Mixed Deck — All SMQT Topics Flashcards

Is a surveying method where the size and shape of the earth are taken into account. Large expanses and long lines are ideal for this kind of survey, which is used to pinpoint the exact placement of fundamental points required to set up control for subsequent surveys.

Answer: geodetic surveying

Geodetic surveying accounts for the true size and shape (curvature) of the Earth, making it ideal for large areas and long lines and for fixing precise control points for later work. Plane surveying ignores curvature, while route and topographic surveys are project-specific types that rely on control established by geodetic methods.

Which of the following BEST describes the purpose of the Quality Indicator Survey (QIS) trigger system?

Answer: To identify areas of concern from MDS data that guide survey task focus

QIS uses MDS-derived quality indicators to help surveyors prioritize which areas to investigate during an on-site survey.

Which of the following is NOT a permissible basis for a facility-initiated discharge under federal LTC requirements?

Answer: The resident's family frequently files grievances about care

The regulation lists six allowable reasons: needs cannot be met, health has improved, the safety of others is endangered, the health of others is endangered, nonpayment after notice, and facility closure. Discharging a resident because the family files grievances is retaliation and is prohibited.

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?

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

According to 42 CFR §483.30(c)(1), a resident must be seen by a physician at least once every 30 days for the first 90 days after admission. Since the resident was admitted 40 days ago and the first visit was on day 5, a follow-up visit was due by day 35. The absence of this visit constitutes non-compliance.

A surveyor discovers that a facility failed to investigate and report an allegation of resident-to-resident abuse. The MOST appropriate action is to:

Answer: Cite deficiencies under abuse prohibition and reporting requirements

Failure to investigate and report abuse allegations constitutes a citable deficiency independent of local law enforcement action.

When surveying a Medicaid managed care plan's Quality of Life protections, what does 'dignity and respect' primarily require staff to do?

Answer: Treat enrollees as capable adults regardless of disability status

Dignity and respect standards require that staff treat all enrollees as capable adults, honoring their individuality and autonomy regardless of disability or condition.

During a survey, a resident tells the surveyor they are afraid to complain about care because they fear retaliation from staff. This concern relates most directly to the resident's right to:

Answer: Voice grievances without discrimination or reprisal

Residents have the explicit right to voice grievances without fear of discrimination, interference, coercion, or reprisal from the facility or its staff.

Under 42 CFR §483.12, which of the following is the regulatory definition of 'abuse' in nursing facilities?

Answer: Willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish

42 CFR §483.12 defines abuse as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish.

During a survey, you observe that care plan conferences are held but family members consistently report not being invited. The most likely citation would be:

Answer: F-tag 656 (Comprehensive Care Plan) for failure to ensure participation

Failing to provide residents and representatives an opportunity to participate in care planning is a direct deficiency under F-tag 656.

A facility's policy states care plans are updated 'as needed.' A surveyor would find this policy deficient primarily because:

Answer: Regulations mandate minimum review frequencies that cannot be replaced by discretionary language

Federal rules require quarterly review at minimum; a policy permitting updates only 'as needed' creates a gap where mandatory reviews could be skipped.

Determining the dimensions and form of the earth is the focus of __________________ surveying. Large areas, such as a state or county, would be surveyed using this type.

Answer: Geodetic

Geodetic surveying focuses on determining the size and shape of the earth and is used for very large areas like states or counties, where curvature matters. Plane surveying ignores curvature and suits only small areas, while topographic and GPS describe what is mapped or the tool used, not the large-scale, curvature-accounting purpose.

The measurement and mapping of the earth's physical features—both natural and man-made—are the focus of __________________________ surveys.

Answer: Topographic

Topographic surveys measure and map the physical features of the land—both natural (rivers, hills) and man-made (roads, buildings). Plane and geodetic refer to whether curvature is considered, and GPS is a positioning technology, so none of them specifically mean mapping the land's physical features.

A surveyor observes a resident being repositioned without following the documented care plan. This finding is BEST documented as:

Answer: A potential deficiency to be corroborated with interview and record review

Initial observations must be corroborated through interviews and records before a deficiency is cited.

A resident has been diagnosed with a Clostridioides difficile (C. diff) infection. For terminal cleaning of the resident's room after discharge, the surveyor should confirm that housekeeping staff use:

Answer: An EPA-registered sporicidal disinfectant.

C. difficile produces spores that are resistant to standard disinfectants and alcohol-based products. The CDC and EPA recommend using an EPA-registered disinfectant with a sporicidal claim (found on EPA List K) to effectively kill the spores on environmental surfaces.

Under Quality of Life requirements, an enrollee's right to participate in community activities is best described as which type of right?

Answer: A fundamental right that plans must actively support

Community integration is a fundamental right for LTSS enrollees, and managed care plans are required to actively support access to community activities.

Which of the following triggers an Immediate Jeopardy (IJ) declaration during a survey?

Answer: A situation where a facility's noncompliance has caused or is likely to cause serious injury or death

Immediate jeopardy requires that noncompliance caused or is likely to cause serious harm, injury, impairment, or death.

During a survey, a resident tells a surveyor that staff skip her scheduled bath twice a week. This information is BEST classified as:

Answer: Interview data to be corroborated with observation and records

Resident interviews are valid data sources that must be corroborated before a deficiency is cited.

When surveying medication reconciliation practices at a hospital, which patient transition is most associated with high-risk medication errors?

Answer: Admission from home to the hospital

Admission from home is a high-risk transition because complete and accurate home medication lists are often unavailable, leading to omissions or duplications.

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?

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

42 CFR §483.35 requires a facility to have sufficient nursing staff with the appropriate competencies and skill sets to provide nursing services and assure resident safety. The inability to safely operate essential equipment like a mechanical lift is a direct indicator that the staff member may lack the necessary competency for the task, which is the facility's responsibility to ensure.

A facility's food safety log shows that a steam table was holding mashed potatoes at 130°F during lunch service. The required minimum hot holding temperature for cooked foods is:

Answer: 135°F

The FDA Food Code requires hot foods to be held at 135°F or above to prevent bacterial growth in the temperature danger zone.