RCAL NABS
Whichvtofvtthevtfollowingvthelpsvttovtcontrolvtcommunityvtriskvtbyvtevaluatingvtcurrentvtincide
nts**vt-vtanswer--A.vtsharedvtriskvtagreementvtSafetyvtcommitteevtprograms
Whichvtdepartmentvtisvtresponsiblevtforvtoversightvtofvtresourcesvtactivitiesvt-vtanswer--
Administration
Whatvtdoesvtavtgoodvtculturalvtfitvtrefersvttovt-vtanswer--Valuesvtandvtbeliefsvtofvtthevtfacility
whichvtofvtthevtfollowingvtarevthiringvtrequirementsvtofvtcaregiversvt(NACvt449.196)vt?vt-
vtanswer--ability vttovtreadvtandvtwritevtEnglish
OBRAvtisvtknownvtasvt-vtanswer--
OmnibusvtBudgetvtReconciliationvtActvtofvt87.vtAlsovtknownvtasvtthevtFederalvtNursingvtHo
mevtReformvtAct.vtThisvtwasvtenactedvttovtprotectvtthevtrightsvtofvtpatientsvtinvtlong-
termvtcarevtfacilitiesvtsuchvtasvtnursingvthomes,vtskilledvtnursingvtfacilities,vtandvtassistedvtli
vingvthomes.vt(1987)vtitvtisvtavtfederalvtlawvtthatvtestablishesvtregulationsvtforvtnursingvtfacili
tiesvtandvtnursevtaidevttrainingvtfacilities.vtThevtIntentvtofvtOBRA:vtisvttovtimprovevtthevtqualit
yvtofvtlifevtforvtresidentsvtinvtnursingvtfacilities.
RestrictionsvtofvtAdmissionvt-vtanswer--
Avtfacilityvtshallvtnotvtadmitvtorvtallowvttovtremainvtinvtthevtfacilityvtanyvtpersonvtthatvtisvtbedfa
st,vtrequiresvtrestraint,vtrequiresvtconfinementvtinvtlockedvtquarters,vtorvtrequirevtskillvtnursi
ngvtorvtothervtmedical
Twovtcompetentvtresidentsvtarevtinvolvedvtinvtavtsexualvtrelationship.vtThevtfamiliesvtofvtbot
hvtresidentsvtarevtangryvtandvtdemandvtthatvtthevtadministratorvtforcevtthevtresidentsvttovten
dsvtthevtrelationship.vtWhatvtisvtthevtbestvtcoursevtofvtaction?vt-vtanswer--And:
Respectvtthevtresidents'vtwishesvtandvtensurevttheirvtprivacy
-refervtthevtThevtsituationvttovtsocialvtservicesvtandvtadjustvtthevtservicevtplan
-involvedvtinvtwoodsmanvtinvtthevtsituation
-Refervttovtthevtethicsvtcommitteevtforvtdiscussion
ThevtdocumentvtbestvtusedvttovtsetvtrealisticvtexpectationsvtbetweenvtthevtRCALvtcommuni
tyvtandvtthevtresidentvtisvtthevt-vtanswer--Servicevtplanvtagreement
Onevtgoalvtofvtassistedvtlivingvtisvttovthelpvtseniorsvtremainvtasvtindependentvtasvtpossiblevtb
yvtprovidingvt-vtanswer--Dailyvtstructurevtandvtfixedvtschedulesvtforvtmealsvtandvtactivities
Whenvtavtresidentvtisvtnotvtcompetentvttovtmakevtavtmedicalvtdecisionvtthevtcourtvtmayvtapp
ointvtavt-vtanswer--LegalvtGuardian
Anvtexamplevtofvtinsurancevtthatvtisvtgenerallyvtrequiredvtbyvtfederalvtstatevtlawvtisvt-
vtanswer--Workersvtcompensation.vtAllvtbusinessvtarevtrequiredvtbyvtFederal/
Statevtlawvttovtcovervtanyvtemployeesvtwhovtmayvtbevtinjurevtwhilevtworkingvtonvtthevtjob
