NAB NHA EXAM- PHYSICAL,
ENVIRONMENTAL, AND ATMOSPHERE-
QUESTIONS AND ANSWERS
The physical plant - answer-all designed, constructed, equipped, and maintained to
protect health and safety of residents, personnel, public
Life safety code (lsc) - answer-entire construction plan and materials meet lsc
standards|||cms requires unless have waiver or exception. Cms grants waivers on snfs;
states on nfs
(nfpa) - answer-national fire protection association ||established lsc
Purpose of lsc - answer-to provide reasonable degree of safety from fire.
Waivers for life safety code - answer-if cms finds a state fire and safety code adequately
protects residents and personnel thenlsc does not apply. Older facilities may obtain a
waiver if they are and have been in compliance with an older addition of lsc as specified
by cms.||before a nursing home may be built it must present architectural plant to state
medicaid or designated agency that approves construction. All major renovations, such
as additional beds, change in utilization of space, and so on must receive approval. The
state provides guidelines on what must be a approved. Upkeep and repairs do not
require prior approval.
Blueprints - answer-keep as-built plans available for surveyors who do lsc inspection as
well as for repair persons who may need prints for big jobs.
Lsc and other standards - answer-building and contact standards are set by lsc, cms,
Ansi/adaag - (dependent on which the state chooses) and state and local codes. ||- for
handicapped|-follow which on specific state requires (ansi/adaag)
Lsc and ansi/adaag - answer-lsc accepts both standards, so they are essentially all lsc
standards. Administrator does not need to know every standard but must keep a copy of
the "lsc handbook" as reference. The architect who designs the facility must know and
incorporate all lsc and other standards, but it is advisable for the nha to check his
building to ensure compliance.
Lsc, ansi/adaag, and cms - answer-**- building materials - fire-rate according to number
of stories. 2 hour and 1 hour rating|**- sprinklers - new buildings have automatically
activated by smoke/heat|- exits - no room more than 100 feet from exit. Lighted exit
signs of specific size. |- walls extend continuously to roof deck of next floor. Wall finish
must meet flame-spread requirements ( have certificate of this)|- furnishings - curtains
, and carpet must meet fire rating|- rooms - cms requirements - 4 residents to room max.
80 sq ft/resident (multi-resident room), 100 sq ft for single occupancy.
Requirement for rooms| - answer-- direct access to corridor|- outside window (cms) or
door (lsc)|- privacy|- furnishing| separate bed, proper size and height| bedding
appropriate to climate| individual closet space| bedside table| comfortable chair| enough
overbid tables to meet needs of residents|- toilets (cms, ansi, ada)|- bathing facilities
(cms)|- resident call system (cms, lsc) 24/7 - back up system available|- temperature
range (71-81 degree f) (three feet above floor), states set actual, a/c not required
Doors - answer-all 44" or more in new construction (41.5 opening) |outside doors open
egress. No locks on resident door except staff has key (lsc)||bathroom door 32"
(ansi/adaag)||fire doors with automatic hold-open devices required in corridors||(over
bed tables not required for patient)
Smoking - answer-written regulations, enforced. |smoking ares with non-combustible
ashtrays, metal containers with self-closing lids. Prohibited areas include resident rooms
and beds, oxygen, flammable liquid storage. Proper signs posted. Supervise non-
responsible.
Ansi/adaag(americans with disabilities act accessibility guidelines) - answer-make
building available to and usable by physically handicapped, no mental (blind, deaf, non-
ambulatory, semi-ambulatory, uncoordinated). Adaag = make buildings available to
ada's. |state decides whether to apply ansi or adaag standards to nursing homes
Accessible route - answer-no incline more than 10%
Parking - answer-13 feet||cannot block sidewalk; alley for 2 cars. The number of
handicap parking places is determined from a grid issued by ansi. It must be noted that
for every eight (8) handicap parking slots, one must be van accessible. ||if the facility
only has one handicapped place, it must be van accessible.
Ramps - answer-maximum rise 30". Slope not more than 1:10
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