RCAL END OF COURSE QUESTIONS AND SOLUTIONS
2025/2026 GRADED A+
✔✔A national study have estimated that 3 to 4 % of nursing home and ALF residents
have lost capacity and have no formal or informal surrogate and have not executed any
advance directive. - ✔✔True. These residents are sometimes called unrepresented
residents
✔✔Some ALF communities will not accept unrepresented residents because they need
someone with legal authority to sign the admission agreement - ✔✔True. Providers
cannot contract with unrepresented residents or residents who does not have capacity
to sign admission agreement
✔✔ALF should adamentaly avoid acting as health care surrogates for unrepresented
residents. If a resident does not have capacity or a surrogate, no consent can be legally
given and any provider who does so may be guilty of batter, false imprisonment or
crimes and torts. - ✔✔True. A local guardian should be engaged for unrepresented
residents
✔✔Review Tort laws, contracts, estate planning, advance planning surrogate decision
making, - ✔✔Be mindful of elder laws that should be an ally of ALF rules and
regulations are there to help navigate concerns for unrepresented elders
✔✔Accounting is a discipline that is based on basic and evident concepts which should
be understood by the financial manager. - ✔✔True
✔✔The financial system should allow for basic cost accounting so that the senor
management will be aware of all expenses and revenues relating to each department.
this accounting system should also be able to collect data such as number of
admissions, readmissions, resident transfers upgrades downgrades discharges in order
for senior management to do what? - ✔✔Strategic Planning
✔✔What are the two basic systems in accounting - ✔✔cash basis and accrual basis
✔✔7 basic accounting concepts are: - ✔✔
✔✔Tort Law is - ✔✔The law governing people's relationships with one another as
general members of a civil society
✔✔What are the key elements to a Tort Law - ✔✔1. civil wrong against a person or
property 2.prosecuted by the victim or their representative e.g, usually personal injury
law
,✔✔What are statutes? - ✔✔written laws enacted by legislatures. statues comes from
Federal, state and local governments and vary considerably
✔✔Regulations/Rules - ✔✔1. Operate with a large grant of power from Congress
2. Must first develop guidelines
3.Apply and enforce rules
4.Are passed by government agencies operating within the executive branch
5. statues usually prevails regulations
✔✔Agency that addresses ALF is often called: - ✔✔Department of health and human
services
✔✔Common Law comes from: - ✔✔1. Judges
2. To fill the void of Statutes and Regulations
3. Are developed as courts consideted cases and rendered decisions based on
principles of general fairness
4. Common law is prominent in tort laws involving negligence
✔✔Law comes from - ✔✔constitutions (state and federal)- includes treaties made by the
federal government
statutory (state and federal)- found in books on line
administrative agencies (state and federal)-
case law and common law doctrines- judge made law, decisions of courts interpreting
the above types of law.
essentially all 3 branches of government. Statutes comes from the legislative branch.
Regulations from the executive branch and common law from the judicial branch
✔✔What are tort law remedies? - ✔✔1.Monetary compensation-focus on making the
victim whole
2. Equitable relief-a=injunctions e,g court orders and b=specific performance or court
order requiring a party to complete its promises made in a contract
✔✔Negligence - ✔✔careless neglect, often resulting in injury. Failure to live up to the
applicable standard of care. does not require a failure to act; positive actions can
constitute negligence
✔✔What are the 4 elements of negligence claims - ✔✔1.the negligent party must have
a duty of exercising due care to the victim
1.Must have been a breach of the standard of care
3.the breach must have caused actual harm to the victim
4.the harm must be measurable in damages
✔✔What is the most important element of Negligence? - ✔✔The duty to care - based on
state laws and professional standards
, ✔✔What are the applicable standard of care expressed by state laws? - ✔✔1. Required
Services(shelter, food, supervision assistance with ADLS, assist with meals, dressing,
grooming, transportation to Md apts essentially oversight and assistance with the
residents personal needs
2. Resident care plan - must be updated whenever the residents needs change,
reviewed by an MD annually
3. the care plan assessment must reflect the residents current condition and address a
plan for any changing needs and continuous revision
and should be viewed as active, fluid process involving both assessment and
implementation
4.Staffing levels - minimum staffing levels to provide adequate care to residents -
monitor staff levels and the care needs of the residents
✔✔Medication Management - ✔✔Communicating with the physician about
prescriptions, filling prescriptions at the pharmacy, interpreting medication instructions,
taking medications on a routine basis, refilling prescriptions in a timely manner.