,Invtregardvttovtmanagingvtavtresidentsvtpersonalvtfunds,vtthevthealthcarevtorganizationvt-
vtanswer--
Shouldvthavevtavtwrittenvtauthorizationvttovtmanagevtthevtresidentsvtpersonalvtfunds
AvtRCALvtcommunityvthasvtyardvtservicevtperformedvtinvtMayvtforvt$500.vtButvtdoesvtnotvtpa
yvtthevtvendorvtuntilvtJune.vtThevt$500vtexpensesvtisvtanvtexamplevtofvt-vtanswer--Accrual-
basedvtaccounting
Whichvtinsurancevtpolicyvtprotectsvtagainstvtclaimsvtallegingvtthatvtnegligencevtorvtinappro
priatevtactionvtresultedvtinvtbodilyvtharmvtorvtpropertyvtdamagevt-vtanswer--
PropertyvtandvtCasualtyvtInsurance
Avtresidentvthasvtthevtrightvttovtparticipatevtinvtsocial,vtreligiousvtandvtcommunityvtactivitiesvt
providedvtthesevtdovtnotvt-vtanswer--Conflictvtwithvtthevtordersvtofvtthevtphysician
Avtresidentvtwithvtdementiavtatvtavthealthcarevtorganizationvtlikesvttovthelpvtfoldvtclothesvtan
dvtsetvttables,vtaskingvtthisvtresidentvttovthelpvt-vtanswer--
Isvtavtwayvttovtengagevtthevtresidentvtinvtsomethingvtenjoyablevtandvtenhancesvtpersonvtce
nteredvtcare
Thevtprimaryvtpurposevtofvtanvtinitialvtcarevtrecipientvtassessmentvtisvttovtdeterminevt-
vtanswer--OverallvtFunctionalvtStatus
Thevtbestvtwayvtforvtthevtadministratorvttovtgetvtfeedbackvtaboutvtdiningvtservicesvtisvt-
vtanswer--Throughvtthevtresidentvtcouncil
Ifvtcontractedvtlaundryvtservicesvtforvtthevtresidentsvtpersonalvtclothingvtarevtprovidedvtoffvt
sitevt-vtanswer--
Thevtusevtofvtcommercialvtlaundryvtequipmentvtbyvtthevtcontractorvtisvtrequiredvtbyvtthevthe
althvtdepartment
MaryvtJvtsuffersvtfromvtdementia.vtNovtmattervthowvtmanyvttimesvtthevtstaffvtexplainsvtsome
thingvttovthervtshevtdoesn'tvtseemvtablevttovtaccomplishvtthevttask.vtWhichvtofvtthevtfollowingv
tisvtthevtbestvtsolutionvt-vtanswer--Taskvtbreakdown
Thevtbestvtwayvttovtmanagevturinaryvtincontinencevtisvt-vtanswer--
Regularlyvtschedulevttoileting
CriteriavtforvtmovevtoutvtfromvtthevtRC/ALvtcommunityvtshouldvtbevtdisclosedvtat:vt-
vtanswer--Partvtofvtthevtmovevtin
Avtmajorvtconsiderationvtinvtcreatingvtavtcomprehensivevtactivitiesvtprogramvtisvtthatvtthevta
ctivityvtdirectorvtunderstandsvtthevt-vtanswer--
Naturevtandvtextentvtofvtcarevtrecipient'svtdisabilities
Forvtresidentsvtwithvtdementia,vtoptimalvtfoodvtconsumptionvtisvtbestvtachievedvtby:vt-
vtanswer--Goodvtscreening,vtpropervtnutritionvtandvthydration,vtandvtpleasantvtmealvttimes
, AvtprearrangedvtcontractvtwithvtlocalvtagenciesvtisvtpartvtofvtanvtRCALvtcommunity'svtdisast
ersvtplanvtbecausevtthisvtwillvtensurevt-vtanswer--
Thatvtthevtcommunityvtwillvthavevtwhatevervtisvtneededvttovtkeepvtresidentsvtsafevtandvtrelat
ivelyvtcomfortablevtduringvtandvtemergency
