Compliance and Accreditation Flashcards
6 cards from real CHSP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Compliance and Accreditation flashcards as text
What is the purpose of an Interim Life Safety Measure (ILSM) in a healthcare facility?
Answer: To provide temporary compensating measures when life safety features are compromised
ILSMs are temporary measures implemented when normal life safety features are impaired, such as during construction, to maintain an equivalent level of safety.
Which organization developed the Sentinel Event policy requiring healthcare facilities to report serious adverse events?
Answer: The Joint Commission
The Joint Commission established the Sentinel Event policy, which encourages voluntary reporting of serious adverse events and requires root cause analysis.
In the context of healthcare accreditation, what does the acronym EC stand for?
Answer: Environment of Care
EC stands for Environment of Care, which encompasses the management of safety, security, hazardous materials, fire safety, medical equipment, and utilities.
What type of survey does The Joint Commission conduct when it arrives at a facility without prior announcement?
Answer: Unannounced survey
The Joint Commission conducts unannounced surveys, arriving at facilities without advance notice to evaluate compliance under normal operating conditions.
Which element is required as part of a healthcare facility Emergency Operations Plan under CMS regulations?
Answer: Policies and procedures for sheltering in place
CMS Emergency Preparedness regulations require facilities to have policies and procedures addressing shelter-in-place as part of their comprehensive emergency operations plan.
What is the primary function of a Safety Management Plan in a healthcare facility?
Answer: To provide a comprehensive framework for identifying and mitigating safety hazards
A Safety Management Plan provides a structured framework for identifying, assessing, and mitigating safety hazards to protect patients, staff, and visitors.