Federal regulations governing the “Protection of Human Subjects” define the relationship between researcher, the institution’s research oversight committee (the Institutional Review Board — IRB), the sponsoring organization and the research subject. Under these regulations, in the event that a sponsoring institution desires to initiate a research project but the IRB disapproves, the sponsoring institution:

The Healthcare Quality Improvement Act requires the reporting of medical professional liability payments made on behalf of certain healthcare practitioners to the National Practitioner Data Bank and the appropriate state licensing board within days.

If The Joint Commission becomes aware of a sentinel event that meets the definition of a reviewable sentinel event, the organization is required to submit to the Joint Commission its root cause analysis and action plan, or otherwise provide for Joint Commission evaluation of its response to the sentinel event under an approved protocol, within calendar days of the known occurrence of the event.

A board policy on hospital preparedness that outlines the hospital’s responsibilities and procedures to be followed in the event of a natural disaster or an incident of terrorism should do all of the following EXCEPT:

A risk manager should review which of the following information when considering the effectiveness of an organization’s workers’ compensation program?

1. Workers’ compensation claims history
2. OSHA 300 Log
3. Listing of all employees and volunteers
4. Directors and officers of the organization

Employee health programs can be used to manage certain risks. Which of the following is NOT an integral part of an effective employee health program?

Which of the following should be included in an institution’s contract with a vendor for biomedical equipment?

1. The responsibilities of each party regarding preventative and ongoing maintenance of the particular biomedical equipment
2. A guarantee of equipment “uptime” or prompt provision of a substitute acceptable to the facility for biomedical equipment critical to patient care
3. A procedure for the vendor to directly notify the institution regarding identified product hazards or recalls
4. A contingency plan in the event of an internal disaster

During an operation on an I8-year-old male in a Joint Commission accredited hospital, an electrocautery device ignites the surgical drapes. Operating room staff quickly extinguishes the fire. However, the patient suffers second-degree burns to his right thigh. Based on all applicable state and federal laws and regulations, what is the risk manager’s best course of action?

It is the risk manager’s responsibility to report actual or potential claims to the healthcare organization& insurance provider. Which of the following are generally considered reportable?

1. Lawsuits
2. Claims
3. Potentially compensable events
4. Patient complaints

Which of the following statements regarding the use of restraints are TRUE?

1. Wrist or vest devices can be considered restraints
2. Locked seclusion is considered a form of physical restraint
3. Medication used to significantly alter a patient’s behavior on an emergency basis is considered a form of chemical restraint
4. Voluntary use by a patient of an unlocked “quiet room” is NOT considered a form of physical restraint

The medical record historically has been a tool of risk management. In the event of an untoward outcome or unusual incident, documentation in the medical record should include all of the following EXCEPT:

1. A description of the occurrence
2. Comments about the notification of and related care provided by the patient’s physician
3. The fact that an incident report was completed
4. The fact that the risk manager was notified

One of the risk manager’s responsibilities, in concert with the organization’s legal counsel, is to prepare a witness for trial. In that regard, which of the following statements is FALSE?One of the risk manager’s responsibilities, in concert with the organization’s legal counsel, is to prepare a witness for trial. In that regard, which of the following statements is FALSE?

The legal theory res ipsa loquitur would most likely apply to which of the following scenarios?

Which of the following is an example of risk avoidance?

Which of the following is NOT pan of risk identification and analysis?

Which is NOT a role of the risk manager when it is determined that a medical record has been altered?

According to HIPAA, which of the following disclosures are permitted without an individual’s authorization and without granting the individual an opportunity to agree or object to the disclosure?

1. A physician discloses an individual’s medical record to a colleague, who is a cardiac surgeon, for review prior to consultation on that individual’s heart condition.
2. A hospital discloses individually identifiable health information to the company that provides its billing services.
3. A hospital discloses 2 patient’s name and general condition in its facility directory.
4. A nursing home discloses patient health information to an accreditation organization for the purpose of obtaining accreditation.