Onevtofvtthevtfundamentalvtelementsvtofvteffectivevtdementiavtcarevtis:vt-vtanswer--
Creatingvtavtspecialized,vtsecurevtandvtquietvtenvironmentvtforvtpatientsvtwithvtdementia
Informationvtshouldvtbevtaddedvttovtanvtindividualvtservicevtplan:vt-vtanswer--
Atvtavtminimumvtwhenvtthevtresidentvthasvtavtsignificantvtchangevtofvtcondition
Avtsmallvtfirevthasvtstartedvtinvtavtresidentvtbedroom.vtThevtlifevtsafetyvtcodevt(LSC)vtdirectsvt
thevtstaffvttovtfirst:vt-vtanswer--
Removevtthevtresidentvtandvtanyvtothervtpersonsvtfromvtthevtroom
InvtLifevtsafetyvtCodevt(LSC),vtfirevtextinguishersvtarevtlistedvtbyvtwhichvtofvtthevtfollowingvtcl
assificationsvt-vtanswer--A,vtBvtandvtC
Anvtexamplevtofvtcreatingvtavtdementiavtlivingvtenvironmentvtthatvtintegratesvtresidentialvtfe
aturesvtwithvtclinicalvtandvtsocialvtaspectsvtis:vt-vtanswer--
Incorporatingvtnaturalvtelementsvtsuchvtasvtanimalsvtandvtplants
Anvtemployeevtworkingvtovertimevtseesvtavtsupervisorvtandvtavtcoworkervtkissingvtinvtthevtu
noccupiedvtroomvtanvthourvtaftervttheirvtshiftvthasvtended.vtThevtnextvtday,vtthevtsupervisorvt
tellsvtthevtemployeevtyouvtdovtnotvtneedvttovtmentionvtwhatvtyouvtsawvtyesterday.vtWevtarevt
allvtadultsvthere,vtandvtwhatvtwevtdovtaftervthoursvtisvtourvtownvtbusiness.vtThevtemployeevtfe
elsvtthreatened.vtIsvtanvtexamplevtofvtsexualvtharassment?
No.vtbecausevtitvtdidvtnotvthappenvttovtthevtwitnessingvtemployee
No.vtbecausevtthevtincidentvthappenedvtaftervtthevtsupervisorvtcoworkersvtshiftvthadvtende
d
Yes.vtbecausevtitvtisvtmorallyvtreprehensiblevtandvtethicallyvtunacceptable
Yes.vtbecausevtthevtconductvtonlyvtneedvttovtbevtoffensivevttovtthevtwitnessingvtemployeevt-
vtanswer--Yes,vtbecausevtitvtisvtmorallyvtreprehensiblevtandvtethicallyvtunacceptable
Twovtsimplevttechniquesvtforvtminimizingvtthevtspreadvtofvtmicroorganismsvtalongvtfloorsvt
whenvtwetvtmoppingvtare:vt-vtanswer--
Utilizingvtavtdoublevtbucketvtmoppingvttechniquevtandvtfrequentvtchangingvtmopvtwater
Whethervtorvtnotvtthevtstatevtsetsvtavtminimumvtnumbervtofvtstaffvtorvtstaffingvthours,vtcomm
unitiesvtshouldvtstaffvtbasedvtonvtthevt-vtanswer--Residentvtcarevtneeds
Thevtoccupationalvtsafetyvtandvthealthvtadministrationvt(OSHA)
a.vtProvidesvtrightsvtandvtprotectionvtforvtparticipantsvtinvtgroupvthealthvtplansvt-vtanswer--
Requiresvtemployersvttovtmaintainvtavtlogvtofvtcertainvtinjuriesvtandvtillnesses
Whatvtarevtthevttopvt4vtadditionallyvtcitedvtqualityvtofvtcarevtdeficienciesvtinvtALvtbetweenvt19
96-1997vt-vtanswer--Providingvtpoorvtcare
insufficientvtandvtunqualifiedvtuntrainedvtstaff
Poorvtmedicationvtmanagementvt
Notvtfollowingvtadmissionvtandvtdischargevtpolicies
