Hartman’s Nursing Assistant Care – Chapter 1: The Nursing Assistant in Long-Term Care

These QUESTION_AND_ANSWER flashcards review essential concepts from Chapter 1 of Hartman’s Nursing Assistant Care, including LTC settings, roles, professionalism, legal & ethical issues, Residents’ Rights, HIPAA, documentation, MDS, and incident reporting.

What is long-term care (LTC)?

24-hour skilled care provided in a facility for people who need ongoing medical or personal assistance.

Which term is now preferred over “nursing home” for facilities that provide 24-hour skilled care?

Long-term care facility (LTCF) or skilled nursing facility.

Define skilled care.

Medically necessary care given by a licensed nurse or therapist, available 24 hours a day and ordered by a doctor.

What type of illness causes death and has no cure?

A terminal illness.

What are chronic conditions?

Long-lasting illnesses or disabilities that usually require ongoing treatment, such as heart disease or dementia.

Name two settings where care is provided outside LTCFs that still assist older or chronically ill people.

Home health care and assisted-living facilities.

What type of facility provides housing for people who need some help with daily care but not 24-hour skilled care?

Assisted-living facility.

Adult day services are designed for what purpose?

To provide supervision and care for people during certain hours while giving relief to caregivers.

Differentiate acute care from subacute care.

Acute care is short-term, immediate treatment in hospitals; subacute care is for people who need more care than for a chronic illness but less than acute care, usually in a hospital or LTCF.

What is hospice care?

Comfort-focused care for people who have six months or less to live, provided in homes or facilities.

List four basic activities of daily living (ADLs) provided in LTCFs.

Bathing, dressing, toileting, eating (plus transferring and walking).

Which federal agency runs Medicare and Medicaid?

The Centers for Medicare & Medicaid Services (CMS).

Who is eligible for Medicare?

People 65 or older, or any age with permanent kidney failure or certain disabilities.

Match each Medicare part with its coverage: Part A, Part B, Part C, Part D.

A: Hospital/Skilled nursing/Hospice/Home health; B: Physician services & equipment; C: Private Medicare Advantage plans; D: Prescription drugs.

What is Medicaid?

A medical assistance program for low-income people and those with disabilities, funded jointly by federal and state governments.

Why do nursing assistants act as the “eyes and ears” of the care team?

They spend the most time with residents, observe changes, and report them for care planning.

Give three tasks nursing assistants are NOT permitted to perform.

Insert or remove tubes, change sterile dressings, give tube feedings, administer medications (any three).

Define the chain of command.

The line of authority that ensures residents receive proper care and protects staff from liability.

What is liability in healthcare?

Legal responsibility for causing harm to another person.

Explain scope of practice.

The tasks healthcare providers are legally allowed to perform as defined by state law and training.

What are policies and procedures in a facility?

Policies: rules about what should be done; Procedures: the specific methods for carrying out policies.

Give two examples of professional behavior toward residents.

Keeping information confidential and addressing residents by their preferred name (others: positive attitude, explaining care, etc.).

List four personal qualities of a professional nursing assistant.

Compassionate, honest, dependable, respectful (others: patient, tactful, conscientious, tolerant).

What federal law set minimum training standards for nursing assistants?

The Omnibus Budget Reconciliation Act (OBRA) of 1987.

How many training hours does OBRA require at minimum for nursing assistants?

At least 75 hours (many states require more).

Define Residents’ Rights.

Legal rights specifying how residents must be treated while living in a facility, covering quality of life, privacy, dignity, and more.

What is informed consent?

The process by which a person, with a doctor’s help, makes decisions about his or her healthcare after receiving full information.

Describe the difference between abuse and neglect.

Abuse is purposeful harm; neglect is failure to provide needed care, resulting in harm.

Give two examples of physical abuse.

Slapping and rough handling (others: pushing, hitting, burning, restraining improperly).

What is financial abuse?

Improper or illegal use of a resident’s money, property, or assets.

Define active vs. passive neglect.

Active neglect is deliberate failure to provide care; passive neglect is unintentional failure to provide care.

Who is an ombudsman?

A legal advocate assigned to protect residents’ rights and help resolve complaints.

What is HIPAA’s main purpose?

To protect the privacy and security of individuals’ health information (PHI).

List three pieces of information considered Protected Health Information (PHI).

Name, Social Security number, medical record number (others: address, email, phone, etc.).

State the rule for correcting a handwritten charting error.

Draw one line through the error, write the correct information, date, and sign initials.

Why must care be documented immediately after it is given?

To ensure accuracy and because legally, if it is not documented, it did not happen.

Explain military (24-hour) time conversion for 4:00 p.m.

Add 12 → 1600 hours.

What is the Minimum Data Set (MDS)?

A comprehensive assessment tool that guides care planning and must be completed for each resident within 14 days of admission and reviewed regularly.

Define an incident in a healthcare facility.

An accident or unexpected event during care, such as a fall, error, or injury, requiring documentation.

When should an incident report be completed?

As soon as possible after the incident, with objective facts and actions taken.

Give two examples of incidents that require a report even if no injury is apparent.

A resident fall or an NA giving the wrong meal tray.

What does culture change in LTC aim to promote?

Individualized care that honors choice, dignity, respect, and a meaningful life for residents.

Define person-directed care.

An approach that focuses on the resident’s individual preferences, strengths, and community-building.

Why should nursing assistants refuse gifts or money from residents?

Accepting gifts is unprofessional, may create conflicts, and can violate facility policy and ethics.

What is false imprisonment in a care setting?

Illegal restraint or restriction of a person’s freedom of movement without consent.

Name two signs that may indicate resident neglect.

Pressure ulcers and unanswered call lights (others: poor hygiene, weight loss, soiled bedding).

What should an NA do if a resident refuses care?

Respect the refusal, report it to the nurse immediately, and document it accurately.