RCFE GUIDE Flashcards
1
Q
- Each resident must eat how many meals each day?
2. Elapsed time between 3rd and 1st meal?
A
- 3 meals per day
2. 15 hours max
2
Q
A reappraisal must be done when?
A
When there is a significant chance in the resident’s condition, OR once every 12 months.
3
Q
Auditor & visual signal system must be used at what capacity?
A
16+
4
Q
Components of appraisal needs & plans include: (4)
A
- Medical assessment
- Functional capabilities
- Mental capabilities
- Social factors
5
Q
Destruction of medication record retained for:
A
Atleast 3 years
6
Q
Residents records retained for:
A
3 years following termination.
7
Q
Exception
A
A variance for a special purpose for only 1 person.
8
Q
Theft & Loss policies
- $25+ stolen, report within:
- $100+ stolen, report within:
A
- 72 hours
2. 36 hours
9
Q
When does your direct care staff require a criminal record clearance?
A
Prior to employment
10
Q
- Notice of any room changes within __ days in advance.
2. Photocopied records must be provided when requested within __ days.
A
- 30 days
2. 2 days
11
Q
Provisional license granted for:
A
Maximum 6-12 months
12
Q
Direct care staff must have their health screening report completed within:
A
6 months prior to employment or 7 days after employment.
13
Q
- Fees paid in advance must be refunded within __ days after personal property is removed.
- When must personal property be removed?
A
- 15 days
2. 3 days after becoming aware of residen’s death
14
Q
- Hospice care training includes these types of care(in-service training): (3)
- Hospice related records must be maintained for:
A
- -Turning/Incontinence care to prevent skin breakdowns
- hydration
- infection control - 3 years
15
Q
A licensee can increase operational costs with a prior notice of ___ days.
A
60 days.
16
Q
Medication training hours:
- Less than 16:
- More than 16:
A
- 10 hours: (6 hours shadowing, 4 hour lecture) within 2 weeks of employment.
- 24 hours: (16 hours shadowing, 8 hours lecture) within 4 weeks of employment.
17
Q
Pharmacy consultants/LVN/RN to review medication management how often yearly?
A
Semiannually.
18
Q
Affidavit regarding client cash resources updated:
A
Annually
19
Q
Emergency Approval to Operate(EAO) granted for:
A
60 days.
20
Q
- SSI
2. SSP
A
- Supplemental Security Income
2. State Supplemental Program
21
Q
How many hours of on the job (hands-on) training is required?
A
16 hours.
22
Q
Penalties for:
- Serious deficiency (first offense)
- Serious deficiency (second offense within a 12 month period)
- Serious deficiency (third offense within a 12 month period)
A
- $50/day.
- $150 immediate penalty, then $50/day until corrected.
- $1000 immediate penalty, then $100/day until corrected.
23
Q
Notice to quit for good cause
A
3 days
24
Q
Modification of rate change:
- Change in level of care time frame:
- Change in operational costs, within how many days do you modify rate?
A
- Within 2 business days.
2. Within 60 days.
25
Civil penalties: Abuse
1. Death of a client due to abuse
2. Serious injury of a client due to abuse
3. The licensee has the right to:
1. $15,000
2. $10,000
3. The licensee has the right to appeal
26
Who must care for clients with prohibited/restricted health conditions?
Care must be provided by skilled professionals.
27
Notice of eviction:
1. Notice to client
2. Notice to DSS
1. 30 days.
| 2. 5 days.
28
If you sell the facility, you must notify the family and DSS within:
60 days
29
New staffing requirement laws for your facility: (3)
- You must have an administrator, manager, or substitute that is 21+ on the premises 24/7.
- CPR/First-Aid training.
- Building/fire safety and response to emergencies.
30
How many hours are required for annual staff training? (In-service training)
20 hours.
31
For what penalties is $150 assessed? (2)
- 2nd violation in a 12 month period.
| - Dearh, illness, and injury due to non-compliance.
32
Freezer foods can kept for:
6 months.
33
Change of administrator, notify department within:
30 days.
34
Clean linen is mandatory at your facility!!
