WGU C724 Top Exam Questions with accurate answers, rated A+ | Nursing Home Administration

Nursing Home Administration Glossary - Terms, prefixes, suffixes, common diagnoses, abbreviations. This is ALL of these others rolled into one. WGU C724 Top Exam Questions with accurate answers, rated A+ Abuse - ...

Nursing Home Administration Glossary - Terms, prefixes, suffixes, common diagnoses, abbreviations. This is ALL of these others rolled into one. WGU C724 Top Exam Questions with accurate answers, rated A+ Abuse - ✔✔-(1) Willful intent to cause harm. Abuse may be resident to resident or staff to resident harm.(2) Fraud committed against a public program such as Medicare or Medicaid Accelerated Method of Depreciation - ✔✔-A depreciation method that allows for larger amounts of depreciation in early years and smaller amounts in later years. The double declining-balance method is an example. (This enables the owner to receive tax and/or reimbursement benefits more quickly than using the straight line method ). Access - ✔✔-The ability of a person needing services to obtain those services. Accident - ✔✔-Any unexpected or unintentional incident, which may result in injury or illness to a resident. This does not include adverse outcomes from treatment or care. Accounting - ✔✔-The process of identifying, recording, and communicating information about the financial position and results of operations of a business entity, using principles designed to facilitiate informed decision-making by the entity's managers as well as by external groups. Accounting Equation - ✔✔-Assets = Liabilities + Owners' Equity (capital). This equation states that the assets of a firm are equal to the claims of the creditors plus the claims of the owners. The balance sheet is a detailed statement of this equation. Accounts Payable - ✔✔-Amounts owed to suppliers for goods and services. Accounts Receivable - ✔✔-Amounts owed to the facility for services or for the sale of goods. Accreditation - ✔✔-Accreditation of a nursing facility by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Accrual Basis of Accounting - ✔✔-A system of accounting in which revenues are recorded in the period earned, and expenses are recorded in the period incurred even if cash is received or paid in a later or earlier time period. (Contrast with CASH BASIS of accounting) Accumulated Depreciation - ✔✔-The total depreciation from the start of the life of a plant asset to any point in time. On the balance sheet, there is a deduction for accumulated depreciation taken from the gross evaluation of depreciable plant and equipment to yield a net evaluation. Acquired Immune Deficiency Syndrome (AIDS) - ✔✔-AIDS develops when a person infected with the human immunodeficiency virus (HIV) undergoes a breakdown and becomes susceptible to serious illness and death from other viruses, parasistes, fungi, and bacteria. Acid-Test Ratio (or Quick Ratio) - ✔✔-Cash and other current assets that can be converted to cash right away (such as marketable securities and current receivables) divided by current liabilities. A measure of the ability of a firm to pay its current liabilities in the very short term (see also CURRENT RATIO). Activities - ✔✔-Refer to any endeavor, other than routine activities of daily living, in which a resident participates that is intended to enhance his/her sense of well-being and to promote or enhance physical, cognitive, and emotional health. These include, but are not limited to, activities that promote self-esteem, pleasure, comfort, education, creativity, success, and independence. Activities of Daily Living - ✔✔-Individual self-performance skills needed in everyday life such as ambulation/locomotion, eating, toileting, grooming/personal hygiene, and bathing. Activity Therapist (AT) - ✔✔-An allied health professional trained to develop and provide leisure time activities for facility residents (patients). Acuity - ✔✔-The level of severity of a patient's condition. For example, patients who require intensive services are referred to as those having a higher level of acuity in relation to those who require less care. Acute Care - ✔✔-Short-term, intense medical care for an episode of illness or injury often requiring hospitalization. Acute Conditions - ✔✔-Episodic conditions that require short-term but intensive medical interventions. Adjusting Entries - ✔✔-Entries made at the end of an accounting period to record certain transactions or other accounting events that have not been recorded or have been improperly recorded during the accounting period. Examples include entries for depreciation expense and unused portions of prepaid expenses. Administer - ✔✔-The direct application of a vaccine or prescribed drug or device, whether by injection, ingestion or any other means, to the body of a resident (patient). Administrative Information System - ✔✔-Information technology that is designed to assist in