Quality Assurance & Compliance Flashcards
7 cards from real CAS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Quality Assurance & Compliance flashcards as text
A new counselor asks why the agency uses the ASAM Patient Placement Criteria. The BEST answer is that the ASAM criteria:
Answer: Provide a standardized, evidence-based framework for matching clients to appropriate levels of care
The ASAM criteria offer a multidimensional, evidence-based approach to determining the most appropriate level of addiction treatment for each client.
A state auditor finds that a residential program has not been conducting mandatory fire drills as required by its license. This finding would most likely be classified as a:
Answer: Plan of correction deficiency
Licensing deficiencies related to regulatory non-compliance, such as missed fire drills, typically result in a plan of correction being required.
Under HIPAA, which of the following is NOT a permitted disclosure of protected health information (PHI) without patient authorization?
Answer: Disclosure to a marketing firm that partners with the facility
HIPAA prohibits disclosing PHI to marketing entities without explicit patient authorization.
Which JCAHO/Joint Commission standard requires treatment programs to demonstrate continuous performance improvement rather than simply meeting minimum thresholds?
Answer: Performance Improvement (PI) Standard
The Joint Commission's Performance Improvement standards require ongoing systematic efforts to improve care quality, not just compliance with minimums.
A facility's quality committee reviews data showing that urine drug screens are being collected inconsistently. The MOST appropriate corrective action is to:
Answer: Retrain all staff on collection protocols and establish monitoring
Retraining with subsequent monitoring directly addresses the root cause (inconsistent practice) and prevents recurrence.
The purpose of a utilization review (UR) process in a managed care environment is primarily to:
Answer: Ensure the medical necessity and appropriateness of services being provided
Utilization review evaluates whether the level and type of care provided is medically necessary and clinically appropriate.
A counselor notices that several clients' treatment plans have not been updated in 90 days despite clinical changes. This represents a failure in which QA domain?
Answer: Treatment planning timeliness and responsiveness
Treatment plans must be updated regularly and in response to client progress or changes; outdated plans indicate a documentation quality failure.