NAB NHA Exam Compiled Cards Questions with
Verified Answers
/. the physical plant - Answer-all designed, constructed, equipped, and maintained to
protect health and safety of residents, personnel, public
/.Life Safety Code (LSC) - Answer-Entire construction plan and materials meet LSC
standards|||CMS requires unless have waiver or exception. CMS grants waivers on
SNFs; states on NFs
/.(NFPA) - Answer-National Fire Protection Association ||established LSC
/.Purpose of LSC - Answer-to provide reasonable degree of safety from fire.
/.Waivers for Life Safety Code - Answer-If CMS finds a state fire and safety code
adequately protects residents and personnel thenLSC does not apply. OLder facilities
may obtain a waiver if they are and have been in compliance with an older addition of
LSC as specified by CMS.||Before a nursing home may be built it must present
architectural plant to State Medicaid or designated agency that approves construction.
All major renovations, such as additional beds, change in utilization of space, and so on
must receive approval. The state provides guidelines on what must be a approved.
Upkeep and repairs do not require prior approaval.
/.Blue Prints - Answer-keep as-built plans available for surveyors who do LSC
inspection as well as for repair persons who may need prints for big jobs.
/.LSC and other standards - Answer-Building and contact standards are set by LSC,
CMS, ANSI/ADAAG - (dependent on which the state chooses) and state and local
codes. ||- for handicapped|-follow which on specific state requires (ANSI/ADAAG)
/.LSC and ANSI/ADAAG - Answer-LSC accepts both standards so they are essentially
all LSC standards. Administrator does not need to know EVERY standard, but must
keep a copy of the "LSC Handbook" as reference. The architect who designs the facility
must know and incorporate all LSC and other standards, but it is advisable for the NHA
to check his building to ensure compliance.
/.LSC, ANSI/ADAAG, and CMS - Answer-**- building materials - fire-rate according to
number of stories. 2 hour and 1 hour rating|**- sprinklers - new buildings have
automatically activated by smoke/heat|- exits - no room more than 100 feet from exit.
Lighted exit signs of specific size. |- walls extend continuously to roof deck of next floor.
wall finish must meet flame-spread requirements ( have certificate of this)|- furnishings -
curtains and carpet must meet fire rating|- rooms - CMS requirements - 4 residents to
room MAX. 80 sq ft/resident (multi-resident room), 100 sq ft for single occupancy.
,/.requirement for rooms| - Answer-- direct access to corridor|- outside window (CMS) or
door (LSC)|- privacy|- furnishing| separate bed, proper size and height| bedding
appropriate to climate| individual closet space| bedside table| comfortable chair| enough
overbid tables to meet needs of rsidents|- toilets (CMS, ANSI, ADA)|- bathing facilities
(CMS)|- resident call system (CMS, LSC) 24/7 - back up system available|- temperature
range (71-81 degree F) (three feet above floor), states set actual, A/C not required
/.Doors - Answer-All 44" or more in new construction (41.5 opening)|outside doors open
egress.|no locks on resident door except staff has key (LSC)||Bathroom door 32"
(ANSI/ADAAG)||Fire Doors with automatic hold-open devices required in corridors||(over
bed tables not required for patient)
/.corridors - Answer-no dead-ends (LSC)||8 feet wide (CMS)
/.Floors - Answer-at or above ground level. (LSC) |Fire rating if carpeted. (LSC)|Non-slip
bath/toilet (ANSI, LSC)|Asphalt tile best
/.Fire alarms - Answer-flashing and audible. |connect with local fire dept, if
possible|must have NFPA 71 certification of fire alarm service|
/.smoke detectors - Answer-approved detectors requried
/.smoking - Answer-written regulations, enforced. |smoking ares with non-combustible
ashtrays, metal containers with self-closing lids.|Prohibited areas include resident rooms
and beds, oxygen, flammable liquid storage.|proper signs posted.|supervise non-
responsible.
