Questions and CORRECT Answers
For Cause Survey - CORRECT ANSWER - investigate a specific issue based on
patient/family complaint
Triennial Survey - CORRECT ANSWER - a team of surveyors evaluate the organization
and the healthcare being provided based on "tracer" evaluations of a sample of the patient
population and the organization's processes
Example of federal and state laws - CORRECT ANSWER - board/licensure, NFPA,
deemOSHA
Example of additional optional disease specific certifications - CORRECT ANSWER -
stroke, VAD, spine, COPD
Example of CMS certification & accreditation by approved agency - CORRECT
ANSWER - TJC, DNV, CIHQ
deemed status - CORRECT ANSWER - An official accreditation indicating that a
healthcare facility is in compliance with the CMS regulations
Joint Commission surveys - CORRECT ANSWER - instead of CMS certification surveys,
organizations can voluntarily participate in these, which are completely unannounced inspections
at a minimum of once every 36 months
How many chapters are in the joint commission? - CORRECT ANSWER - 18
How many standards are in the joint commission? - CORRECT ANSWER - 275
, How many elements of performance are in the joint commission? - CORRECT
ANSWER - 1568
APR - CORRECT ANSWER - accreditation participation requirements
EC - CORRECT ANSWER - environment of care
EM - CORRECT ANSWER - emergency management
HR - CORRECT ANSWER - human resources
IC - CORRECT ANSWER - infection prevention and control
IM - CORRECT ANSWER - information management
LD - CORRECT ANSWER - leadership
LS - CORRECT ANSWER - life safety
MM - CORRECT ANSWER - medication management
MS - CORRECT ANSWER - medical staff
NPSG - CORRECT ANSWER - national patient safety goals
NR - CORRECT ANSWER - nursing