Essentials of Health Care Compliance Final Exam Latest Update 2024-2025 Actual Exam 150 Questions and 100% Verified Correct Answers Verified by Professor
A behavioral health specialist notices a particularly high number of restraint deaths at a facility. An analysis of the root causes of these events is most likely to indicate problems
with:
- Equipment
- Staff orientation and training
- Staffing levels
d. Alarm systems - CORRECT ANSWER: b. Staff orientation and training
Equipment, staffing levels, and alarm system can also be culpable in restraint deaths, but problems with orientation and training are much more likely.
A healthcare facility's income statement is an example of:
- baseline audit
- retrospective audit
- concurrent audit
d. snapshot audit - CORRECT ANSWER: b. retrospective audit
Concurrent audit is real-time evaluations of records/policies.Snapshot audit is a comprehensive picture of the organization at a particular time.Baseline audit is also a comprehensive evaluation but undertaken for establishing benchmarks against which future performance may be compared.
A hospital's medication system is vast, and various element of it fall within the purview of several different departments. One important step forwards reducing errors in this
system is to: 1 / 3
- make each department responsible for the system as a whole
- have each department use the same self-assessment tools
- give a single person responsibility for overseeing the entire system
- simplify it - CORRECT ANSWER: c. give a single person responsibility for overseeing
the entire system
According to the Federal Sentencing Guidelines, which of the following factors could increase the punishment of an organization?
- obstruction of justice
- violation of direct court order
- prior history of violations
d. all of the above - CORRECT ANSWER: d. all of the above
These are aggravating factors that increase the culpability score under the FSG.
See FSG chapter 8-C2.5 https://guidelines.ussc.gov/gl/%C2%A78C2.5
According to the Institute of Medicine, which of the following is NOT one of the domains of quality of care?
- government regulation
- customization
- safety
d. interventions consistent with the latest findings - CORRECT ANSWER: a.
government regulation
According to the OIG, which of the following would likely be the least helpful measure for improving outpatient services?
- describe the hospital's post-submission testing process to a fiscal intermediary
- evaluate all possible bills for outpatient services provided at the hospital and within
- implement computer programs to identify outpatient services that are not billed
the applicable time period
separately from inpatient services 2 / 3
- establish a regular manual review of outpatient service claims - CORRECT
ANSWER: a. describe the hospital's post-submission testing process to a fiscal
intermediary
According to title II of HIPAA, disclosure of Protected Health Information related to which of the following actions requires the patient's express written authorization?
- state in which the treatment occur
- health care operations
- treatment
d. payment - CORRECT ANSWER: a. state in which the treatment occur
A covered entity may disclose PHI for TPO (treatment, payment, and healthcare operations)
At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified independent contractor?
- first level appeal
- second level appeal
- third level appeal
d. fourth level appeal - CORRECT ANSWER: b. second level appeal
There are five levels of appeal.First level entails a redetermination of claim; second level involves reconsideration by a qualified independent contractor; third level includes a hearing overseen by admin law judge; fourth level is a review of Medicare Review Council; and fifth level is a judicial review in federal court.
Because of a doctor's poor handwriting, a prescription must be reworked before it leaves the pharmacy. Which of the following is true?
- the doctor should be reprimanded
- the pharmacy should incorporate bar coding
- / 3