AHA Certified Professional in Healthcare Risk Management Practice Test

CPHRM test Format | Course Contents | Course Outline | test Syllabus | test Objectives

- Assess the current state of patient safety and staff awareness within the organization
- Collaborate on proactive patient safety initiatives
- FMEA
- RCA
- Safety Culture
- Just Culture
- Design, implement, and maintain educational programs on risk management and patient safety related topics

- Promote a culture of patient safety through education, policy development, and standardization of processes
- Educate providers, staff, employees, patients and families on the role of patients and families in improving patient safety and reducing risk
- Coach physicians, leaders, managers, and staff on appropriate disclosure methods and processes
- Participate in critical incident debriefing

- Participate in the development of corrective action plans and supervise follow-up of recommended improvements
- stemming from risk assessments
- audits and investigations of reported incidents
- Provide guidance to staff regarding any of the following:
- disruptive patient, family member and/or visitors
- informed consent
- substitute (Surrogate) Decision Makers
- minors consent
- release of information
- law enforcement
- subpoenas
- attorneys
- search warrants
- abuse allegations
- advance directives/orders for life sustaining treatment
- Manage an incident reporting and data analysis system for patient safety, patient complaints, and other risk events
- Provide risk management consultation for specific ethical dilemmas
- Maintain awareness of patient safety initiatives occurring locally and nationally
- Review documentation and assist providers/staff with appropriate documentation to mitigate risk

- Manage a broad comprehensive insurance program including such activities as captive management
- insurance
- insurance purchasing
- insurance consulting
- administering self‐insured coverages
- managing or coordinating the management of claims for all lines of insurance

- Oversee the investigation of accidents or circumstances that could lead to financial loss
- professional
- institutional
- general liability
- product liability

- Analyze historical loss experience; address trends
- Develop enterprise risk financing strategies to address the organization's areas of exposure
- general liability (GL)
- professional liability (PL)
- cyber liability

- Provide recommendations to reduce risk in contracts, ensuring adequate controls and obligations for insurance coverage are appropriate to the risk
- Ensure timely reporting of incidents according to insurance policy language

- Promote compliance with federal and state laws and regulations through policy development, guidance, or education
- Promote compliance with federal and state laws and regulations governing patient confidentiality through policy development
- guidance
- education including protected health information (PHI)
- Promote compliance with federal and state reporting requirements through policy development, guidance, or education
- abuse of vulnerable populations

- Promote compliance with federal and state reporting requirements governing violence in the workplace through policy development, guidance, or education
- Promote compliance with federal and state regulations/organization policy regarding the investigation and resolution of patient complaints or grievances through policy development, guidance, or education
- Collaborate with other departments by preparing and conducting quality and/or risk assessments to maintain a constant state of accreditation readiness

- Promote compliance with laws and regulations governing involuntary detention of patients through policy development, guidance, or education
- Promote compliance with the requirements of the following federal acts/regulations through policy development, guidance, or education:
- Centers for Medicare and Medicaid Services (CMS)
- Emergency Medical Treatment and Active Labor Act (EMTALA/COBRA)
- Health Insurance Portability and Accountability Act (HIPAA)
- National Practitioner Data Bank (NPDB)
- Safe Medical Device Act (SMDA)

- Design a risk management data collection/analysis system to ensure timely reporting and monitoring of:
- device reporting and tracking logs
- regulatory inquiries
- Collaborate in the development of the organization's regulatory compliance plan to ensure workforce compliance of all applicable accreditation standards
- Promote, in partnership with Patient Safety and Medical Staff departments, programs that address provider and staff behavioral issues are culturally, legally and psychologically sound and non-discriminatory
- Participate in the development of responses to inquiries from regulatory and licensing agencies, and insurance companies

- Collaborate with leaders and security personnel on workplace violence prevention
- Conduct risk assessments to identify exposures related to new and existing services and enterprise‐wide services
- Establish a method for planning, evaluating, selecting, management, and on‐going evaluation of enterprise wide event reports of harm or near‐harm incidents
- Supervise and develop risk management staff

- Develop/maintain risk management department specific policies and procedures and modify as required
- Coordinate risk activities for the organization
- Develop annual institutional goals for the risk program/department
- Evaluate the effectiveness of risk management activities
- Develop policies and procedures for acceptance of legal documents
- summons
- complaints
- subpoenas
- court orders

- Support patient safety committee meetings by collecting and formulating relevant information to facilitate decision-making process
- Participate in professional association activities
- Understand the peer review, credentialing and privileging process
- Provide education/in‐service for staff, patients, families, communities on patient’s rights
- end of life decisions

- Collaborate on the development of policies and procedures which provide direction to the organization on syllabus which have a significant degree of risk
- Privacy
- Informed Consent
- Infection Prevention
- Documentation
- Telemedicine


