CPHRM EXAM PREP - HEALTHCARE
OPERATIONS QUESTIONS WITH 100%
ACCURATE ANSWERS
What's the primary goal of a Risk Management Program? - Accurate answers To comply with
regulatory and accreditation mandates and maintaining regulatory readiness for any type of external
review or survey.
To foster org's mission and strategic plan.
and
To identify risks and opportunities to avoid patient harm, and damage to the organization or its
workforce.
True of False:
The facility's risk management program should be consistently reviewed and reassessed for
effectiveness. - Accurate answers TRUE
Especially as new services are added and business operations change or expand.
Differentiate between for-profit and nonprofit healthcare operations - Accurate answers For-
profit:
1. Shareholders owns the corp.
2. Shareholders hope to profit from the biz.
3. Board of director governs the org with the goal of maximizing profits.
4. Board members are often paid a salary/stipend
Non-profit:
1. No shareholders
2. Governing body doesn't own or profit from the org/biz.
3. Board of directors governs the org with the goal of pursuing the charitable mission. Org's profits must
be applied back to the org rather than being distributed to shareholders
4. Board members are unpaid/volunteers
Policies that address key areas of risk management and patient safety - Accurate answers ➤Report
concerns related policy (e.g., patient grievance policy). A process for reporting concerns and
confidentiality requirements.
➤Product recall related policy (e.g., product recall, product safety and alerts). process for tracking and
responding to recalls/defected devices.
➤Patient safety events policy (including definitions of near misses, adverse events, root cause analysis
for sentinel events, etc.)
➤Informed Consent policy (required form to be included in the patient consent process).
➤Confidentiality of health info/PHI policy (HIPAA requirement to protect PHI/PII).
Define regulatory and accreditation compliance, and related risk activities - Accurate answers
Includes activities to ensure compliance with federal and state laws, as well as accreditation standards.
This involves:
, ➤Compliance with OSHA, EMTALA, SMDA, HIPAA, and CMS
➤Facilitating compliance with accreditation standards (Joint Commission, DNV, URAC, etc.)
➤Reporting certain events to state surveyors/agencies (e.g., abuse, domestic violence, workplace
violence)
➤Promoting awareness of patient safety initiatives (IHI, Institute for Healthcare Improvement)
➤Facilitating compliance with State Emergency Preparedness initiatives
➤Monitoring and reporting public health issues/trends
Define risk financing, including key activities - Accurate answers Risk financing include analysis and
decision making regarding the allocation of risk, whether retained by the facility or transferred via
insurance purchase. This involves:
➤Tracking and trending data regarding losses and potential exposures for the org.
➤Completing insurance applications and renewals.
➤Collaborating with brokers, underwriters, a nd actuaries to determine risk financing needs of the org.
➤Evaluating lines of coverage, limits, and deductibles to ensure that potential exposures are adequately
covered.
➤Exploring risk financing options, including insurance purchase, retention, captives, and risk retention
groups to meet the needs of the org.
➤Monitoring and evaluating the effectiveness of the org's risk financing program.
Define loss prevention and reduction, include key activities - Accurate answers Loss Prevention and
reduction includes the identification, analysis, and control risk within the org. This involves:
➤Develop methods to identify risks (occurrence reporting, medical record review, patient grievance,
review of quality data).
➤Conducting risk assessment and audits (corrective action planning and performance improvement)
➤Participating in patient safety initiatives (safety rounds, safety culture surveys)
➤Collaborating with key departments (quality, medical staff services, infection prevention, patient
advocacy/experience, etc.)
➤Reporting risk management trends to senior leadership
➤Completing root cause analyses (RCA) of significant safety events.
➤Educating staff on patient safety topics
➤Reviewing agreements for potential risks
Outline steps of risk management process - Accurate answers Risk identification
Risk analysis (e.g., severity levels, categories)
Risk techniques includes: Risk Control (preventing/mitigating the impact of losses) and Risk Financing
(paying for unavoidable losses).
List key elements of any healthcare contract - Accurate answers Outline of the terms (who will
provide and pay for the services)
Timeline (for providing the goods/services)
Compliance with the terms
Breach of contract (remedies)
Termination
Insurance requirements
Notice requirements
Indemnification clause (one party will not hold the other responsibly or reimburse the other for
damages)
OPERATIONS QUESTIONS WITH 100%
ACCURATE ANSWERS
What's the primary goal of a Risk Management Program? - Accurate answers To comply with
regulatory and accreditation mandates and maintaining regulatory readiness for any type of external
review or survey.
