CMD Long-Term Care & Post-Acute Care Management 1 — Questions and Answers
Question 1: Which federal legislation primarily established standards for nursing facility care, resident rights, and quality of life in long-term care settings?
- Medicare Catastrophic Coverage Act of 1988
- Omnibus Budget Reconciliation Act of 1987 (OBRA 87) (Correct answer)
- Balanced Budget Act of 1997
- Affordable Care Act of 2010
Correct answer: Omnibus Budget Reconciliation Act of 1987 (OBRA 87)
OBRA 87 established comprehensive federal standards for nursing facilities, including resident rights, quality of care mandates, and the Resident Assessment Instrument (RAI) requirement.
Question 2: What is the Minimum Data Set (MDS) in the context of long-term care?
- A financial reporting tool for nursing facility billing
- A standardized resident assessment instrument required by CMS for nursing home residents (Correct answer)
- A quality metric comparing nursing facilities nationally
- A staffing ratio benchmark for skilled nursing facilities
Correct answer: A standardized resident assessment instrument required by CMS for nursing home residents
The MDS is a comprehensive, standardized assessment tool mandated by CMS that captures clinical, functional, and psychosocial data on nursing home residents to guide care planning.
Question 3: Under Medicare Part A, what is the maximum number of covered days in a skilled nursing facility (SNF) following a qualifying 3-day hospital stay?
- 30 days
- 60 days
- 90 days
- 100 days (Correct answer)
Correct answer: 100 days
Medicare Part A covers up to 100 days per benefit period in a SNF, with full coverage for days 1–20 and a daily copay for days 21–100.
Question 4: Which CMS survey process is conducted without advance notification to nursing facilities and is the primary method of regulatory oversight?
- Complaint investigation survey
- Standard unannounced survey (Correct answer)
- Focused infection control survey
- Life safety code survey
Correct answer: Standard unannounced survey
The standard unannounced survey is conducted without prior notice to assess a facility's compliance with federal certification requirements.
Question 5: Which level of care in long-term care primarily provides assistance with activities of daily living (ADLs) without requiring skilled nursing services?
- Skilled nursing facility (SNF)
- Inpatient rehabilitation facility (IRF)
- Intermediate care facility (ICF) / Assisted living (Correct answer)
- Long-term acute care hospital (LTACH)
Correct answer: Intermediate care facility (ICF) / Assisted living
Intermediate care facilities and assisted living communities provide custodial care and ADL support for individuals who do not require skilled nursing or rehabilitation services.
Question 6: What is the primary purpose of the Care Area Assessment (CAA) process in long-term care?
- To determine Medicare reimbursement rates for each resident
- To identify triggered clinical problem areas and guide individualized care planning (Correct answer)
- To report quality indicators to state survey agencies
- To document staffing levels required per resident acuity
Correct answer: To identify triggered clinical problem areas and guide individualized care planning
The CAA process reviews triggered MDS items in depth to guide clinical decision-making and the development of individualized care plans for nursing home residents.
Question 7: Which CMS quality reporting program uses a star-based rating system to compare nursing facility performance on health inspections, staffing, and quality measures?
- Hospital Compare
- Nursing Home Compare Five-Star Quality Rating System (Correct answer)
- HEDIS Quality Measurement Program
- Leapfrog Hospital Safety Grade
Correct answer: Nursing Home Compare Five-Star Quality Rating System
CMS's Nursing Home Compare Five-Star Quality Rating System provides a 1–5 star composite rating based on health inspections, staffing levels, and quality measures to help consumers evaluate facilities.
CMD Long-Term Care & Post-Acute Care Management 1
Which federal legislation primarily established standards for nursing facility care, resident rights, and quality of life in long-term care settings?