The federal “right to know” standard is also known as the:

The insurance industry is cyclical. It is characterized by periods of time noted as “hard” and “soft” markets. ‘Which of the following statements is TRUE?

21. A group of obstetricians and neonatologists submits a proposal for a study on a new drug that might improve fetal lung maturity and, therefore, the survivability of newborn infants

The standard of care in a medical malpractice trial is established by:

1. State licensing regulations
2. Standards published by medical professional associations
3. Expert opinion testimony.
4. Quality of care measures defined by voluntary accreditation organizations.

Which of the following is true regarding ownership of medical records?

 Changes to the federal EMTALA regulations that became effective in November 2003 include which of the following?

1. All hospitals must have physicians on call 24 hours a day, seven days a week.
2. Physicians are not allowed to schedule elective procedures when they are on call for emergencies.
3. The EMIALA regulations no longer apply to inpatients.
4. The definition of “hospital property” was narrowed.

 All of the following are effective error prevention strategies EXCEPT:

Which of the following is NOT a benefit of an external benchmarking project?

Which of the following statement about reporting a sentinel event is FALSE?

Which of following has the responsibility to determine initial emergency response level?

Calculation of retrospective rating premiums typically takes places:

Which of the following is NOT ground for wrongful termination liability?

In the process of determining whether a patient has adequate mental or cognitive capacity to make healthcare decisions, the physician must determine if the patient is:

1. Able to communicate either verbally or in writing
2. of age according to state law
3. Able to understand the nature of the situation
4. Able to understand the consequences of the decision

 Which of the following criteria are necessary to establish that a healthcare advertisement is deceptive?

1. The advertisement contains a representation or omission that is likely to mislead a consumer
2. The advertisement is in poor taste.
3. Consumers likely to be misled by the advertisement are “reasonable people,” representative of the audience targeted by the advertisement.
4. The representation or omission has a real impact on the consumer’s choices.

Which of the following should prompt a root cause analysis according to Joint Commission standards?

1. Surgery performed on the wrong body part
2. Infant abduction
3. Non-hemolytic transfusion reaction
4. Death from a community-acquired infection

A nursing home resident attempts to wander away from a facility and activates the alarm when he exits the building via the main entrance. A nurse, who is in her first week of training, turns off the alarm at the nurse’s station. She then goes outside to find the patient. The resident is found and is returned to the facility. The nurse in training then completes an incident report about the occurrence. She places a copy in the medical record and sends the original to the risk manager. She also makes an objective entry about the event in the nurses’ notes in the medical record.

With regard to the alarm, which of the following is the most accurate statement?

A nursing home resident attempts to wander away from a facility and activates the alarm when he exits the building via the main entrance. A nurse, who is in her first week of training, turns off the alarm at the nurse’s station. She then goes outside to find the patient. The resident is found and is returned to the facility. The nurse in training then completes an incident report about the occurrence. She places a copy in the medical record and sends the original to the risk manager. She also makes an objective entry about the event in the nurses’ notes in the medical record.

With regard to the incident report, which of the following is the most accurate statement?

Interrogatories are

The doctrine of Iex loci delecti commissi implies than

Which of the following is NOT a type of consent?

Issues surrounding the disposal of biomedical equipment generally fall into two categories: 1) the sale, donation or abandonment of a healthcare facility’s equipment to another entity, group, or individual; and 2) the acquisition of a piece of biomedical equipment that is being disposed of by another facility.

 Based on the above, which of the following are key risk management considerations?

1. The selling/donating entity could find itself being considered part of the distribution chain, with a potential for product liability exposure.
2. The capital outlay to acquire the piece of biomedical equipment or the potential income to the entity if they arc the seller.
3. Compliance with FDA-mandated medical device tracking and documentation requirements that may be associated with the disposal.
4. If the selling/donating entity is a tax exempt organization, it might jeopardize its tax exempt status.

