SMQT Nursing and Physician Services 5

Question 1

A facility contracts with a telemedicine physician to fulfill all required physician visit obligations. Under current CMS guidance, this arrangement:

Accepted Answer

May be acceptable if the state permits telemedicine visits to satisfy face-to-face requirements

Answer

CMS has recognized telemedicine visits may satisfy physician visit requirements, but acceptability depends on applicable state law and the visit meeting required evaluation standards.

Question 2

A surveyor finds that the facility's charge nurses routinely change the frequency of wound dressing changes based on clinical observation without a new physician order. This practice is:

Accepted Answer

A deficiency — treatment changes require a new or modified physician order

Answer

Nursing staff may not unilaterally modify treatment parameters established in physician orders without obtaining a new or revised order from the physician.

Question 3

During record review, a surveyor notes a resident's care plan lists 'prn physician visits as needed.' What is the problem with this approach?

Accepted Answer

It does not satisfy the required scheduled minimum visit frequency under 42 CFR §483.30

Answer

Federal regulations mandate minimum physician visit frequencies on a scheduled basis; a prn-only approach does not meet this requirement regardless of resident stability.

Question 4

A nursing facility surveyor observes that licensed nurses are documenting assessments they did not perform, signing off on tasks completed by unlicensed aides. This constitutes a deficiency in:

Accepted Answer

Nursing services — falsification of medical records and improper delegation

Answer

Nurses who falsify documentation by signing off on assessments they did not perform violate professional and regulatory standards for nursing services.

Question 5

Which of the following best demonstrates a facility's compliance with requirements for physician services during an emergency when the attending physician is unavailable?

Accepted Answer

A documented on-call physician arrangement that was activated and resulted in timely evaluation of the resident

Answer

Compliance requires both a written on-call arrangement and evidence it was activated and resulted in timely physician evaluation when needed.

SMQT - Surveyor Minimum Qualifications Test Practice Test

SMQT - Surveyor Minimum Qualifications Test Practice Test

SMQT Nursing and Physician Services 5