To foster org's mission and strategic plan.
and
To identify risks and opportunities to avoid patient harm, and damage to the organization or its
workforce.
True of False:
The facility's risk management program should be consistently reviewed and reassessed for
effectiveness. - Accurate answers TRUE
Especially as new services are added and business operations change or expand.
Differentiate between for-profit and nonprofit healthcare operations - Accurate answers For-
profit:
1. Shareholders owns the corp.
2. Shareholders hope to profit from the biz.
3. Board of director governs the org with the goal of maximizing profits.
4. Board members are often paid a salary/stipend
Non-profit:
1. No shareholders
2. Governing body doesn't own or profit from the org/biz.
3. Board of directors governs the org with the goal of pursuing the charitable mission. Org's profits must
be applied back to the org rather than being distributed to shareholders
4. Board members are unpaid/volunteers
Policies that address key areas of risk management and patient safety - Accurate answers ➤Report
concerns related policy (e.g., patient grievance policy). A process for reporting concerns and
confidentiality requirements.
➤Product recall related policy (e.g., product recall, product safety and alerts). process for tracking and
responding to recalls/defected devices.
➤Patient safety events policy (including definitions of near misses, adverse events, root cause analysis
for sentinel events, etc.)
➤Informed Consent policy (required form to be included in the patient consent process).
➤Confidentiality of health info/PHI policy (HIPAA requirement to protect PHI/PII).
Define regulatory and accreditation compliance, and related risk activities - Accurate answers
Includes activities to ensure compliance with federal and state laws, as well as accreditation standards.
This involves:
, ➤Compliance with OSHA, EMTALA, SMDA, HIPAA, and CMS
➤Facilitating compliance with accreditation standards (Joint Commission, DNV, URAC, etc.)
➤Reporting certain events to state surveyors/agencies (e.g., abuse, domestic violence, workplace
violence)
➤Promoting awareness of patient safety initiatives (IHI, Institute for Healthcare Improvement)
➤Facilitating compliance with State Emergency Preparedness initiatives
➤Monitoring and reporting public health issues/trends
Define risk financing, including key activities - Accurate answers Risk financing include analysis and
decision making regarding the allocation of risk, whether retained by the facility or transferred via
insurance purchase. This involves:
➤Tracking and trending data regarding losses and potential exposures for the org.
➤Completing insurance applications and renewals.
➤Collaborating with brokers, underwriters, a nd actuaries to determine risk financing needs of the org.
➤Evaluating lines of coverage, limits, and deductibles to ensure that potential exposures are adequately
covered.
➤Exploring risk financing options, including insurance purchase, retention, captives, and risk retention
groups to meet the needs of the org.
➤Monitoring and evaluating the effectiveness of the org's risk financing program.
Define loss prevention and reduction, include key activities - Accurate answers Loss Prevention and
reduction includes the identification, analysis, and control risk within the org. This involves:
➤Develop methods to identify risks (occurrence reporting, medical record review, patient grievance,
review of quality data).
➤Conducting risk assessment and audits (corrective action planning and performance improvement)
➤Participating in patient safety initiatives (safety rounds, safety culture surveys)
➤Collaborating with key departments (quality, medical staff services, infection prevention, patient
advocacy/experience, etc.)
➤Reporting risk management trends to senior leadership
➤Completing root cause analyses (RCA) of significant safety events.
➤Educating staff on patient safety topics
➤Reviewing agreements for potential risks
Outline steps of risk management process - Accurate answers Risk identification
Risk analysis (e.g., severity levels, categories)
Risk techniques includes: Risk Control (preventing/mitigating the impact of losses) and Risk Financing
(paying for unavoidable losses).
List key elements of any healthcare contract - Accurate answers Outline of the terms (who will
provide and pay for the services)
Timeline (for providing the goods/services)
Compliance with the terms
Breach of contract (remedies)
Termination
Insurance requirements
Notice requirements
Indemnification clause (one party will not hold the other responsibly or reimburse the other for
damages)