Whichvtofvtthevtfollowingvthelpsvttovtcontrolvtcommunityvtriskvtbyvtevaluatingvtcurrentvtincide
nts**vt-vtanswer--A.vtsharedvtriskvtagreementvtSafetyvtcommitteevtprograms
Whichvtdepartmentvtisvtresponsiblevtforvtoversightvtofvtresourcesvtactivitiesvt-vtanswer--
Administration
Whatvtdoesvtavtgoodvtculturalvtfitvtrefersvttovt-vtanswer--Valuesvtandvtbeliefsvtofvtthevtfacility
whichvtofvtthevtfollowingvtarevthiringvtrequirementsvtofvtcaregiversvt(NACvt449.196)vt?vt-
vtanswer--ability vttovtreadvtandvtwritevtEnglish
OBRAvtisvtknownvtasvt-vtanswer--
OmnibusvtBudgetvtReconciliationvtActvtofvt87.vtAlsovtknownvtasvtthevtFederalvtNursingvtHo
mevtReformvtAct.vtThisvtwasvtenactedvttovtprotectvtthevtrightsvtofvtpatientsvtinvtlong-
termvtcarevtfacilitiesvtsuchvtasvtnursingvthomes,vtskilledvtnursingvtfacilities,vtandvtassistedvtli
vingvthomes.vt(1987)vtitvtisvtavtfederalvtlawvtthatvtestablishesvtregulationsvtforvtnursingvtfacili
tiesvtandvtnursevtaidevttrainingvtfacilities.vtThevtIntentvtofvtOBRA:vtisvttovtimprovevtthevtqualit
yvtofvtlifevtforvtresidentsvtinvtnursingvtfacilities.
RestrictionsvtofvtAdmissionvt-vtanswer--
Avtfacilityvtshallvtnotvtadmitvtorvtallowvttovtremainvtinvtthevtfacilityvtanyvtpersonvtthatvtisvtbedfa
st,vtrequiresvtrestraint,vtrequiresvtconfinementvtinvtlockedvtquarters,vtorvtrequirevtskillvtnursi
ngvtorvtothervtmedical
Twovtcompetentvtresidentsvtarevtinvolvedvtinvtavtsexualvtrelationship.vtThevtfamiliesvtofvtbot
hvtresidentsvtarevtangryvtandvtdemandvtthatvtthevtadministratorvtforcevtthevtresidentsvttovten
dsvtthevtrelationship.vtWhatvtisvtthevtbestvtcoursevtofvtaction?vt-vtanswer--And:
Respectvtthevtresidents'vtwishesvtandvtensurevttheirvtprivacy
-refervtthevtThevtsituationvttovtsocialvtservicesvtandvtadjustvtthevtservicevtplan
-involvedvtinvtwoodsmanvtinvtthevtsituation
-Refervttovtthevtethicsvtcommitteevtforvtdiscussion
ThevtdocumentvtbestvtusedvttovtsetvtrealisticvtexpectationsvtbetweenvtthevtRCALvtcommuni
tyvtandvtthevtresidentvtisvtthevt-vtanswer--Servicevtplanvtagreement
Onevtgoalvtofvtassistedvtlivingvtisvttovthelpvtseniorsvtremainvtasvtindependentvtasvtpossiblevtb
yvtprovidingvt-vtanswer--Dailyvtstructurevtandvtfixedvtschedulesvtforvtmealsvtandvtactivities
Whenvtavtresidentvtisvtnotvtcompetentvttovtmakevtavtmedicalvtdecisionvtthevtcourtvtmayvtapp
ointvtavt-vtanswer--LegalvtGuardian
Anvtexamplevtofvtinsurancevtthatvtisvtgenerallyvtrequiredvtbyvtfederalvtstatevtlawvtisvt-
vtanswer--Workersvtcompensation.vtAllvtbusinessvtarevtrequiredvtbyvtFederal/
Statevtlawvttovtcovervtanyvtemployeesvtwhovtmayvtbevtinjurevtwhilevtworkingvtonvtthevtjob
