Question 1

Which of the following responsibilities of managers in long-term care should be the top priority?&#10;A) Marketing&#10;B) Staffing&#10;C) Mission and Vision&#10;D) Communication

Accepted Answer

Staff turnover is the major challenge in long-term care. Marketing, communication, mission and vision are all important responsibilities but rely on the skills of staff committed to the mission and vision and inter-professional communication so that market share of potential patients is achieved, therefore making staffing the most important responsibility.

Question 2

What is the role of rehab in residential care units of nursing homes?&#10;A) None, unless the patient is receiving Medicare Part B services&#10;B) Serving as consultant to nursing when a patient need arises&#10;C) Establishing and monitoring a restorative care program for each resident&#10;D) Using a PT tech to make sure patients walk and exercise

Accepted Answer

Rehab services are responsible for establishing a restorative care program for each resident to maintain optimal functional levels that are carried out by Certified Nursing Assistants (CNAs). If medically necessary, any of these residential care residents may also receive intermittent skilled services that are billed as Medicare Part B in addition to the restorative care program. They do not wait for a need to arise because every patient receives restorative care.

Question 3

What is the role of medical director in skilled nursing homes?&#10;A) Leads the care teams&#10;B) Controls personnel decisions&#10;C) Executive position&#10;D) Legally responsible for patient outcomes

Accepted Answer

The medical director position is more of an executive position than a position of daily management of patient care. Medical directors report to the SNF's Board of Directors

Question 4

Which of the following factors is key to the management of long-term care in the United States?&#10;A) Patients admitted are more acutely ill.&#10;B) Financial constraints have been decreased.&#10;C) Free-standing facilities have increased.&#10;D) Medicare reimbursement for care has increased.

Accepted Answer

The number of patients who are discharged from hospitals to nursing homes with complex acute conditions have increased while Medicare reimbursement has decreased and constraints have been imposed on owners of long-term care services. Large corporations have added many smaller facilities that have been forced to declare bankruptcy in order to better "share" resources among those that generate more revenue than others.

Question 5

What differentiates the responsibilities of long-term care rehab managers from managers in other healthcare settings?&#10;A) Documentation requirements&#10;B) Productivity standards&#10;C) Regulatory demands&#10;D) Carry-over of care needs

Accepted Answer

Productivity standards, regulatory demands and carry-over of care needs are common to all practice settings. Long-term care heavily relies on many caregivers, therefor rehab managers in long-term care have more responsibility for the carry-over of rehab services to nursing staff and families to assure and maintain the quality of life of patients and residents in long-term care settings than managers in other settings.

Question 6

What is the best way to describe discharge planning in skilled nursing facilities?&#10;A) Discharge is determined through interdisciplinary planning&#10;B) Discharge plans are provided to the team by the Director of Nursing&#10;C) Discharge dates are set by Medicare at the time of admission&#10;D) The nursing home administrator has no role in discharge planning

Accepted Answer

The Director of Nursing follows the team's decisions and not vice versa. Although there are limits on reimbursement and other rules, the patient's condition and safety drive decisions. The administrator has some say from a financial perspective. Medicare requires interdisciplinary planning.

Question 7

What are the characteristics of patients in residential care facilities?&#10;A) They no longer have potential to improve function&#10;B) The mix of patients is only about 50% elderly&#10;C) Dementia is the primary reason they are there&#10;D) They are short term placements that recur

Accepted Answer

50% of the patients in residential care are young people with mental and cognitive disabilities. They are all monitored for opportunities to improve their function and quality of life. Dementia care is often provided in specialized units for safety. They are long term placements.

Deck 13: Management Issues in Long-Term Care