Store/distribute medication to the hands of the resident never in the mouth.
✔✔Medication Management Liabilities includes: - ✔✔medication error. overdose of
residents. if residents not able to continue taking their medication the facility must take
the medication. staff training must be satisfied for Med MGMT. supervise outside
nursing performance.
✔✔Resident falls dilemma - ✔✔Resident autonomy, explore risks and benefits, how to
walk/ambulate, explore residents safety, how to prevent residents from falling, can lead
to severe injuries and permanent declines in functioning or death. Falls leads to
personal injury law suits.
✔✔Resident falls dilemma 2 - ✔✔The only way to prevent fall is to restrain residents,
which is prohibited by law, but the state does not set any care standards or guidelines to
prevent falls. Care plans should indicate if a resident is at risk for falls and how it is
addressed. Implement appropriate measures to limit that risk of falls as much as
possible. assistance to bathroom. walkers, wc cane. document residents acceptance or
refusal of recommended fall prevention techniques. explore environmental issues,
carpeting, grab bars, lighting, spill clean up. Detailed post fall procedures that at
minimum assess the resident for a physician visit. documents the falls and triggers
additional care plan revision. post fall procedures will be scrutinized by attorneys
whenever a fall leads to significant injury or death
✔✔resident and wandering - ✔✔Balance the rights for residents to be free however,
supervision and safety is utmost important as well balance the rights of both standard
care.
✔✔Accounting is - ✔✔The system which accumulates data of quantitative nature
relating to the activities taking place in the facility
2025/2026 GRADED A+
✔✔A national study have estimated that 3 to 4 % of nursing home and ALF residents
have lost capacity and have no formal or informal surrogate and have not executed any
advance directive. - ✔✔True. These residents are sometimes called unrepresented
residents
✔✔Some ALF communities will not accept unrepresented residents because they need
someone with legal authority to sign the admission agreement - ✔✔True. Providers
cannot contract with unrepresented residents or residents who does not have capacity
to sign admission agreement
✔✔ALF should adamentaly avoid acting as health care surrogates for unrepresented
residents. If a resident does not have capacity or a surrogate, no consent can be legally
given and any provider who does so may be guilty of batter, false imprisonment or
crimes and torts. - ✔✔True. A local guardian should be engaged for unrepresented
residents
✔✔Review Tort laws, contracts, estate planning, advance planning surrogate decision
making, - ✔✔Be mindful of elder laws that should be an ally of ALF rules and
regulations are there to help navigate concerns for unrepresented elders
✔✔Accounting is a discipline that is based on basic and evident concepts which should
be understood by the financial manager. - ✔✔True
✔✔The financial system should allow for basic cost accounting so that the senor
management will be aware of all expenses and revenues relating to each department.