carrying out financial and administrative support activities such as payroll, patient accounting, billing, accounts receivable, materials management, budgeting, cost control and office automation. Administrative Law - ✔✔-Rules and regulations formulated by departments or agencies of the executive branch of government to carry out the intent of statutory law. Administrator - ✔✔-See NURSING HOME ADMINISTRATOR/NURSING FACILITY ADMINISTRATOR Administrator In Training (AIT) - ✔✔-An internship with a certified preceptor required for an LTCA (NHA) license in some states; a person undertaking on-the-job training, or an internship, approved by a given state in preparation for licensing as a NHA. Admission Agreement - ✔✔-A contract that spells out the services the nursing home will provide and the cost of those services. Adult Day Care - ✔✔-A daytime program of nursing, rehabilitation therapies, supervision and socialization that enables elderly people to remain in the community and live with family. Services are generally provided on weekdays from 7 am to 6 pm to individuals who return home in the evening. Advance Directive - ✔✔-Written instructions from residents (patients) about the management and provision of care if they become incapacitated (e.g., living wills, do not resuscitate orders, durable power of attorney for healthcare). Adverse Drug Reaction (ADR) - ✔✔-Any unintended response to a drug which is injurious or harmful to health and which occurs at normal doses. Adverse Impact - ✔✔-Under the Civil Rights Act of 1964 and its amendments, adverse impact occurs whenever the selection rate for any protected group is less than 80% of the rate for the group with the highest rate. The focus is on the hiring standard used by the employer as a method of screening applicants. "The burden of proof is on the employer to show that a hiring standard is job related." Affirmative Action - ✔✔-Review of a facility's hiring practices (recruiting, advertising, and data on the applicants) by the federal government to ensure conformity to the 1964 Civil Rights Act and its amendments. Legal violations can be processed if it is determined that the facility has discriminated based on age, sex, marital status, race, religion, handicap or national origin. Aged - ✔✔-People who by definition in their culture have reached an advanced age during which they may become less productive. In the U.S. they are offen referred to as senior citizens, especially after reaching age 65. Ageism - ✔✔-Prejudicial treatment of the elderly based on stereotypes and misconceptions. Agent - ✔✔-Someone authorized to act on behalf of another (a principal); for example, a corporation generally authorizes the administrator to represent it or act on its behalf. Aging-in-place - ✔✔-Accommodating the changing needs of older adults while living in familiar surroundings. Aging of Accounts Receivable - ✔✔-Summarizing unpaid balances in terms of age groups, such as: currently due, 1-30 days past due, 31-60 days past due each of the remaining 30-day periods through 151-180 days past due, and finally past due more than 180 days. This classification may be broken down by type of debtor. Aging receivables is a step in the collections effort, in reporting on the balance sheet a deduction from accounts receivable for estimated bad debt, and in making write-off decisions. Aging Schedule - ✔✔-Also called an "aging report," it shows the length of time that various amounts within each patient's account have been outstanding (not paid). Agitation - ✔✔-Verbal, vocal, and motor activities that are repetitive and outside of socially acceptable norms. Allopathic Medicine - ✔✔-Medical approach--as practiced by physicians trained as doctors of medicine (MDs)--that views medical treatment as active intervention to produce a counteracting reaction in an attempt to neutralize the effects of disease. Allowable Charge - ✔✔-The maximum fee that a third party will use in reimbursing or paying a provider for a service rendered. Allowable Costs - ✔✔-Costs that are reimburseable under a third-party payment formula. Alzheimer's Disease - ✔✔-A progressive degenerative disease of the brain, producing memory loss, confusion, irritability, and severe funtional decline. The disease becomes progressively worse and eventually results in death. Ambulation - ✔✔-Moving about. Ambulatory - ✔✔-Able to walk with or without difficulty or help. Ambulatory Care (Ambulatory Services) - ✔✔-Services that require the patients to come and receive needed services at a community-based location. In a broader context, ambulatory care can be any outpatient services such as a visit to the physician's office or clinic or outpatient surgery. Americans with Disabilities Act - ✔✔-Forced businesses and organizations to make significant changes in physical accessibility to their buildings and in the employment and customer service policies. Amortization of Debt - ✔✔-The periodic reduction of a debt by regular payments applied to both principal and interest over a scheduled period. Ancillary Charges - ✔✔-Extra charges for supplies and services, e.g., drugs and lab tests, that are not included in the per diem rate. Annual Assessment - ✔✔-An annual assessment of a resident's (patient's) physical, mental, emotional, cognitive, and functional status. Antianxiety Medication - ✔✔-Psychoactive medications given to reduce anxiety (e.g., Ativan, Valium, Xanax) Anti-Kickback Law - ✔✔-The Medicare and Medicaid Anti-Kickback Law penalizes anyone who knowingly and willfully solicits, receives, offers, or pays a remunerationin cash or in kind to induce, or in return for: A. Referring and individual to a person for the furnishing, or arranging of the furnishing, of an item or service to be paid for by the Medicare or Medicaid program; or B. Arranging or recommending the purchase, lease, or order of goods or services to be paid for under Medicare or Medicaid. Violators are subject to criminal penalties or exclusion from participation in the Medicare and Medicaid programs, or both (see also SAFE HARBORS). Antisepsis - ✔✔-Removing or destroying microorganisms. Aphasia - ✔✔-Impaired ability to communicate. Apraxia - ✔✔-A speech disorder in which the tongue, lips, and vocal chords are unable to work together. As a result, the person is unable to say what he or she wants to say. Arbitration - ✔✔-Utilization of a third party to resolve disputes. As used here, this concept is related to facilities that have unions. The third party hears the arguments on both sides and then makes a decision which is binding on both the union and the facility. Area of refuge - ✔✔-A zone of safety within a building that is protected from the effects of fire and smoke that provides direct access to an exit. As-built plans - ✔✔-The blueprints or plans depicting the way the building was actually completed and approved. Asepsis - ✔✔-Absence of harmful microorgansms called pathogens. It refers to the practice of clean procedures, such as hand-washing. Aspiration - ✔✔-The inhaling of foreign objects, such as food or beverages if swallowed incorrectly into the lungs; results in introduction of bacteria from the mouth and stomach into the lungs which can lead to pulmonary bacterial infection known as aspiration pneumonia. Assessment - ✔✔-The process by which health care professionals attempt to reliably characterize the patient's physical health, functional abilities, cognitive functioning, psychological state, social well-being, and past and current use of formal services. Assets - ✔✔-Resources owned by a business that are measured in monetary terms. On a balance sheet, assets are generally classified into current and noncurrent portions. Current Assets are cash, accounts receivable, supply inventories, and prepaid expenses. Noncurrent assets include Property, Plant & Equipment (PP&E)(also referred to as fixed assets, capital assets, or plant assets) which are assets having an estimated life in excess of one year and not intended for sale in the ordinary course of operations. Assisted Living Facility (ALF) - ✔✔-Term applied to broad array of residential options for frail senior who need assistance with one or more activities of daily living, such as dressing or bathing, but do not require continuous skilled nursing care. ALF's generally emphasize a homelike environment offering a maximum amount of independence, privacy, and choice. Audiologist - ✔✔-A health care professional who is specially trained and licensed to provide direct clinicl services to individuals with hearing or balance disorders. Audit - ✔✔-Examination of accounting systems, controls, and records to ascertain their conformity to legal and professional standards and their adequacy in protecting against loss of assets by fraud and waste. Autism - ✔✔-A complex developmental disability that typically appears during the first three years of life and is the result of a brain disorder. It affects the person's social interaction and communication. Autonomy - ✔✔-A cluster of notions that include self-determination, freedom, independence, and liberty of choice or actions. Average Daily Census - ✔✔-The average number of patients per day over a specified period of time such as a week, a month, or a year. Avoidable Accident - ✔✔-An accident that occurred because the facility failed to identify a hazard, evaluate the hazard, implement interventions, and monitor the effectiveness. Baby Boomers - ✔✔-People born between 1946 and 1964. This age group constitutes approximately 70 million Americans who will start retiring around 2010. By 2030, when all the Baby Boomers will have retired, experts predict that they will severely strain the nation's health care system. Bad Debt - ✔✔-An account receivable determined to be uncollectible. Balance Sheet (or Statement of Financial Position) - ✔✔-A report summarizing