/.ANSI/ADAAG(Americans with Disabilties Act Accessibility Guidelines) - Answer-Make
building available to and usable by physically handicapped, no mental (blind, deaf, non-
ambulatory, semi-ambulatory, uncoordinated). ADAAG = MAKE BUILDINGS
AVAILABLE TO ADA'S. |State decides whether to apply ANSI or ADAAG standards to
nursing homes
/.accessible route - Answer-no incline more than 10%
/.Wheelchair passage - Answer-32" bathroom doors||36" elsewhere
/.parking - Answer-13 FEET||cannot block sidewalk; alley for 2 cars.|The number of
handicap parking places is determined from a grid issued by ANSI. It MUST BE NOTED
THAT FOR EVERY EIGHT (8) HANDICAP PARKING SLOTS, ONE MUST BE VAN
ACCESSIBLE.||If the facility only has one handicapped place, it must be van accessible.
/.ramps - Answer-maximum rise 30". Slope not more than 1:10
,/.What items must be accessible to wheelchair residents?| - Answer-WATER
FOUNTAINS, telephones (non-Braille), light switches
/.Toilets and handrails - height - Answer-toilets (Also ADA for staff) seat **17" to 19"
height;||hand rails/grab bars 33" to 36". |5% or more meet standards as determined by
state and CMS||(easier to replace with handicapped toilet)
/.Handrails - Answer-outside ramp, stairwell, bathroom required by ANSI, and specific
height.||CMS requires in corridors.||ADAAG specifies all 34" to 38" in public places. |On
stairwell must be 32" and MUST EXTEND 12" beyond last step. (ANSI|
/.Monitored - Answer-monitored nationally the Office of Civil Rights monitors ANSI.
States may assign to Fire Marshall, Medicaid Agency, other. |ADAAG is monitored by
State Agency handling LSC and ANSI.
/.Alarms - Answer-flashing alarms for deaf, sound alarms for blind, tactile warnings for
blind to identify danger areas.
/.Grating - Answer-No greater than one-half inch; openings perpendicular to travel rout,
if elongated.
/.Threshold - Answer-no more than 1/2 inch on entrance and exit doors, except exterior
sliding door can be 3/4 inch in height
/.GROUNDS and parking - Answer-Maintenance cost-mowing biggest. State decides on
number of parking spaces per bed.
/.Water - Answer-water must have backup source of supply. Temperature established
by state. Automatic Control Valves. (surveyors will ask for contract) (110 degrees in GA)
/.Ventilation - Answer-All areas ventilated to outside - window, mechanical ventilation, or
combination. | a. good movement (state determines| b. acceptable humidity/temperature
levels (state determines)| c. surveyor rating:| A= Good movement; acceptable
temp/humidity/odor levels| B= Little movement; temp/humidity/odor levels less
acceptable.| C= No movement; temp/humidity/odor levels unacceptable. Residents and
staff apprea distressed due to levels.
/.Pest control - Answer-PREVENTION PROGRAM BEST; use contractor and staff||no
traps, poisons, sticky fly paper.||advantage - to use pest control service:||licensed and
trained in use of all pesticides, how to rotate chemicals to prevent buildup of resistance.
||(close garbage bin: attracts pests)
/.Space and Equipment - Answer-Facility must provide sufficient space and equipment
for dining, healthcare services, recreation and rehabilitation. ||Sufficient means enough
to enable staff to provide residents with needed services as identified in the plan of
care.| - space large enough to accommodate usual number that use it; must be
, accessible.| - accommodate wheelchairs, walkers, other ambulatory devices.| - rehab
areas have exercise equipment, storage for supplies and equipment.
/.Monitoring - Answer-States decide who will monitor LSC and ANSI/ADAAG standards.
the monitor may be the State Medicaid Agency, State Fire Marshall, or other. If it is an
agency other than State Medicaid, the monitoring agency must coordinate its findings
with the Medicaid agency.