this accounting system should also be able to collect data such as number of
admissions, readmissions, resident transfers upgrades downgrades discharges in order
for senior management to do what? - ✔✔Strategic Planning
✔✔What are the two basic systems in accounting - ✔✔cash basis and accrual basis
✔✔7 basic accounting concepts are: - ✔✔
✔✔Tort Law is - ✔✔The law governing people's relationships with one another as
general members of a civil society
✔✔What are the key elements to a Tort Law - ✔✔1. civil wrong against a person or
property 2.prosecuted by the victim or their representative e.g, usually personal injury
law
,✔✔What are statutes? - ✔✔written laws enacted by legislatures. statues comes from
Federal, state and local governments and vary considerably
✔✔Regulations/Rules - ✔✔1. Operate with a large grant of power from Congress
2. Must first develop guidelines
3.Apply and enforce rules
4.Are passed by government agencies operating within the executive branch
5. statues usually prevails regulations
✔✔Agency that addresses ALF is often called: - ✔✔Department of health and human
services
✔✔Common Law comes from: - ✔✔1. Judges
2. To fill the void of Statutes and Regulations
3. Are developed as courts consideted cases and rendered decisions based on
principles of general fairness
4. Common law is prominent in tort laws involving negligence
✔✔Law comes from - ✔✔constitutions (state and federal)- includes treaties made by the
federal government
statutory (state and federal)- found in books on line
administrative agencies (state and federal)-
case law and common law doctrines- judge made law, decisions of courts interpreting
the above types of law.
essentially all 3 branches of government. Statutes comes from the legislative branch.
Regulations from the executive branch and common law from the judicial branch
✔✔What are tort law remedies? - ✔✔1.Monetary compensation-focus on making the
victim whole
2. Equitable relief-a=injunctions e,g court orders and b=specific performance or court
order requiring a party to complete its promises made in a contract
✔✔Negligence - ✔✔careless neglect, often resulting in injury. Failure to live up to the
applicable standard of care. does not require a failure to act; positive actions can
constitute negligence
✔✔What are the 4 elements of negligence claims - ✔✔1.the negligent party must have
a duty of exercising due care to the victim
1.Must have been a breach of the standard of care
3.the breach must have caused actual harm to the victim
4.the harm must be measurable in damages
✔✔What is the most important element of Negligence? - ✔✔The duty to care - based on
state laws and professional standards
, ✔✔What are the applicable standard of care expressed by state laws? - ✔✔1. Required
Services(shelter, food, supervision assistance with ADLS, assist with meals, dressing,
grooming, transportation to Md apts essentially oversight and assistance with the
residents personal needs
2. Resident care plan - must be updated whenever the residents needs change,
reviewed by an MD annually
3. the care plan assessment must reflect the residents current condition and address a
plan for any changing needs and continuous revision
and should be viewed as active, fluid process involving both assessment and
implementation
4.Staffing levels - minimum staffing levels to provide adequate care to residents -
monitor staff levels and the care needs of the residents
✔✔Medication Management - ✔✔Communicating with the physician about
prescriptions, filling prescriptions at the pharmacy, interpreting medication instructions,
taking medications on a routine basis, refilling prescriptions in a timely manner.
Store/distribute medication to the hands of the resident never in the mouth.
✔✔Medication Management Liabilities includes: - ✔✔medication error. overdose of
residents. if residents not able to continue taking their medication the facility must take
the medication. staff training must be satisfied for Med MGMT. supervise outside
nursing performance.
✔✔Resident falls dilemma - ✔✔Resident autonomy, explore risks and benefits, how to
walk/ambulate, explore residents safety, how to prevent residents from falling, can lead
to severe injuries and permanent declines in functioning or death. Falls leads to
personal injury law suits.
✔✔Resident falls dilemma 2 - ✔✔The only way to prevent fall is to restrain residents,
which is prohibited by law, but the state does not set any care standards or guidelines to
prevent falls. Care plans should indicate if a resident is at risk for falls and how it is
addressed. Implement appropriate measures to limit that risk of falls as much as
possible. assistance to bathroom. walkers, wc cane. document residents acceptance or
refusal of recommended fall prevention techniques. explore environmental issues,
carpeting, grab bars, lighting, spill clean up. Detailed post fall procedures that at
minimum assess the resident for a physician visit. documents the falls and triggers
additional care plan revision. post fall procedures will be scrutinized by attorneys
whenever a fall leads to significant injury or death
✔✔resident and wandering - ✔✔Balance the rights for residents to be free however,
supervision and safety is utmost important as well balance the rights of both standard
care.
✔✔Accounting is - ✔✔The system which accumulates data of quantitative nature
relating to the activities taking place in the facility
