Archive for the ‘Education’ Category

I recently had an email exchange with Randy Linder, President & CEO for the NAB. He expressed his concern for individuals who could accidentally breach the confidentiality agreement by sharing/positing questions from the NAB exam on Nursing Home Talk. In an effort to avoid such issues, please read the following notice from the NAB:

“Nursinghometalk.com is pleased to host online forums for nursing home administrators and welcomes your participation. We want your online experience to be positive and mutually beneficial. Of course, all participants must adhere to the general forum rules regarding discussions and protocol. Relative to discussions focused on the NAB Nursing Home Administrator exam, we ask that all participants be cognizant of the confidentiality agreement and obligations required by NAB that all candidates accept when taking the exam. There should be no disclosure of any NHA exam items, questions or answers, to any individual or entity in any context. The forum is monitored and any inappropriate discussions or disclosures will be addressed by NAB and subject to sanction. Monitors will report to the licensing board of the applicant’s state any impropriety as an ‘ethics’ allegation/violation for further investigation. Thank you for your cooperation.”

When I was studying for the NAB exam (not too long ago), I tried to find a free exam that could test my knowledge. Despite my efforts, I didn’t find one and for this reason, I designed this simple 20 question exam.

This test is only a snapshot of what the Nursing Home Administrator (NAB) exam will cover. It should ONLY be considered supplemental to the many resources available–books written by individuals that know the NAB exam far better than I do. (Check out my other recent post on recommended books for NAB exam). These questions may not even be similar to the ones you receive, but it is my hope that it assists you with learning this vast amount of material.

The NAB Exam Study Questions & Answers (at the end):

1. When the power at your facility goes out, the emergency generator needs to reestablish it in:
a. 10 seconds
b. 1 minute
c. 20 seconds
d. 2.5 minutes

2. A major issue in malnutrition is a result of:
a. Poor tasting food
b. Poor dentition
c. Lack of assistance
d. Meal times

3. The daughter of a female resident tells a CNA about a male resident who supposedly has been sexually harassing her mom. Who should the CNA report this incident to?
a. Charge Nurse
b. Administrator
c. Activity Director
d. Social Worker

4. Definition of working capital is:
a. All assets less all liabilities
b. Fixed assets less fixed liabilities
c. All current and fixed assets
d. Currents assets less current liabilities

5. A full time social worker is required when there is:
a. 120 residents
b. 121 residents
c. 60 residents
d. 61 residents

6. The main components of the risk management program are:
a. Liability control
b. Preventative measures and case management
c. Unionization
d. All of the above

7. Type A Fire Extinguisher assists with what type of fire:
a. Chemical/Flammable liquids, no residue
b. Electrical
c. Metals
d. Materials that burn to ash

8. A facility must not serve morning meals more than ___ hours after the evening meal.
a. 12 hours
b. 13 hours
c. 14 hours
d. 15 hours

9. The comprehensive MDS assessment is required within ___ days of admission:
a. 7
b. 10
c. 15
d. 14

10. Who established Theory Z:
a. Dr. William Ouchi
b. W. Edwards Deming
c. Dr. James E. Allen
d. Dr. Roberta Greene

11. To operate a fire extinguisher, you must:
a. Pull, Aim, Squeeze, Sweep
b. Pull, Aim, Squeeze, Spray
c. Push, Aim, Squeeze, Spray
d. Push, Point, Release, Sweep

12. Person who implements resident care policies and coordinates the medical care in the facility is the:
a. Administrator
b. Director of Nursing
c. Medical Director
d. Social Worker

13. A facility should conduct a minimum of ____ fire drills annually:
a. 15
b. 12
c. 10
d. 14

14. The theory “hierarchy of need” was founded by:
a. Douglas McGregor
b. William Ouchi
c. A.H. Maslow
d. Dr. David Snowdon

15. A 3rd party used to advise or counsel in the negotiation process is considered:
a. Arbitration
b. Conciliation
c. Mediation
d. Total Quality Management (TQM)

16. Hematology is the study of:
a. Diseases of the blood and blood-forming organs
b. Disorders in the endocrine system and its specific secretions
c. A “holistic” approach to medical care
d. Disorders of the rectum

17. If an employee works 52 hours in a 7 day work week and is paid $10.00 per hour for regular time, the employee should be paid a total weekly income of :
a. $333
b. $580
c. $520
d. $780

18. In September, a facility had a total of 99 employees. Then, in October they had a total of 98 employees. By the month of December there were 100 employees. Over this 3-month time span, 10 employees were hired, fired, or laid off. What was the turnover ratio for the quarter?
a. 10%
b. 50%
c. 18%
d. 20%

19. A federally required screening for all future nursing home residents, to determine if they are mentally ill or mentally retarded:
a. MMSE
b. MAR
c. PASARR
d. HIPAA

20. Therapeutic diets are prescribed by a _____ and approved by a ________.
a. Physician and Dietician
b. Dietician and Physician
c. Nurse and Dietician
d. Dietician and Pharmacist

Scroll Down for the Answer Key
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_
_
_
_
_
_
_
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Answer Key:

1. A
2. B
3. A
4. D
5. B
6. B
7. D
8. C
9. D
10. A
11. A
12. C
13. B
14. C
15. C
16. A
17. B
18. A (Turnover ratio: # of employees who left divided by total # of employees in a given period)
19. C
20. A

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NAB exam, Nursing Home Administrator, malnutrition, working capital, social worker, risk management, MDS assessment, fire extinguisher

I found an interesting website that predicts a website user’s age, gender, and other demographic information, based on their online behavior, such as what queries they search online and what sites they visit.

