LNHA NAB 2026 REVISION NOTES AND
STRUCTURED NURSING FACILITY
ADMINISTRATION OVERVIEW GUIDE
◉ Reporting. Answer: -Report all suspected incidents of abuse,
neglect, financial exploitation, or misappropriated property
-Notify state of allegations immediately or as soon as the resident is
protected
-Notify administrator
-" police of suspect criminal activity
-" coroner/medical examiner timely and accurately of resident death
in certain circumstances
-" state DoH and log in any state reporting log of abuse, neglect,
superficial/substantial injuries of an unknown source, and
misappropriated property
◉ Prevention and Corrective Actions. Answer: -Resolve cause of
incident. Injury or loss
-Prevent recurrence of incident (revise plan of care, staff disciplinary
action, institute necessary education or training and revise policies)
-Achieve compliance w/regs relative to any other failed facility
practices identified
-Incorporate concepts learned into Facility administrative decision
,◉ Minimization of Antipsychotic Drugs (type of psychotropic).
Answer: Antipsychotic drugs are not given to those residents who
have not used them unless the drug therapy is necessary to treat a
specific condition as dx and documented in the clinical record
Antipsychotic is used if the res has one of these specific conditions:
-Schizophrenia
-Tourette's
-Delirium, Dementia, and other cognitive disorders w/ associated
psychotic and or agitated behaviors
◉ Antipsychotic Drugs: Discontinuance Efforts. Answer: Res who
take antipsychotics receive a gradual dose reductions and behavioral
interventions unless clinically contraindicated
◉ Residents Free of Significant Medication Errors. Answer: Free of
medication error rates of 5% or greater
◉ Resident Care Satisfaction. Answer: -Res care satisfaction is the
focus of the MDS and the QA efforts of surveyors
-Administrator may measure resident satisfaction through resident
council meetings or res care satisfaction forms
◉ Consultant Pharmacist Required
,Facility will employ or obtain services of a licensed pharmacist who.
Answer: A) Provides consultation on all aspects of the provision of
pharmacy services in the facility
B) Establishes a system of records of receipt and disposition of all
controlled drugs in sufficient detail to enable an accurate
reconciliation
C) Determines that drug records are in order and that an account of
all controlled drugs is maintained and periodically reconciled
◉ Drug Regimen Use. Answer: Each resident's drug regimen will be
reviewed at least once a month (More if necessary)
◉ Unnecessary Drugs
Each drug regimen will be free from unnecessary drugs:. Answer:
(any drug when used)
A) in excessive dose (including duplicate therapy)
B) for excessive duration
C) W/O adequate monitoring
D) W/O adequate indications for its use
E) In the presence of adverse consequences, which indicate the dose
should be changed
F) any combo of the aforementioned reasons
, ◉ Long-Acting Benzodiazepine Drugs. Answer: Will not be used in
residents unless an attempt w/ a shorter-acting drug other
sedative/anxiolytic pr drugs used for sleep induction
◉ Action Required on Pharmacists Reports. Answer: DON and
attending physicians are not required to agree w/ the pharmacist's
report nor are they required to provide the rationale for their
acceptance or rejection of the report. They will act upon the report
by accepting or rejecting the report and then signing it
Med dir. Receives copy w/ copy of drug regimen review reports
◉ Labeling of Drugs and Biologicals. Answer: Drugs used will be
labeled and include the appropriate accessory and cautionary
instructions as well as expiration date
◉ Storage of Drugs and Biologicals. Answer: Facility will store all
drugs and biologicals in locked compartments under proper temp
and permit authorized personnel to have access to the keys
Schedule II drugs will be separately locked in permanently affixed
compartments
◉ Controlled drugs listed in Schedule I of the Comprehensive Drug
Abuse Act of 1970 are. Answer: Not permitted in the facility
STRUCTURED NURSING FACILITY
ADMINISTRATION OVERVIEW GUIDE
◉ Reporting. Answer: -Report all suspected incidents of abuse,
neglect, financial exploitation, or misappropriated property
-Notify state of allegations immediately or as soon as the resident is
protected
-Notify administrator
-" police of suspect criminal activity
-" coroner/medical examiner timely and accurately of resident death
in certain circumstances
-" state DoH and log in any state reporting log of abuse, neglect,
superficial/substantial injuries of an unknown source, and
misappropriated property
◉ Prevention and Corrective Actions. Answer: -Resolve cause of
incident. Injury or loss
-Prevent recurrence of incident (revise plan of care, staff disciplinary
action, institute necessary education or training and revise policies)
-Achieve compliance w/regs relative to any other failed facility
practices identified
-Incorporate concepts learned into Facility administrative decision
,◉ Minimization of Antipsychotic Drugs (type of psychotropic).
Answer: Antipsychotic drugs are not given to those residents who
have not used them unless the drug therapy is necessary to treat a
specific condition as dx and documented in the clinical record
Antipsychotic is used if the res has one of these specific conditions:
-Schizophrenia
-Tourette's
-Delirium, Dementia, and other cognitive disorders w/ associated
psychotic and or agitated behaviors
◉ Antipsychotic Drugs: Discontinuance Efforts. Answer: Res who
take antipsychotics receive a gradual dose reductions and behavioral
interventions unless clinically contraindicated
◉ Residents Free of Significant Medication Errors. Answer: Free of
medication error rates of 5% or greater
◉ Resident Care Satisfaction. Answer: -Res care satisfaction is the
focus of the MDS and the QA efforts of surveyors
-Administrator may measure resident satisfaction through resident
council meetings or res care satisfaction forms
◉ Consultant Pharmacist Required
,Facility will employ or obtain services of a licensed pharmacist who.
Answer: A) Provides consultation on all aspects of the provision of
pharmacy services in the facility
B) Establishes a system of records of receipt and disposition of all
controlled drugs in sufficient detail to enable an accurate
reconciliation
C) Determines that drug records are in order and that an account of
all controlled drugs is maintained and periodically reconciled
◉ Drug Regimen Use. Answer: Each resident's drug regimen will be
reviewed at least once a month (More if necessary)
◉ Unnecessary Drugs
Each drug regimen will be free from unnecessary drugs:. Answer:
(any drug when used)
A) in excessive dose (including duplicate therapy)
B) for excessive duration
C) W/O adequate monitoring
D) W/O adequate indications for its use
E) In the presence of adverse consequences, which indicate the dose
should be changed
F) any combo of the aforementioned reasons
, ◉ Long-Acting Benzodiazepine Drugs. Answer: Will not be used in
residents unless an attempt w/ a shorter-acting drug other
sedative/anxiolytic pr drugs used for sleep induction
◉ Action Required on Pharmacists Reports. Answer: DON and
attending physicians are not required to agree w/ the pharmacist's
report nor are they required to provide the rationale for their
acceptance or rejection of the report. They will act upon the report
by accepting or rejecting the report and then signing it
Med dir. Receives copy w/ copy of drug regimen review reports
◉ Labeling of Drugs and Biologicals. Answer: Drugs used will be
labeled and include the appropriate accessory and cautionary
instructions as well as expiration date
◉ Storage of Drugs and Biologicals. Answer: Facility will store all
drugs and biologicals in locked compartments under proper temp
and permit authorized personnel to have access to the keys
Schedule II drugs will be separately locked in permanently affixed
compartments
◉ Controlled drugs listed in Schedule I of the Comprehensive Drug
Abuse Act of 1970 are. Answer: Not permitted in the facility