,Invtregardvttovtmanagingvtavtresidentsvtpersonalvtfunds,vtthevthealthcarevtorganizationvt-
vtanswer--
Shouldvthavevtavtwrittenvtauthorizationvttovtmanagevtthevtresidentsvtpersonalvtfunds
AvtRCALvtcommunityvthasvtyardvtservicevtperformedvtinvtMayvtforvt$500.vtButvtdoesvtnotvtpa
yvtthevtvendorvtuntilvtJune.vtThevt$500vtexpensesvtisvtanvtexamplevtofvt-vtanswer--Accrual-
basedvtaccounting
Whichvtinsurancevtpolicyvtprotectsvtagainstvtclaimsvtallegingvtthatvtnegligencevtorvtinappro
priatevtactionvtresultedvtinvtbodilyvtharmvtorvtpropertyvtdamagevt-vtanswer--
PropertyvtandvtCasualtyvtInsurance
Avtresidentvthasvtthevtrightvttovtparticipatevtinvtsocial,vtreligiousvtandvtcommunityvtactivitiesvt
providedvtthesevtdovtnotvt-vtanswer--Conflictvtwithvtthevtordersvtofvtthevtphysician
Avtresidentvtwithvtdementiavtatvtavthealthcarevtorganizationvtlikesvttovthelpvtfoldvtclothesvtan
dvtsetvttables,vtaskingvtthisvtresidentvttovthelpvt-vtanswer--
Isvtavtwayvttovtengagevtthevtresidentvtinvtsomethingvtenjoyablevtandvtenhancesvtpersonvtce
nteredvtcare
Thevtprimaryvtpurposevtofvtanvtinitialvtcarevtrecipientvtassessmentvtisvttovtdeterminevt-
vtanswer--OverallvtFunctionalvtStatus
Thevtbestvtwayvtforvtthevtadministratorvttovtgetvtfeedbackvtaboutvtdiningvtservicesvtisvt-
vtanswer--Throughvtthevtresidentvtcouncil
Ifvtcontractedvtlaundryvtservicesvtforvtthevtresidentsvtpersonalvtclothingvtarevtprovidedvtoffvt
sitevt-vtanswer--
Thevtusevtofvtcommercialvtlaundryvtequipmentvtbyvtthevtcontractorvtisvtrequiredvtbyvtthevthe
althvtdepartment
MaryvtJvtsuffersvtfromvtdementia.vtNovtmattervthowvtmanyvttimesvtthevtstaffvtexplainsvtsome
thingvttovthervtshevtdoesn'tvtseemvtablevttovtaccomplishvtthevttask.vtWhichvtofvtthevtfollowingv
tisvtthevtbestvtsolutionvt-vtanswer--Taskvtbreakdown
Thevtbestvtwayvttovtmanagevturinaryvtincontinencevtisvt-vtanswer--
Regularlyvtschedulevttoileting
CriteriavtforvtmovevtoutvtfromvtthevtRC/ALvtcommunityvtshouldvtbevtdisclosedvtat:vt-
vtanswer--Partvtofvtthevtmovevtin
Avtmajorvtconsiderationvtinvtcreatingvtavtcomprehensivevtactivitiesvtprogramvtisvtthatvtthevta
ctivityvtdirectorvtunderstandsvtthevt-vtanswer--
Naturevtandvtextentvtofvtcarevtrecipient'svtdisabilities
Forvtresidentsvtwithvtdementia,vtoptimalvtfoodvtconsumptionvtisvtbestvtachievedvtby:vt-
vtanswer--Goodvtscreening,vtpropervtnutritionvtandvthydration,vtandvtpleasantvtmealvttimes
, AvtprearrangedvtcontractvtwithvtlocalvtagenciesvtisvtpartvtofvtanvtRCALvtcommunity'svtdisast
ersvtplanvtbecausevtthisvtwillvtensurevt-vtanswer--
Thatvtthevtcommunityvtwillvthavevtwhatevervtisvtneededvttovtkeepvtresidentsvtsafevtandvtrelat
ivelyvtcomfortablevtduringvtandvtemergency
