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NAB NHA Exam Compiled Cards

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NAB NHA Exam Compiled Cards 2023 the physical plant Ans- all designed, constructed, equipped, and maintained to protect health and safety of residents, personnel, public Life Safety Code (LSC) Ans- Entire construction plan and materials meet LSC standards|||CMS requires unless have waiver or exception. CMS grants waivers on SNFs; states on NFs (NFPA) Ans- National Fire Protection Association ||established LSC Purpose of LSC Ans- to provide reasonable degree of safety from fire. Waivers for Life Safety Code Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- **- 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| Ans- - 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 Ans- 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 Ans- no dead-ends (LSC)||8 feet wide (CMS) Floors Ans- at or above ground level. (LSC) |Fire rating if carpeted. (LSC)|Non-slip bath/toilet (ANSI, LSC)|Asphalt tile best Fire alarms Ans- flashing and audible. |connect with local fire dept, if possible|must have NFPA 71 certification of fire alarm service| smoke detectors Ans- approved detectors requried smoking Ans- 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) Ans- 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 Ans- no incline more than 10% Wheelchair passage Ans- 32" bathroom doors||36" elsewhere parking Ans- 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 Ans- maximum rise 30". Slope not more than 1:10 What items must be accessible to wheelchair residents?| Ans- WATER FOUNTAINS, telephones (nonBraille), light switches Toilets and handrails - height Ans- 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 Ans- 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 Ans- 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 Ans- flashing alarms for deaf, sound alarms for blind, tactile warnings for blind to identify danger areas. Grating Ans- No greater than one-half inch; openings perpendicular to travel rout, if elongated. Threshold Ans- 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 Ans- Maintenance cost-mowing biggest. State decides on number of parking spaces per bed. Water Ans- water must have backup source of supply. Temperature established by state. Automatic Control Valves. (surveyors will ask for contract) (110 degrees in GA) Ventilation Ans- 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 Ans- 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 Ans- 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 Ans- 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. Ans- checking all systems, including roof, on regular basis and documenting.||roof protects all other assets. (log or cards) 3 points of Preventative Maintenance Ans- 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. Ans- 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 Ans- 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 Ans- 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) Ans- programs OSHA falls under U.S. Department of Labor safety and infection control program - Ans- complete procedures for all staff to follow best infection control. committee may be desirable. universal precautions Ans- 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. Mishandling is most frequent exposure to communicable materials. OSHA requires contaminated to be containerized at location. aseptic cleaning of isolation area. |OSHA APPROVED SPILL KITT*** CMS STANDARDS for infection control Ans- investigate, control, prevent infections|set up procedure for entire program|document incidents and correctivev action|isolate infected resident|no employee with communicable diseases or skin lesions can have contact with food or residents|hand washing after each direct resident contact|handle, process, store, and transport linens in manner to prevent spread of infection blood born pathogens (BBP) Ans- focused on AIDS and Hepatitis B. (OSHA) Training for BBP Ans- all staff trained in how to handle| 1. blood spills and materials that may be infected, and | 2. exposure incidents PERSONAL PROTETIVE EEQUIPMENT (PPE) Ans- FACILITY MUST PROVIDE GLOVES, GOWNS, LAB COATS, FACE SHIELDS, EYE PROTECTION, MOUT PIECES, AND RESUSCITATION BAS, POCKET MASKS, OR OTHER VENTILATION DEVICES. TRAINED TO USE Disposal Ans- of sharps and other contaminated materials (OSHA) must have container in nursing, laundry, etc. and policy on emptying container (med carts: check levels)| regulated waste Ans- contaminated sharps, blood, pathological waste, etc. Have written procedures for handling. Needlestick Safety and Prevention Act Ans- follow OSHA standards|engineering controls - shield, retracting needles, shielded catheters, needles housed in protective covering, and jet injections. NOW required to USE SAFETY SYRINGES.|Law requires employee input on what works best. isolation room procedures Ans- single occupancy|toilet|hand washing faciltities|vented to outside|sign when in use| HBV requirements Ans- vaccine offered free to all employees (OSHA) Employee with lesions Ans- never works in kitchen or patient care area post-exposure procedures Ans- must have written plan for evaluation and follow-up. individuals involved tested (consent may be gained-OSHA says not required)-test blood of exposed person documentation Ans- every exposure incident. facility should have "OSHA Compliance and Exposure Control Plan Checklist" in order to know if incompliance reporting communicable diseases to: Ans- state agency SAFETY mandated by CMS, OSHA: Goals Ans- 1. reduce work-related illness, injury, death in staff.|2. reduce accidents, injuries among resident, families, visitors. programs Ans- procedures to cover preventive measures, investigating of accidents, documentation, corrective action, reporting. committee may be useful - not required identify potential hazards Ans- BED RAILS, wheelchairs, walkers (misuse or poor maintenance|WET FLOORS mopping, spills|HOT WATER-temperature set by state. Automatic control valves|extension cords|frayed electrical wires|unattended cleaning carts (medication carts)|restraints|adapters (cheaters) accidents Ans- unintentional damage to object or injury to person. two causes: |(1) unsafe behavior|(2) unsafe working or living conditions investigate Ans- every accident, document, corrective measures - identify patterns, discuss with dept. head. document Ans- on OSHA forms log (FORM 300***) only inventory staff, not residents. need copy of "what every employer needs to know about OSHA Record-keeping . keep records for 5 years. non-recordable- Ans- if only first aid unconscious reportable Ans- accidental death, and 5 or more hospitalized (within 8 hours report) POSTER Ans- required by OSHA HCP Ans- Hazard Communication Program ||Mandated by O