1. Bed linen must be changed at a minimum of:
1. Once a week.
35
The amount of bond required:
1. $750 or less
2. $751-$1500
3. $1501-2500
4. Any additional $1000
1. $1000
2. $2000
3. $3000
4. An extra $1000
36
Medication errors must be reported within:
1 business day.
37
All facilities must meet the following training requirements for all direct care staff, including ___hours of dementia care training which must be completed within the first ___ weeks, then annual in-service training of___.
1. 12 hours
2. 4 hours
3. 8 hours
38
If an LPA visits your facility and sees your storage area within toxic items, poisons, weapons, etc., unsecured, and there are dementia residents, the facility will receive:
Type A deficiency.
39
Destruction of medication by an administrator must be witnessed by:
An adult.
40
What is required to be in every residents’ rooms?
- Chair
- Nightstand
- Lamp/Lights for reading
41
Prohibited health conditions: (6)
1. Stage 3 & 4 pressure injuries
2. Gastronomy care
3. Naso-Gastric tubes
4. Staph infections or other serious infections
5. Tracheostomies
6. Residents who depend on others to perform all activities of daily living.
42
1. In facilities that are 16+ capacity, when should the menu be written?
2. How long should they be kept on file?
1. Menu must be written 1 week in advance.
| 2. Copies of the menu shall be dated and kept on file for at least 30 days.
43
1. Supplies for perishables?
| 2. Supplies for non-perishables?
1. Minimum 2 days.
| 2. Minimum 1 week.
44
Room temperatures:
1. Heat room temperature to:
2. In extreme heat:
3. Cool rooms to a comfortable range:
1. Minimum of 68F.
2. 30F less than outside temperature.
3. Between 78F-85F
45
Universal Precautions: (4)
1. Hand washing
2. Gloves use
3. Cleaning with disinfectant
4. Proper disposal of infectious materials
46
A record of centrally stored medications shall be retained for:
Atleast 1 year.
47
A record of destruction of medication records must be maintained for:
Atleast 3 years.
48
What is anaphylactic shock?
An extreme allergic reaction that can result in death.
49
1. Before working independently with residents, direct care staff staff must complete how many training hours?
2. What does the training consist of?
1. 10 hours initial training within first 4 weeks. Then 4 hours annual.
2. 6 hours dementia & 4 hours of postural support, hospice, and restricted health conditions
50
Notify DSS for changes in email addresses within:
10 days.
51
Changes of ownership due to forfeiture/abandonment or due to surrender of license, notify clients within:
60 days.
52
Submission of request for administrator certification (days)
30 days.
53
Appeal for a denial for a license application must be within:
15 days.
54
Administrator to pass the exam within:
60 days.
55
Refund due to death given within:
15 days.
56
1. Within the first 4 weeks of employment, direct care staff shall complete how many hours of training?
2. Training consists of: (1)
3. Training also consists of: (9)
1. 20 hours
2. Dementia training=6 hours
3. Physical limitations, ADL care, medication, resident’s rights, psychosocial needs of the elderly, fire safety, Dementia care, Alzheimer’s care, and cultural competency(LGBT)
57
ADL care
- Bathing
- Grooming
- Dressing
- Eating
- Transferring
- Continence
- Toileting
58
Can you crush medication?
NO, unless the doctor orders it.
59
Notice to discontinue advertisement for dementia:
30 days.
60
Acceptance to hospice time frame:
5 working days.
61
Abandonment new laws:
If you abandon your facility, you will completely lose your rights for reinstatement.
62
Administrator and direct care staff new training law changes: (2)
- Increase in administrator training (80 hours).
| - increase in direct care staff training (40 hours).
63
If you want to change a resident’s room, you must let clients know within:
30 days.
64
Admission agreements must be signed in:
7 days.
65
Start-up funds must meet a minimum of:
3 months operational costs.
66
Incidents reportable within 2 hours to the licensing agency, local ombudsman, and local law enforcement: (2)
1. Violations resulting in death of a resident.
| 2. Physical abuse with serious injuries.
67
Direct care staff total initial training hours
40 hours
68
Administrators who have a nursing home license are only required to complete __ hours of the required 40 hours of continuing education when renewing their RCFE administrator certification.