Behavioral health patients may be at high risk for abuse. Which of the following statements regarding the risk of abuse of behavioral health patients are true

1. Pediatric, adolescent and geriatric behavioral health patients are particularly vulnerable populations that may be at even greater risk for abuse.
2. A crucial abuse prevention strategy is to require that all behavioral health workers undergo reference checks and criminal background checks before they are allowed to work with patients.
3. The organization must have a zero tolerance philosophy regarding any form of abuse including physical, sexual and emotional abuse.
4. Behavioral health patients may be confused and/or disoriented, and staff should be given ‘the benefit of the doubt* and be allowed to continue working while a patient’s allegation of abuse is being investigated.

Which of the following arc advantages of using an alternative dispute resolution mechanism as compared to going to trial?

1. Better outcome
2. More economical
3. Las hostile
4. Quicker

If a Facility is accredited by the Joint Commission, which of the following are important rids management reasons to review contracts?

1. To assure the Joint Commission standards are met regarding contracted services
2. To evaluate indemnification/hold harmless provisions
3. To apply appropriate state law CO the COM= provisions
4. To monitor financial performance for the organization

 Mature or emancipated minors generally can consent to treatment of which of the following?

1. Sexually transmitted disease
2. Pregnancy
3. Alcohol abuse
4. Mental health

The risk manager should be vigilant in assessing the quality of medical record documentation, looking for opportunities to enhance the value and quality of the medical record. This can be done in which of the following ways?

1. Participate in general orientation for new employees.
2. Collaborate with Medical Records Department personnel.
3. Review incident patterns and trends for documentation issues and problems throughout the organization.
4. Contact defense counsel whenever there is a violation of a documentation guideline or standard of practice.

Legal essentials for a valid contract include:

1. A bargained for exchange of legal value between die contracting parties
2. The purpose or object of the contract is legal
3. The contract must be in writing
4. The contract contains risk assumption provisions

The Needle stick Safety and Prevention Act:

Which of the following does NOT pertain to first-party insurance.

Which of the following statements about occurrence and claims-made insurance policies is TRUE?

The Patient Self-Determination Act obligates which of the following entities to provide their clients with information regarding advance directives?

1. Hospitals
2. Physician’s offices
3. Health maintenance organizations (HMOs)
4. Home healthcare services

The most important aspect of claims handling is:

Reserving a claim— that is, Identifying what amount of money will be paid out in indemnity and loss adjustment costs by the time the case is settled or resolved— is more an art than a science. Therefore

1. Reserves should reflect only the insurance coverage available.
2. Reserves should be based on all the information available.
3. Reserves should nor rake into account immunity provisions in either contracts or statutes.
4. Reserves should be changed every 90 days.

Behavioral health patients must be assessed for the risk of suicidal ideation or homicidal acts in order to protect the patient and community. Select the following statement that Is NOT an appropriate risk control practice when managing a patient who is at risk of suicidal ideation or homicidal acts.

Under EMTA1LA regulations, the Emergency Department must maintain a roster of physicians who are available on-call to provide consultation or are for EMTALA patients. If the hospital cannot provide complete on-call coverage for a particular service represented by the medical staff:

Ha state has its own occupational safety and health agency:

High-reliability organizations share all of the following characteristics EXCEPT:

A central log must be kept of everyone who comes to the Emergency Department seeking emergent care. Such logs must also be maintained by departments that:

Most healthcare risk managers gain access to the commercial insurance market by using an insurance broker or agent. Which of the following statements is FALSE?

The insurance coverage a hospital purchases may be written on either an occurrence or claims-made basis. Which of the following statements are TRUE?

1. An occurrence policy covers an insured for incidents chat occur while the policy is in effect, regardless of when the incident is reported to the insurer.
2. A claims-made policy covers an insured for incidents that occur and are reported to the insurer while the policy is in force.
3. Regardless of which type is purchased, supplemental tail coverage must be purchased, too.
4. For coverage to apply under a claims-made policy, the incident or claim must have occurred before the retroactive date of the policy.

