CPHRM CPHRM Exam 2 — Questions and Answers
Question 1: Which body of law primarily governs healthcare risk management programs in US hospitals?
- The Joint Commission standards (Correct answer)
- State licensing statutes only
- Federal OSHA regulations exclusively
- Hospital medical staff bylaws
Correct answer: The Joint Commission standards
The Joint Commission accreditation standards establish foundational requirements for risk management programs in US hospitals.
Question 2: A patient claims a nurse gave incorrect medication instructions verbally. What type of liability does this primarily represent?
- Strict liability
- Vicarious liability (Correct answer)
- Premises liability
- Product liability
Correct answer: Vicarious liability
Vicarious liability holds the hospital responsible for the negligent acts of its employees, including nurses, under respondeat superior.
Question 3: Which metric best measures the financial impact of a hospital's risk management program?
- Number of incident reports filed
- Total cost of risk (TCOR) (Correct answer)
- Patient satisfaction scores
- Number of staff trained annually
Correct answer: Total cost of risk (TCOR)
Total cost of risk (TCOR) captures all costs associated with risk including premiums, retained losses, and administrative expenses.
Question 4: A risk manager discovers a physician has not disclosed a financial conflict of interest. Under STARK Law, what is the primary concern?
- Medicare/Medicaid fraud for prohibited referrals (Correct answer)
- HIPAA privacy violation
- Joint Commission noncompliance
- State medical board licensing issue only
Correct answer: Medicare/Medicaid fraud for prohibited referrals
The Stark Law prohibits physicians from referring Medicare/Medicaid patients to entities with which they have financial relationships.
Question 5: What is the primary purpose of a claims reserve in healthcare risk management?
- To fund capital equipment purchases
- To estimate the future cost of pending and unreported claims (Correct answer)
- To pay current employee salaries
- To cover routine operational expenses
Correct answer: To estimate the future cost of pending and unreported claims
A claims reserve is a financial estimate set aside to cover the anticipated future costs of open and incurred-but-not-reported (IBNR) claims.
Question 6: When a hospital employee is injured on the job, which coverage is triggered first?
- General liability insurance
- Workers' compensation insurance (Correct answer)
- Professional liability insurance
- Directors and officers insurance
Correct answer: Workers' compensation insurance
Workers' compensation is a no-fault system that provides mandatory coverage for employee work-related injuries and illnesses.
Question 7: Which element is NOT required to establish a claim of medical negligence?
- Duty of care
- Breach of the standard of care
- Intentional misconduct by the provider (Correct answer)
- Causation and damages
Correct answer: Intentional misconduct by the provider
Medical negligence (malpractice) requires duty, breach, causation, and damages — it does not require proof of intent.
CPHRM CPHRM Exam 2
Which body of law primarily governs healthcare risk management programs in US hospitals?