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Essentials of Health Care Compliance Final Exam Latest Update Actual Exam 150 Questions and 100% Verified Correct Answers Verified by Professor$20.49
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Essentials of Health Care Compliance Final
Exam Latest Update 2024-2025 Actual Exam 150
Questions and 100% Verified Correct Answers
Verified by Professor
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 - CORRECT ANSWER: 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.
A healthcare facility's income statement is an example of:
a. baseline audit
b. retrospective audit
c. concurrent audit
d. snapshot audit - CORRECT ANSWER: b. retrospective audit
Concurrent audit is real-time evaluations of records/policies.
Snapshot audit is a comprehensive picture of the organization at a particular time.
Baseline audit is also a comprehensive evaluation but undertaken for establishing
benchmarks against which future performance may be compared.
A hospital's medication system is vast, and various element of it fall within the purview
of several different departments. One important step forwards reducing errors in this
system is to:
,a. make each department responsible for the system as a whole
b. have each department use the same self-assessment tools
c. give a single person responsibility for overseeing the entire system
d. simplify it - CORRECT ANSWER: c. give a single person responsibility for overseeing
the entire system
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 - CORRECT ANSWER: 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
According to the Institute of Medicine, which of the following is NOT one of the domains
of quality of care?
a. government regulation
b. customization
c. safety
d. interventions consistent with the latest findings - CORRECT ANSWER: a.
government regulation
According to the OIG, which of the following would likely be the least helpful measure
for improving outpatient services?
a. describe the hospital's post-submission testing process to a fiscal intermediary
b. evaluate all possible bills for outpatient services provided at the hospital and within
the applicable time period
c. implement computer programs to identify outpatient services that are not billed
separately from inpatient services
, d. establish a regular manual review of outpatient service claims - CORRECT
ANSWER: a. describe the hospital's post-submission testing process to a fiscal
intermediary
According to title II of HIPAA, disclosure of Protected Health Information related to
which of the following actions requires the patient's express written authorization?
a. state in which the treatment occur
b. health care operations
c. treatment
d. payment - CORRECT ANSWER: a. state in which the treatment occur
A covered entity may disclose PHI for TPO (treatment, payment, and healthcare
operations)
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 - CORRECT ANSWER: 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.
Because of a doctor's poor handwriting, a prescription must be reworked before it
leaves the pharmacy. Which of the following is true?
a. the doctor should be reprimanded
b. the pharmacy should incorporate bar coding
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