Certified Home Care & Hospice
Executive (CHCE) Practice Exam 150
Questions with Correct Answers &
Detailed Rationales
ABOUT THE CHCE EXAM
The Certified Home Care & Hospice Executive (CHCE) credential is administered by the
National Board for Home Care and Hospice Certification (NBHHC®) through the
National Association for Home Care & Hospice (NAHC). The certification is designed for
senior administrators and executives with a minimum of three years of experience in a
medium to large size agency.
Exam Details:
Length: 223 questions
Format: Multiple-choice, skills-based
Focus: Management and leadership proficiency,
Key Domains Covered:
1. Legal Requirements
2. Financial Operations
3. Payment Sources
4. Regulatory Compliance
5. Strategic Planning & Operations
6. Human Resources
7. Quality & Performance Improvement
8. Risk Management
9. Marketing & Public Relations
10. Training & Continuing Education
11. Ethics
12. Technology Application
,13. Policy & Advocacy
SECTION 1: LEGAL & REGULATORY COMPLIANCE
1. A home health agency receives a notice of a scheduled survey from its
accrediting body. The executive's best initial response is to:
A) Postpone the survey until all staff are fully trained
B) Conduct an internal mock survey to identify and address deficiencies
C) Cancel all patient visits during the survey period
D) Hire external consultants to manage the survey process
Answer: B ✅
Rationale: A mock survey is the best proactive approach to identify and correct deficiencies
before the actual survey. Survey readiness is an ongoing process, not something that
should be postponed. Canceling patient visits is not appropriate, and while consultants can
be helpful, internal preparation is essential.
2. Under the Conditions of Participation (CoPs) for Home Health, which of the
following is a requirement for patient care planning?
A) A plan of care must be established within 48 hours of admission
B) The plan of care must be reviewed and updated every 30 days
C) The plan of care must be developed by the physician only
D) The plan of care must be reviewed at least every 90 days
Answer: A ✅
Rationale: Medicare Conditions of Participation require that a plan of care be established
within 48 hours of the patient's admission to home health services. The plan must be
reviewed and updated at least every 60 days, not 30 or 90. The interdisciplinary team, not
just the physician, participates in care planning.
, 3. A hospice agency is undergoing a survey by the state survey agency. The
surveyor requests access to patient records. The executive should:
A) Refuse access without a subpoena
B) Allow access to all requested records
C) Allow access but redact all patient identifiers
D) Request the surveyor to sign a confidentiality agreement
Answer: B ✅
Rationale: Surveyors have the legal authority to review patient records during surveys.
HIPAA permits disclosure for oversight and survey activities. Refusing access would
constitute a deficiency. Redaction would defeat the purpose of the survey.
4. Which federal law requires home health and hospice agencies to have a
compliance and ethics program?
A) HIPAA
B) False Claims Act
C) Deficit Reduction Act of 2005
D) Affordable Care Act
Answer: C ✅
Rationale: The Deficit Reduction Act of 2005 requires providers that receive annual
Medicaid payments of $5 million or more to have a compliance and ethics program.
HIPAA addresses privacy, the False Claims Act addresses fraud, and the ACA addresses
access.
5. A hospice executive receives a report from the compliance officer about
potential billing irregularities. The executive's FIRST action should be to:
A) Terminate the employees involved
B) Conduct an internal investigation
C) Self-disclose to the OIG
D) Ignore the report
, Answer: B ✅
Rationale: The first step is to conduct an internal investigation to determine the validity
and scope of the allegations. Self-disclosure may be appropriate after the investigation.
Termination should follow due process. Ignoring the report is a breach of fiduciary duty.
6. Under the Emergency Medical Treatment & Labor Act (EMTALA), which of the
following applies to home health and hospice agencies?
A) Full EMTALA compliance is required for all agencies
B) EMTALA does not apply to home health or hospice agencies
C) Only agencies with emergency departments must comply
D) Hospice agencies must have emergency transfer agreements
Answer: B ✅
Rationale: EMTALA applies to hospitals with emergency departments, not to home health
or hospice agencies. Home health and hospice agencies are not subject to EMTALA
requirements.
7. The Conditions of Participation (CoPs) for Hospice require that a plan of care is
established:
A) Within 48 hours of admission
B) At the time of the initial comprehensive assessment
C) Within 5 days of admission
D) At the interdisciplinary team meeting
Answer: B ✅
Rationale: The hospice CoPs require that the plan of care be established at the time of the
initial comprehensive assessment, which must be completed within 5 days of admission.
The plan is developed by the interdisciplinary group (IDG) and reviewed at IDG meetings.
