CCM Care Coordination & Resource Management 5

Question 1

Which federal program provides comprehensive care coordination specifically designed for low-income elderly individuals who qualify for both Medicare and Medicaid?

Accepted Answer

PACE (Program of All-inclusive Care for the Elderly)

Answer

CHIP (Children's Health Insurance Program)

Answer

TRICARE

Answer

Medicare Advantage Special Needs Plan only

Question 2

A care manager conducting a care needs assessment discovers a client is a caregiver for an ill spouse while managing their own chronic illness. The BEST response is to:

Accepted Answer

Assess caregiver burden and include caregiver support resources in the care plan

Answer

Focus only on the client's clinical needs

Answer

Refer the spouse to a separate care manager without coordination

Answer

Advise the client to reduce caregiving responsibilities

Question 3

In care coordination, 'care compacts' between primary care providers and specialists are designed to:

Accepted Answer

Define mutual responsibilities and communication expectations between providers

Answer

Replace formal referral documentation

Answer

Limit the number of specialist visits per year

Answer

Establish billing agreements between practices

Question 4

A care manager identifies that a high-risk client has not filled a critical prescription for two months. The PRIORITY intervention is to:

Accepted Answer

Conduct an immediate outreach call to identify and address the barrier

Answer

Note it in the chart and wait for the next scheduled contact

Answer

Alert the insurer to flag the client for non-compliance

Answer

Reduce the care plan goals to simpler targets

Question 5

Which type of community resource assessment tool helps identify local service availability, eligibility criteria, and contact information for referrals?

Accepted Answer

Community resource directory (e.g., 211 database)

Answer

LACE index

Answer

CAGE questionnaire

Answer

InterRAI assessment

Question 6

A care manager is preparing for an interdisciplinary team meeting. To maximize effectiveness, the care manager should FIRST:

Accepted Answer

Review the client's current care plan and gather updated clinical data

Answer

Arrive early to set up the conference room

Answer

Send meeting minutes from the last session to all members

Answer

Confirm billing codes with the finance department

Question 7

When a care manager documents a client interaction, which principle should guide the content of the documentation?

Accepted Answer

Record objective facts, interventions, responses, and follow-up plans

Answer

Include personal opinions about the client's choices

Answer

Summarize only positive outcomes to maintain morale

Answer

Document only items billable under the client's insurance plan