Continuing education test #95 * based on nursing homes March 2005.

How to use this self-study program

* Take the Pre-Test before you begin to read this issue of Nursing Homes/Long Term Care Management. Online CE tests for this and previous issues are available at www.achca.org/study/courses.asp?c=7.

* After reading the articles, complete the Test and Evaluation Section.

* If you score is 70% or above, we will send you a certificate of completion and notify the state(s) that you indicate. If your score is less than 70%, you may retake the test.

* Please include your license numbers for each state (NHA licenses only).

* Tests will be graded and state boards notified within three (3) weeks of receipt.

* According to the ACHCA Code of Ethics, "Preservation of the highest standards of integrity and ethical principles is vital to the successful discharge of the professional responsibilities of all long-term care administrators." You are expected to complete this program according to these guidelines.

* Each Post-Test is approved for 2 CE Credits for nursing home administrators and 2.4 Contact Hours for nurses.

* Not all states accept self-study programs for credit. Check with your state to confirm restrictions. If you feel that you have benefited from this program, please encourage your state to change its policy.

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PRE-TEST

1. While not addressing larger organizations, HIPAA regulations prevent insurers from denying coverage to organizations with employees numbering:

a. 1 to 25.

b. 2 to 50.

c. 51 to 100.

d. 52 to 125.

2. CMS's new guidance to surveyors on pressure ulcers is likely to cause citations for deficiencies to:

a. moderately decrease.

b. significantly decrease.

c. remain at current levels.

d. significantly increase.

POST-TEST

1. According to Zespy ("Improving Health Benefits for Staff"), what factors make LTC workers high risk for the health insurance industry?

a. age, turnover, hazardous working conditions

b. age, education, turnover

c. education, turnover, job attitude

d. turnover, low income, age

2. To obtain affordable health insurance coverage for both the employer and employee, the Institute for the Future of Aging Services report cited by Zespy includes all of the following recommendations except:

a. Counsel workers about state insurance programs.

b. Begin coverage a few months after hire.

c. Reduce rates for lower-paid employees.

d. Partner with other organizations.

3. With which statement would Lyder ("CMS's New Guidance for Pressure Ulcers: What It Means") disagree?

a. Assessment tools capture all risk factors.

b. Often staff mislabel other wounds as pressure ulcers.

c. Nutrition and the effects of moisture are key risk factors.

d. Removing the dressing to inspect the wound each day is counterproductive to healing.

4. Which of the following is not part of daily wound monitoring:

a. Look for drainage.

b. Inspect the skin around the dressing.

c. Remove the dressing.

d. none of the above

5. Which of the following is not a suggestion by Meek ("Spring-Cleaning: Keep Pests Where They Belong")?

a. Remove vegetation that touches the building.

b. Review the facility's waste-management process.

c. Monitor grounds for fire ant mounds.

d. Apply liberal amounts of pesticides as a preventive measure.

6. With which statement would Moses ("Long-Term Care's Lone Realist Rides Again") agree?

a. Long-term care insurance is too expensive.

b. Long-term care insurance is only needed to protect assets.

c. People lack prioritization of future needs.

d. Medicaid is a practical alternative to insurance.

7. With which of the following statements about covering the costs of long-term care would Tenenbaum and Batis ("Financing Long-Term Care: The Life Insurance Solution") disagree?

a. An Accelerated Death Benefit (ADB) can cover a percentage of the cost of long-term care.

b. If the entire ADB is used, the policy's death benefit is eliminated.

c. An ADB can be added to a term-life policy.

d. Many insurance companies will allow an ADB add-on at any time.

8. To access the ADB, most companies require that the insured's life expectancy be:

a. one month or less.

b. three months or less.

c. six months or less.

d. 12 months or less.

9. Lewis (NIC on Financing) states that the most recent NIC Key Financial Indicators[TM] indicated all of the following about capitalization rates toward the end of 2004 except:

a. Capitalization rates started to come down for assisted living.

b. Capitalization rates started to come down for independent living.

c. Capitalization rates stayed relatively flat for skilled nursing.

d. Capitalization rates started to come down for skilled nursing.

10. Willging ("It's All About Leading and Managing People") cites a Robert Wood Johnson Foundation report stating that the direct cost of turnover per frontline worker is at least:

a. $2,500

b. $2,000

c. $1,800

d. $1,750

11. According to Dillon ("Critical Cleaning in LTC Settings"), what type of cleaner should you use if your facility experiences an outbreak of Clostridium difficile?

a. diluted bleach

b. quaternary ammonium compounds

c. a phenolic-based disinfectant

d. soapy water

12. As cited by Stoil (View on Washington), which of the following statistics is accurate according to recent National Fire Protection Association reports?

a. An annual average of 610 people aged 75 and over die in fires in private residences.

b. Nearly 60% of those that died are believed to have died in their sleep.

c. Roughly 40% of those that died had a physical impairment that might have prevented escape.

d. Roughly two-thirds of the fatal home fires involving the elderly were caused by tobacco use.

POST-TEST EVALUATON

The article on improving staff insurance benefits was:

_____ very interesting

_____ of some interest

_____ of no interest

The information on CMS's new pressure ulcer guidance was:

_____ very helpful

_____ somewhat helpful

_____ of no help

The article on housekeeping in the healthcare setting was:

_____ interesting

_____ mildly informative

_____ of no concern

In understanding the material covered in this issue of Nursing Homes/Long Term Care Management, the ACHCA testing process was:

_____ very helpful

_____ somewhat helpful

_____ not much help

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PRE-TEST ANSWERS

 1.  b.
 2.  d.
POST-TEST
(Circle the most appropriate answer)

 1.  a  b  c  d
 2.  a  b  c  d
 3.  a  b  c  d
 4.  a  b  c  d
 5.  a  b  c  d
 6.  a  b  c  d
 7.  a  b  c  d
 8.  a  b  c  d
 9.  a  b  c  d
10.  a  b  c  d
11.  a  b  c  d
12. a  b  c  d