SMQT Comprehensive Care Plan Process 3 — Questions and Answers
Question 1: Which document most directly informs the development of a resident's comprehensive care plan?
- The facility's staffing schedule
- The Minimum Data Set (MDS) assessment (Correct answer)
- The state licensing survey report
- The resident's insurance authorization
Correct answer: The Minimum Data Set (MDS) assessment
The MDS assessment identifies clinical problems and triggers Care Area Assessments (CAAs) that drive the individualized care plan.
Question 2: A care plan goal states: 'Resident will maintain current weight within 5 lbs over the next 90 days.' This goal is best described as:
- Too vague because it lacks a discipline assignment
- Appropriate because it is measurable, time-bound, and realistic (Correct answer)
- Non-compliant because weight goals require physician co-signature
- Deficient because it does not include the resident's subjective statement
Correct answer: Appropriate because it is measurable, time-bound, and realistic
This goal meets regulatory standards by being specific, measurable, and time-bound with a realistic outcome.
Question 3: A surveyor reviews a care plan and notes that psychosocial needs are not addressed despite the resident's documented history of depression. This deficiency falls under which regulatory tag area?
- F-tag 684 (Quality of Care)
- F-tag 656 (Comprehensive Care Plans) (Correct answer)
- F-tag 758 (Unnecessary Medications)
- F-tag 600 (Abuse Prohibition)
Correct answer: F-tag 656 (Comprehensive Care Plans)
Failure to address identified needs in the care plan is cited under F-tag 656, which governs comprehensive care plan requirements.
Question 4: A resident's care plan includes an intervention of 'encourage fluids.' A surveyor would flag this intervention because:
- Fluid interventions require a physician order
- It lacks specificity—amount, frequency, and method are undefined (Correct answer)
- Only dietitians may write fluid interventions
- The term 'encourage' is prohibited by CMS guidance
Correct answer: It lacks specificity—amount, frequency, and method are undefined
Interventions must be specific enough for any staff member to implement consistently; 'encourage fluids' does not define target volume, frequency, or approach.
Question 5: When must a facility notify a resident (or representative) of a scheduled care plan meeting?
- At least 24 hours in advance so the resident can participate (Correct answer)
- Notification is optional if the facility invites them
- Only if the resident previously requested notification
- At least 72 hours in advance per CMS regulation
Correct answer: At least 24 hours in advance so the resident can participate
CMS requires facilities to provide at least 24 hours advance notice of care plan meetings to enable meaningful resident participation.
Question 6: Which of the following is NOT a required component of a comprehensive care plan per federal nursing facility regulations?
- Measurable objectives
- Specific interventions
- Estimated cost of each intervention (Correct answer)
- Timetables to meet objectives
Correct answer: Estimated cost of each intervention
Federal regulations require measurable goals, specific interventions, and timetables, but do not require cost estimates in the care plan.
Question 7: A resident newly admitted for short-term rehabilitation has different care plan requirements than a long-term resident primarily because:
- Short-term residents do not require care plans under federal law
- The initial assessment and care plan timeline may be abbreviated to 14 days for Medicare Part A stays (Correct answer)
- Therapy staff are solely responsible for their care plans
- Physicians write the entire care plan for rehabilitation stays
Correct answer: The initial assessment and care plan timeline may be abbreviated to 14 days for Medicare Part A stays
For Medicare Part A short-stay residents, facilities may use an abbreviated care planning process with an initial assessment completed within 14 days.
SMQT Comprehensive Care Plan Process 3
Which document most directly informs the development of a resident's comprehensive care plan?