CPHQ Regulatory and Accreditation 5

Question 1

The False Claims Act (FCA) allows private citizens to file lawsuits on behalf of the government against entities that commit fraud. These individuals are called:

Accepted Answer

Qui tam relators

Answer

Under the False Claims Act, private citizens who file fraud lawsuits on behalf of the government are called qui tam relators and may receive a portion of recovered funds.

Question 2

When a healthcare organization identifies a sentinel event, The Joint Commission requires submission of which analysis within 45 days?

Accepted Answer

Root Cause Analysis (RCA) and action plan

Answer

The Joint Commission requires an accredited organization to submit a thorough root cause analysis and improvement action plan within 45 days of identifying a sentinel event.

Question 3

Under CMS Hospital Conditions of Participation, which standard requires hospitals to have a process for credentialing and privileging practitioners?

Accepted Answer

Medical Staff CoP (§482.22)

Answer

The Medical Staff CoP (§482.22) requires hospitals to have a well-organized medical staff with bylaws governing credentialing, privileging, and peer review.

Question 4

A hospital receives a 'Immediate Jeopardy' (IJ) citation during a survey. The organization must respond by:

Accepted Answer

Removing the IJ by implementing acceptable corrective actions before the surveyor leaves or within a short timeframe

Answer

An Immediate Jeopardy finding requires the organization to implement corrective actions acceptable to the surveyor, often before the survey team departs, to remove the immediate threat.

Question 5

Which federal agency administers the Medicare and Medicaid programs and sets Conditions of Participation for healthcare facilities?

Accepted Answer

Centers for Medicare and Medicaid Services (CMS)

Answer

CMS, within the Department of Health and Human Services, administers Medicare and Medicaid and establishes the Conditions of Participation that facilities must meet.

CPHQ - Certified Professional in Healthcare Quality Practice Test

CPHQ - Certified Professional in Healthcare Quality Practice Test

CPHQ Regulatory and Accreditation 5