Exam Code : CPHRM
Exam Name : AHA Certified Professional in Healthcare Risk Management
Vendor Name :
"Nursing"
Which of the following is a responsibility of the CPHRM in relation to claims and litigation?
Providing direct patient care during legal proceedings
Setting loss reserves for potential compensatory events
Conducting forensic investigations of potential malpractice cases
Reviewing and approving medical research studies
Answer: B
Explanation: The CPHRM is responsible for setting loss reserves for potential compensatory events as part of claims and litigation management. Loss reserves are estimates of the potential financial liability associated with claims and are used for financial planning and reporting purposes.
Which of the following federal acts/regulations does the CPHRM promote compliance with through policy development, guidance, or education?
Occupational Safety and Health Act (OSHA)
Food and Drug Administration (FDA) regulations
Emergency Medical Treatment and Active Labor Act (EMTALA/COBRA)
Federal Communications Commission (FCC) regulations
Answer: C
Explanation: The CPHRM promotes compliance with the Emergency Medical Treatment and Active Labor Act (EMTALA/COBRA) through policy development, guidance, or education. EMTALA/COBRA is a federal act that requires hospitals with emergency departments to provide medical screening
examinations and stabilize patients who have emergency medical conditions, regardless of their ability to pay.
Which of the following is an example of a risk assessment conducted by the CPHRM?
Financial analysis of the organization's investments
Analysis of patient satisfaction survey results
Evaluation of employee performance
Identification of exposures related to new and existing services
Answer: D
Explanation: The CPHRM conducts risk assessments to identify exposures related to new and existing services. This involves assessing potential risks and vulnerabilities associated with the organization's services and developing strategies to mitigate those risks.
Which of the following activities does the CPHRM participate in when responding to inquiries from regulatory and licensing agencies, and insurance companies?
Negotiating physician contracts
Conducting clinical trials
Reviewing patient medical records for billing purposes
Providing requested documentation and information
Answer: D
Explanation: The CPHRM participates in providing requested documentation and information when responding to inquiries from regulatory and licensing agencies, and insurance companies. This may involve gathering relevant records, reports, and other documents to address the inquiries.
In developing the organization's regulatory compliance plan, which of the following should a risk management professional ensure?
1: Workforce compliance with accreditation standards
2: Collaboration with patient safety and medical staff departments
3: Cultural, legal, and psychological soundness of programs addressing behavioral issues
4: Non-discriminatory practices in provider and staff management
1 and 2 only
1, 2, and 3 only
2, 3, and 4 only
1, 2, 3, and 4
Answer: D
Explanation: A risk management professional plays a crucial role in developing the organization's regulatory compliance plan. Workforce compliance with accreditation standards is essential to ensure that the organization meets the necessary quality and safety requirements. Collaboration with patient safety and medical staff departments ensures a comprehensive approach to addressing risk and safety issues. Programs addressing provider and staff behavioral issuesshould be culturally, legally, and psychologically sound to promote a safe and inclusive work environment. Non-discriminatory practices in provider and staff management are vital to ensure fair treatment and adherence to anti- discrimination laws. Therefore, all options 1, 2, 3, and 4 should be ensured by a
risk management professional in developing the organization's regulatory compliance plan, making option D the correct answer.
Which of the following is a responsibility of the CPHRM in relation to enterprise-wide event reports of harm or near-harm incidents?
Conducting medical research studies
Establishing performance improvement initiatives
Managing the organization's budget
Planning and evaluating the reporting and monitoring system
Answer: D
Explanation: The CPHRM is responsible for planning and evaluating the reporting and monitoring system for enterprise-wide event reports of harm or near-harm incidents. This includes establishing processes for timely reporting, analyzing the data, and monitoring trends to support patient safety and risk management.
What is the role of the CPHRM in evaluating claims?
Providing expert medical testimony in court
Determining the guilt or innocence of healthcare providers
Assessing the financial exposure of the organization
Negotiating settlement agreements with claimants
Answer: C
Explanation: The role of the CPHRM in evaluating claims is to assess the financial exposure of the organization. This involves analyzing the facts and circumstances of the claim, reviewing relevant documentation, and considering potential financial implications for the organization.
