CHC Final Exam Multiple choice. Short and long answer 2024 | Actual
Questions and Answers Latest Updated 2024/2025 (Graded A+)
7 elements - ✔✔Policies & Procedures
Oversight Responsibilities/Assignments
Oversight Responsibilities/Due Care
Education and Training
Monitoring and Auditing
Enforcement and Discipline
Response and Prevention
ECHO - ✔✔Economic, Clinical and Humanistic Outcomes
Economic Outcomes - ✔✔Comparison between the cost of what was received and the benefit derived
from alternatives
Clinical Outcomes - ✔✔Changes to moribity/mortality rates as a result of healthcare intervention
Humanistic Outcomes - ✔✔Psychological consequences of healthcare which include patient measures of
functional status, quality of life and satisfaction with care
A formal system that assures that products or services meet the characteristics associated with
excellence - ✔✔Quality Assurance
Process of identifying/evaluating quality of patient care services to ensure that a predetermined
standard is being met - ✔✔QA
Based on the assumption that quality can never be completely assured - a sustained program for
identifying opportunities is necessary - ✔✔Quality Improvement
,Continuously improve the ability of all processes to meet the needs of customers - ✔✔QI
Proactive, positive - ✔✔QI
Reactive - focus on negative (look/find errors/correct) - ✔✔QA
HMO, PPO, EPO - ✔✔Managed Care Organizations
How do you determine the effectiveness of compliance education and training? - ✔✔Program
evaluation summaries; post-tests; and internal and external monitoring and evaluation
A relative value assigned to a diagnosis related group of patients in a medical care environment -
✔✔Case Mix INdex
What is the case mix index used for? - ✔✔To determine the allocation of resources to care for and/or
treat the patients in a group.
Groups having the same condition based on main and secondary diagnosis, procedures and age,
complexity and needs - ✔✔Diagnosis Related Groups (DRG) or Resource Use Groups (RUG)
What has a relative average value assigned to it that indicates the amount of resources required to treat
patients in a group, as compared to all of the other diagnosis-related groups within the system? -
✔✔DRG
What does the CMI of a hospital reflect? - ✔✔The diversity, clinical complexity and needs for resources
in the population of all patients in the hospital
EMTALA - ✔✔Emergency Medical Treatment and Labor Act
, What does EMTALA Require? - ✔✔EDs to medically screen every patient who seeks emergency care and
to stabilize or transfer those with medical emergencies, regardless of health insurance status or ability
to pay
What is EMTALA a part of? - ✔✔COBRA
What is EMTALA designed to prevent? - ✔✔To prevent hospitals from refusing to see or transferring
financially undesirable patients to public hospitals without, at a minimum, providing a medical screening
examination and treatment to ensure they are stable for transfer.
What are the CMPs for hospitals and physicians who violate EMTALA? - ✔✔$50,000 per violation
What is another penalty of violating EMTALA besides CMPs? - ✔✔Threat of Medicare decertification
Any individual who comes and requests exam or treatment of a medical condition must receive a
medical screening exam to determine whether an emergency medical condition exists.
If an emergency medical condition exits, treatment must be provided until it is resolved or stabilized
Hospitals with specialized capabilities are obligated to accept transfers from hospitals who lack the
capability to treat unstable emergency medical conditions. - ✔✔EMTALA Objectives
When is a patient considered stable for transfer under EMTALA? - ✔✔IF the treating physician
determines that no material deterioration is reasonably likely to occur during or as a result of the
transfer between facilities.
If a patient is unstable, can the hospital transfer the patient under EMTALA? - ✔✔Only if one of the two
below:
A physician certifies the medical benefits expected from the transfer outweigh the risks
A patient makes a transfer request in writing after being informed of the hospital's obligations under
EMTALA and the risks of transfer.
Questions and Answers Latest Updated 2024/2025 (Graded A+)
7 elements - ✔✔Policies & Procedures
Oversight Responsibilities/Assignments
Oversight Responsibilities/Due Care
Education and Training
Monitoring and Auditing
Enforcement and Discipline
Response and Prevention
ECHO - ✔✔Economic, Clinical and Humanistic Outcomes
Economic Outcomes - ✔✔Comparison between the cost of what was received and the benefit derived
from alternatives
Clinical Outcomes - ✔✔Changes to moribity/mortality rates as a result of healthcare intervention
Humanistic Outcomes - ✔✔Psychological consequences of healthcare which include patient measures of
functional status, quality of life and satisfaction with care
A formal system that assures that products or services meet the characteristics associated with
excellence - ✔✔Quality Assurance
Process of identifying/evaluating quality of patient care services to ensure that a predetermined
standard is being met - ✔✔QA
Based on the assumption that quality can never be completely assured - a sustained program for
identifying opportunities is necessary - ✔✔Quality Improvement
,Continuously improve the ability of all processes to meet the needs of customers - ✔✔QI
Proactive, positive - ✔✔QI
Reactive - focus on negative (look/find errors/correct) - ✔✔QA
HMO, PPO, EPO - ✔✔Managed Care Organizations
How do you determine the effectiveness of compliance education and training? - ✔✔Program
evaluation summaries; post-tests; and internal and external monitoring and evaluation
A relative value assigned to a diagnosis related group of patients in a medical care environment -
✔✔Case Mix INdex
What is the case mix index used for? - ✔✔To determine the allocation of resources to care for and/or
treat the patients in a group.
Groups having the same condition based on main and secondary diagnosis, procedures and age,
complexity and needs - ✔✔Diagnosis Related Groups (DRG) or Resource Use Groups (RUG)
What has a relative average value assigned to it that indicates the amount of resources required to treat
patients in a group, as compared to all of the other diagnosis-related groups within the system? -
✔✔DRG
What does the CMI of a hospital reflect? - ✔✔The diversity, clinical complexity and needs for resources
in the population of all patients in the hospital
EMTALA - ✔✔Emergency Medical Treatment and Labor Act
, What does EMTALA Require? - ✔✔EDs to medically screen every patient who seeks emergency care and
to stabilize or transfer those with medical emergencies, regardless of health insurance status or ability
to pay
What is EMTALA a part of? - ✔✔COBRA
What is EMTALA designed to prevent? - ✔✔To prevent hospitals from refusing to see or transferring
financially undesirable patients to public hospitals without, at a minimum, providing a medical screening
examination and treatment to ensure they are stable for transfer.
What are the CMPs for hospitals and physicians who violate EMTALA? - ✔✔$50,000 per violation
What is another penalty of violating EMTALA besides CMPs? - ✔✔Threat of Medicare decertification
Any individual who comes and requests exam or treatment of a medical condition must receive a
medical screening exam to determine whether an emergency medical condition exists.
If an emergency medical condition exits, treatment must be provided until it is resolved or stabilized
Hospitals with specialized capabilities are obligated to accept transfers from hospitals who lack the
capability to treat unstable emergency medical conditions. - ✔✔EMTALA Objectives
When is a patient considered stable for transfer under EMTALA? - ✔✔IF the treating physician
determines that no material deterioration is reasonably likely to occur during or as a result of the
transfer between facilities.
If a patient is unstable, can the hospital transfer the patient under EMTALA? - ✔✔Only if one of the two
below:
A physician certifies the medical benefits expected from the transfer outweigh the risks
A patient makes a transfer request in writing after being informed of the hospital's obligations under
EMTALA and the risks of transfer.