/.Preventative Maintenance definition. - Answer-checking all systems, including roof, on
regular basis and documenting.||roof protects all other assets. (log or cards)
/.3 points of Preventative Maintenance - Answer-1. Value:| Everything safe and
operative for resident care (#1)| saves downtime| small reparis cost less than complete
breakdown| equipment and systems last longer|2. personnel - major error in hiring|3.
work orders
/.environmental quality - clean, attractive, home. - Answer-1. housekeeping -
procedures for floors, rooms, aseptic cleaning, storage of materials, ODOR CONTROL,
role in infection control, equipment care, safety|2. homelike - residents brings own
belongings as long as it does not interfere with staff work or infringe on other residents'
rights. de-emphasize institutional look. | a. sound - comfortable, does not interefre with
hearing. background noise under resident control. Level not require staff to raise voices.
consider differences in room assignments.| b. lighting - adequate for resident/staff to
perform. comfortable - minimize glare, GIVE RESIDENT CONTROL.
/.environmental design - Answer-now part of all new construction. Must be designed to
provide most attractive, comfortable, usable environment. | a. landscaping - all grounds,
nursing home sign.| b. choice of colors.| c. room size- too small?, adequately
designed?| d. medical records storage| e. parking - inconspicuous| f. functional
equipment - not just fancy.
/.linen supply and laundry - Answer-clean linens in good condition, not ragged, stained.
what resident clothing will launder?| a. monitoring costs - bulk soap, temperatures,
overloading/under loading, overydrying, filters| GUIDELINES- after 10 years of use,
maintenance cost usually justify replacement of equipment| b. Theft|
/.Occupational Safety and Health Administration (OSHA) - Answer-programs OSHA falls
under U.S. Department of Labor
/.safety and infection control program - - Answer-complete procedures for all staff to
follow best infection control. committee may be desirable.
/.universal precautions - Answer-checked by OSHA; includes|-CDC HAND WASHING
procedures. NOW recommend use of alcohol-based solution to cleanse hands (except
dietary employees)|-SOILED LINENS and bedclothes means used linens.|-
Contaminated linen is soiled by blood or other potentially infectious materials.
Verified Answers
/. the physical plant - Answer-all designed, constructed, equipped, and maintained to
protect health and safety of residents, personnel, public
/.Life Safety Code (LSC) - Answer-Entire construction plan and materials meet LSC
standards|||CMS requires unless have waiver or exception. CMS grants waivers on
SNFs; states on NFs
/.(NFPA) - Answer-National Fire Protection Association ||established LSC
/.Purpose of LSC - Answer-to provide reasonable degree of safety from fire.
/.Waivers for Life Safety Code - Answer-If CMS finds a state fire and safety code
adequately protects residents and personnel thenLSC does not apply. OLder facilities
may obtain a waiver if they are and have been in compliance with an older addition of
LSC as specified by CMS.||Before a nursing home may be built it must present
architectural plant to State Medicaid or designated agency that approves construction.
All major renovations, such as additional beds, change in utilization of space, and so on
must receive approval. The state provides guidelines on what must be a approved.
Upkeep and repairs do not require prior approaval.
/.Blue Prints - Answer-keep as-built plans available for surveyors who do LSC
inspection as well as for repair persons who may need prints for big jobs.
/.LSC and other standards - Answer-Building and contact standards are set by LSC,
CMS, ANSI/ADAAG - (dependent on which the state chooses) and state and local
codes. ||- for handicapped|-follow which on specific state requires (ANSI/ADAAG)
/.LSC and ANSI/ADAAG - Answer-LSC accepts both standards so they are essentially
all LSC standards. Administrator does not need to know EVERY standard, but must
keep a copy of the "LSC Handbook" as reference. The architect who designs the facility
must know and incorporate all LSC and other standards, but it is advisable for the NHA
to check his building to ensure compliance.
/.LSC, ANSI/ADAAG, and CMS - Answer-**- building materials - fire-rate according to
number of stories. 2 hour and 1 hour rating|**- sprinklers - new buildings have
automatically activated by smoke/heat|- exits - no room more than 100 feet from exit.
