CAS Quality Assurance & Compliance 2 — Questions and Answers
Question 1: A substance use disorder treatment program is undergoing a CARF accreditation survey. Which document must be available to demonstrate that clients were informed of their rights upon admission?
- Signed client rights acknowledgment form (Correct answer)
- Agency policy manual
- Staff training records
- Incident report log
Correct answer: Signed client rights acknowledgment form
CARF requires programs to document that clients were informed of their rights, typically through a signed acknowledgment obtained at admission.
Question 2: Under 42 CFR Part 2, which action requires explicit written patient consent before records can be disclosed?
- Sharing records with a court that issued a subpoena
- Releasing records to a general medical provider for integrated care
- Disclosing records to law enforcement investigating a crime at the facility
- Sending records to another substance use disorder program for continuing care (Correct answer)
Correct answer: Sending records to another substance use disorder program for continuing care
42 CFR Part 2 requires explicit written patient consent for disclosures to other SUD programs, even for continuing care, unless a specific exception applies.
Question 3: A quality improvement team reviews outcome data and finds that only 40% of clients complete treatment. The FIRST step in a performance improvement cycle is to:
- Implement a new retention intervention immediately
- Analyze root causes of early discharge (Correct answer)
- Report findings to the state licensing board
- Reduce the length of treatment to match client preference
Correct answer: Analyze root causes of early discharge
Before implementing changes, a PI team must analyze root causes to understand why the problem exists.
Question 4: Which federal law specifically requires covered behavioral health organizations to ensure that mental health and substance use disorder benefits are no more restrictive than medical/surgical benefits?
- Americans with Disabilities Act (ADA)
- Mental Health Parity and Addiction Equity Act (MHPAEA) (Correct answer)
- Affordable Care Act (ACA)
- Employee Retirement Income Security Act (ERISA)
Correct answer: Mental Health Parity and Addiction Equity Act (MHPAEA)
MHPAEA mandates parity between mental health/SUD benefits and medical/surgical benefits in insurance plans.
Question 5: A counselor documents a session using vague language such as 'client doing well.' This violates which core principle of clinical documentation?
- Confidentiality
- Specificity and objectivity (Correct answer)
- Timeliness
- Co-signature requirements
Correct answer: Specificity and objectivity
Clinical documentation must be specific and objective, using observable, measurable language rather than vague or subjective terms.
Question 6: During a licensing inspection, a surveyor asks to review grievance logs. The PRIMARY purpose of tracking client grievances in a QA program is to:
- Identify staff members who require disciplinary action
- Detect patterns that indicate systemic program problems (Correct answer)
- Satisfy a single compliance checkbox
- Justify rate increases to payers
Correct answer: Detect patterns that indicate systemic program problems
Grievance tracking is a QA tool used to identify recurring issues and systemic problems that require program-level intervention.
Question 7: Which of the following is an example of a process measure (versus an outcome measure) in addiction treatment quality assurance?
- 30-day readmission rate
- Percentage of clients achieving abstinence at 6 months
- Percentage of clients who received a ASAM-level-of-care assessment within 24 hours of admission (Correct answer)
- Client satisfaction scores at discharge
Correct answer: Percentage of clients who received a ASAM-level-of-care assessment within 24 hours of admission
Process measures evaluate whether specific clinical procedures were performed, such as completing a level-of-care assessment within a defined timeframe.
CAS Quality Assurance & Compliance 2
A substance use disorder treatment program is undergoing a CARF accreditation survey.
Which document must be available to demonstrate that clients were informed of their rights upon admission?