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HSA3223 Management of Long Term Care Facilities

Midterm Exam

Question 1

What government program was designed to cover medical expenses for the indigent who cannot afford to pay for health services?

Social Security

Medicaid

Medicare

Affordable Care

Question 2

The long-term care system works best when it maintains its focus on medical treatment, rather than being distracted by nonmedical or nonclinical services.

True

False

Question 3

True or False: The insurance portability section of HIPAA, while important to many consumers, does not have as much of an impact on the long-term care industry as the provisions regarding privacy do.

True

False

Question 4

What government act or legislation focused specifically on the quality of care in nursing facilities?

Omnibus Budget Reconciliation Act

Social Security Act

Medicare and Medicaid amendments

Affordable Care Act

Question 5

True or False: An instrument that measures the quality of a facility by examining issues such as staff-to-client ratio would be considered a process-based measurement.

True

False

Question 6

What type of care has emerged recently as a way to bridge the gap for patients who no longer need to be hospitalized but require more care than is offered in nursing facilities?

subacute

postacute

assisted living

skilled nursing

Question 7

True or False: Medicare reimbursement is available for certified home health and hospice care providers, but not for adult day care.

True

False

Question 8

True or False: The Obama administration used its executive discretion to delay implementation of some of the less popular portions of the Affordable Care Act, such as raising taxes to help pay for it.

True

False

Question 9

True or False: A 2012 survey by NAHCH found that the majority of home health agencies were based in a hospital, rather than freestanding, independent facilities.

True

False

Question 10

One weakness of the current long-term care system is that it focuses on payment availability. What is the primary reason for this focus?

it is a fragmented system.

it is a reimbursement-driven system.

there are multiple entry points into the system.

services are distributed unequally.

Question 11

True or False: Rather than simply maintain their current quality of life, most seniors moving into senior housing want their quality of life to improve.

True

False

Question 12

True or False: As hospitals have entered the long-term care market, they have a competitive advantage over some of the other players because they have sound infrastructures that are not overly hard to adapt in order to meet the needs of long-term care consumers.

True

False

Question 13

True or False: While the consumers of long-term health care represent a wide range of people, one clearly defined, consistent group is the elderly.

True

False

Question 14

True or False: Regulations generated by the Occupational Safety and Health Administration impact both the employees of nursing facilities and the physical construction of those facilities.

True

False

Question 15

True or False: One of the major advantages of congregate housing over the other types of senior housing options is that consumers have the option to move between different units within the same facility as their needs change.

True

False

Question 16

What reason did the Supreme Court give for upholding the constitutionality of the individual mandate of the Affordable Care Act?

It is a tax, and the president is allowed to impose or raise taxes.

It is a fee for purchase, and Congress is allowed to enact laws compelling consumers to purchase something that is in their best interest.

It is a tax, and Congress is allowed to impose or raise taxes.

It is a fee for purchase, and the president is allowed to enact laws compelling consumers to purchase something that is in their best interest.

Question 17

Which health insurance exchanges are included as part of the ACA?

do not include plans that have long-term care coverage.

include a range of long-term care plans from which consumers have the option to choose.

automatically bundle long-term care insurance with other healthcare insurance.

require consumers to purchase both standard healthcare and long-term care insurance.

Question 18

True or False: While the Supreme Court did uphold the individual mandate of the ACA, it also ruled, in a separate case, that states had the right to opt out of the Medicaid expansion, since the cost to extend Medicaid coverage would fall upon the states to pay.

True

False

Question 19

What was the intention of provisions of the ACA such as the CLASS Act, the Community First Choice Option, and the Balancing Incentive Payments Program?

to direct consumers toward less expensive, often noninstitutional, forms of long-term care

to provide long-term care coverage for hospitalized patients

to simplify access to long-term care services and support for all consumers

to relieve the financial burden on private-paying acute care consumers so they could remain in the hospital as long as necessary

Question 20

True or False: Since assisted living facilities focus primarily on quality of life and autonomy for consumers, they must contract with outside agencies in order to provide healthcare services for their residents.

True

False

Question 21

In an ideal long-term care system based on the needs, rights, and responsibilities of individuals, What term best describes the role of the consumer?

consumer-oriented

consumer-focused

client-centered

consumer-driven

Question 22

True or False: Whether a subacute care unit is freestanding or physically housed within a larger facility, it will most likely be afficialted with, or even owned and operated by, a hospital or nursing facility.

True

False

Question 23

What best describes the goal of providing long-term care in the least restrictive environment?

allowing consumers to remain home in all cases, if that is what they want to do.

ensuring that long-term care services are user friendly.

delivering single-site care availability for consumers.

providing consumers with the highest level of independence possible.

Question 24

True or False: One difference between subacute care and postacute care is that subacute care provides outpatient services, while postacute care provides inpatient services.

True

False

Question 25

A quality measurement that ensures that a facility administers medications on time, as prescribed, is an example of what type of measurement?

outcome-based

structure-based

process-based

schedule-based

Question 26

How did HIPAA provide an incentive for consumers to self-finance their own long-term care?

It expanded Medicare to cover long-term care services.

It legalized certain public/private funding options for long-term care insurance.

It made long-term care insurance premiums tax deductible.

It eliminated the spend-down requirement for Medicaid eligibility.

