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CPHRM : AHA Certified Professional in Healthcare Risk Management Exam
Healthcare CPHRM Questions & Answers
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AHA Certified Professional in Healthcare Risk Management
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Question: 1
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
eviewing and approving medical research studies wer: B
anation: The CPHRM is responsible for setting loss reserves for poten pensatory events as part of claims and litigation management. Loss ves are estimates of the potential financial liability associated with cla re used for financial planning and reporting purposes.
stion: 2
ch of the following federal acts/regulations does the CPHRM promote pliance with through policy development, guidance, or education?
ccupational Safety and Health Act (OSHA)
ood and Drug Administration (FDA) regulations
mergency Medical Treatment and Active Labor Act (EMTALA/COB ederal Communications Commission (FCC) regulations
Conducting forensic investigations of potential malpractice cases
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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.
Question: 3
Which of the following is an example of a risk assessment conducted by the CPHRM?
inancial analysis of the organization's investments nalysis of patient satisfaction survey results valuation of employee performance
dentification of exposures related to new and existing services wer: D
anation: The CPHRM conducts risk assessments to identify exposures ed to new and existing services. This involves assessing potential risk erabilities associated with the organization's services and developing egies to mitigate those risks.
stion: 4
ch of the following activities does the CPHRM participate in when onding to inquiries from regulatory and licensing agencies, and insura panies?
F A E I Ans Expl relat s and vuln strat Whi resp nce com 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. wing should a risk management professional ensure? orkforce compliance with accreditation standards ollaboration with patient safety and medical staff departments ultural, legal, and psychological soundness of programs addressing vioral issues on-discriminatory practices in provider and staff management nd 2 only 2, and 3 only 3, and 4 only 2, 3, and 4 wer: D anation: A risk management professional plays a crucial role in devel rganization's regulatory compliance plan. Workforce compliance with editation standards is essential to ensure that the organization meets th In developing the organization's regulatory compliance plan, which of the follo 1: W 2: C 3: C beha 4: N 1 a 1, 2, 1, Ans Expl oping the o accr e 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? onducting medical research studies stablishing performance improvement initiatives anaging the organization's budget lanning and evaluating the reporting and monitoring system wer: D anation: The CPHRM is responsible for planning and evaluating the rting and monitoring system for enterprise-wide event reports of harm harm incidents. This includes establishing processes for timely report yzing the data, and monitoring trends to support patient safety and risk agement. is the role of the CPHRM in evaluating claims? C E M P Ans Expl repo or near- ing, anal man What 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. ehavioral issues? inance department uman Resources department arketing department nformation Technology department wer: B anation: The CPHRM collaborates with the Human Resources depart dress provider and staff behavioral issues. Human Resources is onsible for managing employee relations and addressing issues related vior and conduct in the workplace. ch of the following activities are part of supervising and developing ri agement staff? Which department does the CPHRM collaborate with to address provider and staff b F H M I Ans Expl ment to ad resp to beha Whi sk man 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 and expectations provides a clear direction for the staff and aligns th with organizational objectives. Conducting performance evaluations ws for assessing individual performance, providing feedback, and ifying areas for improvement. Providing ongoing training and educati res that the staff remains updated with relevant knowledge and skills. ementing risk management policies and procedures is crucial for taining consistency and adherence to established protocols. Therefore ns 1, 2, 3, and 4 are part of supervising and developing risk managem making option B the correct answer. ch of the following activities should a risk management professional ge in to support patient safety committee meetings? ollecting and formulating relevant information cilitating the decision-making process hairing the meetings work allo ident on ensu Impl main , all optio ent staff, Whi enga 1: C 2: Fa 3: C 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 menting meeting minutes, although important, are not explicitly ment tivities that a risk management professional should engage in to supp nt safety committee meetings in this context. Therefore, options 1 ecting and formulating relevant information) and 2 (facilitating the ion-making process) are the activities that a risk management professi ld engage in, making option A the correct answer. ch of the following is a responsibility of a risk management profession ms management? ssignment of counsel tting loss reserves esponding to discovery requests/interrogatories agnosis and treatment of patients 2, and 3 only docu ioned as ac ort patie (coll decis onal shou Whi al in clai 1: A 2: Se 3: R 4: Di 1, 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, onsibilities. Therefore, options 1 (assignment of counsel), 2 (setting lo ves), and 3 (responding to discovery requests/interrogatories) are onsibilities of a risk management professional in claims management, ng option A the correct answer. ch of the following federal acts/regulations require compliance throug y development, guidance, or education in healthcare risk management enters for Medicare and Medicaid Services (CMS) mergency Medical Treatment and Active Labor Act (EMTALA/COB ealth Insurance Portability and Accountability Act (HIPAA) ational Practitioner Data Bank (NPDB) fe Medical Device Act (SMDA) 2, and 3 only 3, 4, and 5 only resp ss reser resp maki Whi h polic ? 1: C 2: E RA) 3: H 4: N 5: Sa 1, 1, 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 SMDA) focuses on the reporting and tracking of adverse events relat cal devices. Therefore, all options 1, 2, 3, 4, and 5 require compliance ugh policy development, guidance, or education, making option D the ct answer. ch of the following activities does the CPHRM participate in to suppo nt safety committee meetings? onducting employee satisfaction surveys eviewing facility maintenance records ollecting and formulating relevant information for decision-making eveloping marketing strategies for the organization wer: C anation: The CPHRM participates in supporting patient safety commi medi thro corre Whi rt patie C R C D Ans Expl ttee 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 tient advocacy 2, and 3 only 2, 3, and 4 nd 3 only nd 4 only wer: C anation: To promote compliance with laws and regulations governing untary detention of patients, risk management professionals play a cr Policy development is essential to establish clear guidelines and edures that align with the legal requirements. Guidance helps healthca iders understand and interpret the laws and regulations to ensure prop pliance. Education involves training and educating the staff on the rele regulations, and procedures. Patient advocacy, although important, is tly related to promoting compliance with involuntary detention laws a ations in this context. Therefore, options 1 (policy development) and 4: Pa 1, 1, 1 a 2 a Ans Expl invol ucial role. proc re prov er com vant laws, not direc nd regul 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 anation: Employee performance evaluations are not typically included anagement data collection/analysis system. Such evaluations are mo ed to human resources and performance management rather than risk agement. development of the organization's regulatory compliance plan, the RM ensures workforce compliance with: ccupational Safety and Health Administration (OSHA) standards nvironmental Protection Agency (EPA) regulations enters for Medicare and Medicaid Services (CMS) requirements ederal Trade Commission (FTC) guidelines wer: C anation: The CPHRM ensures workforce compliance with Centers for Expl in a risk m re relat man In the CPH O E C F Ans Expl 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 2, and 3 only 2, 3, and 4 3, and 4 only 3, and 4 only wer: A anation: A robust risk management data collection/analysis system is al for timely reporting and monitoring. Device reporting and tracking ssential for capturing information about medical devices, including an unctions or adverse events. Regulatory inquiries refer to investigation s conducted by regulatory agencies to ensure compliance with standar egulations. Incident reports capture details about any adverse incident isses, or harm events that occur within the organization. Patient faction surveys, although valuable for assessing overall patient experi ot directly related to risk management data collection and analysis in ext. Therefore, options 1 (device reporting and tracking logs), 2 (regul ries), and 3 (incident reports) are components that should be included
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