Lighted exit signs of specific size. |- walls extend continuously to roof deck of next floor.
wall finish must meet flame-spread requirements ( have certificate of this)|- furnishings -
curtains and carpet must meet fire rating|- rooms - CMS requirements - 4 residents to
room MAX. 80 sq ft/resident (multi-resident room), 100 sq ft for single occupancy.
,/.requirement for rooms| - Answer-- direct access to corridor|- outside window (CMS) or
door (LSC)|- privacy|- furnishing| separate bed, proper size and height| bedding
appropriate to climate| individual closet space| bedside table| comfortable chair| enough
overbid tables to meet needs of rsidents|- toilets (CMS, ANSI, ADA)|- bathing facilities
(CMS)|- resident call system (CMS, LSC) 24/7 - back up system available|- temperature
range (71-81 degree F) (three feet above floor), states set actual, A/C not required
/.Doors - Answer-All 44" or more in new construction (41.5 opening)|outside doors open
egress.|no locks on resident door except staff has key (LSC)||Bathroom door 32"
(ANSI/ADAAG)||Fire Doors with automatic hold-open devices required in corridors||(over
bed tables not required for patient)
/.corridors - Answer-no dead-ends (LSC)||8 feet wide (CMS)
/.Floors - Answer-at or above ground level. (LSC) |Fire rating if carpeted. (LSC)|Non-slip
bath/toilet (ANSI, LSC)|Asphalt tile best
/.Fire alarms - Answer-flashing and audible. |connect with local fire dept, if
possible|must have NFPA 71 certification of fire alarm service|
/.smoke detectors - Answer-approved detectors requried
/.smoking - Answer-written regulations, enforced. |smoking ares with non-combustible
ashtrays, metal containers with self-closing lids.|Prohibited areas include resident rooms
and beds, oxygen, flammable liquid storage.|proper signs posted.|supervise non-
responsible.
/.ANSI/ADAAG(Americans with Disabilties Act Accessibility Guidelines) - Answer-Make
building available to and usable by physically handicapped, no mental (blind, deaf, non-
ambulatory, semi-ambulatory, uncoordinated). ADAAG = MAKE BUILDINGS
AVAILABLE TO ADA'S. |State decides whether to apply ANSI or ADAAG standards to
nursing homes
/.accessible route - Answer-no incline more than 10%
/.Wheelchair passage - Answer-32" bathroom doors||36" elsewhere
/.parking - Answer-13 FEET||cannot block sidewalk; alley for 2 cars.|The number of
handicap parking places is determined from a grid issued by ANSI. It MUST BE NOTED
THAT FOR EVERY EIGHT (8) HANDICAP PARKING SLOTS, ONE MUST BE VAN
ACCESSIBLE.||If the facility only has one handicapped place, it must be van accessible.
/.ramps - Answer-maximum rise 30". Slope not more than 1:10
,/.What items must be accessible to wheelchair residents?| - Answer-WATER
FOUNTAINS, telephones (non-Braille), light switches
/.Toilets and handrails - height - Answer-toilets (Also ADA for staff) seat **17" to 19"
height;||hand rails/grab bars 33" to 36". |5% or more meet standards as determined by
state and CMS||(easier to replace with handicapped toilet)
/.Handrails - Answer-outside ramp, stairwell, bathroom required by ANSI, and specific
height.||CMS requires in corridors.||ADAAG specifies all 34" to 38" in public places. |On
stairwell must be 32" and MUST EXTEND 12" beyond last step. (ANSI|
/.Monitored - Answer-monitored nationally the Office of Civil Rights monitors ANSI.
States may assign to Fire Marshall, Medicaid Agency, other. |ADAAG is monitored by
State Agency handling LSC and ANSI.
/.Alarms - Answer-flashing alarms for deaf, sound alarms for blind, tactile warnings for
blind to identify danger areas.
/.Grating - Answer-No greater than one-half inch; openings perpendicular to travel rout,
if elongated.