20 hours.
69
Physical abuse report:
1. Serious injury.
2. Non-Serious injury.
3. Injuries inflicted client on client.
1. Within 2 hours.
2. Within 24 hours.
3. Within 24 hours.
70
To resolve grievances or complaints from the family, the administrator must respond within:
14 calendar days.
71
Administrator qualifications:
1. 16-49 beds:
2. 50+ beds:
1. Completed at least 15 college courses or units, and 1 year RCFE experience.
2. Completed at least 2 years of college and 3 years RCFE experience.
72
Physical abuse shall be reported to: (3)
- Local ombudsman
- Local law enforcement
- Licensing Agency
73
For facilities who have clients with dementia, they must conduct emergency drills how often?
Every 3 months.
74
What is “PRN Medication?”
“Pro re nata”
| Medication that should be taken as prescribed.
75
You can retain a temporary client that is bedridden for a maximum of:
14 days.
76
1. Who has the authority to change the labels on medications?
2. Can medication be taken out of the bottle and put into another container?
1. Only the pharmacist can. Administrator and direct care staff are NOT allowed.
2. NO, it cannot be taken out of a bottle and put into another container.
77
Notice to DSS for death of a licensee and the family wants to take over.
5 days.
78
Change of facility location or relocation, notify within:
30 days.
79
Restricted health conditions: (11)
1. Administration of oxygen.
2. Intermittent Positive Pressure Breathing Machine (IPPB)
3. Diabetes
4. Injections
5. Colostomy/Ileostomy
6. Catheter care
7. Contractures
8. Incontinence of bowel/bladder
9. Enemas, suppositories, or fecal impaction removal
10. Stage 1 & 2 pressure injuries
11. Wound Care
80
Admission agreements specify the following: (5)
- Basic services
- Additional Services available
- Payment provisions
- Modification conditions
- Refund conditions
81
1. If a client is a threat to self or others, you can have a notice ___.
2. What is “5150”?
3. If you evict a client, you must assist them in relocation within a ___ radius.
* Client has a right to appeal eviction!
1. 3 day notice to quit for good cause.
2. A court-ordered 72 hour hold in an acute hospital.
3. 60 mile radius.
82
Refunds:
1. If the resident provides the notice at the time they leave, they must be refunded within __ days.
2. If they don’t provide the notice, they must be refunded within __ days from the date the resident left.
1. 5 days
| 2. 7 days
83
Dementia
Loss of intellectual function
* Reversible if caused by: Depression, drugs, alcohol, or hormonal imbalance.
* Not reversible if caused by: Injury or illness
84
Ambulatory person
A person who is capable of demonstrating physical & mental competence to leave a building without assistance.
85
Pathological Aging
Results from disease or adverse features of the individual’s lifestyle.
86
Elderly person
Someone who is 60 years or older.
87
How to prevent medication errors!!
| 5
Follow the 5 rights!
1. Right medication
2. Right person
3. Right time
4. Right dosage
5. Right way
88
Waiver
Variance for the entire facility.
89
Non-ambulatory person
A person who is unable to leave a building unassisted under emergency conditions.
Example: stretcher, wheelchair, and/or can’t respond physically or mentally to oral instructions.
90
Egress-Alert device
A device worn by residents that triggers a visual or auditory alarm when the resident leaves the facility.
91
For what penalties is $250 assessed? (2)
1. Not posting the family council.
| 2. Not posting the resident council.
92
Review of theft and loss policies and procedures are updated:
Semiannually
93
Penalties for unlicensed facilities!
1. First offense:
2. Second offense
1. $100 per violation per resident per day.
| 2. $200 per violation per resident per day.
94
Notice to fire Marshall for bedridden status
2 days
95
Incidents reportable within 24 hours of occurrence to the licensing agency.
1. Physical abuse (non-serious injuries)
2. Poisoning
3. Fire/explosion
4. Catastrophe
5. Major accidents
6. Epidemic outbreaks
96
How much liability insurance is required?
$1 million / $3 million
97
Renewal of administrator’s certificate every:
2 years.
98
Change of licensee, notify within:
30 days.
