CCM Trivia 4

Question 1

Which transitional care model, developed by Mary Naylor, focuses on preventing hospital readmissions in elderly patients?

Accepted Answer

Transitional Care Model (TCM)

Answer

The Transitional Care Model (TCM), developed by Dr. Mary Naylor at the University of Pennsylvania, uses advanced practice nurses to coordinate care transitions for high-risk elderly patients.

Question 2

A case manager notices a client's cultural beliefs conflict with the recommended treatment plan. The BEST first action is to:

Accepted Answer

Explore the client's beliefs to identify culturally acceptable alternatives

Answer

Cultural competence requires the case manager to first understand the client's cultural perspective and then collaborate to find solutions that respect beliefs while meeting medical needs.

Question 3

What does 'subrogation' refer to in the context of workers' compensation or insurance?

Accepted Answer

The right of an insurer to recover costs from a liable third party

Answer

Subrogation allows an insurer that has paid a claim to pursue reimbursement from the party legally responsible for the loss or injury.

Question 4

Under HIPAA, a 'covered entity' includes all of the following EXCEPT:

Accepted Answer

Employers who only self-administer a health plan internally

Answer

Employers acting solely in their capacity as employers (not as health plan administrators transmitting PHI electronically) are not HIPAA covered entities.

Question 5

The Case Management Society of America (CMSA) was founded in which year?

Accepted Answer

1990

Answer

CMSA was founded in 1990 and serves as the leading professional membership organization for case managers, setting standards of practice.

CCM - Certified Case Manager Exam Practice Test

CCM - Certified Case Manager Exam Practice Test

CCM Trivia 4