CCM Care Coordination & Resource Management 4

Question 1

A care manager working in a managed care organization receives a request to discharge a client prematurely to reduce costs. The care manager's FIRST obligation is to:

Accepted Answer

Advocate for the client's medically necessary care needs

Answer

Comply with the organization's financial directives

Answer

Consult the billing department for guidance

Answer

Transfer the case to another care manager

Question 2

Which care setting BEST describes a skilled nursing facility (SNF) in terms of care intensity?

Accepted Answer

Intermediate level providing skilled therapy and nursing post-acute care

Answer

Least intensive, primarily custodial care only

Answer

Equivalent to acute hospital care

Answer

Purely residential with no clinical services

Question 3

A care manager is coordinating care for a patient with limited English proficiency. The MOST appropriate interpreter resource is:

Accepted Answer

A trained medical interpreter service

Answer

The patient's bilingual family member

Answer

The care manager using a translation app

Answer

Written translated materials only

Question 4

During a home visit, a care manager observes unsanitary living conditions that may endanger the client. After addressing immediate safety, the care manager should:

Accepted Answer

File an Adult Protective Services (APS) report if abuse or neglect is suspected

Answer

Ignore conditions if the client does not express concern

Answer

Contact the landlord without the client's knowledge

Answer

Discharge the client from case management services

Question 5

Which care coordination framework emphasizes the relationship between a prepared, proactive practice team and an informed, activated patient?

Accepted Answer

Chronic Care Model (CCM)

Answer

Patient-Centered Medical Home (PCMH)

Answer

GRACE model

Answer

Transitional Care Model (TCM)

Question 6

A care manager is evaluating the effectiveness of a care plan. Which outcome measure reflects the MOST meaningful improvement for a client with COPD?

Accepted Answer

Reduction in emergency department visits and hospitalizations

Answer

Number of care plan documents completed on time

Answer

Frequency of care manager phone calls

Answer

Number of specialist referrals generated

Question 7

A client with dementia lives alone and repeatedly forgets to take medications. The MOST sustainable care coordination solution is to:

Accepted Answer

Arrange for a daily visiting home health aide to supervise medications

Answer

Call the client daily as a reminder

Answer

Instruct the client to set a phone alarm independently

Answer

Mail medication reminders weekly