State of Michigan Nursing Home
Administrator Exam
"Licensed bed capacity" - ANS-means the autorized and licensed bed complement of a
nursing home
"Medical Audit" - ANS-means the retrospective examination, review, and evaluation of the
clinical application of medical knowledge utilized in the diagnosis and treatment of poatients
as revealed n the patient's clinical record and carried out for purpose of education,
accountability, and quality control.
"Quality Control" - ANS-means the planned and systematic medical management actions
which assures the consistent acceptabe quality of health care and services rendered to
patients including the use of variousmonitoring techniques.
"Utilization Review" - ANS-means retrospective, concurrent, and prospective review of the
provision and utilzation of health care services by providers and recipients in terms of cost,
effectiveness, efficiiency, and quality
1) Policy: - ANS-Must have a policy.
May state that the facility will not handle monies in excess of $5,000.00.
The facility may charge a reasonable fee not to exceed the ACTUAL COST of providing
service.
10) Surety Bond: - ANS-Not LESS than $2,000.00 or 125% of the previous year's patient
trust funds average balance held, whichever is greater.
11) Department of Community Health (MDCH or DCH) - ANS-DCH is responsible for the
Medicaid Program under contract to the federal agency named Centers for Medicare and
Medicaid Services (CMS).
MDCH also contracts with other departments and agencies to provide specific services.
12) Medical Services Administration (MSA) - ANS-This agency, under authority of MDCH
writes policy, acts as fiscal intermediary, designs categorical reimbursement programs,
audits and authorizes facility-specific reimbursement rates.
13) Bureau of Health Systems: DCH - ANS-has this bureau under its department for
oversight of the quality of care within nursing homes through the certification process.
The actual certifying agency is CMS. This is accomplished through the surveys and
inspections.
14) Department of Community Health, Bureau of Construction Codes, Office of Fire Safety. -
ANS-DCH contracts with Office of Fire Safety to conduct the Life Safety Code portion of the
survey.
15) Michigan Department of Human Services (DHS): - ANS-DCH contacts with DHS who
determine an individuals Medicaid eligibility and "co-payment" responsibility. DHS utilized the
local offices for direct contract with applicants.
, 16) Bureau of Health Professions: DCH - ANS-Has this bureau under its department for
oversight and licensing of Nursing Home Administrator (NHA)
17) Michigan Department Community Health - ANS-This Department contracts directly with
the federal agency CMS and as such is designated responsibility for Title XIX of the Social
Security Act.
Currently this program is 56% federally funded and 44% state funded.
18) Medical Service Administration (MSA) - ANS-itself handles two primary aspects of the
program POLICY AND REIMBURSEMENT.
19) Providers must adhere to - ANS-ALL POLICIES TO PARTICIPATE
2) Required Printed Information: - ANS-This must be given resident upon admission.
A statement that the facility will handle personnal funds if no other person is available.
Periodic statement of accounts (Minimum: Quarterly)
20 feet of unobstructed vision space outside of any - ANS-window in a room requiring
windows. One additional foot shall be added to the minimum distance of 20 feet for each 2
foot rise above the first story up to a max of 40 feet of required unobstructed space
20) Facility must be licensed - ANS-MANDATORY
21) Certification of Facility - ANS-VOLUNTARY
22) MDCH uses the - ANS-Bureau of Health Systems to perform surveys for this
certification.
23) Delivery of Services (Fairness/Non-Discrimination Doctrine) - ANS-Services Reimbursed
by MSA are listed in the Medicaid manual.
Facilities MUST render covered services to ALL ELIGIBLE recipients in the same scope,
quality, and manner as provided to the general public.
24) Compliance: - ANS-Facility must render services in accordance with all federal and state
statutory and regulatory requirements.
25) Medicaid is Payor of : - ANS-LAST RESORT
26) Medicaid Payment is: - ANS-PAYMENT IN FULL (critical issue)
For covered services the facility must except the Medicaide reimbursement rate as payment
in full for each and every Medicaid recipient.
The facility may not seek additional payment from residents or families for covered services.
27) For NON-COVERED SERVICES - ANS-The facility may seek payment from the recipient
IF the resident chooses the service AND is informed of the charge PRIOR to receiving the
service.
28) Retention: - ANS-Facility services - 6 years
Orders of Contracted Services (Not records) - 6 years
29) Attending Physicians' responsibility - ANS-Federal and State regulations require the
attending physician (MD or DO licensed in Michigan) to provide specific services to
recipients.
3) Procedure: American Institute of CPA - ANS-Quarterly statements including all activity,
(A-H) in easily readable form.
Written account of all personal funds held in trust must be sent to the executor, administrator,
rep payee or next of kin within 10 DAYS OF THE DEATH OF A PATIENT.