a firm's assets, liabilities, and owners' equity at a specific date. Bank Statement - ✔✔-Statement sent by a bank to a bank account holder showing beginning and ending balances, and all transactions in the account for a month. Bank Statement Reconciliation - ✔✔-Process of explaining and correcting any discrepancies between a bank statement balance and the depositor's record of the cash balance. Bargaining Unit - ✔✔-Determination by the National Labor Relations Board of which workers will be grouped together for the purposes of forming or taking steps towards forming a union. Bed-hold - ✔✔-When a patient is temporarily out of the facility (at a hospital or with family), but the bed is being held and must be paid for. Bedsore - ✔✔-See PRESSURE SORE/ULCER Behavioral Intervention - ✔✔-Non-drug interventions used to change the resident's (patient's) behavior or environment to lessen or accommodate the resident's (patient's) behavioral symptoms. Benefit Period - ✔✔-Period of consecutive days during which covered services furnished to a patient, up to certain specified maximum amounts, may be paid for by an insurance plan. Each insurance carrier has its own definition of benefit period. Benefits (Fringe Benefits) - ✔✔-Compensation other than wages paid to workers, such as paid vacation/leave, paid health insurance, and retirement plans. Best practices - ✔✔-Evidence-based practices Bidding - ✔✔-The process of requesting from vendors a response (bid or offer) to provide goods or services according to written specifications. The bidding may be closed (directed to select bidders) or open (to all bidders). The bids may be negotiated (as to price, payment terms, etc.) before a contract is finalized. Biophilia - ✔✔-The human tendency to pay attention to, affiliate with and respond positively to nature. Bloodborne Pathogens - ✔✔-Pathogenic micro-organisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency Virus (HIV). Board of Directors - ✔✔-Also "board of trustees" or "governing body." It has the ultimate legal responsibility for a facility's operations. Boarding Home - ✔✔-A facility that offers room and board and sometimes supervision of daily activities. It does NOT offer health care. Bonds - ✔✔-Interest-bearing notes, usually in $1,000 or $5,000 amounts, in which the issuer (borrower) promises to repay the bondholder (lender) the principal and interest of a loan according to a schedule. Bookkeeping - ✔✔-The clerical process of recording the financial transactions of an organization. Break-Even Point - ✔✔-The point at which total revenues for a firm or a program are equal to the total expenses incurred. This may be illustrated on a graph where revenues (and expenses) are plotted on the vertical axis while resident-days are plotted on the horizontal axis. Look for the point where the line representing total cost (fixed plus variable) intersects with the line representing total revenue. The number of resident-days indicated by the point on the horizontal axis directly below this intersection is the number of resident days needed for the firm or program to break even, i.e., neither incur any loss nor make any profit. Budget - ✔✔-A tool for exercising financial control. It sets expectations that become financial objectives that the administrator is responsible for achieving. "Budgeting" is the process of financial planning. Cardiologist - ✔✔-A physician who specializes in the treatment of heart diseases. Care Plan - ✔✔-A plan designed to meet all of a resident's (patient's) identified physical, mental, emotional, cognitive, and functional needs. The care plan is generally the result of assessment and collaboration by an interdisciplinary team of provider staff (also known as the Plan of Care). Career Ladder - ✔✔-Paths or promotion routes established by the organization along which employees can seek to progress, such as financial assistance and release time to CNAs who seek to become a licensed nurse, or a licensed practical nurse who seeks to become a registered nurse. Career Paths - ✔✔-Defined avenues for upward mobility available to employees within an organization (similar to career ladder) Case Mix - ✔✔-A system that uses resident (patient) attributes (e.g., functional status in ADLs or coginitive abilities) to classify residents (patients) for purposes such as reimbursement. OR A measure of the intensity of care and services used by a group of residents in a nursing facility. "Case" refers to the overall data collected and used regarding an individual person under study. "Used" describes the combination of variables (observations) used for flassifying an observation accordint to distinctive characteristics on the basis of a dependent variable, such as time or costs. Case Mix Index - ✔✔-Each RUG group is assigned a weight, or numeric score, which reflects the relative resources predicted to provide care to a resident. The higher the case mix index (weight), the greater the resource requirements are for the resident. Payment for each resident is made monthly to the facility based on the case mix index for the facility. Case-Mix-Based Payment Systems - ✔✔-Payment systems used by Medicare and many state Medicaid programs under which the per diem rates for each nursing facility are determined in part by some measure of the acuity, and thus the likely resource consumption, of each covered resident in the facility. Assessments are conducted to classify covered residents into defined groups based primarily on functional disability scores, but certain diagnoses, service needs and behavioral problems may also be considered. The per diem rate is different for each group, with higher rates paid for residents needing and receiving more services. Cash Basis of Accounting - ✔✔-A system of accounting in which revenues are recorded when cash is received, and expenses are recorded when cash is paid (contrast with accrual basis of accounting). Cash Flow - ✔✔-Cash inflows from collections of revenues and other sources minus cash outflows for payments of expenses and liabilities. A cash budget of cash-flow forecast projects these amounts, whereas a cash flow report shows actual experience. Census - ✔✔-Number of patients in a facility on a given day. Centers for Medicare & Medicaid Services (CMS) - ✔✔-Federal agency responsible for administering the Federal Medicare and Medicaid programs. CMS headquarters is located in Baltimore, Maryland. Formerly the Health Care Financing Administration (or HCFA). Also administers Child Health Insurance Programs. Certificate of Need (CON) - ✔✔-Aimed at restraining health care facility costs and allowing coordinated planning of new services and construction. Laws authorizing such programs are one mechanism by which state governments seek to reduce overall health and medical costs. Require certain health care providers to obtain state approval before offering certain new or expanded services. Certification - ✔✔-The process by which federal and state governments determine if a health care facility meets Medicare and/or Medicaid standards. Certified Nursing Assistant (CNA) - ✔✔-A nurse aide who has completed at least the minimum training required by regulations. Charge Nurse - ✔✔-The nurse in charge or supervising a particular part of a facility for a given time shift. Charity Care - ✔✔-Care provided to a patient who does not have the capacity to pay. Chart of Accounts - ✔✔-A list of names and numbers of all the accounts used in a business. There typically are accounts for various subcategories of each of the following: assets, liabilities, owner's equity, revenues, and expenses. Chemical Restraint - ✔✔-A psychoactive drug used by a facility for discipline or convenience and not for medical treatment. Chronic - ✔✔-Continuing over a long period of time or recurring frequently. Chronic conditions often begin inconspicuously and symptoms are less pronounced than in acute conditions. Chronic Care - ✔✔-Care for residents (patients) who enter a nursing facility typically because they have chronic illnesses that require more assistance than they have available in their own home. The residents (patients) tend to remain in the facility for several months to years. Civil Law - ✔✔-Body of laws governing private legal affairs, such as private rights and duties, contracts, and commercial relations. Civil Liability - ✔✔-The three primary sources in health care malpractice lawsuits are: (1) failure to obtain consent before intervening in the life of the resident; (2) breach or violation of a contract or promise; and (3) the rendering of substandard, poor-quality care. Civil Money Penalties - ✔✔-A per day or per instance fine resulting from deficiencies in quality of care or resident safety following a CMS Survey. Claim - ✔✔-A bill submitted to the fiscal intermediary claiming payment for services provided. Clinical Approach to Hiring Decision - ✔✔-A hiring technique in which the employer makes the decision after reviewing all the information in hand about the match of the applicant and the job (see also STATISTICAL APPROACH) Clinical Information System - ✔✔-Information technology that is designed to be used by various clinicians to support the delivery of patient care. Clinical Pathway - ✔✔-A care-planning tool that outlines in a time sequence important aspects of care necessary for meeting specific outcomes. Clinical Practice Guidelines - ✔✔-Evidence-based standardized protocols indicated for the treatment of specific health conditions. Coaching - ✔✔-Either help given by a superior to a subordinate, or personal assistance from a person who is not the employee's supervisor, but may be a manager of another division or from outside the company. Code of Federal Regulations (CFR) - ✔✔-The federal Congress passes laws for which implementing rules are written and enforced...these are the The