CCM General 5

Question 1

Which of the following BEST describes the case management concept of 'transitional care'?

Accepted Answer

A set of actions ensuring care coordination as clients move between healthcare settings

Answer

Transitional care encompasses coordinated actions that ensure safe, effective handoffs between settings such as hospital to home or SNF.

Question 2

Social determinants of health (SDOH) that a case manager should routinely screen for include all of the following EXCEPT:

Accepted Answer

Physician's malpractice history

Answer

SDOH screening focuses on upstream factors affecting client health such as housing, food, and transportation, not provider credentials.

Question 3

A client with end-stage heart failure asks about hospice care. The case manager should explain that hospice is appropriate when:

Accepted Answer

Life expectancy is 6 months or less if the illness runs its normal course

Answer

Hospice eligibility under Medicare requires a physician certification that life expectancy is 6 months or less if the disease follows its expected course.

Question 4

Which law prohibits insurance companies from discriminating against individuals based on pre-existing health conditions in the individual and small group markets?

Accepted Answer

The Affordable Care Act (ACA)

Answer

The ACA prohibits health insurers in the individual and small group markets from denying coverage or charging higher premiums based on pre-existing conditions.

Question 5

A case manager is evaluating a client's functional status after stroke. Which standardized tool is MOST commonly used to measure activities of daily living (ADL) independence?

Accepted Answer

Barthel Index

Answer

The Barthel Index is a widely validated scale measuring independence in 10 ADLs including feeding, bathing, dressing, and mobility.

CCM - Certified Case Manager Exam Practice Test

CCM - Certified Case Manager Exam Practice Test

CCM General 5