Certified Home Care & Hospice Executive
(CHCE) Practice Exam Questions And
Answers Rated A+ New Update Assured
Satisfaction
1. A home health agency is developing its annual budget. The executive team
notes a significant increase in the cost of medical supplies. Which of the following
financial management strategies would be most effective in controlling these
costs while maintaining quality of care?
A) Passing the full cost increase directly to patients through higher co-pays.
B) Implementing a just-in-time inventory system to reduce waste and storage costs.
C) Switching to the lowest-cost supplier for all supplies, regardless of quality.
D) Eliminating the use of disposable supplies and switching to reusable items.
Answer: B
Explanation: A just-in-time inventory system minimizes waste, reduces storage costs,
and prevents supplies from expiring, which directly addresses cost control. Option A is
not feasible as Medicare and other payers have strict rules on patient billing. Option C
compromises patient safety and quality. Option D is impractical and may increase the
risk of infection.
2. Under the Medicare Conditions of Participation (CoPs) for Home Health
Agencies, which of the following is a required element of the patient care plan?
A) A detailed financial plan for the patient.
B) The patient's social security number.
C) A description of the patient's nutritional status.
D) The name of the patient's primary care physician.
Answer: D
,Explanation: The CoPs require that the plan of care include the name of the attending
physician or primary care provider. Nutritional status is assessed as part of a
comprehensive assessment, but it is not a specifically required element to be listed in
the plan of care. Financial plans and social security numbers are not clinical care
requirements.
3. A hospice executive is reviewing the agency's Quality Assessment and
Performance Improvement (QAPI) program. What is the primary regulatory
purpose of this program?
A) To increase the agency's profitability.
B) To reduce employee turnover.
C) To monitor and improve the quality of care and services provided.
D) To ensure compliance with state licensure laws only.
Answer: C
Explanation: The QAPI program is mandated by federal regulations (CoPs) to ensure
that an agency continuously monitors, evaluates, and improves the quality of care and
services. While it can indirectly impact profitability and employee retention, its core
purpose is quality improvement and patient safety, not just state licensure.
4. In the context of the OASIS (Outcome and Assessment Information Set), what is
the primary purpose of the "M" items?
A) To collect financial billing information.
B) To document the patient's functional status and care needs.
C) To track employee satisfaction.
D) To record the agency's operational costs.
Answer: B
Explanation: The OASIS "M" items are the core clinical assessment items used to
measure patient outcomes, functional status, and the need for care. They are crucial for
calculating quality measures and risk adjustment. They are not used for billing,
employee satisfaction, or operational costs.
,5. A home health agency is experiencing a high rate of hospital readmissions for
patients with heart failure. Which of the following interventions is most likely to
reduce this rate, as supported by evidence-based practice?
A) Discharging patients as soon as they are stable.
B) Increasing the frequency of home health aide visits for personal care.
C) Implementing a telehealth monitoring program for daily weight and symptom checks.
D) Reducing the number of nursing visits to cut costs.
Answer: C
Explanation: Telehealth and remote patient monitoring (RPM) are proven interventions
for managing chronic conditions like heart failure. Daily weight monitoring can detect
fluid retention early, preventing exacerbations. Discharging early or reducing nursing
visits increases readmission risk. Home health aide visits, while helpful, do not address
the clinical monitoring needed for this specific condition.
6. The Emergency Preparedness Rule for Medicare and Medicaid providers requires
home health agencies to do which of the following?
A) Have a written emergency preparedness plan and test it annually.
B) Ensure all patients have a personal emergency plan.
C) Stockpile a 6-month supply of all medications.
D) Employ a full-time security guard.
Answer: A
Explanation: The CMS Emergency Preparedness Rule requires all participating providers
to have a written emergency plan, conduct a risk assessment, and perform drills/training
annually. The agency is responsible for its own plan, not for creating individual patient
plans, stockpiling medications (beyond supplies), or hiring security.
7. An executive is considering a merger with another home health agency. What is
the most critical initial step in this strategic process?
A) Designing a new logo and marketing campaign.
B) Conducting a thorough due diligence review of the other agency's financial and
operational health.
, C) Informing all staff of the pending merger immediately.
D) Setting a date for the merger announcement.
Answer: B
Explanation: Due diligence is the cornerstone of any merger. It involves a
comprehensive review of financial statements, legal liabilities, compliance history, clinical
outcomes, and operational risks. Jumping to marketing, informing staff too early, or
setting dates without this review can lead to catastrophic failure.
8. Under HIPAA, a home health aide discusses a patient's diagnosis with their
neighbor while at a grocery store. What is this an example of?
A) A minor administrative error.
B) A breach of patient confidentiality.
C) Acceptable practice if the neighbor is a friend.
D) A necessary exchange of information for care coordination.
Answer: B
Explanation: Discussing a patient's protected health information (PHI) in a public
setting like a grocery store, especially with someone not involved in their care, is a clear
violation of HIPAA privacy rules. It is not an administrative error, acceptable practice, or
necessary for care coordination.
9. In the home health setting, what is the distinction between a "skilled" service
and an "unskilled" service?
A) Skilled services are more expensive.
B) Skilled services require a physician's order, while unskilled services do not.
C) Skilled services must be performed by or under the supervision of a licensed
professional (RN, PT, OT, SLP) and require clinical judgment.
D) Unskilled services are primarily for patients with chronic conditions.
