CNHA Roles and Responsibilities 2 — Questions and Answers
Question 1: A nursing home administrator receives a complaint from a resident's family about inadequate pain management. What is the administrator's FIRST responsibility?
- Dismiss the complaint as a medical matter outside administrative scope
- Investigate the complaint promptly and involve the Director of Nursing (Correct answer)
- Refer the family directly to the attending physician without follow-up
- Document the complaint and wait for the next care plan meeting
Correct answer: Investigate the complaint promptly and involve the Director of Nursing
The administrator must promptly investigate complaints and coordinate with clinical leadership to ensure resident welfare.
Question 2: Which federal law primarily governs nursing home standards of care and resident rights in the United States?
- Health Insurance Portability and Accountability Act (HIPAA)
- Omnibus Budget Reconciliation Act of 1987 (OBRA '87) (Correct answer)
- Americans with Disabilities Act (ADA)
- Emergency Medical Treatment and Labor Act (EMTALA)
Correct answer: Omnibus Budget Reconciliation Act of 1987 (OBRA '87)
OBRA '87 established the Nursing Home Reform Act, setting comprehensive federal standards for nursing facility care and resident rights.
Question 3: An administrator discovers that a licensed nurse has been falsifying medication administration records. What must the administrator do?
- Counsel the nurse privately and monitor behavior going forward
- Report the falsification to the state licensing board and document the incident (Correct answer)
- Transfer the nurse to a different unit to prevent further issues
- Consult legal counsel before taking any action
Correct answer: Report the falsification to the state licensing board and document the incident
Falsifying medical records is a serious patient safety and licensure issue requiring mandatory reporting to the state licensing board.
Question 4: What is the administrator's role in the facility's Quality Assurance and Performance Improvement (QAPI) program?
- Serve as a passive observer who reviews reports quarterly
- Lead and champion the QAPI program to drive systemic improvement (Correct answer)
- Delegate all QAPI responsibilities to the quality assurance coordinator
- Participate only when CMS surveyors are present
Correct answer: Lead and champion the QAPI program to drive systemic improvement
Federal regulations require the administrator to actively lead and champion the QAPI program as a core governance responsibility.
Question 5: A nursing home administrator is responsible for ensuring that the facility maintains a valid operating license. How often must most state nursing facility licenses be renewed?
- Every 5 years
- Every 3 years
- Annually (Correct answer)
- Every 6 months
Correct answer: Annually
Most states require nursing facility operating licenses to be renewed annually, though specific timelines vary by state.
Question 6: Which of the following best describes the administrator's responsibility regarding advance directives for residents?
- Ensure staff are trained and that facility policies honor residents' advance directives (Correct answer)
- Personally review and approve each resident's advance directive upon admission
- Delegate advance directive compliance entirely to the social services department
- Advise residents on what type of advance directive to complete
Correct answer: Ensure staff are trained and that facility policies honor residents' advance directives
The administrator must ensure policies, staff training, and procedures are in place to honor residents' advance directives as required by the Patient Self-Determination Act.
Question 7: A new administrator takes over a facility that is on CMS Special Focus Facility (SFF) status. What does this designation mean?
- The facility has received extra funding for improvement programs
- The facility has a history of serious quality issues requiring enhanced oversight (Correct answer)
- The facility specializes in a specific clinical population
- The facility is under consideration for Medicare certification
Correct answer: The facility has a history of serious quality issues requiring enhanced oversight
SFF status is assigned to facilities with a pattern of serious deficiencies, subjecting them to more frequent surveys and potential sanctions.
CNHA Roles and Responsibilities 2
A nursing home administrator receives a complaint from a resident's family about inadequate pain management.
What is the administrator's FIRST responsibility?