- Maintain data collection and analysis systems including elements of reports of Potential Compensatory Events (PCEs), open and closed claims and loss runs
- Notify carriers and/or third-party claims and litigation department or administrators of potential compensatory events or actual claims
- Participate in claims management activities
- assignment of counsel
- setting loss reserves
- respond to discovery requests/interrogatories
- preparation and attendance for depositions
- mediation
- arbitration
- trials
- evidence/record preservation and management
- review and approve legal expenses

- Participate in evaluating claims to determine exposure to organization and the appropriate method for resolution
- Inform administration of high exposure cases and aggregate claims experience, including any impact to the risk financing program.
- Manage and maintain all information related to a potential or actual legal case under attorney/client privilege and protected from discoverability
- Manage the response to service of process and notify appropriate parties of such service
- Support insured defendants through all phases of the litigation process

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AHA Certified Professional in Healthcare Risk Management
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Question: 1
Which of the following is a responsibility of the CPHRM in relation to claims and litigation?
1. Providing direct patient care during legal proceedings
2. Setting loss reserves for potential compensatory events
eviewing and approving medical research studies wer: B
anation: The CPHRM is responsible for setting loss reserves for poten pensatory events as part of claims and litigation management. Loss ves are estimates of the potential financial liability associated with cla re used for financial planning and reporting purposes.
stion: 2
ch of the following federal acts/regulations does the CPHRM promote pliance with through policy development, guidance, or education?
ccupational Safety and Health Act (OSHA)
ood and Drug Administration (FDA) regulations
mergency Medical Treatment and Active Labor Act (EMTALA/COB ederal Communications Commission (FCC) regulations
Conducting forensic investigations of potential malpractice cases
3. R
Ans
Expl tial
com
reser ims
and a
Que
Whi com
1. O
2. F
3. E RA)
4. F
Answer: C
Explanation: The CPHRM promotes compliance with the Emergency Medical Treatment and Active Labor Act (EMTALA/COBRA) through policy development, guidance, or education. EMTALA/COBRA is a federal act that requires hospitals with emergency departments to provide medical screening
examinations and stabilize patients who have emergency medical conditions, regardless of their ability to pay.
Question: 3
Which of the following is an example of a risk assessment conducted by the CPHRM?
inancial analysis of the organization's investments nalysis of patient satisfaction survey results valuation of employee performance
dentification of exposures related to new and existing services wer: D
anation: The CPHRM conducts risk assessments to identify exposures ed to new and existing services. This involves assessing potential risk erabilities associated with the organization's services and developing egies to mitigate those risks.
stion: 4
ch of the following activities does the CPHRM participate in when onding to inquiries from regulatory and licensing agencies, and insura panies?
F
A
E
I
Ans Expl
relat s and
vuln strat
Que
Whi
resp nce
com
1. Negotiating physician contracts
2. Conducting clinical trials
3. Reviewing patient medical records for billing purposes
4. Providing requested documentation and information Answer: D
Explanation: The CPHRM participates in providing requested documentation and information when responding to inquiries from regulatory and licensing agencies, and insurance companies. This may involve gathering relevant records, reports, and other documents to address the inquiries.
Question: 5
wing should a risk management professional ensure?
orkforce compliance with accreditation standards ollaboration with patient safety and medical staff departments
ultural, legal, and psychological soundness of programs addressing vioral issues
on-discriminatory practices in provider and staff management
nd 2 only
2, and 3 only
3, and 4 only
2, 3, and 4 wer: D
anation: A risk management professional plays a crucial role in devel rganization's regulatory compliance plan. Workforce compliance with editation standards is essential to ensure that the organization meets th
In developing the organization's regulatory compliance plan, which of the follo
1: W
2: C
3: C
beha 4: N
1. 1 a
2. 1,
3. 2,
4. 1,
Ans
Expl oping
the o
accr e
necessary quality and safety requirements. Collaboration with patient safety and medical staff departments ensures a comprehensive approach to addressing risk and safety issues. Programs addressing provider and staff behavioral issuesshould be culturally, legally, and psychologically sound to promote a safe and inclusive work environment. Non-discriminatory practices in provider and staff management are vital to ensure fair treatment and adherence to anti- discrimination laws. Therefore, all options 1, 2, 3, and 4 should be ensured by a
risk management professional in developing the organization's regulatory compliance plan, making option D the correct answer.
Question: 6
Which of the following is a responsibility of the CPHRM in relation to enterprise-wide event reports of harm or near-harm incidents?
onducting medical research studies
