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SMQT Exam (Latest Update) Questions
and Verified Answers (100 out of 100)
GRADED A
What is severity level 2 Noncompliance that has potential to cause more than minimal harm that is not IJ resident has no more than minimal discomfort, their is a potential to compromise residents ability to reach highest practicable level, shame/embarassment without loss of interest minimal episodic pain, facility has no system to prevent problems The TC must complete which tasks during offsite prep? Create/export shell from ACO Import shell into ASE-q Add team members Complete offsite prep screen Make unit assignments Make mandatory task assignments print documents
Share offsite prep with team What documents are printed by the TC during offsite prep? 1 matrix with instructions 1 entrance conference worksheet 3 beneficiary worksheets What is the purpose of the initial pool process? To briefly screen all residents and observe, interview and complete initial record review. When should you share data? At the end of each day and when the team composition changes. What must be done prior to Sample Selection The completed I.P data is shared and the TC confirms that the data is complete. What are the 7 LTSCP steps?
Offsite prep
Facility entrance
Initial Pool Process
Sample Selction 5.Investigation
Ongoing and other survey activities
What is Extrapyramidal symptoms" (EPS)? a neurological side effect that may occur within a few day or years of treatment with antipsychotics. Includes various syndromes such as; akathisia, medication-induced Parkinsonism, and dystonia. What is akathesia? a distressing feeling of internal restlessnesss that may appear as constant motion, the inability to sit still, fidgeting, pacing or rocking. What is Medication-induced Parkinsonism? Syndrome of symptoms like Parkinson's; tremor, shuffling gait, slowness of movement, expressionless face, drooling, postural unsteadiness and rigidity of muscles. What is dystonia? acute, painful, spastic contraction of muscle groups (commonly the neck, eyes and trunk) that often occurs soon after initiating treatment. What is Neuroleptic Malignant Syndrome (NMS)? Syndrome related to the use of antispychotics that presents with a sudden onset of diffuse muscle rigidity, high fever, labile blood pressure, tremor, and cognitive dysfunction. Potentially fatal if not treated immediatley, including stopping the offending medication. What is serotonin syndrome? Serious clinical condition resulting from overstimulation of serotonin receptors. Commonly related to the use of SSRI's, SNRI's, triptans, and antibiotics. Restlessness, hallucinations, confusion, loss of
coordination, fast heartbeat, rapid changes in blood pressure, increased temperature, overactive reflexes, NV&D. What is Tradive dyskinesia? abnormal, recurrent, involuntary movements that typically present as lateral movements of the tongue or jaw, thrusting, chewing, frequent blinking, brow arching, grimacing, and lip smacking. May be irreversible Significant weight loss in 1 month? 5% weight loss Severe weight loss in 1 month? greater than 5% weight loss Significant weight loss in 3 months? 7.5% weight loss Severe weight loss is 3 months? greater than 7.5% weight loss Significant weight loss in 6 months? 10% weight loss
What areas are reviewed for non-interviewable residents? Pressure ulcers, dialysis, infections, nutrition, falls in last 120 days, ADL decline, low risk B&B, unplanned hospitalization, elopement, change of condition in last 120 days. All residents are reviewed for which areas? Advanced directives, confirm specific information based on RI/RO, other concerns. What act established Medicare and Medicaid Social Security Act of 1965 signed by Johnson established Medicare for aged over 65 and Medicaid health insurance for low income. What was created in 1977 to combine Medicare and Medicaid? Health Care Financing Administration (HCFA), the predecessor of CMS Who does Medicaid provide services for? low income, needy elders, blind, disabled getting SSI, certain infants and low income pregnant women. What is Title XVIII(18)? Regulations for Medicare. Covers hospital, post hospital, home health services and hospice. What is Titile XIX(19)? Regulations for Medicaid for families with children, aged, blind or disabled with low income.
What is the Impact Act of 2014? Impoving Medicare Post-Acute Care Transitions-effective 11/19/19. Includes Discharge Planning rule, Burden reduction and Emergency Preparedness. What is the survey process based on? Person centered care, resident centered outcomes, QOC and QOL. What are the 8 principles of Documentation?
- Entity Compliance or Noncompliance
- Using plain language.
- Components of a Deficiency statement
- Relevance of Onsite correction of findings
- Interpretive guidelines
- Citation of State or local code violations
- Cross-referencing
- Condition of Participation Deficiencies What are the components of a deficiency statement?
- regulatory reference
- deficient practice statement 3.relevance facts and findings What are CMS core values?
Which residents are included in the survey shell?
- Offsite selected who make up 70% of the sample
- Residents with at least 1 MDS in the last 120 days
- Residents for closed record review What is the CASPER report? Certification and Survey Provider Enhanced Reporting What items are required upon entrance
- Census excluding bed holds
- Matrix for new admits in the last 30 days
- Alphabetized list of resdients
- List of resident who smoke When screening residents, what other concerns should you pay attention to? resident behavior, staff-resident interactions, resident grooming and cleanliness, strong urinary odors, evidence of abuse or neglect How many compliant/FRI residents are in the initial pool? 5 residents What types of residents must you include in the initial pool?
- who smokes
2 dialysis 3.Hopsice
- Ventilator
- TBP What are the types of interview status?