Federal Requirements and Guidelines to Surveyors; guidelines issued by the federal government interpreting how a given law is to be administered. Collection period - ✔✔-Number of days' worth of revenue that is accounts receivable. Collective Bargaining - ✔✔-Bargaining by groups of workers recognized and constituted through supervised election procedures under the National Labor Relations Board. Community Advisory Board - ✔✔-Composed of key community leaders, the community advisory board functions as the "eyes and ears" for the facility. Through their influences, the advisory board members can also assist the administrator to form meaningful partnerships with community agencies. Community-Based Care - ✔✔-See, similar idea, Adult Day Care Comorbidity - ✔✔-The simultaneous presence of two or more health problems. Compensation Management - ✔✔-Determining and administering wage, incentive, and benefit programs for a facility. Compensation Theory - ✔✔-Ideas or approaches to the functions of wages and benefits in motivating employees to meet the requirements of the employer (see e.g., EQUITY THEORY). Consultant Pharmacist - ✔✔-Pharmacist who is contracted by the nursing home to do drug regimen reviews and provide other services. Continence - ✔✔-The ability to self-regulate bladder and bowel elimination. Continuing Care Retirement Community (CCRC) - ✔✔-Also called a life-care community, it is an organization that integrates and coordinates the independent living and other institution-based components of the LTC continuum. Different levels of services are generally housed in separate buildings, all located on one campus. Continuum of long-term care - ✔✔-The full range of long-term care services that increase in the level of acuity and complexity from one end to the other -- from informal and community-based services at one end of the continuum to the institutional system at the other end. Contractual Discount - ✔✔-The difference between the rate the facility normally charges for services to its self-pay residents, and the lower rate that the facility has agreed to receive as reimbursement from Medicare, Medicaid, or other third-party payers. For external reporting purposes, revenues are recorded as the amount to be actually collected. However, for internal reporting purposes, management may record such contractual discounts as deductions from operating revenues on the income statement and accounts receivable on the balance sheet so that the amount of discounts given to each payer class is known. Controlled Subtance - ✔✔-A drug, substance or immediate precursor included in Schedules I to V of the Controlled Substance Act (e.g., morphine, acetaminophen with codeine, oxycodone). Except as provided under the law, their possession and use are illegal. Controller (or Comptroller) - ✔✔-The chief accountant of a firm. Controlling - ✔✔-(as a managerial behavior) Determination by administration of how well jobs have been done and what progress is being made to achieve the organization goals, then taking necessary corrective actions to achieve these goals. It is the process of monitoring, evaluating and correcting. Corporate Integrity Agreement - ✔✔-Agreement negotiated by the Office of the Inspector General (OIG) with a health care provider as part of the settlement of a federal health care program investigation arising under the False Claims Act. To avoid worse penalties, a company may agree to such compliance activities as: hire a compliance officer or appoint a compliance committee, develop writeen standards and policies, implement an employee training program, and/or retain an independent review organiztion to review claims submitted to fderal health care programs. Cost Center - ✔✔-An organizational unit charged with responsibility for controlling its own costs, and so its costs (for salaries, supplies, etc.) are separately accumulated in the accounts. A cost center may or may not be a revenue center, i.e., a unit providing direct services to patients for which they are charged. Cost of Living Allowance (COLA) - ✔✔-Upward adjustments in wages during times of inflation to assist workers to maintain their purchasing power. Cost Shifting - ✔✔-Practice by health care providers of charging private-pay patients more than the actual costs of their care, in order to compensate for shortfalls in payments for patients covered by Medicaid and other government programs which may pay less than actual costs. Cross-contamination - ✔✔-Transfer of disease causing organisms through contact with a dirty surface, unwashed hands, or insects. Cultural Competency - ✔✔-The ability of service agencies to understand the world view of clients of different cultures, and adapt practices to ensure their effectiveness. Cultural Diversity - ✔✔-The mosaic of individuals and groups with varying backgrounds, experiences, styles, perceptions, values and beliefs. Culture - ✔✔-A society's typical