported how often
Quarterly
94
Who is responsible for Informed consent
the Physician
95
Outpatient therapy must have
handwashing facility
96
Soiled linen sorted in
a seperate room
97
Mentally disordered get special rehab time of
27 hours a week
98
Piped gasses checked
at time of installation, if changes are made, or integrity breached
99
Emergency supply drugs to be checked by
pharmacist
100
Non movable solid waste containers must be
leak proof, rodent proof, tight fitting lids, and external handles. label is not required
101
Beds must be
clean comfortable and have blanket, sheets, pillow w/pillowcase and mattress
102
SNF may have more patients than licenced beds with approval of
director of DHS
103
Log of registry workers kept for
3 years
104
Hours and dates employees worked kept
12 months
105
Rights cannot be
denied or taken away
106
External disaster plan reviewed
annually
107
Facility must release drugs on discharge IF
doc orders do not include provision for drug disposition
108
Optional services approved by
PCP
109
Med error rate
5% or less
110
Provisional licence valid for
6 months
111
Pt. may not smoke in bed
unless supervised
112
Transfer record shall include:
Date, time, condition of Pt and reason for transfer - Name NOT included
113
Cannot say "approved by DHS"
ever...
114
Admit patients only on
physicians orders
115
Admin must be present
sufficient hours to run facility
116
Resident injury
notify physician, family member, legal representative
117
Bond for $750 or less in patient trust =
$1000
118
Committee NOT req'd by title 22
QA
119
Resident being involuntarily Dc'd requires
30 day notice
120
DON can be charge nurse IF
ADC less than 60
121
Fridges storing drugs must have
accurate thermometers
122
Patient bacteriological tests kept for
12 months
123
Infectious waste stored with other waste requires
DHS approval
124
Medical Director responsible for
standards, surveillance, coordination and improvement of medical care. Acts as consultant to DON, liason between ADMIN and MD's, and is responsible for employee physicals
125
If equipment is maintained by outside company, must have
documentation of req'd standards
126
Handwashing facility shall not have
aerators
127
Test generator every
14 days for 30 min load conditions
128
Bedpans emptied in
utility rooms or toilets with flushing attachments
129
Soiled linen transported in
closed containers
130
Linen supply requirements
3 complete changes for capacity
131
Housekeeping leader qualified by
training and experience
132
Mop heads removed and changed
daily
133
Thermometer check logs
keep 12 months
134
Rooms must have
bedside table, chair, reading light, and overbed table
135
Fire drills every
quarter for all shifts
136
Close chart
30 days after DC
137
If Pt records damaged or defaced notify DHS
3 days
138
Employees health exam completed
90 days prior or 7 days after employment - annually thereafter
139
Admin must appoint acting admin if
absent 30 days
140
Size of activity room
not stipulated in regulations
141
Activities inservice
annually
142
Emergency drugs stored in
portable sealed container
143
Drugs for internal and external use
stored seperately
144
Dishwasher standards
National Sanitation Foundation
145
ICF with less than 50 beds
no additional licenced personnell required
146
Piped oxygen tests are by
the National Fire Protection Agency standards
147
Inspection and cleaning record of air filters must include
information on static pressure drop
148
Staff may not transfer gasses
between containers
149
Gases for medical use:
CO2, NO, O2, Ethylene, Cyclopropane, helium (NOT Nitrogen or CO)
150
Utility rooms must have
rim flush sink, work counters, and storage cabinets (call system NOT required)
151
Must maintain grab bars
in resident bathrooms
152
Ambulatory rooms required signage
"reserved for ambulatory patients" in half inch letters next to door.
153
Housekeeping schedule
daily, weekly, monthly
154
Telephone installed
on each floor with residents
155
Must maintain generalized and specialized
storage space
156
External disaster program must have:
P&P for recalling off duty staff, unified medical command, P&P for Pt relocation
157
ADMIN office must have contracts for
dentist
158
Working flashlights required for
emergency supply
159
Must report which diseases
TB, Brucellosis, Pertussis
160
Standard for measuring student learning is
Student Performance Standard
161
Demonstration and return demonstration is
clinical training
162
At a citation review conference the licencee cannot
subpeona witnesses, record testimony, or cross examine
163
Centralized services may be
shared by facilities
164
Water that is too hot in fixtures used by patients is a
class B violation
165
Direct supervision means
that the supervisor is in the same building
166
Violations with direct relationship to health and safety of patients are
class B violations
167
Hospital License correction not req'd
for ownership change.
168
Occupational Therapy Assistant certified through
AOTA
169
PCP meets
annually
170
OT floor space =
PT floor space
171
Dietician licensed through
American Dietetic Association
172
Autoclaves must have
time record and mercury thermometer
173
Interpersonal relationship programs include
outings, educational and recreational therapy, and social counselling (NOT mental health counselling)
174
Violations relating to nursing staff are
class B violations
175
Physical Therapists are registered through
California Board of Medical Quality Assurance
176
Violations relating to employee personnel records
are class C violations
177
59 beds or less nursing requirements
at least one RN or LVN on duty and awake at all times
178
Dietary Card lists
likes, dislikes, allergies, diet order
179
Violations relating to care plans are
class B violations
180
Physical Therapy room must have
training stairs, full view mirror, overhead pulley and weights, and treatment table with curtain
181
Physical therapy evaluates
functionality, muscles and joints (NOT pain)
182
In deciding time for elimination of a condition of a violation - Dept considers
number of patients, seiousness, and availability of resources
183
Unauthorized administration of medication is either a
class A or B violation
184
Physician visits
As needed + every 30 days
185
How many hours between last meal and breakfast
14 hours
186
Emergency drugs used to be replaced within
72 hours; kit resealed by pharmacist
187
Supply storage space requirements
15 sqft per unit
188
Soiled linen storage space requirements
10 sqft per unit
189
Clean linen storage space requirements
8sqft per unit
190
Dining room space requirements
12sqft per bed plus 100sqft
191
Utility rooms minimum space requirements
100sqft
192
Max distance from nurses station to patient room door
90 ft
193
Refrigerated drugs stored at
36F-46F
194
Violations relating to fire safety procedures are
class A or class B violations
195
Powdered milk can only be used
in cooking - NOT for drinking.
