SMQT- Fraud & Abuse Exam Questions & Answers
Correct
Incorrect
Questions & Answers
1 of 57
Request Written Evidence:
Request written evidence of how the facility has handled alleged
violations.
Select two or three alleged violations (if the facility has this many)
since the previous standard survey or the previous time this review
has been done by the State.
Determine if the facility implemented adequate procedures for the
following:
,- Reporting and investigating
- Protection of the resident during the investigation
- The provision of corrective action
NOTE:
The reporting requirements at
- §483.13(c)(2), (c)(4), F225;
- specify both a report of the alleged violation and a report of the
results of the investigation to the State Survey Agency.
- You must determine if the facility re-evaluated and revised
applicable procedures as necessary.
Give this one a try later!
Investigative Protocol for Abuse
Investigative Protocol for Abuse
Prohibition:
Prohibition:
2) Interview the Responsible
6) Interview Front Line Supervisors
Individual(s)
Investigative Protocol for Abuse
Investigative Protocol for
Prohibition
Abuse Prohibition:
1) Obtain & Review Policies &
3) Request Written Evidence
Procedures
, 2 of 57
Term
QUIZ QUESTION:
What is the general objective of the Abuse Prohibition Review?
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ANSWER:
The general objective of the Abuse Prohibition Review is to determine if the
facility has BOTH developed & operationalized policies & procedures that
PROHIBIT
1) abuse
2) neglect
3) involuntary seclusion
4) misappropriation of property for all residents.
General Procedures:
The review includes components of the facility's policies and procedures as
contained in the Guidance to Surveyors. These include policies and procedures
for:
- Screening of potential hirees (or employees)
- Training of employees (both for new employees and ongoing training for all
employees)
- Prevention policies and procedures
- Identification of possible incidents or allegations that need (or require)
investigation
, - Investigation of incidents and allegations
- Protection of residents during investigations
- Reporting of incidents, investigations, and facility response to their
investigations
- The general procedure for the Abuse Prohibition Review is to use/follow the
Abuse Prohibition Investigative Protocol to complete the task.
The following information must be included in the report to the Nurse Aide
Registry:
Documentation of the investigation, including the nature of the allegation and
the evidence that led to the State's conclusion that the allegation was valid
The date of the hearing, if the individual chose to have one, and its outcome
A statement by the individual disputing the allegation if the individual chose to
make one
This information must be included in the registry within 10 working days of the
finding and must remain in the registry permanently, unless:
- The finding was made in error
- The individual was found not guilty in a court of law
- The State is notified of the individual's death
The registry removes entries for individuals who have performed no nursing or
nursing related services for 24 consecutive months, unless the individual's
registry entry includes documented findings of abuse, neglect, or
misappropriation of resident property.
Keep in mind, a State must not make a finding that an individual has neglected a
resident if the individual demonstrates that such neglect was caused by factors
beyond the control of the individual.
The facility's reporting requirements under
Correct
Incorrect
Questions & Answers
1 of 57
Request Written Evidence:
Request written evidence of how the facility has handled alleged
violations.
Select two or three alleged violations (if the facility has this many)
since the previous standard survey or the previous time this review
has been done by the State.
Determine if the facility implemented adequate procedures for the
following:
,- Reporting and investigating
- Protection of the resident during the investigation
- The provision of corrective action
NOTE:
The reporting requirements at
- §483.13(c)(2), (c)(4), F225;
- specify both a report of the alleged violation and a report of the
results of the investigation to the State Survey Agency.
- You must determine if the facility re-evaluated and revised
applicable procedures as necessary.
Give this one a try later!
Investigative Protocol for Abuse
Investigative Protocol for Abuse
Prohibition:
Prohibition:
2) Interview the Responsible
6) Interview Front Line Supervisors
Individual(s)
Investigative Protocol for Abuse
Investigative Protocol for
Prohibition
Abuse Prohibition:
1) Obtain & Review Policies &
3) Request Written Evidence
Procedures
, 2 of 57
Term
QUIZ QUESTION:
What is the general objective of the Abuse Prohibition Review?
Give this one a try later!
ANSWER:
The general objective of the Abuse Prohibition Review is to determine if the
facility has BOTH developed & operationalized policies & procedures that
PROHIBIT
1) abuse
2) neglect
3) involuntary seclusion
4) misappropriation of property for all residents.
General Procedures:
The review includes components of the facility's policies and procedures as
contained in the Guidance to Surveyors. These include policies and procedures
for:
- Screening of potential hirees (or employees)
- Training of employees (both for new employees and ongoing training for all
employees)
- Prevention policies and procedures
- Identification of possible incidents or allegations that need (or require)
investigation
, - Investigation of incidents and allegations
- Protection of residents during investigations
- Reporting of incidents, investigations, and facility response to their
investigations
- The general procedure for the Abuse Prohibition Review is to use/follow the
Abuse Prohibition Investigative Protocol to complete the task.
The following information must be included in the report to the Nurse Aide
Registry:
Documentation of the investigation, including the nature of the allegation and
the evidence that led to the State's conclusion that the allegation was valid
The date of the hearing, if the individual chose to have one, and its outcome
A statement by the individual disputing the allegation if the individual chose to
make one
This information must be included in the registry within 10 working days of the
finding and must remain in the registry permanently, unless:
- The finding was made in error
- The individual was found not guilty in a court of law
- The State is notified of the individual's death
The registry removes entries for individuals who have performed no nursing or
nursing related services for 24 consecutive months, unless the individual's
registry entry includes documented findings of abuse, neglect, or
misappropriation of resident property.
Keep in mind, a State must not make a finding that an individual has neglected a
resident if the individual demonstrates that such neglect was caused by factors
beyond the control of the individual.
The facility's reporting requirements under