stablishing performance improvement initiatives anaging the organization's budget
lanning and evaluating the reporting and monitoring system wer: D
anation: The CPHRM is responsible for planning and evaluating the rting and monitoring system for enterprise-wide event reports of harm harm incidents. This includes establishing processes for timely report yzing the data, and monitoring trends to support patient safety and risk agement.
stion: 7
is the role of the CPHRM in evaluating claims?
C
E
M
P
Ans Expl
repo or
near- ing,
anal man
Que
What
1. Providing expert medical testimony in court
2. Determining the guilt or innocence of healthcare providers
3. Assessing the financial exposure of the organization
4. Negotiating settlement agreements with claimants Answer: C
Explanation: The role of the CPHRM in evaluating claims is to assess the financial exposure of the organization. This involves analyzing the facts and circumstances of the claim, reviewing relevant documentation, and considering potential financial implications for the organization.
Question: 8
ehavioral issues?
inance department
uman Resources department arketing department
nformation Technology department wer: B
anation: The CPHRM collaborates with the Human Resources depart dress provider and staff behavioral issues. Human Resources is onsible for managing employee relations and addressing issues related vior and conduct in the workplace.
stion: 9
ch of the following activities are part of supervising and developing ri agement staff?
Which department does the CPHRM collaborate with to address provider and staff b
1. F
2. H
3. M
4. I
Ans
Expl ment
to ad
resp to
beha
Que
Whi sk
man
1: Setting performance goals and expectations 2: Conducting performance evaluations
3: Providing ongoing training and education
4: Implementing risk management policies and procedures
1. 1, 2, and 3 only
2. 1, 2, 3, and 4
3. 2, 3, and 4 only
4. 1 and 4 only Answer: B
and expectations provides a clear direction for the staff and aligns th with organizational objectives. Conducting performance evaluations
ws for assessing individual performance, providing feedback, and ifying areas for improvement. Providing ongoing training and educati res that the staff remains updated with relevant knowledge and skills. ementing risk management policies and procedures is crucial for taining consistency and adherence to established protocols. Therefore ns 1, 2, 3, and 4 are part of supervising and developing risk managem making option B the correct answer.
stion: 10
ch of the following activities should a risk management professional ge in to support patient safety committee meetings?
ollecting and formulating relevant information cilitating the decision-making process
hairing the meetings
Explanation: Supervising and developing risk management staff involves various activities to ensure their effectiveness and growth. Setting performance goals eir
work allo
ident on
ensu Impl
main , all
optio ent
staff,
Que
Whi enga
1: C
2: Fa
3: C
4: Documenting meeting minutes
1. 1 and 2 only
2. 1, 2, and 3 only
3. 2, 3, and 4 only
4. 1, 2, 3, and 4
Answer: A
menting meeting minutes, although important, are not explicitly ment tivities that a risk management professional should engage in to supp nt safety committee meetings in this context. Therefore, options 1 ecting and formulating relevant information) and 2 (facilitating the ion-making process) are the activities that a risk management professi ld engage in, making option A the correct answer.
stion: 11
ch of the following is a responsibility of a risk management profession ms management?
ssignment of counsel tting loss reserves
esponding to discovery requests/interrogatories agnosis and treatment of patients
2, and 3 only
Explanation: Supporting patient safety committee meetings requires active involvement from a risk management professional. Collecting and formulating relevant information is important to provide the committee with necessary data and insights for informed decision-making. Facilitating the decision-making process involves guiding the committee members through discussions, analysis, and evaluation of safety-related matters. Chairing the meetings and
docu ioned
as ac ort
patie (coll
decis onal
shou
Que
Whi al in
clai
1: A
2: Se
3: R
4: Di
1. 1,
2. 1, 2, 3, and 4
3. 2, 3, and 4 only
4. 1 and 4 only Answer: A
Explanation: Claims management is an important aspect of risk management,
onsibilities. Therefore, options 1 (assignment of counsel), 2 (setting lo ves), and 3 (responding to discovery requests/interrogatories) are onsibilities of a risk management professional in claims management, ng option A the correct answer.
stion: 12
ch of the following federal acts/regulations require compliance throug y development, guidance, or education in healthcare risk management
enters for Medicare and Medicaid Services (CMS)
mergency Medical Treatment and Active Labor Act (EMTALA/COB ealth Insurance Portability and Accountability Act (HIPAA)
ational Practitioner Data Bank (NPDB) fe Medical Device Act (SMDA)
2, and 3 only
3, 4, and 5 only
and the role of a risk management professional includes specific responsibilities in this area. Assignment of counsel involves selecting and appointing legal representation for the organization in claims-related matters. Setting loss reserves is the process of estimating the potential financial impact of a claim and allocating funds accordingly. Responding to discovery requests/interrogatories involves providing requested information and documentation during the legal discovery phase. Diagnosis and treatment of patients are not within the scope of a risk management professional's