99
Persons who are not acceptable for care in RCFE: (4)
1. Person who has active communicable tuberculosis.
2. Person who requires total care.
3. Person who has mental disorder that would upset the general resident group.
4. Person with dementia, unless sec.87705 requirements are met.
100
Hospice agency shall be responsible for the control, storage, and administration of these medication types:
Schedule II-V.
| All controlled drugs
101
Chest of drawers should measure at least:
Minimum 8 cubic-feet.
102
1. Ratio for bathroom:
2. Ratio for shower:
3. Maximum number of residents per room
1. 1 bathroom for every 6 clients, family, and live-in personnel.
2. 1 shower for every 10 clients, family, and live-in personnel.
3. 2 clients per room maximum.
103
Planned activities notice:
1. 7 or more:
2. 16-49:
3. 50+:
1. Notice of planned activities must be posted in a central location.
2. One staff, designated by the administrator, shall have primary responsibility for the organization and evaluation of planned activities.
3. One person hired with full time responsibility.
104
5 senses:
1. Sight
2. Hearing
3. Scent
4. Taste
5. Touch
1. Visual
2. Auditory
3. Olfactory
4. Gustatory
5. Tactile
105
Civil penalty for allowing staff without a criminal record clearance:
1. Immediate assessment:
2. Subsequent violations in a 12 month period:
1. $100 per violation per person per day for a maximum of 5 days.
2. $100 per violation per person per day for a maximum of 30 days.
106
Who needs a criminal record clearance? (8)
1. Applicant.
2. Administrator.
3. Anyone residing in the facility.
4. Anyone providing clients assistance.
5. Anyone responsible for supervision of staff.
6. Anyone who has any direct contact with the clients.
7. If it’s a firm, the CEO.
8. Anyone with financial interest.
107
Minimum requirements for administrator qualifications: (4)
- 21+
- High school diploma or GED
- Get a criminal record clearance
- Pass the initial training program exam
108
Grounds for forfeiture of license: (6)
1. Sale or transfer of property.
2. Surrender of license.
3. Death of the licensee.
4. Relocation.
5. Criminal conviction.
6. Licensee abandons the facility.
109
Requirements for staff training was effective on:
January 01, 2016
110
Incidents that are reportable within 7 days: (4)
1. Death of a client for any reason.
2. Any serious injury while attending physical or under supervision.
3. Use of an Automated Electronic defibrillator(AED).
4. Any incident that threatens the welfare, health, and safety of residents.
111
Which physical plant is required by the Americans with Disabilities Act (ADA) in every facility?
Grab bars in each resident’s room.
112
Annual medication management hours:
8 hours.
113
What must be posted in every facility by law?
Minimum wage notice for California.
114
Hospice care waivers:
1. What is it?
2. Within how many days do you notify the department the initiation of hospice care services for any terminally ill residents in the facility?
3. When will the department notify approval/denial or deficient request?
1. To accept/retain terminally ill residents and permit them to receive care from a hospice agency.
2. Within 5 working days. (have it in writing)
3. Within 30 days.
115
Dementia residents cannot have any access to: (4)
- Knives/matches.
- Cigarettes/alcohol.
- Nutritional supplements and vitamins.
- Household products.
116
Temperature controls!
1. Freezer:
2. Refrigerator:
3. Dishwasher :
4. Hot water must be maintained at:
5. Hot water warning sign past:
1. 0F
2. 40F
3. 170F
4. Between 105F-120F
5. 125F
117
Physiological Aging
Normal wear and tear that occurs with passage of time.
118
The disaster & mass casualty plan must include:
Transportation arrangements.
119
Licensee has the right to appeal a citation within:
10 days.
120
Deficiency new laws
1. Correct deficiencies and notify DSS within:
2. Also, you must post:
1. 10 days.
2. Post a poster of complaint/emergency reporting agency.
“If you see something, say something!”
121
RCFE capacity is based on: (4)
- Physical energy to meet clients’ needs.
- Physical features of the facility.
- Available direct care staff.
- Anyone who might live in the facility.
122
Medications must be centrally stored if: (3)
- The medication requires refrigeration.