All you have to do is type in a topic or web address, and this tool gives information pertaining to what demographic is interested in the topic. For example, if you typed in my URL, Nursing Home Talk you would find that 71% (as of today) of the readers are female compared to males. So, if you are curious to know what age group, for example, is interested in home health in your area, this may be a tool to check out.

Here is the link:

Demographic Prediction Tool

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home health

For those of you who have asked…here, finally is my recommendation for taking the nursing home administrator exams. Not to sound overly confident, but I had no trouble with either test (NAB or state). Of course, I listened to some very wise people in deciding what to do. At the time my preceptor said, “don’t even attempt” to take these exams without a review course. She claimed books and study guides were insufficient on their own.

For the most part, I would agree with her. The material I received from the review courses was by far the most relevant. Originally, I looked into a lot of different avenues. For example James E. Allen has a long term care administration online review course which runs about $600 for both parts. At the time, I was student and this was far more than I could afford. So instead I bought a few books that had been recommended, and decided to sign up for a local review course, which cost me about $150 each.

Below I have listed out a few books, I would recommend to those taking the NAB exam. The most relevant is the NAB Nursing Home Administrators Examination. I read this book several times, and each time I found more relevant material. When taking the exam, it seemed many questions came directly from this text.

Whatever you do, take your time to review all material so you feel prepared. Know your weaknesses, and properly study for them. If you need any help or have questions, don’t hesitate to contact me.

Recommended Books & Study Guides:

NAB Nursing Home Administrators Examination

Principles to Health Care Administration

The Licensing Exam Review Guide in Nursing Home Administration: 1000 Test Questions in the Nation Examination Format on the 1996 Domains of Practice

The Licensing Exam Review Guide in Nursing Home Administration: Fifth Edition

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nursing home administrator, James E. Allen, long term care administration

Honesty is something we expect from most people. We assume that the cashier will accurately give us our change, the police officer will protect us from criminals, and our boss will pay us on time for the work we do. Unfortunately, not everyone treats us fairly.

Yesterday someone close to me was robbed in Ocala. Two men wandered up to her property the day before, asking for farm labor. They claimed to be hard workers and would do a good job for her. Needless to say, she hired them on the spot. To her surprise the next day, all her lawn equipment and tools had been stolen, adding up to about $4,000. This left her feeling violated and extremely angry.

She stated, “How could they do such a thing? When no one would hire them. I gave them work and paid them fairly. Why couldn’t they treat me with the same respect?”

Later, she found out from the police that these men had long criminal records including assault. One of the men even had a warrant out for his arrest. Although this incident is truly upsetting, she is fortunate to be alive.

Honesty is something my friend expected, and they violated it. In long-term care, we often entrust strangers to provide quality care. But truly–how do we know they are honest individuals? And, how do we know they will do a good job? Hiring someone new is a gamble…that’s why people often look to an outside agency to provide quality workers, and also to take on the liability.

Most companies whether nursing facilities or home health agencies, thoroughly background screen their employees. If these dishonest men had worked in the health care field, they likely wouldn’t have been hired. At the same time, if my dear friend had checked into their background, she would have been aware of their dangerous history.

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long-term care

Often in the early stages of Alzheimer’s disease, I have had caregivers come to me and ask:

– “Dad keeps forgetting how to act in public. The other day he started to take off his clothes in the grocery store. What can I do to stop him?”

– “I am completely exhausted from caring for my wife. The moment I take a break, she is headed for the front door, or attempts to use the stove or other unsafe appliances. How do I keep her safe?”

These are just a couple of examples. A caregiver of these individuals has a lot of responsibility which can often lead to stress, and sometimes burnout. Just in Marion County it has been estimated that 11,455 persons have been diagnosed or show signs and symptoms of Alzheimer’s disease or related dementia.

Marion county has been very fortunate in the last year. A new not-for-profit organization began that specializes in this field. It is called The Alzheimer’s & Dementia Alliance Education & Support Inc. (www.adaesinc.org), led by Terrie Hardison of Ocala, Florida.

The purpose of this organization is to bring knowledge and hope to caregivers, the community at large and professionals through education and support. As a volunteer for this organization, I have seen many benefit from their services.

In a way, Marion County should thank the Alzheimer’s Association for the origin of this new organization. Prior to the Memory Walk of 2007, Terrie Haridson ran the local headquarters for the Alzheimer’s Association in Ocala. Unfortunately, after the county raised significant funds for the Memory Walk, it was canceled due to rain. Following this event the local Alzheimer’s Association office was abruptly shut down.