Onevtofvtthevtfundamentalvtelementsvtofvteffectivevtdementiavtcarevtis:vt-vtanswer--
Creatingvtavtspecialized,vtsecurevtandvtquietvtenvironmentvtforvtpatientsvtwithvtdementia
Informationvtshouldvtbevtaddedvttovtanvtindividualvtservicevtplan:vt-vtanswer--
Atvtavtminimumvtwhenvtthevtresidentvthasvtavtsignificantvtchangevtofvtcondition
Avtsmallvtfirevthasvtstartedvtinvtavtresidentvtbedroom.vtThevtlifevtsafetyvtcodevt(LSC)vtdirectsvt
thevtstaffvttovtfirst:vt-vtanswer--
Removevtthevtresidentvtandvtanyvtothervtpersonsvtfromvtthevtroom
InvtLifevtsafetyvtCodevt(LSC),vtfirevtextinguishersvtarevtlistedvtbyvtwhichvtofvtthevtfollowingvtcl
assificationsvt-vtanswer--A,vtBvtandvtC
Anvtexamplevtofvtcreatingvtavtdementiavtlivingvtenvironmentvtthatvtintegratesvtresidentialvtfe
aturesvtwithvtclinicalvtandvtsocialvtaspectsvtis:vt-vtanswer--
Incorporatingvtnaturalvtelementsvtsuchvtasvtanimalsvtandvtplants
Anvtemployeevtworkingvtovertimevtseesvtavtsupervisorvtandvtavtcoworkervtkissingvtinvtthevtu
noccupiedvtroomvtanvthourvtaftervttheirvtshiftvthasvtended.vtThevtnextvtday,vtthevtsupervisorvt
tellsvtthevtemployeevtyouvtdovtnotvtneedvttovtmentionvtwhatvtyouvtsawvtyesterday.vtWevtarevt
allvtadultsvthere,vtandvtwhatvtwevtdovtaftervthoursvtisvtourvtownvtbusiness.vtThevtemployeevtfe
elsvtthreatened.vtIsvtanvtexamplevtofvtsexualvtharassment?
No.vtbecausevtitvtdidvtnotvthappenvttovtthevtwitnessingvtemployee
No.vtbecausevtthevtincidentvthappenedvtaftervtthevtsupervisorvtcoworkersvtshiftvthadvtende
d
Yes.vtbecausevtitvtisvtmorallyvtreprehensiblevtandvtethicallyvtunacceptable
Yes.vtbecausevtthevtconductvtonlyvtneedvttovtbevtoffensivevttovtthevtwitnessingvtemployeevt-
vtanswer--Yes,vtbecausevtitvtisvtmorallyvtreprehensiblevtandvtethicallyvtunacceptable
Twovtsimplevttechniquesvtforvtminimizingvtthevtspreadvtofvtmicroorganismsvtalongvtfloorsvt
whenvtwetvtmoppingvtare:vt-vtanswer--
Utilizingvtavtdoublevtbucketvtmoppingvttechniquevtandvtfrequentvtchangingvtmopvtwater
Whethervtorvtnotvtthevtstatevtsetsvtavtminimumvtnumbervtofvtstaffvtorvtstaffingvthours,vtcomm
unitiesvtshouldvtstaffvtbasedvtonvtthevt-vtanswer--Residentvtcarevtneeds
Thevtoccupationalvtsafetyvtandvthealthvtadministrationvt(OSHA)
a.vtProvidesvtrightsvtandvtprotectionvtforvtparticipantsvtinvtgroupvthealthvtplansvt-vtanswer--
Requiresvtemployersvttovtmaintainvtavtlogvtofvtcertainvtinjuriesvtandvtillnesses
Whatvtarevtthevttopvt4vtadditionallyvtcitedvtqualityvtofvtcarevtdeficienciesvtinvtALvtbetweenvt19
96-1997vt-vtanswer--Providingvtpoorvtcare
insufficientvtandvtunqualifiedvtuntrainedvtstaff
Poorvtmedicationvtmanagementvt
Notvtfollowingvtadmissionvtandvtdischargevtpolicies