ways of behaving; its customs, mores and beliefs Culture Change (Cultural Change) - ✔✔-A course of action to move from one way of doing things to another. In long-term care, culture change is widely referred to as a process of transforming from an institutional to a homelike model. It is the integration of the three elements of person-centered care -- clinical care, socio-residential elements and human factors -- along with the enrichment of the environments in which people live and the empowerment of both clients and associates. Current Ratio - ✔✔-Current assets divided by current liabilities. A measure of a firm's ability to pay current debts. A current ratio much below 1.00 (or 1:1) may indicate problems in meeting current liabilities as they become due. (see also ACID-TEST RATIO). Custodial Care - ✔✔-Nonmedical care that includes routine assistance with the ADLs but does not include active nursing or rehabilitative treatments. Such care is provided to maintain function because the person's overall condition is not likely to improve. Data Assessment and Verification (DAVE) - ✔✔-A program administered by CMS designed to ensure accuracy of MDS data accomplished through data analysis, off-site review, on-site review, and provider education. Days in Resident Accounts Receivable - ✔✔-The number of days during which expenses could be paid using the cash on hand. It is: Cash + Marketable Securities (Total operating expenses minus depreciation)/365 Days of Care - ✔✔-Also called "Patient Days." Cumulative census over a specified period of time. Debilitated - ✔✔-Weak and infirm, unable to care for many personal needs Debt Service Coverage Ratio - ✔✔-Projected annual cash flow (i.e., excess of cash receipts over cash expenses), divided by required annual debt payments. Measure used by potential lenders of the creditworthiness of an entity. Debt-to-Assets Ratio - ✔✔-A measure of the relative obligations of a facility. Generally, the lower the debt ratio, the more financially sound the facility is believed to be. The ratio is calculated by: (Current Liabilities + Noncurrent Liabilities) / Total Assets Deemed Status - ✔✔-Medicare rule that a hospital accredited by the Joint Commission on Accreditation of Healthcare Organizations is deemed to have met the Medicare certification criteria. Deficiency - ✔✔-A nursing facility's failure to meet any of the standards as determined by a survey. Degenerative - ✔✔-Disorders in which tissue or an organ deterioriates and vitality is diminished. Dehydration - ✔✔-A loss of the body's normal water content which can affect both physical and mental functions. Individuals with brain, kidney, or gastrointestinal disease may find it difficult to maintain a normal amount of water in the body with the aid of medications. Dementia - ✔✔-A generic term that describes progressive and irreversible mental dysfunction that results in complex cognitive decline. These cognitive changes are commonly accompanied by disturbances of mood, behavior and personality. Dentition - ✔✔-The makeup of a set of teeth including their kind, number, arrangement and usability. Depreciation - ✔✔-The systematic allocation of the cost of a fixed asset to expense over its useful life. Depression - ✔✔-An abnormal state of mind in which a person usually becomes inactive and disinterested in his environment and lacks motivation. Dermatologist - ✔✔-A specialist physician who treats infections, growths, injuries, and other disorders related to the skin. Dietary history - ✔✔-A review of a resident's usual food intake patterns, including any food preferences, chewing and swallowing problems, or difficulties with self-feeding that might affect overall food intake. Dietitian - ✔✔-Sometime referred to as nutritionist, a dietitian provides nutritional information and diet-related services to residents/patients. Director of Nursing (DON) - ✔✔-A registered nurse responsible for supervising the activities, functions, and training of nursing personnel. Differentiation - ✔✔-A competitive strategy in which a facility creates distinctive features that allow customers to distinguish the facility's offer from that of its competitors. Director of Nursing Services (DNS) - ✔✔-See DIRECTOR OF NURSING (DON). Discharge Planning - ✔✔-A process that includes decisions about when a patient may need to be discharged from the facility and what may be needed to make a smooth transition from one level of care to another or from the facility to living independently. Discrimination - ✔✔-The use of any selection procedure which has an adverse impact on the hiring, promotion or other employment or membership opportunities of members of any race, age, religion, marital status, sex, or national origin. Dispense - ✔✔-To deliver a prescribed drug to an ultimate user, including the compounding, packaging, and labeling necessary to prepare the prescribed drug. Dividend - ✔✔-A distribution of earnings