- If it’s too hazardous for the client to keep in their possession.
- If the mediation is a safety hazard to others.
123
What places/persons are exempt from licensure? (5)
- Clinics.
- Health facilities.
- Religious organizations.
- Places like hotels that are room only, not board and care.
- Spouse.
124
Increase initial/annual fee by approximately how much?
10% based on facility capacity.
125
“911” new law
Prohibits discrimination of anyone to call “911”.
126
Carbon monoxide detector new law
Have 1 (or more) carbon monoxide detectors in the facility.
127
Resident bill of rights new laws: (3)
- Residents must be given copies of records.
- Resident rights must be posted in the facility.
- Post rights in other languages if 5% of the facility can only speak that language.
128
Application disclosure new requirements and penalties:
Disclose any bankruptcies or changes of ownership within 60 days. Penalty of not doing so is $1000.
129
Temporary illness
Illness which persists for 14 days or less.
130
Basic services include: (6)
- Safe/healthful living accommodations.
- Personal assistance/care.
- Monitoring client’s condition.
- 3 meals per day (or modified diets.
- Arrangements to meet needs including transportation.
- Planned activities program.
131
Dementia training will include: (6)
- Effects of medication on client’s behavior.
- Common problems like wandering.
- Positive therapeutic intervention like exercise.
- Communication skills.
- Promoting resident dignity, privacy, choice, etc.
- End of life issues, like hospice.
132
Serious Deficiencies examples: (16)
- criminal record clearance
- fire clearance
- limitations on # or types of residents
- telephone services
- persons with communicable diseases
- non-ambulatory persons
- resident’s rights
- restraints
- safety of resident’s accommodations
- storage, prep., and service of food
- medical and dental care of residents
- storing/dispensing medications
- hot water temperature
- toilet, hand-washing, & bathing accommodations
- storage and disposal of solid wastes, needles, etc.
- night supervision.
133
Requirements for night supervision.
1. Less than 16:
2. 16-100:
3. 101-200:
4. Every additional 100:
1. 1 employee, qualified, on call, on the premises.
2. 2 employees; 1 on duty, 1 on call and capable of responding within 10 minutes.
3. 3 employees; 2 on duty, 1 on call and capable of responding within 10 minutes.
4. Addition 1 employee on duty and awake.
134
Admission agreements
1. What point font? What color print? On what kind of paper?
2. What form must be maintained in the resident’s file if they indicate that they are deaf, or are hearing impaired?
3. Admission agreements must be signed & dated when?
1. Black, 12 pt font, on plain white paper. Print must appear only on 1 side.
2. Telecommunication Device Notification Form. (LIC 9158, 11104)
3. No later than 7 days following admission.
135
Persons acceptable in RCFE care: (7)
1. Person who can administer their own medications.
2. Person receiving medical care and treatment outside of the facility or has a visiting nurse.
3. Person who needs to be reminded or assisted to take their medications.
4. Person with problems like confusion, wandering, forgetfulness, etc.
5. Person who has a mild temporary emotional disturbance like personal loss or change in living arrangement.
6. Person who is bedridden, providing requirements of sec.87606 are met.
7. Person who is under 60 whose needs are compatible with other residents.
136
Pre-Admission Fee Refunds
1. If client backs out of facility before preadmission appraisal, you must refund how much?
2. If fee is $500+ and client backs out before admission or during first month, how much is refunded?
3. If fee is $500+ and client leaves within 2 months, how much is refunded?
4. If fee is $500+ and client leaves within 3 months, how much is refunded?
5. If client stayed 4 months or more, how much is refunded?
1. 100% refund.
2. At least 80% refunded.
3. At least 60% refunded.
4. At least 40% refunded.
5. Not required, but you may refund if you want to.
137
Pre-Admission Refunds
If licensee forfeits, abandons, sells, transfers, or changes the use of the property:
1. $500 paid within 6 months of eviction notice:
2. $500 paid 6-12 months before eviction notice:
3. $500 paid 12-18 months before eviction notice:
4. $500 paid 18-25 months before eviction notice:
5. $500 paid 25+ months before eviction notice:
6. Refunds are required to be paid within__days of issuing notice.
1. 100% refund.