The Patient’s Rights Conditions of Participation mandates that a patient placed in a restraint for behavioral reasons must be seen and assessed by a “licensed independent practitioner”:

The investigative process is composed of which of the following steps?

1. Discovering the facts
2. Determining the applicable standard of care
3. Assessing the applicable legal principles
4. Reviewing the appropriate HIPAA regulations

Disasters can strike at anytime, anywhere. Hospitals that are accredited by the Joint Commission must ensure that they can document they are prepared for such disasters by doing which of the following?

1. Performing at least four drills a year
2. Evaluating each drill formally
3. Performing no more than two tabletop drills annually
4. Ensuring that drills are conducted no closer than 4 months apart

In the risk management process, the fourth step is:

If Mere is no OSHA standard fora given potential health hazard

Which of the following la NOT true regarding child abuse and neglect reporting?

One of the most important considerations when purchasing property insurance is

Within the Safe Medical Device Act, the Food and Drug Administration (FDA) defined a reportable event as “information [from any source) that reasonably suggests that a device has or may have caused or contributed to a death or serious injury.” Such events must be reported to the FDA alone whenever:

1. They involve a serious patient injury
2. They involve a patient death
3. The identity of the manufacturer of the device is unknown
4. The distributor of the device is unknown

In July 2001, the Joint Commission created additional Patient Safety Standards that speak to risk management as a resource for policy-making, not just a data source for monitoring improvement. These standards require organizations to develop policies and procedures for which of the following?

1. 1. Proper response to an adverse event
2. Prevention of accidental harm
3. Disclosure of adverse events to patients and families
4. Fiscal accountability

To encourage the participation of physicians in the peer review process, federal law provides protection from civil liability for those who participate in good faith in this endeavor. The specific federal law that provides such protection is:

An organization has structured professional liability coverage with a combination of SIR and commercial insurance. The SIR limits are $2,000,000 per incident and $6,000,000 yearly aggregate. In addition to the SIR, the organization purchased excess coverage in the amounts of $10,000,000 per incident and $25,000,000 yearly aggregate. Assume that all the policies are written on a calendar year basis, all payouts are in the correct year, and the SIR fund and the commercial insurance carrier are financially solvent.

If the above organization has not had a claim paid during the year, what amount would be available for the first claim?

An organization has structured professional liability coverage with a combination of SIR and commercial insurance. The SIR limits are $2,000,000 per incident and $6,000,000 yearly aggregate. In addition to the SIR, the organization purchased excess coverage in the amounts of $10,000,000 per incident and $25,000,000 yearly aggregate. Assume that all the policies are written on a calendar year basis, all payouts are in the correct year, and the SIR fund and the commercial insurance carrier are financially solvent.

If the first claim is settled for $5,500,000, how much will the commercial insurance company have to pay?

An organization has structured professional liability coverage with a combination of SIR and commercial insurance. The SIR limits are $2,000,000 per incident and $6,000,000 yearly aggregate. In addition to the SIR, the organization purchased excess coverage in the amounts of $10,000,000 per incident and $25,000,000 yearly aggregate. Assume that all the policies are written on a calendar year basis, all payouts are in the correct year, and the SIR fund and the commercial insurance carrier are financially solvent.

If the above organization loses three consecutive $2,000 000 oases then loses a case for $3,000,000, how much money from the SIR will be used to pay the fourth claim?

According to the Healthcare Quality Improvement Act, which of the following require(s) reporting of the medical professional liability payments to the National Practitioner Data Banks

1. A verdict against a dentist
2. A verdict against a physician
3. A verdict against a solo physician’s practice corporation
4. A verdict against physician group practice Corporation

A physician has a $2-million policy limit with a $100,000 per claim deductible. How much total insurance does the insured have?

Many organizations are striving to become “highly reliable.” Which of the following characteristics is NOT considered indicative of a highly-reliable organization?

The Joint Commission is concerned about workforce shortage and is requiring hospitals to develop screening criteria for monitoring the problem. Which criteria are acceptable to the Joint Commission?

