CPHRM CPHRM Exam 2

Question 1

Which body of law primarily governs healthcare risk management programs in US hospitals?

Accepted Answer

The Joint Commission standards

Answer

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?

Accepted Answer

Vicarious liability

Answer

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?

Accepted Answer

Total cost of risk (TCOR)

Answer

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?

Accepted Answer

Medicare/Medicaid fraud for prohibited referrals

Answer

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?

Accepted Answer

To estimate the future cost of pending and unreported claims

Answer

A claims reserve is a financial estimate set aside to cover the anticipated future costs of open and incurred-but-not-reported (IBNR) claims.

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