196
Standing orders may
not be used
197
DON must have how much supervising experience
one year of supervising experience in the last 5 years
198
Trash storage dimensions
25 sq ft
199
Corridor widths
8ft wide in pt areas, 6 ft wide in service areas
200
Toilets ratio
1:6
201
Showers ratio
1:12
202
Ceiling minimum height
8ft
203
Wheelchair storage space requirements
15 sqft per unit
204
PT space minimum
300sqft (12ft min dimension)
205
Menu AS SERVED to be kept
30 days
206
Menus to be posted
in kitchen one week prior
207
Itemized food purchase records kept
ONE year
208
Unit dose system is responsibility of
Pharmacist
209
CNA training records kept for
4 years
210
24 hours per year of training for
CNA's
211
Medications must be given no more than
2 hours after being prepared and given by the preparer - drug prep for more than one administration time is not permitted
212
Keep certification program records for
4 years
213
3 hours clinical training =
1 CEU
214
CNA training must be completed in
4 months
215
DSD requirements for facility with certification program
100+ requires 40 hours per week; 60-99 beds requires 30 hours per week; 59 or less beds requires 20 hours per week
216
DSD experience requirements
one year of patient care and one year planning and implementing educational programs
217
Student to instructor ratio
1:15 maximum
218
Immediate supervsion means
instructor in the building AND present when clinical procedure performed.
219
If Dept initiates disciplinary action nurse can request hearing
within 15 days - hearing within 5 days of request.
220
Substantial Compliance means
conformity to regulations to an extent that patient safety, welfare and quality of care are assured.
221
Clinical Social Worker licensed by
California Board of Behavioral Science Examiners.
222
Legend drugs have label
stating federal law prohibits dispensing without prescription, or are dangerous drugs under the Business and professions code
223
Orientation - first 8 hours include:
Tour, emergency P&P's, intro to patient care
224
DON can only be DON in
one facility, work 8 hours a day 5 days a week on the day shift be an RN
225
Infectious disease - residents shall have room
vented to the outside with a separate towel, handwashing facility, soap dispenser, and toilet.
226
Restraints checked
every 30 minutes
227
Dry foods to be stored
12" above floor
228
Facility may dispute survey findings with an
Informal Dispute Resolution
229
Pharmacist req'd
as many hours as needed + quarterly review
230
E-kit contents
Max 6 emergency drugs; max 4 doses each
231
Seclusion as a restraint
may NOT be used
232
Physical restraints shall NOT have a
PRN order and must have written physicians order specifying the duration and circumstances of use.
233
Special treatment programs in ICF must have
30 pt's initially - cannot drop below 27
234
ICF - After 90 days from admission resident must be seen
every 60 days
235
ICF menus
posted 3 days in advance, written one week in advance
236
ICF - if LVN only on day shift must have RN consultant
4 hours a week
237
ICF required services
MD, intermittent nursing, Dietary, Pharmacy and Activity
238
ICF - must obtain written dept approval to acquire
10% or more of a facility
239
Drugs returned to facility in ICF keep log
3 years
240
Facility to provide physician for emergency care if
attending physician is unavailable
241
ICF special programs orientation requirements
20 hours orientation in first 60 days of employment
242
ICF special programs eval done
30 days prior or within 15 days after admit.
243
Pharmacist review patients drug regimen
monthly
244
Drug orders signed in
5 days transmitted in 48 hours
245
Legend drugs stored at bedside
1.) locked 2.) recorded in chart 3.) be ordered by prescriber 4.) stored in original containers 5.) sublingual or inhalation 6.) not kept in stock after expiration
246
Drug labels must be
legible
247
Automatic dishwashers must have
180F water on the rinse cycle.
248
ICF space per bed
110 sqft for single bed room; 80 sqft for multi bed
249
DON and ADMIN may not be
special program director
250
ICF - check E-kit
monthly
251
ICF activity staff -
50+ bed requires full time, 25-49 bed requires 20 hrs per week, 24 and under requires 10 hrs per week
252
ICF activities requirements
10 hours a week for each patient
253
ICF patient rights
1.) Privacy for visits 2.) Reimbursement for lost property 3.) Visiting hours daily for clergy
254
Special treatment programs for the mentally disordered include:
1.) Money management 2.) Use of community resources 3.) Use of public transportation
(NOT homemaking)
255
Special Disability services in ICF for
1.) mentally disordered 2.) substance abusers 3.) developmentally disabled
256
ICF STP - pro IDT staff
49 patients or less is 48 hrs per week, 50-69 patients is 64 hrs per week, 70-99 patients is 96 hrs per week, over 100 patients is 144 hrs per week
257
ICF psychiatric special treatment hours requirement
30 hours ppweek
258
ICF Ekit
3 doses max
259
ICF menu written
1 week in advance posted 3days in advance
260
ICF RN or Pharm reviews drug order how frequently
monthly
261
ICF Drug orders signed in
48 hours
262
ICF may have skilled care that is
non continuous
263
ICF minimum nursing hours
1.1 ppd
264
ICF bedside nursing permitted if orders are for
temporary and minor care
265
ICF storage space requirements
12 sqft per bed
