CNHA Ethics and Legal Issues 1 — Questions and Answers
Question 1: Under the Omnibus Budget Reconciliation Act (OBRA) of 1987, which of the following is a fundamental right guaranteed to nursing home residents?
- The right to a private room at no additional cost
- The right to be free from unnecessary physical or chemical restraints (Correct answer)
- The right to select their own physician from any licensed provider nationwide
- The right to unlimited visitation at any hour
Correct answer: The right to be free from unnecessary physical or chemical restraints
OBRA 1987 specifically guarantees residents the right to be free from unnecessary physical or chemical restraints used for discipline or staff convenience.
Question 2: What is the primary purpose of obtaining informed consent from a nursing home resident before initiating a new treatment?
- To protect the facility from liability lawsuits
- To ensure the resident understands and voluntarily agrees to the proposed treatment (Correct answer)
- To satisfy Medicare billing requirements
- To document the physician's recommendation in the medical record
Correct answer: To ensure the resident understands and voluntarily agrees to the proposed treatment
Informed consent ensures that residents have sufficient information to make a voluntary, autonomous decision about their own care.
Question 3: A resident presents a legally executed advance directive stating they do not want CPR. What is the nursing home administrator's primary responsibility?
- Override the directive if family members object loudly
- Ensure the directive is honored and communicated to all relevant care staff (Correct answer)
- Require a new directive to be signed upon each admission
- Consult with the medical director before acknowledging the directive
Correct answer: Ensure the directive is honored and communicated to all relevant care staff
Administrators must ensure that valid advance directives are honored and that all care staff are informed of the resident's documented wishes.
Question 4: Under HIPAA, which of the following disclosures of a resident's protected health information (PHI) does NOT require the resident's written authorization?
- Sharing records with an insurance company for marketing purposes
- Providing records to the resident's employer upon request
- Disclosing information to another treating provider for treatment purposes (Correct answer)
- Releasing records to family members not involved in the resident's care
Correct answer: Disclosing information to another treating provider for treatment purposes
HIPAA permits disclosure of PHI without authorization for treatment, payment, and healthcare operations, including sharing with other providers involved in the resident's care.
Question 5: When a nursing home staff member suspects resident abuse by a coworker, what is the legally required first step?
- Confront the coworker privately to resolve the matter internally
- Wait until there is more definitive evidence before making a report
- Report the suspicion immediately to the administrator and appropriate state agency (Correct answer)
- Document the suspicion and review it at the next staff meeting
Correct answer: Report the suspicion immediately to the administrator and appropriate state agency
Mandated reporter laws require immediate reporting of suspected abuse to the administrator and appropriate state agency without delay or internal investigation first.
Question 6: Which ethical principle is MOST directly violated when a nursing home administrator accepts gifts from a vendor seeking a supply contract?
- Beneficence
- Autonomy
- Justice (Correct answer)
- Non-maleficence
Correct answer: Justice
Accepting gifts from vendors violates justice by creating conflicts of interest that compromise impartial, fair decision-making in the facility's and residents' best interest.
Question 7: What legally distinguishes negligence from intentional abuse in a long-term care setting?
- Negligence involves physical harm while abuse involves only emotional harm
- Negligence results from failure to meet the standard of care, while abuse involves deliberate harmful acts (Correct answer)
- Negligence is a criminal matter while abuse is handled through civil litigation only
- Negligence applies only to licensed staff while abuse applies to all employees regardless of license
Correct answer: Negligence results from failure to meet the standard of care, while abuse involves deliberate harmful acts
Negligence is the unintentional failure to meet the standard of care, while abuse involves deliberate acts intended to harm or exploit a resident.
CNHA Ethics and Legal Issues 1
Under the Omnibus Budget Reconciliation Act (OBRA) of 1987, which of the following is a fundamental right guaranteed to nursing home residents?