LTC EXAM TWO CHAPTER 12 QUESTIONS AND ANSWERS
OBRA (Omnibus Budget Reconciliation Act) - CORRECT ANSWER✅✅Passed in 1987, it aimed to improve
nursing home care.
Impact of OBRA-1987 on nursing home care - CORRECT ANSWER✅✅Decreased use of physical
restraints, increased training requirements for CNAs, strengthened resident rights, and established the
Resident Assessment process (RAI/MDS).
Percentage of nursing homes with substandard quality of care - CORRECT ANSWER✅✅25% of nursing
homes still have substandard quality of care.
Quality of care improvement by OBRA-1987 - CORRECT ANSWER✅✅Greatly improved overall quality
through regulation, resident rights, and consistent standards for care.
Quality in other long-term care (LTC) settings - CORRECT ANSWER✅✅Information is less robust and
inconsistent compared to nursing homes.
Tool for tracking nursing home deficiencies - CORRECT ANSWER✅✅The Grid for Nursing Home
Deficiencies, which classifies and monitors areas where facilities fail to meet federal standards.
Quality in long-term care - CORRECT ANSWER✅✅The consistent delivery of services that maximizes
physical, mental, social, and spiritual well-being, produces desirable outcomes, and minimizes the
likelihood of undesirable consequences.
Aim of quality of care - CORRECT ANSWER✅✅To maximize physical, mental, social, and spiritual well-
being.
Desired outcomes of quality of care - CORRECT ANSWER✅✅Produces desirable outcomes.
Minimization in quality of care - CORRECT ANSWER✅✅To minimize the risk of undesirable
consequences, such as falls or infections.
, Example of minimizing undesirable consequences in LTC - CORRECT ANSWER✅✅Implementing fall
prevention programs and infection control procedures.
Quality of life in long-term care - CORRECT ANSWER✅✅The total living experience, resulting in overall
satisfaction with one's life.
Factors contributing to quality of life in LTC settings - CORRECT ANSWER✅✅Lifestyle pursuits, Living
environment, Safety and comfort, Personal preferences, Dignity, Interpersonal relationships/human
factors, Pain management.
Assessment of quality of life in LTC facilities - CORRECT ANSWER✅✅LTC consumers are asked what is
important to them (e.g., through the MDS) and whether they are satisfied.
Example of accommodating resident preferences in LTC - CORRECT ANSWER✅✅Allowing residents to
choose when they shower, such as at night or in the morning.
Three domains of the Donabedian Framework of Quality - CORRECT ANSWER✅✅Structures →
Processes → Outcomes
Structure in the Framework of Quality - CORRECT ANSWER✅✅The foundation and resources needed to
provide good care, such as: Facility design and furnishings, Staffing levels and staff skill, Policies and
administrative structures, Equipment and supplies.
Process in the Framework of Quality - CORRECT ANSWER✅✅The methods of care delivery, such as:
Clinical practice guidelines, Food prep, hygiene, and infection control protocols, Staff-patient
interactions, Delivery of care.
Outcome in the Framework of Quality - CORRECT ANSWER✅✅The final results of care, including:
Clinical goals achieved, Minimized negative outcomes (e.g., infections, falls, pressure ulcers), Maximized
patient satisfaction.
OBRA (Omnibus Budget Reconciliation Act) - CORRECT ANSWER✅✅Passed in 1987, it aimed to improve
nursing home care.
Impact of OBRA-1987 on nursing home care - CORRECT ANSWER✅✅Decreased use of physical
restraints, increased training requirements for CNAs, strengthened resident rights, and established the
Resident Assessment process (RAI/MDS).
Percentage of nursing homes with substandard quality of care - CORRECT ANSWER✅✅25% of nursing
homes still have substandard quality of care.
Quality of care improvement by OBRA-1987 - CORRECT ANSWER✅✅Greatly improved overall quality
through regulation, resident rights, and consistent standards for care.
Quality in other long-term care (LTC) settings - CORRECT ANSWER✅✅Information is less robust and
inconsistent compared to nursing homes.
Tool for tracking nursing home deficiencies - CORRECT ANSWER✅✅The Grid for Nursing Home
Deficiencies, which classifies and monitors areas where facilities fail to meet federal standards.
Quality in long-term care - CORRECT ANSWER✅✅The consistent delivery of services that maximizes
physical, mental, social, and spiritual well-being, produces desirable outcomes, and minimizes the
likelihood of undesirable consequences.
Aim of quality of care - CORRECT ANSWER✅✅To maximize physical, mental, social, and spiritual well-
being.
Desired outcomes of quality of care - CORRECT ANSWER✅✅Produces desirable outcomes.
Minimization in quality of care - CORRECT ANSWER✅✅To minimize the risk of undesirable
consequences, such as falls or infections.
, Example of minimizing undesirable consequences in LTC - CORRECT ANSWER✅✅Implementing fall
prevention programs and infection control procedures.
Quality of life in long-term care - CORRECT ANSWER✅✅The total living experience, resulting in overall
satisfaction with one's life.
Factors contributing to quality of life in LTC settings - CORRECT ANSWER✅✅Lifestyle pursuits, Living
environment, Safety and comfort, Personal preferences, Dignity, Interpersonal relationships/human
factors, Pain management.
Assessment of quality of life in LTC facilities - CORRECT ANSWER✅✅LTC consumers are asked what is
important to them (e.g., through the MDS) and whether they are satisfied.
Example of accommodating resident preferences in LTC - CORRECT ANSWER✅✅Allowing residents to
choose when they shower, such as at night or in the morning.
Three domains of the Donabedian Framework of Quality - CORRECT ANSWER✅✅Structures →
Processes → Outcomes
Structure in the Framework of Quality - CORRECT ANSWER✅✅The foundation and resources needed to
provide good care, such as: Facility design and furnishings, Staffing levels and staff skill, Policies and
administrative structures, Equipment and supplies.
Process in the Framework of Quality - CORRECT ANSWER✅✅The methods of care delivery, such as:
Clinical practice guidelines, Food prep, hygiene, and infection control protocols, Staff-patient
interactions, Delivery of care.
Outcome in the Framework of Quality - CORRECT ANSWER✅✅The final results of care, including:
Clinical goals achieved, Minimized negative outcomes (e.g., infections, falls, pressure ulcers), Maximized
patient satisfaction.