Soon after Terrie Hardison began the Alzheimer’s & Dementia Alliance for Education & Support (ADAES). This organization now gives a voice to local caregivers. While the Alzheimer’s Association continues to remain a national figure for Alzheimer’s research, I would recommend to local caregivers and those interested in volunteering to catch a course offered by ADAES. You won’t regret it.

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Alzheimer’s disease, caregiver, dementia, Marion County, Alzheimer’s Association, Memory Walk, Alzheimer’s & Dementia Alliance for Education & Support, Alzheimer’s research

Recently, I learned of a V.A. aid and attendants program available to veterans or their spouses. Under this program, a veteran can receive a maximum of $1673.00 per month in benefits, and a spouse can receive up to $869.00 per month.

To qualify for this program a veteran must have had 90 days or more of active duty, only one day of which was during wartime. It is not necessary that they saw combat. They must not have had a dishonorable discharge.

In addition, the veteran or spouse must be determined to be “permanently and totally disabled.” This includes but no limited to: trouble dressing/undressing him or herself, blindness, and mental or physical incapacity.

The veteran or spouse does not need to be house bound or considered helpless. You just have to prove the person is in need of aid and attendance on a regular basis. The V.A. will generally accept a letter from a physician, which should state that the person has an incapacity that requires care or assistance on a regular basis to live safely at home.

There is a net worth requirement for this program. This is something the V.A. could assist you with since it changes on a routine basis. The last known net worth cutoff was $80,000, not including your home.

In addition to the net worth requirement, there is also an income requirement. The veteran’s countable income should not exceed the maximum annual pension rate which is currently $1,673 (adjusted periodically), or $869.00 per month for the spouse. However, some items may be deducted from income in order to meet this criteria. For example: doctor and dental visits, co-payments, medical supplies, therapy, transportation to the doctor, ect.

It can take up to ninety days to receive approval. However, once approved payments are made retroactively from the first month after the month that you apply. So, funds you previously spent on home care may be reimbursed to you when the V.A. aid and attendants coverage starts.

This information was provided by Interim Healthcare Private Services (Ocala, Florida), which provides quality home care to veterans and others needing assistance. To view their website, click on the link: www.interimhealthcare.com

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V.A., veterans, Interim Healthcare Private Services, Ocala, Florida

Recently, I had a friend tell me about her grandfather who was left outside all day at a facility in the Ocala/Gainesville area. In Florida, it isn’t unusual to experience 100 degree days. Imagine being trapped outside without water, food, or a toilet. Where were the employees to assist him? The bigger question–why was he not missed? Unattended, this poor man suffered as a result of neglect.

There are many types of abuse such as: physical, mental, verbal, sexual, and intellectual/spiritual abuse. Neglect is considered a more passive form of abuse. For example, if your job was to change Mrs. Smith’s depends every evening, and you knowingly decided not to, and as a result she sat in urine for hours, you passively abused the rights of Mrs. Smith.

As with all types of abuse, they can eventually cause severe mental or physical damage. Sometimes the symptoms can be obvious such as a change in personality or physical evidence (i.e., severe bruising). One must be careful in making assumptions too quickly, because false claims could really damage the name of a reputable nursing home.

For example, one facility where I worked the family called the state to do a thorough investigation because their mother’s arms were severely bruised. Afterwards they found out that the bruising was mostly caused from taking her new medication, Coumadin.

If you believe your loved one or someone else is being abused, it is important to investigate it. Nursing homes have social workers, which can act as your advocate. Another option is your local ombudsman, which is unaffiliated with the nursing home. Information to finding the your nursing home ombudsman can be found at the facility.

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Ocala, Gainesville, Neglect, abuse, nursing home, Coumadin, ombudsman, nursing home, nursing home ombudsman,

Recently, I read an article, entitled “10 Things Your Assisted Living Facility Won’t Tell you” listed on the Fox Business website that discusses the disadvantages of assisted living. For some of you that may be currently looking into assisted living facilities, I thought I would post this article.

Here is the URL:

http://www.foxbusiness.com/personal-finance/financial-planning/family-estates/
article/10-things-assistedliving-facility-wont-tell_167068_30.html

Although I think the article has a lot of relevant information, and could be useful to many people, it is key to remember that the article completely focuses on pointing out all the negative aspects of assisted living. I also want to say that I don’t necessarily agree with all the information.

For example, one of the “10 things to remember” is that assisted living facilities stop spending when the beds are full. While, I cannot speak for all facilities, this statement is largely overstated. I do know of several places where this is the case, but I know of more facilities where this is completely untrue.

Largely, I think several other factors should be considered such as:

- Does it provide a high level of quality of care to the residents?
- What type of reputation does the facility have in the community?
- How well did the facility do in recent inspections?

These are all things to think about…

Overall, I thought the article was worth reading and good “food for thought”. Just remember, the article was written in the negative (to point out problems). While it does give you 10 things to remember, what it doesn’t remind you of is the thousands of things that assisted living facilities do right everyday.