Answer: C
Explanation: The definition hinges on the nature of the service. Skilled services require
the expertise of a licensed professional to be safely and effectively performed, such as
wound care or IV therapy. Unskilled services (e.g., bathing, housekeeping) are custodial
(CHCE) Practice Exam Questions And
Answers Rated A+ New Update Assured
Satisfaction
1. A home health agency is developing its annual budget. The executive team
notes a significant increase in the cost of medical supplies. Which of the following
financial management strategies would be most effective in controlling these
costs while maintaining quality of care?
A) Passing the full cost increase directly to patients through higher co-pays.
B) Implementing a just-in-time inventory system to reduce waste and storage costs.
C) Switching to the lowest-cost supplier for all supplies, regardless of quality.
D) Eliminating the use of disposable supplies and switching to reusable items.
Answer: B
Explanation: A just-in-time inventory system minimizes waste, reduces storage costs,
and prevents supplies from expiring, which directly addresses cost control. Option A is
not feasible as Medicare and other payers have strict rules on patient billing. Option C
compromises patient safety and quality. Option D is impractical and may increase the
risk of infection.
2. Under the Medicare Conditions of Participation (CoPs) for Home Health
Agencies, which of the following is a required element of the patient care plan?
A) A detailed financial plan for the patient.
B) The patient's social security number.
C) A description of the patient's nutritional status.
D) The name of the patient's primary care physician.
Answer: D
,Explanation: The CoPs require that the plan of care include the name of the attending
physician or primary care provider. Nutritional status is assessed as part of a
comprehensive assessment, but it is not a specifically required element to be listed in
the plan of care. Financial plans and social security numbers are not clinical care
requirements.
3. A hospice executive is reviewing the agency's Quality Assessment and
Performance Improvement (QAPI) program. What is the primary regulatory
purpose of this program?
A) To increase the agency's profitability.
B) To reduce employee turnover.
C) To monitor and improve the quality of care and services provided.
D) To ensure compliance with state licensure laws only.
Answer: C
Explanation: The QAPI program is mandated by federal regulations (CoPs) to ensure
that an agency continuously monitors, evaluates, and improves the quality of care and
services. While it can indirectly impact profitability and employee retention, its core
purpose is quality improvement and patient safety, not just state licensure.
4. In the context of the OASIS (Outcome and Assessment Information Set), what is
the primary purpose of the "M" items?
A) To collect financial billing information.
B) To document the patient's functional status and care needs.
C) To track employee satisfaction.
D) To record the agency's operational costs.
Answer: B
Explanation: The OASIS "M" items are the core clinical assessment items used to
measure patient outcomes, functional status, and the need for care. They are crucial for
calculating quality measures and risk adjustment. They are not used for billing,
employee satisfaction, or operational costs.
,5. A home health agency is experiencing a high rate of hospital readmissions for
patients with heart failure. Which of the following interventions is most likely to
reduce this rate, as supported by evidence-based practice?
A) Discharging patients as soon as they are stable.
B) Increasing the frequency of home health aide visits for personal care.
C) Implementing a telehealth monitoring program for daily weight and symptom checks.
D) Reducing the number of nursing visits to cut costs.
Answer: C
Explanation: Telehealth and remote patient monitoring (RPM) are proven interventions
for managing chronic conditions like heart failure. Daily weight monitoring can detect
fluid retention early, preventing exacerbations. Discharging early or reducing nursing
visits increases readmission risk. Home health aide visits, while helpful, do not address
the clinical monitoring needed for this specific condition.
6. The Emergency Preparedness Rule for Medicare and Medicaid providers requires
home health agencies to do which of the following?
A) Have a written emergency preparedness plan and test it annually.
B) Ensure all patients have a personal emergency plan.
C) Stockpile a 6-month supply of all medications.
D) Employ a full-time security guard.
Answer: A
Explanation: The CMS Emergency Preparedness Rule requires all participating providers
to have a written emergency plan, conduct a risk assessment, and perform drills/training
annually. The agency is responsible for its own plan, not for creating individual patient
plans, stockpiling medications (beyond supplies), or hiring security.
7. An executive is considering a merger with another home health agency. What is
the most critical initial step in this strategic process?
A) Designing a new logo and marketing campaign.
B) Conducting a thorough due diligence review of the other agency's financial and
operational health.
, C) Informing all staff of the pending merger immediately.
D) Setting a date for the merger announcement.
Answer: B
Explanation: Due diligence is the cornerstone of any merger. It involves a
comprehensive review of financial statements, legal liabilities, compliance history, clinical
outcomes, and operational risks. Jumping to marketing, informing staff too early, or
setting dates without this review can lead to catastrophic failure.
8. Under HIPAA, a home health aide discusses a patient's diagnosis with their
neighbor while at a grocery store. What is this an example of?
A) A minor administrative error.
B) A breach of patient confidentiality.
C) Acceptable practice if the neighbor is a friend.
D) A necessary exchange of information for care coordination.
Answer: B
Explanation: Discussing a patient's protected health information (PHI) in a public
setting like a grocery store, especially with someone not involved in their care, is a clear
violation of HIPAA privacy rules. It is not an administrative error, acceptable practice, or
necessary for care coordination.
9. In the home health setting, what is the distinction between a "skilled" service
and an "unskilled" service?
A) Skilled services are more expensive.
B) Skilled services require a physician's order, while unskilled services do not.
C) Skilled services must be performed by or under the supervision of a licensed
professional (RN, PT, OT, SLP) and require clinical judgment.
D) Unskilled services are primarily for patients with chronic conditions.
Answer: C
Explanation: The definition hinges on the nature of the service. Skilled services require
the expertise of a licensed professional to be safely and effectively performed, such as
wound care or IV therapy. Unskilled services (e.g., bathing, housekeeping) are custodial
