saint hca303 final exam

 

 

1. The difference between a hospital's charges for an inpatient stay in the facility and the amount the hospital has agreed to accept from the patient's insurance carrier is called:

1. Capitation

 

1. A contractual allowance
2. Fee-for-service
3. Uncompensated care

 

 

1. Which of the following is NOT a possible outcome of the decision-making process in cost accounting in health care organizations?

1. Elimination of services that are losing money
2. Enhancement of departments that are making money
3. Management of "loss leaders" to the organization
4. Management of financial investments for the organization

 

 

1. The largest category of health care workers is:

 

1. Nurses
2. Physicians
3. Respiratory Therapists
4. Physician Assistants
5. Occupational Therapists

 

 

1. Residency training lasts from                    , depending on the specialty.

1. 6 months to a year
2. 4 to 5 years
3. 1 to 2 years

 

1. 3 to 10 years
2. 12 to 15 years

 

 

1. The impetus to change resident work hours was:

 

1. The death of Libby Zion
2. Strong unions
3. Concerns about paying overtime
4. Worries that doctors were too tired
5. All of these are correct.
6. None of these are correct.

 

 

1. Licensure is:

1. Voluntary for medical practice
2. Granted by the state
3. Mandatory for medical and nursing practice
4. Granted by the state, and mandatory for medical and nursing practice
5. Voluntary for medical practice, and mandatory for medical and nursing practice

 

 

1. Criminal background checks for nurses and physicians are:

1. Voluntary
2. Not required to practice nursing

 

1. Mandatory in most states for licensure
2. An invasion of privacy
3. Voluntary, and not required to practice nursing
4. None of these are correct.

 

 

1. Board certification is:

1. Mandatory
2. Part of a criminal background check
3. Involuntary
4. A form of credentialing that a physician has competency in a specific area

 

1. The highest forecast percentage growth in health occupations employment by 2022 is for which of the following occupations?

1. Physician Assistants
2. tered Nurses
3. Physicians and Surgeons
4. Medical and Health Services Managers
5. None of these are correct.

 

 

1. Which of the following is an example of a "workforce planning and recruitment" function?

1. Offering training and development
2. Assessing employee performance
3. Managing compensation and benefits
4. Advertising for employees

 

 

1. Private health insurance coverage includes all of the following EXCEPT:

1. PPOs
2. HMOs
3. Indemnity plans
4. SNFs
5. HDHPs
6. All of these are correct.

 

 

1. The growth in health insurance in the U.S. came about as a result of all of the following EXCEPT:

1. The rising cost of health care
2. The increased government role in providing access to care
3. The urging of employers to add this benefit
4. The involvement of unions and collective bargaining

 

1. In purchasing health insurance, which of the following is NOT typically a consideration?

1. Benefit packages
2. Provider choice
3. Ethical issues
4. Coinsurance

 

 

1. Which type of HMO offers the most flexibility for participating physicians?

 

1. Independent Practice Association
2. Closed-panel HMO
3. Open-panel HMO
4. None of these are correct.

 

 

1. Which type of managed care plan offers patients flexibility in accessing their physician of choice?

1. Health Maintenance Organization
2. Preferred Provider Organization
3. Point of Service Plan
4. All of these are correct.

 

1. Preferred Provider Organization and Point of Service Plan

 

 

1. Access to the care of specialist physicians is limited in which type of health plan?

1. Point of Service Plan
2. Conventional Indemnity Plan
3. Preferred Provider Organization
4. All of these are correct.
5. None of these are correct.

 

 

1. The chief financial officer (CFO) of a hospital supervises all of the following officers EXCEPT:

1. The controller
2. The treasurer

 

1. The internal auditor
2. The independent auditor

 

 

1. The Medicare prospective payment system for reimbursing hospitals utilizes:

1. A "Cost Plus" charging system
2. DRGs
3. Per diem rates
4. The RBRVS system

 

 

1. Which of the following is NOT a characteristic of not-for-profit health care organizations?

1. Must provide designated amounts of community benefit
2. Revenues cannot benefit individuals in the organization
3. May participate in political campaigns
4. Are exempt from paying taxes and most business fees

 

 