Administrator Exam
"Licensed bed capacity" - ANS-means the autorized and licensed bed complement of a
nursing home
"Medical Audit" - ANS-means the retrospective examination, review, and evaluation of the
clinical application of medical knowledge utilized in the diagnosis and treatment of poatients
as revealed n the patient's clinical record and carried out for purpose of education,
accountability, and quality control.
"Quality Control" - ANS-means the planned and systematic medical management actions
which assures the consistent acceptabe quality of health care and services rendered to
patients including the use of variousmonitoring techniques.
"Utilization Review" - ANS-means retrospective, concurrent, and prospective review of the
provision and utilzation of health care services by providers and recipients in terms of cost,
effectiveness, efficiiency, and quality
1) Policy: - ANS-Must have a policy.
May state that the facility will not handle monies in excess of $5,000.00.
The facility may charge a reasonable fee not to exceed the ACTUAL COST of providing
service.
10) Surety Bond: - ANS-Not LESS than $2,000.00 or 125% of the previous year's patient
trust funds average balance held, whichever is greater.
11) Department of Community Health (MDCH or DCH) - ANS-DCH is responsible for the
Medicaid Program under contract to the federal agency named Centers for Medicare and
Medicaid Services (CMS).
MDCH also contracts with other departments and agencies to provide specific services.
12) Medical Services Administration (MSA) - ANS-This agency, under authority of MDCH
writes policy, acts as fiscal intermediary, designs categorical reimbursement programs,
audits and authorizes facility-specific reimbursement rates.
13) Bureau of Health Systems: DCH - ANS-has this bureau under its department for
oversight of the quality of care within nursing homes through the certification process.
The actual certifying agency is CMS. This is accomplished through the surveys and
inspections.
14) Department of Community Health, Bureau of Construction Codes, Office of Fire Safety. -
ANS-DCH contracts with Office of Fire Safety to conduct the Life Safety Code portion of the
survey.
15) Michigan Department of Human Services (DHS): - ANS-DCH contacts with DHS who
determine an individuals Medicaid eligibility and "co-payment" responsibility. DHS utilized the
local offices for direct contract with applicants.
, 16) Bureau of Health Professions: DCH - ANS-Has this bureau under its department for
oversight and licensing of Nursing Home Administrator (NHA)
17) Michigan Department Community Health - ANS-This Department contracts directly with
the federal agency CMS and as such is designated responsibility for Title XIX of the Social
Security Act.
Currently this program is 56% federally funded and 44% state funded.
18) Medical Service Administration (MSA) - ANS-itself handles two primary aspects of the
program POLICY AND REIMBURSEMENT.
19) Providers must adhere to - ANS-ALL POLICIES TO PARTICIPATE
2) Required Printed Information: - ANS-This must be given resident upon admission.
A statement that the facility will handle personnal funds if no other person is available.
Periodic statement of accounts (Minimum: Quarterly)
20 feet of unobstructed vision space outside of any - ANS-window in a room requiring
windows. One additional foot shall be added to the minimum distance of 20 feet for each 2
foot rise above the first story up to a max of 40 feet of required unobstructed space
20) Facility must be licensed - ANS-MANDATORY
21) Certification of Facility - ANS-VOLUNTARY
22) MDCH uses the - ANS-Bureau of Health Systems to perform surveys for this
certification.
23) Delivery of Services (Fairness/Non-Discrimination Doctrine) - ANS-Services Reimbursed
by MSA are listed in the Medicaid manual.
Facilities MUST render covered services to ALL ELIGIBLE recipients in the same scope,
quality, and manner as provided to the general public.
24) Compliance: - ANS-Facility must render services in accordance with all federal and state
statutory and regulatory requirements.
25) Medicaid is Payor of : - ANS-LAST RESORT
26) Medicaid Payment is: - ANS-PAYMENT IN FULL (critical issue)
For covered services the facility must except the Medicaide reimbursement rate as payment
in full for each and every Medicaid recipient.
The facility may not seek additional payment from residents or families for covered services.
27) For NON-COVERED SERVICES - ANS-The facility may seek payment from the recipient
IF the resident chooses the service AND is informed of the charge PRIOR to receiving the
service.
28) Retention: - ANS-Facility services - 6 years
Orders of Contracted Services (Not records) - 6 years
29) Attending Physicians' responsibility - ANS-Federal and State regulations require the
attending physician (MD or DO licensed in Michigan) to provide specific services to
recipients.
3) Procedure: American Institute of CPA - ANS-Quarterly statements including all activity,
(A-H) in easily readable form.
Written account of all personal funds held in trust must be sent to the executor, administrator,
rep payee or next of kin within 10 DAYS OF THE DEATH OF A PATIENT.
