CHC Practice Test Complete Solutions
At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified
independent contractor?
a. first level appeal
b. second level appeal
c. third level appeal
d. fourth level appeal Ans- b. second level appeal
There are f...
CHC Practice Test Complete Solutions
At which level of the Medicare Part A or B appeals process is the appeal reconsidered by a qualified
independent contractor?
a. first level appeal
b. second level appeal
c. third level appeal
d. fourth level appeal Ans- b. second level appeal
There are five levels of appeal.
First level entails a redetermination of claim; second level involves reconsideration by a qualified
independent contractor; third level includes a hearing overseen by admin law judge; fourth level is a
review of Medicare Review Council; and fifth level is a judicial review in federal court.
If an at-risk patient is left unattended and has an adverse response to medication, this is known as:
a. sentinel event
b. initiator
c. latent outcome
d. slip Ans- a. sentinel event
Sentinel event is an adverse occurrence that is not in the normal progression of a patient's illness. In this
scenario, an adverse drug event is considered a sentinel event. AND whenever a sentinel events is
confirmed, the facility should perform a Root Cause Analysis (RCA).
A Latent Outcome - less apparent failures of organization or design that contributed to the error/patient
harm.
A Slip - can be a fall or an everyday risk at hospitals.
A behavioral health specialist notices a particularly high number of restraint deaths at a facility. An
analysis of the root causes of these events is most likely to indicate problems with:
a. Equipment
,b. Staff orientation and training
c. Staffing levels
d. Alarm systems Ans- b. Staff orientation and training
Equipment, staffing levels, and alarm system can also be culpable in restraint deaths, but problems with
orientation and training are much more likely.
Which piece of legislation established a new set of standards for corporate responsibility?
a. sarbanes-oxley act
b. united states patriot act
c. foreign corrupt practices act
d. stark law Ans- a. sarbanes-oxley act
Sarbanes-oxley act was passed after a series of high-profile financial scandals in early 2000s to protect
shareholders, improving corporate governance and accountability setting new set of standards for
corporate responsibility.
According to the Federal Sentencing Guidelines, which of the following factors could increase the
punishment of an organization?
a. obstruction of justice
b. violation of direct court order
c. prior history of violations
d. all of the above Ans- d. all of the above
These are aggravating factors that increase the culpability score under the FSG.
See FSG chapter 8-C2.5 https://guidelines.ussc.gov/gl/%C2%A78C2.5
When a hospital official notes that most errors are occurring at the "sharp end" she means that:
a. they involve surgical tools or knives
b. they occur in clusters
, c. they occur during the interactions between caregivers and patients
d. they are most likely to occur during busy periods Ans- c. they occur during the interactions between
caregivers and patients.
The "sharp end" and "blunt end" are used by quality management professionals to describe areas of
practice.
"Sharp end" is all of the operations that involve direct contact with patient/client/customer.
"Blunt end" is all actions that take place outside awareness of patient/client/customer.
The majority of fraud and abuse violations relate to irregularities in:
a. treatment
b. diagnosis
c. billing
d. scheduling Ans- c. billing
Which of the following words best describe the approach to punishment of the Federal Sentencing
Guidelines:
a. case-specific
b. draconian
c. consistent
d. remedial Ans- a. case-specific
FSG takes numerous factors into account when determining punishment. The range of penalties that
may be applied to a given violation is broad, and organizations may affect the severity of their
punishment with their actions subsequent to the violation
Which of the following groups may request information from the Healthcare Integrity and Protection
Data Bank?
a. professional societies with formal peer review
b. quality improvements organizations
c. plaintiff's attorneys
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