Texas LTC - State Exam Latest
Updated Rated A+
Abuse and Neglect Investigation - ANSWER-TX HHSC will begin investigation within 24
hours of receipt of the report or other allegatio if the report og abuse or neglect or other
complints alleges a residnet's health or safety is in IMMINENT DANGER, a resident has
recently DIED, has been HOSPITALIZED or TREATED in ER because of conduct
alleged in the report
Accident Prevention - ANSWER-each resident must receive adequate supervision and
assistance devices to prevent accidents
Activity Director - ANSWER-must COMPLETE 8 HRS. of APPROVED CONTINUING
EDUCATION EACH YEAR
Administrative Law Judge (ALJ) - ANSWER-State Official of Administrative Hearing
(SOAH) ATTORNEY who conducts formal hearing for TX HHSC
Administrator - ANSWER-appointed by the governing board, must be licensed by TX
Board of Nursing Facility Administrators, responsible for the management of the facility
and required to work at least 40 hours per week on admin. duties
Advance Directives - ANSWER-competent adults may issue advance directives in
accordance with applicable laws - the facility must (within 14 days after the resident is
admitted) orally review and discuss and then again when there is a significant change
(positive or negative) in resident's clinical condition and/or annually
Advance Information on Unannounced Inspections - ANSWER-persons authorized to
receive advanced info. on unannounced inspections include (1) citizen advocates
invited to attend inspections (2) reps. of TX HHSC serving as ombudsmen (3) reps. of
U.S. Dept of HHS whose programs relate to MCR/MCD LTC program (4) reps. of TX
Dept. of HHS whose programs relate to MCR/MCD LTC program
AED (automated external defibrillator) - ANSWER-(1) must have at least 1 AED for use
onsite AT ALL TIMES and placed in location easily accessible for all trained staff to
operate it is onsite at ALL TIMES (training in CPR and AED -American Heart Assoc.
&Amer. Red Cross), (2) licensed physician must provide medical consult/oversight of
staff training on AED to ensure compliance (3) must maintain/test AED per manuf.
guidelines & keep records of maintenance/testing (4) ensure that use of AED is
consistent with Resident's Advanced Directive Executed/issued under TX Health &
Safety Code CHAPTER 166, SUBCHAPTER C
,AEM - ANSWER-if AEM is being conducted in a resident's room, and another resident
is moved into the room who has not yet consented to AEM, the monitoring must cease
until the new resident or the resident's guardian/legal rep. consents
After Survey - ANSWER-survey team has 10 WORK DAYS to get the 2567
(STATEMENT OF DEFICIENT PRACTICE) to admin. & admin. has 10 CALENDAR
DAYS to turn in to tehm an ACCEPTABLE PLAN of CORRECTION
Air Systems - ANSWER-must provide for the INDUCTION and MIXING of AT LEAST
10% OUTSIDE FRESH AIR INTO THE FACILITY unless otherwise approved by TX
HHSC - that is, 100% CONTINUOUS RE-CIRCULATION of INTERIOR AIR in MOST
AREAS IS NOT ACCEPTABLE
ANNUAL INSPECTION - ANSWER-must have ANNUAL INSPECTION by LOCAL FIRE
MARSHALL and MAINTAIN DOCUMENTATION for such an INSPECTION at the
FACILITY
ASSESSMENT of RESIDENTS - ANSWER-primary purpose of a physician visit is
ASSESSMENT of RESIDENT, AFTER ASSESSMENT IS COMPLETED, PHYSICIAN
WILL DO DOCUMENTATION REGARDING the VISIT in the RESIDENT'S CHART on
PHYSICIAN PROGRESS NOTES
Attorney General - ANSWER-TX HHSC may refer a facility to the Attorney General if
immediate steps are not taken to correct a situation which may cause injury or harm to a
resident's health or safety
Auxiliary Station (nurses' station) - ANSWER-when resident bedrooms are more than
150 ft. from the nurses station and the adjacent corridors are not observable from the
station by direct line of sight an auxiliary station must be established and used
Bathtubs and Showers - ANSWER-must be provided at a minimum rate of 1 for each 20
beds
Battery Systems - ANSWER-must be capable of SUSTAINING POWER FOR A
DURATION of AT LEAST 1.5 HRS.
Boilers - ANSWER-all boilers NOT EXEMPTED by the TX HEALTH and SAFETY
CODE must be INSPECTED and CERTIFIED for operation by the TX DEPT. of
LICENSING and REGULATION
Building Insulation Materials - ANSWER-building insulation materials, unless sealed on
all sides and edges in an approved manner with non-combustible material, MUST
HAVE a FLAME-SPREAD RATING of 25 or LESS when tested in accordance with
NFPA 255 and NFPA 258 - TRASH CANS in resident rooms must be NON-
COMBUSTIBLE (there should be 1 trash can in each room), as well as, each room
should have FIRE-RATED CURTAINS and BEDSPREADS
, Certified Alzheimer/Dementia Unit - ANSWER-(1) dining area - MINIMUM of 10 SQ. FT.