Executive (CHCE) Practice Exam 150
Questions with Correct Answers &
Detailed Rationales
ABOUT THE CHCE EXAM
The Certified Home Care & Hospice Executive (CHCE) credential is administered by the
National Board for Home Care and Hospice Certification (NBHHC®) through the
National Association for Home Care & Hospice (NAHC). The certification is designed for
senior administrators and executives with a minimum of three years of experience in a
medium to large size agency.
Exam Details:
Length: 223 questions
Format: Multiple-choice, skills-based
Focus: Management and leadership proficiency,
Key Domains Covered:
1. Legal Requirements
2. Financial Operations
3. Payment Sources
4. Regulatory Compliance
5. Strategic Planning & Operations
6. Human Resources
7. Quality & Performance Improvement
8. Risk Management
9. Marketing & Public Relations
10. Training & Continuing Education
11. Ethics
12. Technology Application
,13. Policy & Advocacy
SECTION 1: LEGAL & REGULATORY COMPLIANCE
1. A home health agency receives a notice of a scheduled survey from its
accrediting body. The executive's best initial response is to:
A) Postpone the survey until all staff are fully trained
B) Conduct an internal mock survey to identify and address deficiencies
C) Cancel all patient visits during the survey period
D) Hire external consultants to manage the survey process
Answer: B ✅
Rationale: A mock survey is the best proactive approach to identify and correct deficiencies
before the actual survey. Survey readiness is an ongoing process, not something that
should be postponed. Canceling patient visits is not appropriate, and while consultants can
be helpful, internal preparation is essential.
2. Under the Conditions of Participation (CoPs) for Home Health, which of the
following is a requirement for patient care planning?
A) A plan of care must be established within 48 hours of admission
B) The plan of care must be reviewed and updated every 30 days
C) The plan of care must be developed by the physician only
D) The plan of care must be reviewed at least every 90 days
Answer: A ✅
Rationale: Medicare Conditions of Participation require that a plan of care be established
within 48 hours of the patient's admission to home health services. The plan must be
reviewed and updated at least every 60 days, not 30 or 90. The interdisciplinary team, not
just the physician, participates in care planning.
, 3. A hospice agency is undergoing a survey by the state survey agency. The
surveyor requests access to patient records. The executive should:
A) Refuse access without a subpoena
B) Allow access to all requested records
C) Allow access but redact all patient identifiers
D) Request the surveyor to sign a confidentiality agreement
Answer: B ✅
Rationale: Surveyors have the legal authority to review patient records during surveys.
HIPAA permits disclosure for oversight and survey activities. Refusing access would
constitute a deficiency. Redaction would defeat the purpose of the survey.
4. Which federal law requires home health and hospice agencies to have a
compliance and ethics program?
A) HIPAA
B) False Claims Act
C) Deficit Reduction Act of 2005
D) Affordable Care Act
Answer: C ✅
Rationale: The Deficit Reduction Act of 2005 requires providers that receive annual
Medicaid payments of $5 million or more to have a compliance and ethics program.
HIPAA addresses privacy, the False Claims Act addresses fraud, and the ACA addresses
access.
5. A hospice executive receives a report from the compliance officer about
potential billing irregularities. The executive's FIRST action should be to:
A) Terminate the employees involved
B) Conduct an internal investigation
C) Self-disclose to the OIG
D) Ignore the report
, Answer: B ✅
Rationale: The first step is to conduct an internal investigation to determine the validity
and scope of the allegations. Self-disclosure may be appropriate after the investigation.
Termination should follow due process. Ignoring the report is a breach of fiduciary duty.
6. Under the Emergency Medical Treatment & Labor Act (EMTALA), which of the
following applies to home health and hospice agencies?
A) Full EMTALA compliance is required for all agencies
B) EMTALA does not apply to home health or hospice agencies
C) Only agencies with emergency departments must comply
D) Hospice agencies must have emergency transfer agreements
Answer: B ✅
Rationale: EMTALA applies to hospitals with emergency departments, not to home health
or hospice agencies. Home health and hospice agencies are not subject to EMTALA
requirements.
7. The Conditions of Participation (CoPs) for Hospice require that a plan of care is
established:
A) Within 48 hours of admission
B) At the time of the initial comprehensive assessment
C) Within 5 days of admission
D) At the interdisciplinary team meeting
Answer: B ✅
Rationale: The hospice CoPs require that the plan of care be established at the time of the
initial comprehensive assessment, which must be completed within 5 days of admission.
The plan is developed by the interdisciplinary group (IDG) and reviewed at IDG meetings.