1. The Balanced Budget Act of 1997 implemented cost controls for Medicare expenditures in all of the following health care sectors EXCEPT:

1. Home health agencies
2. Outpatient hospitals and clinics

 

1. Pharmaceutical companies
2. Skilled nursing facilities

 

 

1. Incentive compensation is believed to have what effect on employee performance?

1. Increase retention

 

1. Increase motivation
2. Decrease performance
3. No effect

 

 

1. Performance appraisals are useful to:

 

1. Identify areas of performance needing improvement
2. Adjust based on performance

 

1. Decide promotions of staff
2. All of these are correct.

 

 

1. The low supply of some health care workers (e.g., nurses) has led to which of the following impacts on HSOs?

1. Lower satisfaction for existing staff
2. Lower human resources costs
3. Higher satisfaction for existing staff
4. Higher retention of existing staff
5. Greater motivation of existing staff

 

 

1. Flexible benefits are helpful to employees because:

1. They can choose benefits in line with their needs
2. Coverage is limited to high-quality providers
3. Employer covers total cost
4. All of these are correct.

 

 

1. A team is:

1. A sports franchise
2. A short-term group pulled together to address a specific agenda that disbands after a report is issued
3. A group of people working together to achieve a common goal
4. A long-term entity with revolving members, elected for three-year terms, staffed by a full-time employee
5. None of these are correct.

 

 

1. One of the ways to engage medical staff is to:

1. Buy them cars
2. Give them free lunches

 

1. Promote alignment between hospitals and physicians
2. Allow them to make all the decisions
3. All of these are correct.

 

 

1. Which of the following is NOT a benefit of effective health care teams?

1. Improved coordination of care

 

1. Less efficient use of health care services
2. Increased job satisfaction among team members
3. Higher patient satisfaction
4. All of these are correct.

 

 

1. Which of the following is NOT correct about Cross Functional Teams (CFTs)?

1. They are not common in health care organizations.
2. They address specific organizational needs.
3. They include clinicians.
4. All of these are correct.
5. None of these are correct.

 

 

1. Teamwork is NOT taught in:

1. Nursing school
2. Medical school
3. Allied health programs
4. All of these are correct.

 

1. None of these are correct.

 

 

1. Participation in the VHA Medical Team Training program was NOT associated with:

1. Higher patient satisfaction
2. Increased productivity
3. A higher surgical mortality rate

 

1. Greater costs of health care delivery

 

1. None of these are correct.

 

 

1. Health disparities have been identified based on the following criteria:

1. Race
2. Ethnicity
3. Sexual orientation
4. Language
5. Income
6. All of these are correct.

 

 

1. The CLAS Standards:

1. If not implemented, cause hospitals to face steep fines and legal ramifications
2. Inform, guide, and facilitate culturally and linguistically appropriate practices across the continuum of health care services
3. Suggest guidelines for how to practice medicine, particularly preventive care for underserved populations
4. Offer free translation services for every language

 

 

1. Social determinants that contribute to health disparities include:

1. Living or working conditions
2. Geographic isolation
3. Income and socioeconomic status
4. Education
5. Access to insurance
6. All of these are correct.

 

 

1. Structural barriers may impede patient care and increase disparities; for example:

1. Providers who don’t respect traditional healing practices of Native Americans
2. Clinic hours from 9 to 5 when most workers cannot take time off for an appointment

 

1. Beliefs that only traditional Western medicine is appropriate
2. Research data that shows a higher incidence of cardiovascular disease among minorities

 

 

1. Select all the terms that can be used interchangeably with cultural competency:

1. Cultural autonomy
2. Cultural proficiency
3. Cultural conditioning
4. Cultural sensitivity
5. Cultural proficiency, cultural conditioning, and cultural sensitivity

 

 

1. Concerns with the term cultural competence include:

1. Changing nature
2. Inability to achieve 100%
3. Difficulty measuring
4. Subjectivity
5. Changing nature, inability to achieve 100%, difficulty measuring, and subjectivity

 

 

1. Which of the following is not a primary source of ethics?

1. Personal beliefs
2. Legal decisions
3. Family traditions
4. Religion
5. Community culture

 

 

1. What are the main sources of American law?

1. Legislatures
2. Judicial decisions
3. Executive orders and administrative regulations
4. State and federal constitutions

 

1. All of these are correct.

 

 

1. What are some of the ways in which health care organizations protect the rights of their patients?

1. Utilization review processes
2. Institutional review boards
3. Patient advocacy or ombudsman offices
4. Institutional ethics committees

 

1. All of these are correct.

 

 

1. A wrong against society as a whole, even if a particular individual is harmed, is considered a violation of which type of law?