Which department does the CPHRM collaborate with to address provider and staff behavioral issues?
Finance department
Human Resources department
Marketing department
Information Technology department
Answer: B
Explanation: The CPHRM collaborates with the Human Resources department to address provider and staff behavioral issues. Human Resources is responsible for managing employee relations and addressing issues related to behavior and conduct in the workplace.
Which of the following activities are part of supervising and developing risk management staff?
1: Setting performance goals and expectations 2: Conducting performance evaluations
3: Providing ongoing training and education
4: Implementing risk management policies and procedures
1, 2, and 3 only
1, 2, 3, and 4
2, 3, and 4 only
1 and 4 only
Answer: B
Explanation: Supervising and developing risk management staff involves various activities to ensure their effectiveness and growth. Setting performance goals and expectations provides a clear direction for the staff and aligns their work with organizational objectives. Conducting performance evaluations allows for assessing individual performance, providing feedback, and identifying areas for improvement. Providing ongoing training and education ensures that the staff remains updated with relevant knowledge and skills. Implementing risk management policies and procedures is crucial for maintaining consistency and adherence to established protocols. Therefore, all options 1, 2, 3, and 4 are part of supervising and developing risk management staff, making option B the correct answer.
Which of the following activities should a risk management professional engage in to support patient safety committee meetings?
1: Collecting and formulating relevant information 2: Facilitating the decision-making process
3: Chairing the meetings
4: Documenting meeting minutes
1 and 2 only
1, 2, and 3 only
2, 3, and 4 only
1, 2, 3, and 4
Answer: A
Explanation: Supporting patient safety committee meetings requires active involvement from a risk management professional. Collecting and formulating relevant information is important to provide the committee with necessary data and insights for informed decision-making. Facilitating the decision-making process involves guiding the committee members through discussions, analysis, and evaluation of safety-related matters. Chairing the meetings and documenting meeting minutes, although important, are not explicitly mentioned as activities that a risk management professional should engage in to support patient safety committee meetings in this context. Therefore, options 1 (collecting and formulating relevant information) and 2 (facilitating the decision-making process) are the activities that a risk management professional should engage in, making option A the correct answer.
Which of the following is a responsibility of a risk management professional in claims management?
1: Assignment of counsel 2: Setting loss reserves
3: Responding to discovery requests/interrogatories 4: Diagnosis and treatment of patients
1, 2, and 3 only
1, 2, 3, and 4
2, 3, and 4 only
1 and 4 only
Answer: A
Explanation: Claims management is an important aspect of risk management,
and the role of a risk management professional includes specific responsibilities in this area. Assignment of counsel involves selecting and appointing legal representation for the organization in claims-related matters. Setting loss reserves is the process of estimating the potential financial impact of a claim and allocating funds accordingly. Responding to discovery requests/interrogatories involves providing requested information and documentation during the legal discovery phase. Diagnosis and treatment of patients are not within the scope of a risk management professional's responsibilities. Therefore, options 1 (assignment of counsel), 2 (setting loss reserves), and 3 (responding to discovery requests/interrogatories) are responsibilities of a risk management professional in claims management, making option A the correct answer.
Which of the following federal acts/regulations require compliance through policy development, guidance, or education in healthcare risk management?