per resident with at least 1 exterior window (2) Staffing ratio - 1:6 DAY SHIFT, 1:10
EVENING SHIFT, 1:18 NIGHT SHIFT
Change of Administrator - ANSWER-FORM must be completed WITHIN 30 DAYS of
the EFFECTIVE DATE of CHANGE and the COST is $20.00 - an administrator can be
imposeda $500.00 PENALTY by the TEXAS BOARD of NURSING FACILITY
ADMINISTRATORS for not reporting such a change
CHOW (Change of Ownership) - ANSWER-(1) a change of 50% or more of the
OWNERSHIP of the business organization, (2) a change in the FEDERAL TAXPAYER
ID NUMBER, or (3) relinquishment by the LICENSE HOLDER of the MGMT of the
FACILITY - the PROSPECTIVE NEW OWNER must submit APPLICATION to TX
HHSC at LEAST 30 DAYS BEFORE the ANTICIPATED DATE of SALE or OTHER
TRANSFER of OWNERSHIP
Clinical Records Retention - ANSWER-clinical records must be retained for 5 years
after medical services end or for a minor, 3 years after a resident reaches legal age
under TX law
CNA - ANSWER-required to complete 12 hours of in-service (must include dementia
mgmt training and resident abuse prevention training) per year, retraining required if
have not worked as a paid CNA within the past 24 months - no waiting period to hire a
CNA unless the Nurse Aid (NA) has not completed CNA school and wants to work for
facility then CNA can work for up to 4 months without being certified; however, CNA
must test and pass the certification within 4 months
Competency - Nurse Aide - ANSWER-facility MUST NOT USE a person who has
worked LESS THAN 4 MONTHS as a Nurse Aide in that facility UNLESS the person is:
(1) a full-time employee in a state-approved training/competency evaluation program (2)
has demonstrated competence through satisfactory participation in a state-approved
nurse-aide training/competency evaluation program or competency evaluation program
(3) has been deemed/determined competent per 42 CODE of FEDERAL
REGULATIONS 483.150 (a) (b)
COMPREHENSIVE ASSESSMENT - ANSWER-must be DONE WITHIN 14 DAYS of
ADMISSION, EXCLUDING RE-ADMISSIONS in WHICH THERE IS NO SIGNIFICANT
CHANGE IN THE RESIDENT'S PHYSICAL OR MENTAL CONDITION - ANNUALLY
(BY DAY 366) and/or SIGNIFICANT CHANGE
COMPREHENSIVE CARE PLAN - ANSWER-must be DEVELOPED WITHIN 7 DAYS
AFTER COMPLETION OF THE COMPREHENSIVE ASSESSMENT - must be
PERSON-CENTERED
Updated Rated A+
Abuse and Neglect Investigation - ANSWER-TX HHSC will begin investigation within 24
hours of receipt of the report or other allegatio if the report og abuse or neglect or other
complints alleges a residnet's health or safety is in IMMINENT DANGER, a resident has
recently DIED, has been HOSPITALIZED or TREATED in ER because of conduct
alleged in the report
Accident Prevention - ANSWER-each resident must receive adequate supervision and
assistance devices to prevent accidents
Activity Director - ANSWER-must COMPLETE 8 HRS. of APPROVED CONTINUING
EDUCATION EACH YEAR
Administrative Law Judge (ALJ) - ANSWER-State Official of Administrative Hearing
(SOAH) ATTORNEY who conducts formal hearing for TX HHSC
Administrator - ANSWER-appointed by the governing board, must be licensed by TX
Board of Nursing Facility Administrators, responsible for the management of the facility
and required to work at least 40 hours per week on admin. duties
Advance Directives - ANSWER-competent adults may issue advance directives in
accordance with applicable laws - the facility must (within 14 days after the resident is
admitted) orally review and discuss and then again when there is a significant change
(positive or negative) in resident's clinical condition and/or annually
Advance Information on Unannounced Inspections - ANSWER-persons authorized to
receive advanced info. on unannounced inspections include (1) citizen advocates
invited to attend inspections (2) reps. of TX HHSC serving as ombudsmen (3) reps. of
U.S. Dept of HHS whose programs relate to MCR/MCD LTC program (4) reps. of TX
Dept. of HHS whose programs relate to MCR/MCD LTC program
AED (automated external defibrillator) - ANSWER-(1) must have at least 1 AED for use
onsite AT ALL TIMES and placed in location easily accessible for all trained staff to
operate it is onsite at ALL TIMES (training in CPR and AED -American Heart Assoc.
