CMS Safety & Infection Control 3 — Questions and Answers
Question 1: Which personal protective equipment is required by CMS guidelines when caring for a Medicare patient on contact precautions?
- Gown and gloves upon room entry (Correct answer)
- N95 respirator and face shield only
- Surgical mask and eye protection only
- No additional PPE beyond standard precautions
Correct answer: Gown and gloves upon room entry
Contact precautions require a gown and gloves to be donned before entering the patient's room or care area.
Question 2: Under CMS regulations, what is the minimum frequency for hand hygiene audits in a certified long-term care facility?
- Ongoing monitoring with documentation in the infection control program (Correct answer)
- Once per year during the annual survey only
- Monthly by an outside accrediting body
- Biannually by the state health department
Correct answer: Ongoing monitoring with documentation in the infection control program
CMS expects continuous, documented monitoring of hand hygiene compliance as part of the facility's infection prevention and control program.
Question 3: A hospital subject to the CMS HAC Reduction Program is in the worst-performing quartile for surgical site infections. What is the financial consequence?
- A 1% reduction in Medicare payments for that fiscal year (Correct answer)
- Exclusion from Medicare participation for 90 days
- A flat $100,000 penalty per infection reported
- Mandatory enrollment in a corrective action plan with no payment reduction
Correct answer: A 1% reduction in Medicare payments for that fiscal year
Hospitals scoring in the worst-performing quartile under the HAC Reduction Program receive a 1% reduction in their Medicare inpatient payments.
Question 4: What does 'droplet precautions' require in a CMS-certified facility, in addition to standard precautions?
- A surgical mask worn within 3 feet of the patient (Correct answer)
- An N95 respirator worn at all times in the facility
- Full-face shield and negative pressure room
- Gown and gloves only, no mask needed
Correct answer: A surgical mask worn within 3 feet of the patient
Droplet precautions require caregivers to wear a surgical mask when within approximately 3 feet (or entering the room) of a patient with droplet-spread illness.
Question 5: Which CMS survey process specifically evaluates a nursing home's infection control practices during an outbreak investigation?
- Complaint/Focused Survey triggered by a reportable event (Correct answer)
- Standard Annual Recertification Survey only
- Life Safety Code Survey
- Payment Error Rate Measurement audit
Correct answer: Complaint/Focused Survey triggered by a reportable event
CMS can initiate a complaint or focused survey specifically targeting infection control practices when an outbreak or complaint is reported.
Question 6: Under Medicare's Interpretive Guidelines, which antibiotic stewardship action is required in long-term care facilities?
- Documenting the clinical indication and expected duration for every antibiotic prescribed (Correct answer)
- Prohibiting the use of broad-spectrum antibiotics entirely
- Requiring infectious disease specialist approval for all antibiotic orders
- Limiting antibiotic use to a predetermined formulary approved by CMS
Correct answer: Documenting the clinical indication and expected duration for every antibiotic prescribed
CMS requires LTC facilities to document the clinical indication, dosage, and anticipated duration for each antibiotic as part of their antibiotic stewardship program.
Question 7: A Medicare beneficiary is admitted to a hospital with active tuberculosis. Which isolation measure is required under CMS-aligned infection control standards?
- Airborne infection isolation room with negative pressure and N95 respirators for staff (Correct answer)
- Private room with positive pressure ventilation
- Droplet precautions and surgical mask for staff
- Cohort the patient with other respiratory patients
Correct answer: Airborne infection isolation room with negative pressure and N95 respirators for staff
Active TB requires airborne infection isolation in a negative pressure room, with staff wearing NIOSH-approved N95 or higher respirators.
CMS Safety & Infection Control 3
Which personal protective equipment is required by CMS guidelines when caring for a Medicare patient on contact precautions?