1: Centers for Medicare and Medicaid Services (CMS)
2: Emergency Medical Treatment and Active Labor Act (EMTALA/COBRA) 3: Health Insurance Portability and Accountability Act (HIPAA)
4: National Practitioner Data Bank (NPDB) 5: Safe Medical Device Act (SMDA)
1, 2, and 3 only
1, 3, 4, and 5 only
2, 3, and 4 only
D. 1, 2, 3, 4, and 5
Answer: D
Explanation: Compliance with various federal acts and regulations is crucial in healthcare risk management. The Centers for Medicare and Medicaid Services
(CMS) sets guidelines and requirements for healthcare facilities participating in these programs. The Emergency Medical Treatment and Active Labor Act (EMTALA/COBRA) ensures that patients receive emergency medical care regardless of their ability to pay. The Health Insurance Portability and Accountability Act (HIPAA) protects patient privacy and sets standards for the security and confidentiality of health information. The National Practitioner Data Bank (NPDB) collects and discloses information on healthcare practitioners' malpractice and disciplinary actions. The Safe Medical Device Act (SMDA) focuses on the reporting and tracking of adverse events related to medical devices. Therefore, all options 1, 2, 3, 4, and 5 require compliance through policy development, guidance, or education, making option D the correct answer.
Which of the following activities does the CPHRM participate in to support patient safety committee meetings?
Conducting employee satisfaction surveys
Reviewing facility maintenance records
Collecting and formulating relevant information for decision-making
Developing marketing strategies for the organization
Answer: C
Explanation: The CPHRM participates in supporting patient safety committee meetings by collecting and formulating relevant information to facilitate the decision-making process. This may involve gathering data, reports, and other information related to patient safety initiatives and presenting it to the committee for discussion and decision-making.
Which of the following activities should a risk management professional engage in to promote compliance with laws and regulations governing involuntary detention of patients?
1: Policy development
2: Guidance
3: Education
4: Patient advocacy
1, 2, and 3 only
1, 2, 3, and 4
1 and 3 only
2 and 4 only
Answer: C
Explanation: To promote compliance with laws and regulations governing involuntary detention of patients, risk management professionals play a crucial role. Policy development is essential to establish clear guidelines and procedures that align with the legal requirements. Guidance helps healthcare providers understand and interpret the laws and regulations to ensure proper compliance. Education involves training and educating the staff on the relevant laws, regulations, and procedures. Patient advocacy, although important, is not directly related to promoting compliance with involuntary detention laws and regulations in this context. Therefore, options 1 (policy development) and 3 (education) should be engaged in by risk management professionals to promote compliance, making option C the correct answer.
Which of the following is NOT a component of a risk management data collection/analysis system?
Incident reporting forms
Device reporting and tracking logs
Regulatory inquiries
Employee performance evaluations
Answer: D
Explanation: Employee performance evaluations are not typically included in a risk management data collection/analysis system. Such evaluations are more related to human resources and performance management rather than risk management.
In the development of the organization's regulatory compliance plan, the CPHRM ensures workforce compliance with:
Occupational Safety and Health Administration (OSHA) standards
Environmental Protection Agency (EPA) regulations
Centers for Medicare and Medicaid Services (CMS) requirements
Federal Trade Commission (FTC) guidelines
Answer: C
Explanation: The CPHRM ensures workforce compliance with Centers for Medicare and Medicaid Services (CMS) requirements as part of the organization's regulatory compliance plan. CMS is a federal agency that administers the Medicare and Medicaid programs and sets standards for healthcare providers participating in these programs.
Which of the following components should be included in a risk management data collection/analysis system for timely reporting and monitoring?
1: Device reporting and tracking logs 2: Regulatory inquiries
3: Incident reports
4: Patient satisfaction surveys
1, 2, and 3 only
1, 2, 3, and 4
1, 3, and 4 only
2, 3, and 4 only
Answer: A
Explanation: A robust risk management data collection/analysis system is crucial for timely reporting and monitoring. Device reporting and tracking logs are essential for capturing information about medical devices, including any malfunctions or adverse events. Regulatory inquiries refer to investigations or audits conducted by regulatory agencies to ensure compliance with standards and regulations. Incident reports capture details about any adverse incidents, near misses, or harm events that occur within the organization. Patient satisfaction surveys, although valuable for assessing overall patient experience, are not directly related to risk management data collection and analysis in this context. Therefore, options 1 (device reporting and tracking logs), 2 (regulatory inquiries), and 3 (incident reports) are components that should be included in a risk management data collection/analysis system, making option A the correct answer.