CSA Adult Care Planning 2 — Questions and Answers
Question 1: A geriatric care manager recommends transitioning a client from independent living to assisted living. Which assessment tool is most commonly used to evaluate functional ability in this decision?
- Mini-Mental State Examination (MMSE)
- Katz Index of Activities of Daily Living (ADL) (Correct answer)
- Beck Depression Inventory
- Barthel Mobility Index
Correct answer: Katz Index of Activities of Daily Living (ADL)
The Katz Index of ADLs measures independence in six basic self-care functions and is the standard tool for determining the appropriate level of residential care.
Question 2: Under the PACE (Program of All-inclusive Care for the Elderly) model, which statement is most accurate?
- Participants must reside in a nursing facility to qualify
- PACE provides coordinated care allowing nursing-home-eligible seniors to remain in the community (Correct answer)
- PACE is only available to Medicare beneficiaries who are not Medicaid-eligible
- PACE programs are privately funded and not covered by government insurance
Correct answer: PACE provides coordinated care allowing nursing-home-eligible seniors to remain in the community
PACE integrates Medicare and Medicaid funding to deliver comprehensive medical and social services so eligible seniors can live safely in the community instead of a nursing home.
Question 3: A senior advisor is helping a family choose between a CCRC entrance-fee contract types. Which contract type offers the lowest monthly fees but provides the least predictable long-term costs?
- Type A (Life Care) contract
- Type B (Modified) contract
- Type C (Fee-for-Service) contract (Correct answer)
- Type D (Rental) contract
Correct answer: Type C (Fee-for-Service) contract
Type C Fee-for-Service contracts have lower upfront and monthly fees, but residents pay full market rates for health services as needed, creating unpredictable future costs.
Question 4: Which federal law requires nursing facilities participating in Medicare and Medicaid to conduct comprehensive resident assessments using the Minimum Data Set (MDS)?
- Older Americans Act (OAA)
- Omnibus Budget Reconciliation Act (OBRA) of 1987 (Correct answer)
- Americans with Disabilities Act (ADA)
- Health Insurance Portability and Accountability Act (HIPAA)
Correct answer: Omnibus Budget Reconciliation Act (OBRA) of 1987
OBRA 1987 established the Resident Assessment Instrument (RAI), including the MDS, to ensure individualized, comprehensive care planning in certified nursing facilities.
Question 5: A 78-year-old client has difficulty managing medications but otherwise lives independently. Which service is most appropriate to address this specific gap in IADLs?
- Skilled nursing facility placement
- Medication management through a home health aide or automatic dispenser (Correct answer)
- Immediate application for Medicaid institutional benefits
- Transfer to a memory care unit
Correct answer: Medication management through a home health aide or automatic dispenser
Medication management is an instrumental ADL, and targeted home-based solutions like a home health aide or automated pill dispenser address this specific gap without unnecessary escalation of care.
Question 6: When developing a care plan for a senior with mid-stage dementia, which principle should guide the planning process above all others?
- Maximizing cost efficiency for the family
- Preserving remaining autonomy and incorporating the person's known preferences (Correct answer)
- Transferring decision-making authority entirely to adult children
- Prioritizing medical interventions over quality of life considerations
Correct answer: Preserving remaining autonomy and incorporating the person's known preferences
Person-centered care planning for dementia patients prioritizes preserving autonomy and honoring previously expressed preferences even as cognitive capacity declines.
Question 7: A CSA is advising a family whose 80-year-old relative refuses home care services despite clear safety risks. What is the most appropriate first step?
- Immediately petition the court for guardianship
- Arrange emergency placement in a nursing facility
- Explore the reasons for refusal and attempt to find acceptable alternatives (Correct answer)
- Contact Adult Protective Services to report self-neglect
Correct answer: Explore the reasons for refusal and attempt to find acceptable alternatives
Exploring the reasons behind refusal—such as fear, cost concerns, or distrust—and offering acceptable alternatives respects autonomy while working toward safety, before escalating to legal interventions.
CSA Adult Care Planning 2
A geriatric care manager recommends transitioning a client from independent living to assisted living.
Which assessment tool is most commonly used to evaluate functional ability in this decision?