CMD Long-Term Care & Post-Acute Care Management 3

Question 1

What distinguishes a Long-Term Acute Care Hospital (LTACH) from a traditional skilled nursing facility?

Accepted Answer

LTACHs treat medically complex patients requiring acute-level care for an average stay of 25+ days

Answer

LTACHs are limited to post-surgical orthopedic cases only

Answer

LTACHs provide custodial care under Medicaid funding exclusively

Answer

LTACHs operate under the same staffing ratios as inpatient rehabilitation facilities

Question 2

Which of the following best describes the role of the interdisciplinary team (IDT) in a long-term care facility?

Accepted Answer

The IDT collaborates across disciplines to develop and implement individualized resident care plans

Answer

The IDT functions solely as a financial review board to assess care costs

Answer

The IDT is responsible only for conducting state-required surveys

Answer

The IDT replaces the physician's role in clinical decision-making

Question 3

Under federal nursing home regulations, which practice regarding physical restraints is required?

Accepted Answer

Restraints may only be used when medically necessary and with the resident's or representative's informed consent

Answer

Restraints may be used routinely for fall prevention without additional documentation

Answer

Restraints must be applied by a physician for any clinical use

Answer

Restraints are prohibited only in dementia units

Question 4

What is the primary goal of transitional care management (TCM) in the post-acute care setting?

Accepted Answer

To reduce preventable hospital readmissions through coordinated care during care transitions

Answer

To maximize the length of the skilled nursing facility stay for billing purposes

Answer

To transfer all clinical responsibility from the hospital to the SNF immediately upon discharge

Answer

To eliminate the need for physician follow-up after hospital discharge

Question 5

Which quality measure is most commonly tracked in long-term care facilities to monitor resident safety and is a core component of the CMS Five-Star rating?

Accepted Answer

Percentage of high-risk residents with pressure ulcers/injuries

Answer

Percentage of residents with diabetes receiving annual HbA1c testing

Answer

Percentage of residents receiving flu vaccines

Answer

Percentage of residents with documented advance directives

Question 6

A medical director reviews a trend showing increased urinary tract infection (UTI) rates in a skilled nursing facility. Which intervention is most aligned with antimicrobial stewardship principles?

Accepted Answer

Implement culture-directed antibiotic therapy and reduce empiric broad-spectrum antibiotic use

Answer

Prescribe prophylactic antibiotics for all catheterized residents

Answer

Increase the frequency of routine urinalysis screening for all residents

Answer

Restrict antibiotic use to physicians only, removing NP/PA prescribing authority

Question 7

Which federal requirement mandates that long-term care facilities have a written infection prevention and control program (IPCP) with a designated Infection Preventionist (IP)?

Accepted Answer

CMS Requirements of Participation (RoP) revised in November 2016

Answer

OBRA 87 original nursing facility standards

Answer

The Joint Commission Comprehensive Accreditation Manual

Answer

Medicare Conditions of Participation for Hospitals (CoP)