CPHIMS CPHIMS Healthcare Environment Fundamentals 5

Question 1

In the US healthcare system, a 'never event' as defined by the National Quality Forum refers to:

Accepted Answer

A serious, largely preventable patient safety event that should never occur in a healthcare setting

Answer

NQF defines 'never events' as serious reportable events that are unambiguous, serious, usually preventable, and of concern to the public and healthcare providers.

Question 2

The Stark Law (Physician Self-Referral Law) prohibits physicians from referring patients to entities with which they have a financial relationship for which of the following services?

Accepted Answer

Designated health services covered by Medicare or Medicaid

Answer

The Stark Law prohibits physician self-referrals to entities in which they have a financial interest for any of 11 'designated health services' billable to Medicare or Medicaid.

Question 3

Which of the following best describes the role of an Integrated Delivery Network (IDN) in healthcare?

Accepted Answer

A coordinated network of providers and facilities under common ownership offering a continuum of care

Answer

An IDN is a single organization or system under common ownership that provides a full spectrum of care—from primary to acute to post-acute—often including its own health plan.

Question 4

The Hospital Readmissions Reduction Program (HRRP) penalizes hospitals by reducing Medicare payments when readmission rates exceed expected levels for which type of readmissions?

Accepted Answer

Unplanned 30-day readmissions for specified conditions such as heart failure and pneumonia

Answer

HRRP reduces Medicare payments to hospitals with excess unplanned 30-day readmission rates for specified conditions including heart failure, AMI, pneumonia, COPD, hip/knee arthroplasty, and CABG.

Question 5

In healthcare accreditation, what is the primary purpose of a 'tracer methodology' used by The Joint Commission during surveys?

Accepted Answer

To follow individual patient care experiences through the organization to assess compliance with standards

Answer

Tracer methodology follows an actual patient's care experience through multiple departments and staff interactions to evaluate compliance with Joint Commission standards in real-world care delivery.

CPHIMS Exam Practice Test

CPHIMS Exam Practice Test

CPHIMS CPHIMS Healthcare Environment Fundamentals 5