/.Threshold - Answer-no more than 1/2 inch on entrance and exit doors, except exterior
sliding door can be 3/4 inch in height
/.GROUNDS and parking - Answer-Maintenance cost-mowing biggest. State decides on
number of parking spaces per bed.
/.Water - Answer-water must have backup source of supply. Temperature established
by state. Automatic Control Valves. (surveyors will ask for contract) (110 degrees in GA)
/.Ventilation - Answer-All areas ventilated to outside - window, mechanical ventilation, or
combination. | a. good movement (state determines| b. acceptable humidity/temperature
levels (state determines)| c. surveyor rating:| A= Good movement; acceptable
temp/humidity/odor levels| B= Little movement; temp/humidity/odor levels less
acceptable.| C= No movement; temp/humidity/odor levels unacceptable. Residents and
staff apprea distressed due to levels.
/.Pest control - Answer-PREVENTION PROGRAM BEST; use contractor and staff||no
traps, poisons, sticky fly paper.||advantage - to use pest control service:||licensed and
trained in use of all pesticides, how to rotate chemicals to prevent buildup of resistance.
||(close garbage bin: attracts pests)
/.Space and Equipment - Answer-Facility must provide sufficient space and equipment
for dining, healthcare services, recreation and rehabilitation. ||Sufficient means enough
to enable staff to provide residents with needed services as identified in the plan of
care.| - space large enough to accommodate usual number that use it; must be
, accessible.| - accommodate wheelchairs, walkers, other ambulatory devices.| - rehab
areas have exercise equipment, storage for supplies and equipment.
/.Monitoring - Answer-States decide who will monitor LSC and ANSI/ADAAG standards.
the monitor may be the State Medicaid Agency, State Fire Marshall, or other. If it is an
agency other than State Medicaid, the monitoring agency must coordinate its findings
with the Medicaid agency.
/.Preventative Maintenance definition. - Answer-checking all systems, including roof, on
regular basis and documenting.||roof protects all other assets. (log or cards)
/.3 points of Preventative Maintenance - Answer-1. Value:| Everything safe and
operative for resident care (#1)| saves downtime| small reparis cost less than complete
breakdown| equipment and systems last longer|2. personnel - major error in hiring|3.
work orders
/.environmental quality - clean, attractive, home. - Answer-1. housekeeping -
procedures for floors, rooms, aseptic cleaning, storage of materials, ODOR CONTROL,
role in infection control, equipment care, safety|2. homelike - residents brings own
belongings as long as it does not interfere with staff work or infringe on other residents'
rights. de-emphasize institutional look. | a. sound - comfortable, does not interefre with
hearing. background noise under resident control. Level not require staff to raise voices.
consider differences in room assignments.| b. lighting - adequate for resident/staff to
perform. comfortable - minimize glare, GIVE RESIDENT CONTROL.
/.environmental design - Answer-now part of all new construction. Must be designed to
provide most attractive, comfortable, usable environment. | a. landscaping - all grounds,
nursing home sign.| b. choice of colors.| c. room size- too small?, adequately
designed?| d. medical records storage| e. parking - inconspicuous| f. functional
equipment - not just fancy.
/.linen supply and laundry - Answer-clean linens in good condition, not ragged, stained.
what resident clothing will launder?| a. monitoring costs - bulk soap, temperatures,
overloading/under loading, overydrying, filters| GUIDELINES- after 10 years of use,
maintenance cost usually justify replacement of equipment| b. Theft|
/.Occupational Safety and Health Administration (OSHA) - Answer-programs OSHA falls
under U.S. Department of Labor
/.safety and infection control program - - Answer-complete procedures for all staff to
follow best infection control. committee may be desirable.
/.universal precautions - Answer-checked by OSHA; includes|-CDC HAND WASHING
procedures. NOW recommend use of alcohol-based solution to cleanse hands (except
dietary employees)|-SOILED LINENS and bedclothes means used linens.|-
Contaminated linen is soiled by blood or other potentially infectious materials.
