Healthcare Administration & Management Flashcards
7 cards from real CMD practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Healthcare Administration & Management flashcards as text
Which committee is typically responsible for overseeing physician credentialing and privileging decisions at a healthcare organization?
Answer: Medical executive committee
The Medical Executive Committee (MEC) holds authority over credentialing, privileging, and professional conduct issues for the medical staff.
A skilled nursing facility's CMS Five-Star Quality Rating dropped due to staffing deficiencies. Which action most directly improves the staffing domain score?
Answer: Improve daily nurse staffing hours per resident day and submit accurate payroll-based journal data
CMS calculates the staffing domain using payroll-based journal (PBJ) data; accurate reporting of adequate nurse staffing hours per resident day directly raises the score.
Under EMTALA, a hospital with specialized capabilities is required to:
Answer: Accept appropriate transfers from hospitals that lack those capabilities
EMTALA obligates hospitals with specialized capabilities (e.g., trauma centers, burn units) to accept appropriate transfers from facilities that cannot provide necessary care.
A medical director wants to benchmark the facility's performance against national standards. Which tool provides nationally standardized, auditable performance measures primarily used by health plans and employers?
Answer: HEDIS (Healthcare Effectiveness Data and Information Set)
HEDIS is a standardized set of performance measures maintained by NCQA that health plans use to compare care quality across organizations.
Which type of advance directive specifically designates another person to make healthcare decisions on behalf of a patient who loses decision-making capacity?
Answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare (healthcare proxy) legally designates an agent to make medical decisions when the patient cannot.
A nursing home medical director is reviewing antipsychotic prescribing rates. Federal regulations under F758 target unnecessary antipsychotic use primarily because:
Answer: Antipsychotics are associated with increased mortality and adverse effects in elderly dementia patients
FDA black-box warnings and CMS regulations target antipsychotic use in dementia patients because of significantly increased risks of stroke and death.
A hospital system is implementing a Clinical Integration Network (CIN). What is the primary purpose of this structure?
Answer: To enable independent physicians to coordinate care and negotiate jointly with payers based on quality and efficiency
A CIN allows independent physicians to clinically integrate care delivery and, if they meet FTC standards, to jointly negotiate value-based contracts with payers.