True or False: Patients in a licensed inpatient bed on observation status are
considered outpatient? Answer - True
Case Managers require certain skills in the planning process. List three skills
Answer - 1. Advocacy
2. Communication
3. Leadership
What is the most common metric concurrently associated with a patient's
treatment plan? Answer - Length of Stay (LOS)
The CMS/Medicare Conditions of Participation include guidelines for
a) Patient choice in the discharge care provider
b) Patient complaint review process
c) Teachback methodology
d) Standardized patient plan of care Answer - a) Patient choice in the discharge
care provider
A case managers decision related to the selection of the most appropriate
mode of transportation to the next level of care includes:
a) mobility
b) if the patient has a h/o HTN
c) payer
, d) allergies Answer - a) Mobility
What does discharge planning and case management involve? Answer -
Developing a plan of care that implement's the physicians orders while taking
the patients rights and wishes into account
Under the conditions of participation, CMS sets clear requirements for
assessment and discharge planning for those who may suffer an adverse
outcome if the assessment is not completed. The need for a DC planning
consult may be identified by which of the following:
a) admission status
b) payer determines which patients need an assessment
c) physician consult, patient/caregiver request, and medical record review
d) all of the above Answer - c) physician consult, patient/caregiver request,
and medical record review
What is face to face certification for post acute home healthcare? Answer - A
billing requirement for the home health agency, a certification that the patient
is homebound, and an attestation by the attending physician that home health
services are medically necessary
Under the CMS conditions of participation for DC planning for Hospitals, the
hospital must provide a DC planning evaluation to the patients identified as
high risk, as well as:
a) If requested by the patient
b) Medicare Advantage patients
c) At the request of the insurance case manager
d) Observation patients Answer - a) If requested by the patient
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