CNML Test Questions and Answers Updated 2026

CNML Test Questions and Answers
Updated 2026
DRGsM-MAnswerMDiagnostic-RelatedMGroups:MpaymentMrateMbasedMonMspecificMdiagnoses



ProspectiveMPaymentMSystemM-MAnswerMUsedMbyMMedicare-
participatingMhospitals:MpretreatmentMdiagnosisMbillingsMbasedMonMDRGs;MrateMdecidedMa
headMofMtimeMbetweenMinsuranceMcompaniesMandMhospitals



ExclusiveMProviderM-
MAnswerMUsedMbyMHMO's:MinsuranceMcoverageMforMcontractedMprovidersMorMinstitution
s



HMOsM-
MAnswerMHealthMmaintenanceMorganizations:McomprehensiveMhealthcareMtoMpeopleMwho
MpayMaMfeeMforMaMfixedMperiodMofMtime



CapitationM-
MAnswerMFixedMrateMpaidMtoMproviderMperMmemberMperMmonthMforMhealthcareMservic
es;MsetMfeeMpaidMbyMinsuranceMcompanyMperMmonthMforMallMtheMpatientMneeds



PPOsM-
MAnswerMPreferredMproviderMorganizations:MspecialMreducedMrateMforMservicesMwhenMcu
stomersMuseMcertainMprovidersMapprovedMbyMtheMinsuranceMcompany;MusuallyMfee-for-
service



IPAsM-
MAnswerMIndividualMproviderMarrangements:MprovideMcareMinMtheirMofficesMforMprepaid
Mplans;McoalitionMofMphysiciansMwhoMserveMHMOMpatientsMandMthird-partyMpatients



FulltimeMFTEMHoursM-MAnswerM2080MhoursM(1.0M@M40MhoursMperMweek)



CapitalMExpensesM-MAnswerMLong-
termMequipmentMorMphysicalMpurchases:MusuallyMoverM$500-
$1000MthatMwillMlastMyearsMandMdepreciateMoverMtimeMandMbeMusedMmultipleMtimes

,Zero-BasedMBudgetM-
MAnswerMWithMeachMnewMbudgetM(i.e.MfiscalMyear),MitMisMdeterminedMwhichMprograms
/areasMgetMmoney;MnoMhistoricalMcontextMisMused;MmayMrankMpackagesMandMthenMonl
yMfundMtop-rankedMones;McanMbeMtime-consumingMwayMtoMcreateMaMbudget



VarianceMCalculationM&MRemindersM-
MAnswerMVarianceM$M/BudgetedM$MXM100M=M%Mdifference;McontractMstaffMonMseparat
eMlineMofMbudget;MmanyMstaffMsickMcostsMmoreMthanMaMfewMstaffMonMLOA



CostMofMNursingMServicesMCalculationM-
MAnswerMNurseMTimeMXM(Avg.MRNMHourlyMRateM+MBenefitsM+MIndirects)M=MTotalMNur
singMCostMperMDRG



GeneralMNurseMStaffingMCalculationM-
MAnswerM#MofMRNsMneededMXMdaysMopenM/M#MdaysMworkedMperMRN



FTEMDefinitionM&MCalculationM-MAnswerMFull-timeMequivalentM=Mfull-
timeMemployeeMpaidMforM1Myear



FTEM=M(HoursMperMshiftMXM#MofMdaysMworked)M/M40Mhours



FixedMCostsM-
MAnswerMStayMtheMsameMnoMmatterMtheMcensus:MmanagerMsalaries,MkeepingMphonesM
on,Mrent,Metc.



VariableMCostsM-MAnswerMChangeMwithMcensusMandMhowMmuchMstaffingMisMused



NetMRevenueMCalculationM-MAnswerMGrossMRevenueM-
MDeductionsMfromMRevenueM(DRGsMandMtheMContractualMallowancesMpaidMbyMinsurance
Mcompanies)



UAPM-MAnswerMUnlicensedMassistiveMpersonnelM(CNA's)



ADCM-MAnswerMAverageMdailyMcensusM(patientsMinMaMbedMatMmidnight)

, TotalMPatientMDaysMCalculationM-MAnswerMADCMXMDaysMopenMperMyearM(forMSCHM-
MADCMXM365)



NurseMHoursMPerMPatientMDayM(HPPD)MCalculationM-
MAnswerMTotalMDirectMCareMHoursM/MTotalMPatientMDaysM=M#MofMRNMhoursMneeded
MtoMprovideMcareMforMaMpt.MforM24Mhours.M



ForMexampleM-
MforM12MhourMstaffMandM12MworkersMeachMshiftMyouMmultiplyM12MstaffMXM2MshiftsM
=M24MstaffMXM12MhoursMeachM=M288MdividedMbyMmidnightMcensusMofM31M=MNHPPD



VBPM-MAnswerMValue-
basedMpurchasing:MhowMCMSMdeterminesMhowMmuchMtoMreimburseMaMhospitalMforMcar
eM(benchmarkedMstandardsMandMhowMtheyMareMmeetingMit);MqualityMofMcareM&Mfollow
ingMbestMpracticeM&MpatientMexperience



PerMDiemMRateM-
MAnswerMNegotiatedMpayMforMservicesMbyMinsuranceMcompaniesMregardlessMofMwhatMse
rvicesMwereMactuallyMcompleted;MperMdayMadmitted



UOSM-
MAnswerMUnitMofMservice:MpatientMdaysMforMinpatientMnursingMbutMcouldMbeMvisitsMor
M#MofMproceduresMorMwhateverMthatMhealthcareMorganizationMcounts



RVUM-
MAnswerMRelativeMvalueMunit:MwhatMancillaryMservicesMmightMuseMtoMaddMupMtheirMU
OS;M#MofMhi-flowsMhookedMupMorMventsMstartedMforMRT.,MforMexample



ALOSMCalculationM-
MAnswerMAverageMlengthMofMstayM=M#MofMpt.MdaysM/M#MofMdischargesM(inMsameMti
meMperiod)



CPUOSM-MAnswerMCostMperMunitMofMserviceM=MsalariesM/MUOS



ProductivityM-MAnswerM#MofMstaffMhoursMorM$'sM/M#MofMUOSM



RNMhoursM/MpatientsMinMbedsM@MmidnightM(HOC)