- intervieable 2.Noninterviewable 3.Refused
- Unavailable
- Out of facility. What should you do if a resident halts the interview midway? Attempt to complete later, if you can't, leave the rest blank, complete RO/RR then mark the resident as complete. What is CFR Part 489.301? Jeopardy What is the definition of Jeopardy? A providers noncompliance has caused, or is likely to cause, serious injury, harm, impairment or death. What do you do if the team has different information then the systemvpopulated information? Enter it under notes field
prior survey and complaint results underrepresented areas of facility. What is investigated when more than 5 complaint/fri residents are added to the sample? You will only investigate for the allegation When finalizing the sample you must ensure that a surveyor is assigned to which residents? every resident in the sample, additional complaint/fri residents, non sampled unnecessary medication review residents What are the 9 mandatory facility tasks
- Beneficiary Protection Notification review 2.Dining observation
- Infection control
- Kitchen
- Medication Administration
- Medication Storage
- QAA/QAPI
- Resident Council Meeting
- Sufficient and Competent Nurse Staff What 3 task are assigned to all surveyors? Dining observation, infection control, sufficient and competent nurse staff. (One surveyor is assigned primary responsibility for completion of each task)
Which facility tasks are triggered tasks? Environment, Personal Funds, Resident Assessment
Quality of Life- pertains to all care and services provided. Facilities must provide necessary care and services to attain or maintain highest practicable physical, mental, and psychosocial well being.
Quality of Care-facility must ensure residents receive care and treatment in accordance with professional standards of practice, person centered care and resident choice What is included on a baseline care plan? Initial goals based on admission orders MD orders and dietary orders Therapy and social Services PASARR What is a PASARR Pre-Admission Screening and Resident review - screening to ensure that the facility coordinates with the appropriate, State designated authority, to ensure that individuals with a mental disorder, intellectual disability or a related condition receive care and services in the most integrated setting appropriate to their needs. What pathway is used to investigate QOC concerns that have no pathway?
What should be discussed at end of day 1 team meeting? Any newly identified harm or IJ concerns? Need to expand sample to r/o SQC? Status of information for complaint/FRI Pertinent findings Work left to complete Need to adjust workload Whether 3 resident rep interviews are done Concerns indicative of system failure What is the importance of record review? Determine how negative outcomes are r/t the facilities failure to provide adequate care Determine if the facility has enabled the resident to reach their highest practicable level What is reviewed during the Infection Control task? All surveyors observe for breaks in infection control throughout the survey. Assigned surveyor reviews IPCP, AB Stewardship, and the influenza/pneumococcal vaccination ( residents), sample of 3 staff including at least 1 that was COVID 19 positive, and 3 residents for TBP( covid + or suspected) as well as screening, testing and reporting of COVID 19 What is reviewed for compliance with the Antibiotic Stewardship program?
- AB use protocol on prescribing
- Protocols to determine if AB is indicated
- A process for review of AB use by prescribers
- Protocols to ensure resident are prescribed the appropriate AB
- A system for feedback reports
What is avoidable decline? The facility failed to do 1 or more of the following;
- evaluate resident clinical condition and risk factors
- develop and implement interventions consistent with resident needs, goals, and standards of practice
- Monitor and evaluate impact of interventions 4revise interventions as appropriate What are the factors in determining Noncompliance
- specific action or lack of action relative to requirement
- Practice the facility implemented or failed to implement
- what the facility did or di not do to cause the noncompliance
- The actual or potential outcome that resulted from the noncompliance. What factors should you consider in determining severity when harm has occured? Is the harm at the level of serious injury, impairment or death? did the resident experience a negative psychosocial outcome? how did the facility practice in question cause, contribute, or perpetuate the harm? What factors should you consider in determining severity when the is no actual harm? how likely is it that a resident could suffer harm, impairment, death or compromise/deterioration? Does the deficient practice require immediate correction? Could the noncompliance have an impact on many residents? Use the psychosocial outcome grid and the reasonable person concept
Deficiency designated under CoP 1 or more def. that poses IJ A pattern of, or widespread def. at severity level 3 A widespread deficiency a severity level 2 (F,H,I,J,K, or L) What does the Beneficiary Protection Notice Review verify? verify notification to resident when Med A ends- SNF-ABN and NOMNC verify the facility billed medicare within the required time frame after the resident requested a demand bill verify that the facility did not bill the resident while a decision was pending. What is 483. Kitchen-store, prep, distribute food under sanitary conditions to prevent food-born illness. F What is the danger zone? above 41degress or below 135 degrees What are the 3 types of contamination Biological, chemical, physical What is Critical Control Point (CCP) a specific point, procedure, or a step in food preparation and serving at which control can be exercised to reduce, eliminate, or prevent the possibility of a food safety hazard.
Cooking ,cooling, holding, reheating What foods are PHF/TCS ground beef, poultry, fish, cut melon, unpasteurized eggs, cottage cheese How should PHF foods be cooled? Cool from 135 degrees to 70 degrees in 2 hours then from 70 degrees to 41 degrees or lower within 6 hours. What temperature should hot foods be held at? 135 degrees or higher What temperature should cold foods be held at? 41 degrees or lower What temperature should food be re-heated to? 165 degrees for 15 seconds within 2 hours Should ABHS be used in food Service? No
