Certified Home Care & Hospice Executive
(CHCE) Practice Exam Questions &
Correct Answers Verified Plus Rationales
2026 | Instant Download Pdf
1. A home health agency is developing its annual budget. The administrator
notices a significant increase in the cost of medical supplies over the past quarter.
Which of the following is the MOST appropriate initial step to address this
variance?
A) Immediately reduce the number of visits per patient to lower supply usage.
B) Implement a new, less expensive vendor for all supplies.
C) Conduct a root cause analysis to determine the drivers of the increased cost.
D) Pass the cost increase directly to the patients through increased co-pays.
Answer: C
Explanation: Before implementing any changes, a root cause analysis is crucial to
understand why costs are increasing. It could be due to patient acuity, waste, or vendor
pricing. Addressing the root cause leads to a more sustainable solution than a blanket
change like switching vendors or reducing care.
2. The Conditions of Participation (CoPs) for Home Health Agencies require that
the agency's governing body assumes legal responsibility for the agency's total
operation. This includes all of the following EXCEPT:
A) Appointing a qualified administrator.
B) Establishing patient care policies.
C) Directly providing all patient care services.
D) Ensuring financial viability.
Answer: C
,Explanation: The governing body is responsible for the overall operation, policies, and
appointing leadership, but they do not directly provide patient care. The clinical services
are provided by the clinical staff under the direction of the clinical
manager/administrator.
3. A hospice patient's family is expressing significant caregiver burnout and is
requesting that the patient be transferred to a nursing home. The hospice team
believes the patient can be safely cared for at home with additional support. What
is the most appropriate action for the hospice executive to support?
A) Immediately begin the transfer process to respect the family's wishes.
B) Arrange a team meeting with the family to reassess the plan of care and explore
additional respite and support services.
C) Inform the family that hospice benefits do not cover transfer to a nursing home.
D) Increase the frequency of skilled nursing visits to replace the family's caregiving role.
Answer: B
Explanation: The hospice philosophy supports patient and family-centered care. The
best approach is to collaborate with the family, reassess their needs, and explore
additional support, such as increased respite care or volunteer hours, to alleviate the
burden while keeping the patient in their preferred setting if possible.
4. The OASIS (Outcome and Assessment Information Set) data is used by CMS for
which primary purpose?
A) To determine the agency's Medicaid reimbursement rates.
B) To measure patient outcomes and for quality improvement.
C) To create the patient's comprehensive care plan.
D) To bill private insurance companies.
Answer: B
Explanation: While OASIS items are used to calculate a patient's case-mix for
reimbursement (via HIPPS codes), the broader CMS purpose is outcome measurement
and quality improvement through public reporting (Home Health Compare) and pay-
for-performance programs.
,5. An administrator is reviewing the agency's case mix index (CMI). A significant
decrease in the CMI over the last quarter might indicate:
A) An increase in the average patient's acuity level.
B) The agency is serving more clinically complex patients.
C) The agency is admitting less clinically complex patients or there are issues with OASIS
documentation accuracy.
D) A significant increase in the number of therapy visits provided.
Answer: C
Explanation: CMI represents the average anticipated resource use for a patient
population. A decrease suggests that the average patient requires fewer resources, or
more likely, that the agency is under-coding patient severity on the OASIS, leading to
lower reimbursement.
6. Under HIPAA's Privacy Rule, which of the following would be considered an
incidental disclosure of protected health information (PHI) and is generally
permitted?
A) Discussing a patient's condition with a family member who is not listed as a contact
in the patient's chart, without the patient's explicit consent.
B) Two clinicians discussing a patient's case quietly in an elevator, where another person
overhears them.
C) A clinician leaving a patient's chart open on a desk in a busy nursing station.
D) A receptionist confirming a patient's appointment time to a visitor who is picking up
the patient.
Answer: B
Explanation: The Privacy Rule permits incidental disclosures that occur as a by-product
of otherwise permitted uses, provided reasonable safeguards are in place. Discussing a
case quietly in a shared space, where someone might overhear despite reasonable
efforts to be private, is an incidental disclosure. Leaving a chart open or confirming PHI
to an unauthorized person is a violation.
, 7. The role of the interdisciplinary team (IDT) in hospice is paramount. The IDT
must meet at least:
A) Weekly to coordinate patient care and update the plan of care.
B) Monthly to review the plan of care for all active patients.
C) Every 60 days to align with the recertification period.
D) Only when a significant change in the patient's condition occurs.
Answer: A
Explanation: The hospice CoPs require that the IDT meets at least every 14 days to
review the plan of care for each patient. In practice, weekly meetings are the standard
and considered a best practice.
8. The OASIS is required to be collected at several time points. Which of the
following is NOT a standard OASIS data collection point for a routine home health
episode?
A) Start of care (SOC).
B) Recertification (follow-up).
C) Transfer to an inpatient facility.
D) Discharge from the agency.
Answer: C
Explanation: OASIS data is collected at SOC, Recertification, and Discharge. While a
transfer to an inpatient facility may trigger a "Transfer" OASIS, it is not a standard data
collection point for a routine episode. The data is used to track outcomes, and a transfer
may indicate a negative outcome.
9. A home health agency is considering a merger with another local agency. What
is the most critical initial step for the executive leadership to take?
A) Publicly announce the merger to all staff and patients.
B) Begin integrating the two clinical software systems.
C) Conduct a thorough due diligence review of the other agency's financial statements,
compliance history, and operations.
D) Merge the two agencies' policies and procedures manuals.
