CDP CDP Legal & Regulatory Frameworks 1 — Questions and Answers
Question 1: Which federal law establishes residents' rights in US nursing facilities, including the right to refuse treatment?
- Nursing Home Reform Act (OBRA 1987) (Correct answer)
- HIPAA Privacy Rule
- Americans with Disabilities Act
- Medicare Prescription Drug Act
Correct answer: Nursing Home Reform Act (OBRA 1987)
OBRA 1987 codified nursing facility residents' rights, including the right to participate in care decisions and refuse treatment.
Question 2: What legal document allows a person with dementia's previously designated agent to make healthcare decisions when they lose capacity?
- Durable Power of Attorney for Healthcare (Correct answer)
- Standard will and testament
- Living will only
- Physician's order for medications
Correct answer: Durable Power of Attorney for Healthcare
A Durable Power of Attorney for Healthcare (DPAHC) authorizes a named agent to make medical decisions when the principal loses decision-making capacity.
Question 3: Under HIPAA, which individuals may access a cognitively impaired patient's health information without their direct consent?
- Their legally designated healthcare proxy or personal representative (Correct answer)
- Any family member who requests it
- Neighbors who provide daily assistance
- Friends listed as emergency contacts only
Correct answer: Their legally designated healthcare proxy or personal representative
HIPAA permits disclosure to a legally designated personal representative who has authority under state law to make healthcare decisions.
Question 4: What is the purpose of a POLST (Physician Orders for Life-Sustaining Treatment) form?
- To translate advance care preferences into actionable medical orders (Correct answer)
- To designate a healthcare proxy for financial decisions
- To authorize nursing facility admission
- To document daily care routines for staff
Correct answer: To translate advance care preferences into actionable medical orders
POLST converts a person's treatment wishes into portable medical orders that are immediately actionable across care settings.
Question 5: Which standard is used to make medical decisions for a person with dementia who has lost capacity but previously expressed clear wishes?
- Substituted judgment standard (Correct answer)
- Best interest standard
- Surrogate consensus standard
- Institutional policy standard
Correct answer: Substituted judgment standard
Substituted judgment asks what the person would have chosen based on known values and prior statements, preserving autonomy.
Question 6: Mandatory reporting laws in the US require dementia care staff to report suspected abuse to:
- Adult Protective Services or the state long-term care ombudsman (Correct answer)
- The facility administrator only
- The family first before any agency
- No agency unless physical injury is visible
Correct answer: Adult Protective Services or the state long-term care ombudsman
State mandatory reporting laws require suspected elder abuse or neglect in care settings to be reported to APS or the ombudsman program.
CDP CDP Legal & Regulatory Frameworks 1
Which federal law establishes residents' rights in US nursing facilities, including the right to refuse treatment?