resp ss
reser resp maki
Que
Whi h
polic ?
1: C
2: E RA)
3: H
4: N
5: Sa
1. 1,
2. 1,
3. 2, 3, and 4 only
D. 1, 2, 3, 4, and 5
Answer: D
Explanation: Compliance with various federal acts and regulations is crucial in healthcare risk management. The Centers for Medicare and Medicaid Services
SMDA) focuses on the reporting and tracking of adverse events relat cal devices. Therefore, all options 1, 2, 3, 4, and 5 require compliance ugh policy development, guidance, or education, making option D the ct answer.
stion: 13
ch of the following activities does the CPHRM participate in to suppo nt safety committee meetings?
onducting employee satisfaction surveys eviewing facility maintenance records
ollecting and formulating relevant information for decision-making eveloping marketing strategies for the organization
wer: C
anation: The CPHRM participates in supporting patient safety commi
(CMS) sets guidelines and requirements for healthcare facilities participating in these programs. The Emergency Medical Treatment and Active Labor Act (EMTALA/COBRA) ensures that patients receive emergency medical care regardless of their ability to pay. The Health Insurance Portability and Accountability Act (HIPAA) protects patient privacy and sets standards for the security and confidentiality of health information. The National Practitioner Data Bank (NPDB) collects and discloses information on healthcare practitioners' malpractice and disciplinary actions. The Safe Medical Device Act ( ed to
medi thro corre
Que
Whi rt
patie
1. C
2. R
3. C
4. D
Ans
Expl ttee
meetings by collecting and formulating relevant information to facilitate the decision-making process. This may involve gathering data, reports, and other information related to patient safety initiatives and presenting it to the committee for discussion and decision-making.
Question: 14
Which of the following activities should a risk management professional engage in to promote compliance with laws and regulations governing involuntary detention of patients?
1: Policy development
2: Guidance
tient advocacy
2, and 3 only
2, 3, and 4
nd 3 only
nd 4 only wer: C
anation: To promote compliance with laws and regulations governing untary detention of patients, risk management professionals play a cr Policy development is essential to establish clear guidelines and edures that align with the legal requirements. Guidance helps healthca iders understand and interpret the laws and regulations to ensure prop pliance. Education involves training and educating the staff on the rele
regulations, and procedures. Patient advocacy, although important, is tly related to promoting compliance with involuntary detention laws a ations in this context. Therefore, options 1 (policy development) and
3: Education
4: Pa
1. 1,
2. 1,
3. 1 a
4. 2 a
Ans Expl
invol ucial
role.
proc re
prov er
com vant
laws, not
direc nd
regul 3
(education) should be engaged in by risk management professionals to promote compliance, making option C the correct answer.
Question: 15
Which of the following is NOT a component of a risk management data collection/analysis system?
1. Incident reporting forms
2. Device reporting and tracking logs
3. Regulatory inquiries
anation: Employee performance evaluations are not typically included anagement data collection/analysis system. Such evaluations are mo
ed to human resources and performance management rather than risk agement.
stion: 16
development of the organization's regulatory compliance plan, the RM ensures workforce compliance with:
ccupational Safety and Health Administration (OSHA) standards nvironmental Protection Agency (EPA) regulations
enters for Medicare and Medicaid Services (CMS) requirements ederal Trade Commission (FTC) guidelines
wer: C
anation: The CPHRM ensures workforce compliance with Centers for
Employee performance evaluations Answer: D
Expl in a
risk m re
relat man
Que
In the CPH
1. O
2. E
3. C
4. F
Ans Expl
Medicare and Medicaid Services (CMS) requirements as part of the organization's regulatory compliance plan. CMS is a federal agency that administers the Medicare and Medicaid programs and sets standards for healthcare providers participating in these programs.
Question: 17
Which of the following components should be included in a risk management data collection/analysis system for timely reporting and monitoring?
1: Device reporting and tracking logs 2: Regulatory inquiries
3: Incident reports
4: Patient satisfaction surveys
2, and 3 only
2, 3, and 4
3, and 4 only
3, and 4 only wer: A
anation: A robust risk management data collection/analysis system is al for timely reporting and monitoring. Device reporting and tracking ssential for capturing information about medical devices, including an unctions or adverse events. Regulatory inquiries refer to investigation s conducted by regulatory agencies to ensure compliance with standar egulations. Incident reports capture details about any adverse incident
isses, or harm events that occur within the organization. Patient faction surveys, although valuable for assessing overall patient experi ot directly related to risk management data collection and analysis in ext. Therefore, options 1 (device reporting and tracking logs), 2 (regul ries), and 3 (incident reports) are components that should be included
1,
1,
1,
2,
Ans Expl
cruci logs
are e y
malf s or
audit ds
and r s,
near m
satis ence,
are n this
cont atory
inqui in a
risk management data collection/analysis system, making option A the correct answer.

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