CNHA Roles and Responsibilities 3 — Questions and Answers
Question 1: A resident with dementia exhibits increased agitation. The administrator notices that chemical restraints are being used without proper documentation. What action is required?
- Allow the clinical team to manage restraint use without administrative interference
- Immediately review facility restraint policies, require proper documentation, and ensure physician orders exist (Correct answer)
- Report the situation to law enforcement as elder abuse
- Wait for the next survey to address documentation gaps
Correct answer: Immediately review facility restraint policies, require proper documentation, and ensure physician orders exist
Administrators must ensure restraint use complies with OBRA '87 requirements, including physician orders and ongoing monitoring documentation.
Question 2: What is the administrator's primary responsibility when a state surveyor arrives for an unannounced inspection?
- Ask the surveyor to reschedule to allow staff to prepare
- Greet the surveyor, verify credentials, and facilitate full access to the facility (Correct answer)
- Contact legal counsel before allowing the survey to begin
- Limit surveyor access to common areas only
Correct answer: Greet the surveyor, verify credentials, and facilitate full access to the facility
Administrators must cooperate fully with state surveys, including verifying surveyor credentials and providing unrestricted access to records and residents.
Question 3: Under the Americans with Disabilities Act (ADA), what must a nursing home administrator ensure regarding employment practices?
- Disabled applicants may be screened out if the job requires physical demands
- Reasonable accommodations must be provided to qualified employees with disabilities (Correct answer)
- Disability status must be disclosed during the hiring process
- ADA requirements do not apply to healthcare settings
Correct answer: Reasonable accommodations must be provided to qualified employees with disabilities
The ADA requires employers to provide reasonable accommodations to qualified individuals with disabilities unless it causes undue hardship.
Question 4: Which of the following is a core financial responsibility of the nursing home administrator?
- Processing individual resident billing statements
- Overseeing the facility budget, monitoring census, and ensuring fiscal solvency (Correct answer)
- Negotiating Medicare reimbursement rates with CMS directly
- Managing resident trust fund investments
Correct answer: Overseeing the facility budget, monitoring census, and ensuring fiscal solvency
The administrator is accountable for the facility's overall financial health, including budget management, census monitoring, and operational sustainability.
Question 5: A long-term care administrator learns that a staff member made an unauthorized social media post showing a resident. What is the administrator's obligation?
- Issue a verbal warning and monitor the employee's future posts
- Investigate, take corrective action, report the HIPAA breach per facility policy, and notify the affected resident (Correct answer)
- Delete the post and consider the matter resolved
- Transfer the employee to a non-resident-facing role
Correct answer: Investigate, take corrective action, report the HIPAA breach per facility policy, and notify the affected resident
Unauthorized images of residents constitute a HIPAA privacy breach requiring investigation, corrective action, and breach notification procedures.
Question 6: The Resident Council in a nursing facility presents concerns about the quality of food service. What is the administrator's appropriate response?
- Inform the council that food service is a dietary department matter
- Meet with the council, document concerns, and develop an action plan with the dietary director (Correct answer)
- Schedule a follow-up meeting for three months later
- Assure the council the issues will be resolved without investigating
Correct answer: Meet with the council, document concerns, and develop an action plan with the dietary director
Administrators must take Resident Council concerns seriously, investigate thoroughly, and respond with documented corrective actions.
Question 7: Which of the following documents governs the operational standards and expectations for a Nursing Home Administrator under their state license?
- The facility's mission statement
- The state Nurse Practice Act
- State licensure laws and the NAB Model Practice Act (Correct answer)
- The Medicare Conditions of Participation only
Correct answer: State licensure laws and the NAB Model Practice Act
NHA practice is governed by state licensure laws and the National Association of Long Term Care Administrator Boards (NAB) Model Practice Act standards.
CNHA Roles and Responsibilities 3
A resident with dementia exhibits increased agitation.
The administrator notices that chemical restraints are being used without proper documentation.
What action is required?