(CHCE) Practice Exam Questions &
Correct Answers Verified Plus Rationales
2026 | Instant Download Pdf
1. A home health agency is developing its annual budget. The administrator
notices a significant increase in the cost of medical supplies over the past quarter.
Which of the following is the MOST appropriate initial step to address this
variance?
A) Immediately reduce the number of visits per patient to lower supply usage.
B) Implement a new, less expensive vendor for all supplies.
C) Conduct a root cause analysis to determine the drivers of the increased cost.
D) Pass the cost increase directly to the patients through increased co-pays.
Answer: C
Explanation: Before implementing any changes, a root cause analysis is crucial to
understand why costs are increasing. It could be due to patient acuity, waste, or vendor
pricing. Addressing the root cause leads to a more sustainable solution than a blanket
change like switching vendors or reducing care.
2. The Conditions of Participation (CoPs) for Home Health Agencies require that
the agency's governing body assumes legal responsibility for the agency's total
operation. This includes all of the following EXCEPT:
A) Appointing a qualified administrator.
B) Establishing patient care policies.
C) Directly providing all patient care services.
D) Ensuring financial viability.
Answer: C
,Explanation: The governing body is responsible for the overall operation, policies, and
appointing leadership, but they do not directly provide patient care. The clinical services
are provided by the clinical staff under the direction of the clinical
manager/administrator.
3. A hospice patient's family is expressing significant caregiver burnout and is
requesting that the patient be transferred to a nursing home. The hospice team
believes the patient can be safely cared for at home with additional support. What
is the most appropriate action for the hospice executive to support?
A) Immediately begin the transfer process to respect the family's wishes.
B) Arrange a team meeting with the family to reassess the plan of care and explore
additional respite and support services.
C) Inform the family that hospice benefits do not cover transfer to a nursing home.
D) Increase the frequency of skilled nursing visits to replace the family's caregiving role.
Answer: B
Explanation: The hospice philosophy supports patient and family-centered care. The
best approach is to collaborate with the family, reassess their needs, and explore
additional support, such as increased respite care or volunteer hours, to alleviate the
burden while keeping the patient in their preferred setting if possible.
4. The OASIS (Outcome and Assessment Information Set) data is used by CMS for
which primary purpose?
A) To determine the agency's Medicaid reimbursement rates.
B) To measure patient outcomes and for quality improvement.
C) To create the patient's comprehensive care plan.
D) To bill private insurance companies.
Answer: B
Explanation: While OASIS items are used to calculate a patient's case-mix for
reimbursement (via HIPPS codes), the broader CMS purpose is outcome measurement
and quality improvement through public reporting (Home Health Compare) and pay-
for-performance programs.
,5. An administrator is reviewing the agency's case mix index (CMI). A significant
decrease in the CMI over the last quarter might indicate:
A) An increase in the average patient's acuity level.
B) The agency is serving more clinically complex patients.
C) The agency is admitting less clinically complex patients or there are issues with OASIS
documentation accuracy.
D) A significant increase in the number of therapy visits provided.
Answer: C
Explanation: CMI represents the average anticipated resource use for a patient
population. A decrease suggests that the average patient requires fewer resources, or
more likely, that the agency is under-coding patient severity on the OASIS, leading to
lower reimbursement.
6. Under HIPAA's Privacy Rule, which of the following would be considered an
incidental disclosure of protected health information (PHI) and is generally
permitted?
A) Discussing a patient's condition with a family member who is not listed as a contact
in the patient's chart, without the patient's explicit consent.
B) Two clinicians discussing a patient's case quietly in an elevator, where another person
overhears them.
C) A clinician leaving a patient's chart open on a desk in a busy nursing station.
D) A receptionist confirming a patient's appointment time to a visitor who is picking up
the patient.
Answer: B
Explanation: The Privacy Rule permits incidental disclosures that occur as a by-product
of otherwise permitted uses, provided reasonable safeguards are in place. Discussing a
case quietly in a shared space, where someone might overhear despite reasonable
efforts to be private, is an incidental disclosure. Leaving a chart open or confirming PHI
to an unauthorized person is a violation.
, 7. The role of the interdisciplinary team (IDT) in hospice is paramount. The IDT
must meet at least:
A) Weekly to coordinate patient care and update the plan of care.
B) Monthly to review the plan of care for all active patients.
C) Every 60 days to align with the recertification period.
D) Only when a significant change in the patient's condition occurs.
Answer: A
Explanation: The hospice CoPs require that the IDT meets at least every 14 days to
review the plan of care for each patient. In practice, weekly meetings are the standard
and considered a best practice.
8. The OASIS is required to be collected at several time points. Which of the
following is NOT a standard OASIS data collection point for a routine home health
episode?
A) Start of care (SOC).
B) Recertification (follow-up).
C) Transfer to an inpatient facility.
D) Discharge from the agency.
Answer: C
Explanation: OASIS data is collected at SOC, Recertification, and Discharge. While a
transfer to an inpatient facility may trigger a "Transfer" OASIS, it is not a standard data
collection point for a routine episode. The data is used to track outcomes, and a transfer
may indicate a negative outcome.
9. A home health agency is considering a merger with another local agency. What
is the most critical initial step for the executive leadership to take?
A) Publicly announce the merger to all staff and patients.
B) Begin integrating the two clinical software systems.
C) Conduct a thorough due diligence review of the other agency's financial statements,
compliance history, and operations.
D) Merge the two agencies' policies and procedures manuals.