Question 27

Which philosophy is the long-term care facilities base on that is designed to serve consumers with a wide range of conditions, including medical, social, and financial?

multidisciplinary approach.

medical model of care.

social model of care.

residential approach.

Question 28

How has the ACA impacted the ownership of nursing facilities?

Affiliations between hospital systems and long-term care facilities have increased.

An increasing number are now part of a national multifacility chain.

More are now owned by for-profit organizations.

The number of government-owned facilities has started to rise.

Question 29

How would an admission to a nursing facility for a consumer who cannot remain at home because of disabilities or care needs be best categorized?

physician-initiated admission.

choice-based admission.

need-driven admission.

family-initiated admission.

Question 30

In most nursing facilities, what is the biggest group of staff made up of?

certified nurse aids (CNA)

occupational therapists (OT)

registered nurses (RN)

kitchen and maintenance workers.

Question 31

A postacute patient with a medically complex condition requiring extended medical and rehabilitative care over a stay of 25 days or more is an ideal consumer for which type of care facility?

long-term care

inpatient rehabilitation

skilled nursing

home health

Question 32

A patient who needs continuing therapy or other monitoring would most likely be included in which category of subacute care?

chronicsubacute care

generalsubacute care

Rational: Chapter 5 (p. 126-127)

“Lengths of stay are somewhat longer for those receiving general subacute care than those in transitional units. Patients needing ongoing therapy or monitoring fall into this group. General subacute care units are apt to be owned and operated by either hospitals or nursing facilities” (p. 127).

long-term transitional subacute care

transitionalsubacute care

Question 33

Why does sub-acute care appeal to reimbursers such as Medicare, MCOs, and private insurance companies, as an option to hospitalization?

They provide required services for consumers at a lower cost.

The clear regulations make them easier to work with.

The lack of regulations allows the reimburser to set prices.

The reimburser has more control over the services that are provided.

Question 34

What term best describes a residential setting for seniors that might provide supportive services?

independent living.

assisted living.

congregate housing.

a continuing care retirement community.

Question 35

Who owns and operates the overwhelming majority of assisted living facilities?

nonprofit organizations

for-profit organizations

managed care organizations

the government

Question 36

What is the primary reason residents move from an independent living community to an assisted living facility?

desire to be closer to family.

decreased independence or functional ability.

increased functional capacity.

dissatisfaction with the services provided.

Question 37

Which type of charge structure is used by assisted living facilities that involves offering consumers various bundles of services at different prices?

fee-for-service model

all-inclusive rate model

basic fee model

tiered-pricing model

Question 38

Of the various types of senior housing options, which of the following could be described as simply a housing arrangement, with little or no non-housing services provided?

cohousing

independent living

age-restricted retirement communities

life care community

Question 39

A senior housing complex is being built by a municipality to serve the needs of its citizens. How would the ownership of this facility be best defined?

publicly owned.

privately owned.

owned by an MCO.

owned by for-profit investors.

Question 40

Which form of senior housing may offer subsidized housing with extra amenities and also may accept seniors on Supplemental Security Income?

continuing care retirement communities

congregate housing

age-restricted housing

independent living

Question 41

What is the basic philosophy of home health care?

give comfort and support to the patient and his or her family.

approach health care in a holistic manner.

provide services for both the patient and the caregiver.

take the healthcare services to the consumer.

Question 42

In what situation would home health care be less cost-effective than institutionalized care?

when the consumer needs nearly constant care

when the consumer needs only sporadic care

None; it is always more cost-effective.

when the consumer needs one-on-one care

Question 43

In what way does a diversified patient population present a challenge that is somewhat unique to hospice care providers?

The diverse population contributes an emotional element to the management of a hospice care agency.

Management must be aware of the views of death and dying held by people of different cultural and religious backgrounds.

The manager is required to serve as a community ambassador in addition to the more conventional duties of management.

The diversity of economic standing adds complexity to the ability to be properly reimbursed for services.

Question 44

While competition has increased, why is the long-term care system not really a market-driven system yet?

There are only a few major buyers.

MCOs dominate the marketplace.

There are only a few major sellers.

The consumers are not well-informed.

Question 45

What type of voluntary cooperation between providers has been encouraged by provisions of the ACA?

shared purchasing to achieve the economy of scale necessary for Medicare eligibility

access to health records electronically by all providers, no matter which one entered the data

contracting the services of a specific pool of care providers on an as-needed basis

the formation of networks of providers who contract with Medicare to serve a defined patient population

Question 46

What is a healthcare system?

a single-ownership form of integration

a formal alliance among otherwise independent organizational entities

two or more organizations that provide similar services forming an alliance for their mutual benefit

an alliance of two or more organizations providing services that are dissimilar but that are interactive with each other

Question 47

Having information about all consumers available at all provider sites of an integrated system is a feature of which specific area of clinical information systems?

quality improvement

patient management

clinical guidelines

clinical outcomes

Question 48A federal regulation that addresses the size of a facility would be included in which general category of government regulations?

quality

process

structure

payment

Question 49

What term describes a voluntary testimony of qualifications, not issued by the government?

registration

licensure

endorsement

certification

Question 50 What is true about accreditation?

There are mandated penalties for not being accredited.

It is given by private agencies that are funded by the participating providers.

It is the process by which agencies are listed as eligible to provide a regulated service.

It is required by law.