1. Civil

 

1. Criminal
2. Administrative
3. All of these are correct.
4. None of these are correct.

 

 

1. Contract violations are generally considered to be part of which type of law?

1. Criminal

 

1. Civil
2. Administrative
3. All of these are correct.
4. None of these are correct.

 

 

1. Which of these elements is NOT necessary for a contract to be binding?

1. An agreement between two or more parties
2. Must be for something of value
3. Must be lawful

 

1. Must be written

 

1. Both must be competent to consent

 

 

1. The investigative and enforcement authority to deal with fraud and abuse violations was granted to the Department of Health and Human Services (DHHS) through:

1. False Claims Act
2. Stark Laws

 

1. Operation Restore Trust
2. Anti-Kickback Act

 

 

1. Examples of health care fraud and abuse include:

1. Claims do not meet medical necessity
2. Duplicate billing
3. Upcoding of services
4. Kickbacks for referrals

 

1. All of these are correct.

 

 

1. Violations of the Criminal Disclosure Provision of the Social Security Act include which of the following penalties?

1. No criminal penalties
2. Up to 10 years in prison and/or $50,000 in fines
3. Up to 1 year in prison and/or up to $10,000 in fines

 

1. Up to 5 years in prison and/or up to $25,000 in fines
2. None of these are correct.

 

 

1. An example of a Stark Law violation is:

1. A hospital offering a physician office space at fair market value
2. Paying a physician for a referral
3. Hiring a doctor who is an excluded party as a Medicare Provider
4. Upcoding a claim to receive higher reimbursement
5. All of these are correct.

 

 

 

1. Violations of the Emergency Medical Treatment and Active Labor Act (EMTALA) include all of the following, except:

1. Dumping a patient on another hospital because they are very sick
2. Diverting a patient to another hospital because they are unable to pay for services
3. Completing a Medical Screening exam and stabilizing the patient
4. Refusing to treat a patient because their benefits are better at a different hospital
5. None of these are correct.

 

 

1. The Anti-Kickback Statutes:

1. Only apply civil penalties for willful payment or receipt of money for referring patients
2. Impose a civil monetary penalty of $10,000 per violation
3. Are not restricted by the Safe Harbor Laws
4. Impose criminal liability for the knowing and willful payment of any kind or receipt of payment of any kind for a patient or service referral
5. All of these are correct.

 

 

1. Seven essential elements of an effective compliance program include:

1. Establishing compliance standards of conduct and procedures
2. Overall compliance program oversight
3. Due care in delegation of authority
4. Monitoring and auditing systems

 

1. All of these are correct.

 

 

1. Gursky identified which of the following issues putting rural hospitals at risk for bioterrorism?

1. Lack of training on how to identify early signs of potential biological hazards
2. Lack of reliable communication equipment
3. Lack of vaccinations
4. Lack of quarantine facilities or up-to-date facilities
5. None of these are correct.

 

 

 

1. Human error is:

1. Intentional act
2. Disregard for human life

 

1. Inadvertent slip, lapse, or mistake
2. All of these are correct.
3. None of these are correct.

 

 

1. Human trafficking involves:

1. Modern-day slavery
2. Exploitation of laborers
3. Exploitation of women and children
4. Sexual exploitation

 

1. All of these are correct.
2. None of these are correct.

 

 

1. Medical tourism includes:

1. Outbound
2. Inbound
3. Intrabound

 

1. All of these are correct.
2. None of these are correct.

 

 

1. Which of the following is NOT an example of stalking?

1. Unwanted phone calls, texts, letters, emails, or social media posts
2. Following or spying on a person
3. Leaving unwanted items, gifts, or flowers

 

1. Spreading rumors about someone
2. All of these are correct.

 

1. None of these are correct.