SMQT - Surveyor Minimum Qualifications Nursing and Physician Services Questions and Answers

Question 1

According to federal regulations for skilled nursing facilities (42 CFR §483.35), which of the following is a mandatory daily staffing requirement for a Registered Nurse (RN), unless a waiver is granted?

Accepted Answer

An RN must be on duty for at least 8 consecutive hours, 7 days a week.

Answer

An RN must be on-site 24 hours a day, 7 days a week.

Answer

An RN must hold the position of facility administrator.

Answer

The facility must employ at least one RN for every 30 residents.

Question 2

A surveyor reviews a resident's record and notes the admission date was 40 days ago. The initial physician visit was completed on day 5. There is no documentation of any subsequent physician visits. How should the surveyor interpret this finding in relation to 42 CFR §483.30?

Accepted Answer

The facility is non-compliant, as a follow-up physician visit was required within 30 days of the initial visit.

Answer

The facility is compliant, as the next visit is not required until 60 days after admission.

Answer

The facility is compliant, as long as a nurse practitioner has documented a visit in the record.

Answer

The facility is non-compliant, because weekly physician visits are required for the first 90 days.

Question 3

A surveyor is at a facility with an average daily occupancy of 85 residents. The Director of Nursing (DON), an RN, is assigned as the charge nurse for a specific unit every weekday from 7 a.m. to 3 p.m. This staffing assignment is:

Accepted Answer

Not permitted, because the DON may only serve as a charge nurse in facilities with an average daily occupancy of 60 or fewer residents.

Answer

Permitted, because the DON is a qualified RN.

Answer

Permitted, as long as the DON works full-time.

Answer

Not permitted, because the DON can only be a charge nurse in a facility with a daily occupancy of 120 or fewer residents.

Question 4

A resident's attending physician has arranged for a nurse practitioner (NP), who is not an employee of the facility, to provide care. Which of the following describes a compliant schedule of required visits after the physician's initial visit?

Accepted Answer

The NP performs the required visits at day 30 and day 60, and the physician performs the visit at day 90, alternating thereafter.

Answer

The physician must personally perform all required visits for the first 90 days; the NP can only perform visits after that.

Answer

The NP can only perform visits if the physician is physically present in the facility to supervise.

Answer

The physician must personally perform all required visits; NPs cannot fulfill this requirement.

Question 5

During a survey, a nurse is observed struggling to operate a new model of a mechanical lift, placing a resident at risk. The nurse states they have not received formal training on this specific device. This observation most directly points to a potential failure by the facility to meet which requirement under Nursing Services?

Accepted Answer

To ensure nursing staff have the specific competencies and skill sets needed to care for residents.

Answer

To post daily nurse staffing data in a prominent place.

Answer

To designate a licensed nurse as a charge nurse on each tour of duty.

Answer

To provide regular in-service education based on performance reviews.

Question 6

A resident experiences a sudden, acute medical issue at 2:00 a.m. The on-duty nurse is unable to reach the resident's attending physician. The facility has no designated backup physician to call in such situations. This scenario represents a potential violation of the facility's duty to:

Accepted Answer

Provide or arrange for emergency physician services 24 hours a day.

Answer

Ensure the resident's medical care is supervised by a single, primary physician.

Answer

Ensure the physician writes, signs, and dates progress notes at each visit.

Answer

Have a registered nurse on duty for at least 8 consecutive hours.