&Amer. Red Cross), (2) licensed physician must provide medical consult/oversight of
staff training on AED to ensure compliance (3) must maintain/test AED per manuf.
guidelines & keep records of maintenance/testing (4) ensure that use of AED is
consistent with Resident's Advanced Directive Executed/issued under TX Health &
Safety Code CHAPTER 166, SUBCHAPTER C
,AEM - ANSWER-if AEM is being conducted in a resident's room, and another resident
is moved into the room who has not yet consented to AEM, the monitoring must cease
until the new resident or the resident's guardian/legal rep. consents
After Survey - ANSWER-survey team has 10 WORK DAYS to get the 2567
(STATEMENT OF DEFICIENT PRACTICE) to admin. & admin. has 10 CALENDAR
DAYS to turn in to tehm an ACCEPTABLE PLAN of CORRECTION
Air Systems - ANSWER-must provide for the INDUCTION and MIXING of AT LEAST
10% OUTSIDE FRESH AIR INTO THE FACILITY unless otherwise approved by TX
HHSC - that is, 100% CONTINUOUS RE-CIRCULATION of INTERIOR AIR in MOST
AREAS IS NOT ACCEPTABLE
ANNUAL INSPECTION - ANSWER-must have ANNUAL INSPECTION by LOCAL FIRE
MARSHALL and MAINTAIN DOCUMENTATION for such an INSPECTION at the
FACILITY
ASSESSMENT of RESIDENTS - ANSWER-primary purpose of a physician visit is
ASSESSMENT of RESIDENT, AFTER ASSESSMENT IS COMPLETED, PHYSICIAN
WILL DO DOCUMENTATION REGARDING the VISIT in the RESIDENT'S CHART on
PHYSICIAN PROGRESS NOTES
Attorney General - ANSWER-TX HHSC may refer a facility to the Attorney General if
immediate steps are not taken to correct a situation which may cause injury or harm to a
resident's health or safety
Auxiliary Station (nurses' station) - ANSWER-when resident bedrooms are more than
150 ft. from the nurses station and the adjacent corridors are not observable from the
station by direct line of sight an auxiliary station must be established and used
Bathtubs and Showers - ANSWER-must be provided at a minimum rate of 1 for each 20
beds
Battery Systems - ANSWER-must be capable of SUSTAINING POWER FOR A
DURATION of AT LEAST 1.5 HRS.
Boilers - ANSWER-all boilers NOT EXEMPTED by the TX HEALTH and SAFETY
CODE must be INSPECTED and CERTIFIED for operation by the TX DEPT. of
LICENSING and REGULATION
Building Insulation Materials - ANSWER-building insulation materials, unless sealed on
all sides and edges in an approved manner with non-combustible material, MUST
HAVE a FLAME-SPREAD RATING of 25 or LESS when tested in accordance with
NFPA 255 and NFPA 258 - TRASH CANS in resident rooms must be NON-
COMBUSTIBLE (there should be 1 trash can in each room), as well as, each room
should have FIRE-RATED CURTAINS and BEDSPREADS
, Certified Alzheimer/Dementia Unit - ANSWER-(1) dining area - MINIMUM of 10 SQ. FT.
per resident with at least 1 exterior window (2) Staffing ratio - 1:6 DAY SHIFT, 1:10
EVENING SHIFT, 1:18 NIGHT SHIFT
Change of Administrator - ANSWER-FORM must be completed WITHIN 30 DAYS of
the EFFECTIVE DATE of CHANGE and the COST is $20.00 - an administrator can be
imposeda $500.00 PENALTY by the TEXAS BOARD of NURSING FACILITY
ADMINISTRATORS for not reporting such a change
CHOW (Change of Ownership) - ANSWER-(1) a change of 50% or more of the
OWNERSHIP of the business organization, (2) a change in the FEDERAL TAXPAYER
ID NUMBER, or (3) relinquishment by the LICENSE HOLDER of the MGMT of the
FACILITY - the PROSPECTIVE NEW OWNER must submit APPLICATION to TX
HHSC at LEAST 30 DAYS BEFORE the ANTICIPATED DATE of SALE or OTHER
TRANSFER of OWNERSHIP
Clinical Records Retention - ANSWER-clinical records must be retained for 5 years
after medical services end or for a minor, 3 years after a resident reaches legal age
under TX law
CNA - ANSWER-required to complete 12 hours of in-service (must include dementia
mgmt training and resident abuse prevention training) per year, retraining required if
have not worked as a paid CNA within the past 24 months - no waiting period to hire a
CNA unless the Nurse Aid (NA) has not completed CNA school and wants to work for
facility then CNA can work for up to 4 months without being certified; however, CNA
must test and pass the certification within 4 months
Competency - Nurse Aide - ANSWER-facility MUST NOT USE a person who has
worked LESS THAN 4 MONTHS as a Nurse Aide in that facility UNLESS the person is:
(1) a full-time employee in a state-approved training/competency evaluation program (2)
has demonstrated competence through satisfactory participation in a state-approved
nurse-aide training/competency evaluation program or competency evaluation program
(3) has been deemed/determined competent per 42 CODE of FEDERAL
REGULATIONS 483.150 (a) (b)
COMPREHENSIVE ASSESSMENT - ANSWER-must be DONE WITHIN 14 DAYS of
ADMISSION, EXCLUDING RE-ADMISSIONS in WHICH THERE IS NO SIGNIFICANT
CHANGE IN THE RESIDENT'S PHYSICAL OR MENTAL CONDITION - ANNUALLY
(BY DAY 366) and/or SIGNIFICANT CHANGE
COMPREHENSIVE CARE PLAN - ANSWER-must be DEVELOPED WITHIN 7 DAYS
AFTER COMPLETION OF THE COMPREHENSIVE ASSESSMENT - must be
PERSON-CENTERED