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NAB NHA Exam Compiled Cards 2023
the physical plant Ans- all designed, constructed, equipped, and maintained to protect health and safety
of residents, personnel, public



Life Safety Code (LSC) Ans- Entire construction plan and materials meet LSC standards|||CMS requires
unless have waiver or exception. CMS grants waivers on SNFs; states on NFs



(NFPA) Ans- National Fire Protection Association ||established LSC



Purpose of LSC Ans- to provide reasonable degree of safety from fire.



Waivers for Life Safety Code Ans- 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 Ans- 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 Ans- 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 Ans- 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 Ans- **- 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| Ans- - 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 Ans- 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 Ans- no dead-ends (LSC)||8 feet wide (CMS)



Floors Ans- at or above ground level. (LSC) |Fire rating if carpeted. (LSC)|Non-slip bath/toilet (ANSI,
LSC)|Asphalt tile best



Fire alarms Ans- flashing and audible. |connect with local fire dept, if possible|must have NFPA 71
certification of fire alarm service|



smoke detectors Ans- approved detectors requried



smoking Ans- 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) Ans- 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 Ans- no incline more than 10%



Wheelchair passage Ans- 32" bathroom doors||36" elsewhere



parking Ans- 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 Ans- maximum rise 30". Slope not more than 1:10



What items must be accessible to wheelchair residents?| Ans- WATER FOUNTAINS, telephones (non-
Braille), light switches



Toilets and handrails - height Ans- 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 Ans- 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 Ans- 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 Ans- flashing alarms for deaf, sound alarms for blind, tactile warnings for blind to identify danger
areas.



Grating Ans- No greater than one-half inch; openings perpendicular to travel rout, if elongated.



Threshold Ans- 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 Ans- Maintenance cost-mowing biggest. State decides on number of parking
spaces per bed.



Water Ans- water must have backup source of supply. Temperature established by state. Automatic
Control Valves. (surveyors will ask for contract) (110 degrees in GA)



Ventilation Ans- 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 Ans- 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 Ans- 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 Ans- 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. Ans- checking all systems, including roof, on regular basis and
documenting.||roof protects all other assets. (log or cards)



3 points of Preventative Maintenance Ans- 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. Ans- 1. housekeeping - procedures for floors, rooms,
aseptic cleaning, storage of materials, ODOR CONTROL, role in infection control, equipment care,

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