2. 75% refund.
3. 50% refund.
4. 25% refund.
5. Not required to give a refund.
6. Within 15 days of issuing notice(s).
138
1. You can have someone who has a need for an IPPB machine if: (2)
2. The licensee is responsible for: (5)
1. If the client can operate it on their own or a skilled professional operates.
2. -Monitoring client’s ongoing ability to operate.
- Equipment is operable and able to be taken out after resident isn’t using.
- Procedure is administered by a professional.
- Room size can accommodate the equipment.
- Direct care staff has the knowledge & ability to operate the equipment.
139
1. You can accept a client who needs injections if: (1)
| 2. The licensee is responsible for: (3)
1. Injections are administered by a skilled professional.
2. -Ensuring that injections are administered by a professional.
- Sufficient amounts of needles/supplies are stored in the facility.
- Syringes/needles are disposed of.
140
1. You can have a client who has diabetes if: (2)
| 2. The licensee is responsible for: (4)
1. The resident can perform their own glucose test with blood or urine specimen. OR if it’s administered by a skilled professional.
2. -Assisting residents with self-administered medications
- Sufficient amounts of supplies are stored in the facility.
- Needles/Syringes must be disposed of.
- Providing modified diets as prescribed by a resident’s physician.
141
1. You can have clients with contractures if: (2)
2. The licensee is responsible for: (2)
3. The professional reviews staff performance how often?
1. Self-care and it isn’t too severe OR cared for by a skilled professional and it isn’t too severe.
2. -Ensuring range of motion or other exercises are performed by a professional.
- Direct care staff can be designated by make sure the professional documents who can be permitted with instructions.
3. Annually.
142
1. You can have a client who needs the use of a catheter if: (1)
2. The licensee is responsible for: (4)
1. The resident is capable of self care besides insertion and/or removal of catheter and irrigation. These must be done only by a skilled professional.
2. -Ensuring that irrigation and insertion/removal is done by a skilled professional.
- Ensuring that bag and tubing is changed by a professional.
- Waste materials are disposed of.
- Privacy is maintained during care.
143
1. You can have a client with a colostomy/ileostomy if: (2)
2. The licensee is responsible for the following: (3)
3. A professional shall review the procedures how often?
1. Resident can provide routine care themselves OR assistance care provided by a skilled professional.
2. -Ensuring that care is provided by a professional.
- Used bags are discarded.
- Privacy is given during care.
3. At least twice each month.
144
1. You can have a client with enemas, suppositories, & fecal impaction removal if: (2)
2. The licensee is responsible for: (2)
1. Self care by the client OR assistance from a skilled professional.
2. -Ensuring that administration is performed by a skilled professional if needed.
- Privacy during care.
145
1. You can have clients with a need for oxygen gas administration if: (2)
2. The licensee if responsible for: (4)
3. Prior to acceptance, the licensee needs:
1. Resident is capable of operating equipment and self-administering medications or its performed by a skilled professional.
2. -Monitoring resident’s ongoing ability to operate the equipment.
- Ensuring that a professional assists.
- Determining that room size can accommodate the equipment.
- Staff has knowledge on how to use.
3. Must get prior approval from the licensing agency.
146
1. You can have a client with healing wounds if: (3)
| 2. Skin tears are:
1. -Care is performed by a skilled professional.
- Wound is resulted from surgery (care is performed by the surgeon).
- Stage 1 & 2 wound must be diagnosed by a professional. All aspects of care must be documented in resident’s file.
2. Skin tears are NOT healing wounds!
147
1. You can have a client who has incontinence if: (4)
| 2. The licensee is responsible for: (9)
1. If the condition can be managed by:
- Self-care
- Structured bowel/bladder retraining program.
- Toileting in scheduled intervals.
- Use of incontinent care products.
2. -Reminding the client to use the bathroom.
- Checking the client.
- Making sure the client is clean and dry; free from odors.
- A professional designs the program.
- A professional trains the direct care staff of the program.
- Reassess and reevaluate client’s condition.
- No skin breakdowns.
- Fluids are not being withheld from the client.
- Privacy is given.