1. Number of skin breakdowns
2. Number of adverse drug events
3. Number of patient-related lawsuits
4. Number of nursing are hours per patient day

An employer may decline to hire a disabled applicant otherwise qualified for the job: 

Which of the following is regulated by both OSHA and EPA?

Managing a request for insurance proposals is a complicated yet necessary task. With regard to market proposals and conceptual proposals, which of the following is FALSE?

HIPAA requires a written agreement for covered entities and business associates in which of the following situations?

1. A skilled nursing facility transferring patients to a hospital pursuant to a transfer agreement
2. A transcription service providing medical record transcription for a physician’s office
3. A hospital contracting for exterior maintenance services
4. A software maintenance company providing services to a hospital’s finance functions

A 72-year-old Alzheimer’s patient develops acute congestive heart failure. Several invasive procedures are performed, but the patient dies within 12 hours of admission. His family files a wrongful death lawsuit naming all the physicians and the hospital as defendants. At trial, the standard of care in the above use must be determined by

A 12-yearold female is administered an excessive amount of a drug and develops transient tachycardia that necessitate monitoring in the pediatric intensive care unit for eight hours. If the preliminary information indicates there is clear liability on the part of the organization, the most prudent course of action for the risk manager would be tor

A 44-year-old man develops severe chest pain while mowing his lawn. His family calls 911, and he is rushed via ambulance to one of the local hospitals. The emergency room physician performs a comprehensive workup and discharges the patient with a diagnosis of costochondritis. He dies that night while asleep in his own bed. The patient’s family files suit against the hospital and the emergency physician, a contracted provider for the hospital. The most likely legal theory that can be used against the hospital would be.

For some behavioral health patients, remaining in the protected environment of an inpatient unit is essential to ensuring their safety and the safety of others. Therefore, elopement prevention is a critical component to the risk control program. Select the following statement that is NOT an appropriate risk control practice.

Having performed an Investigation of a patient’s complaint, the patient grievance review committee determined that the hospital faced a significant liability exposure, turned the results of the investigation over to their attorney, and then told the risk manager that these results would not be shared with the patient. The risk manager reminded them that the patient was, nonetheless, still entitled to the results of the investigation pursuant to:

Workers’ compensation experience modification factors are defined as:

Which’ of the following statements about peer review records is NOT correct?

When a potentially compensable event occurs and it is determined that the event might be a significant one, the original medical records should be:

Congress, in its Patients’ Bill of Rights, directed states to ensure that behavioral health patients receive the protection and services they require. In order to preclude the possibility of litigation and control risk, organizations must ensure that the provisions of these rights are implemented. Select the following statement that does NOT correctly represent the protection afforded to behavioral health patients.

Protecting outdoor air Intakes can mitigate the risk of terrorist acts of introducing airborne agents into a facility. Steps to accomplish this include:

1. Relocate intakes to a rooftop or higher up on the building
2. Establish a security zone around the intakes
3. Add lighting and surveillance cameras to monitor the Mulcts
4. Implement negative ventilation throughout the building

Workers’ compensation injuries often can be substantial not only from a medial cost perspective but also from a productivity standpoint One of the best ways to reduce workers’ compensation claims related to repetitive motion injuries is to:

A federal law that serves to limit the liability of hospital trustees is the:

The best content and format for a risk manager’s report to the board is:

As provided for within the Patient’s Rights Conditions of Participation, all patient death Associated with the use of restraints must be reported to the:

Which of the following BEST describes workers’ compensation coverage?

Which of the following statements is TRUE?

On a steamy summer afternoon, an 86-year-old female is walking toward the entrance of a physician’s private-practice office. There was a light rainfall two hours before. As she steps from the parking lot to the sidewalk, she slips on the curb. She tears her dress and stockings. The woman now seeks reimbursement for her damages after hearing that a portion of the sidewalk near the .door was to be replaced the day after she fell. Which of the following defenses could reasonably be employed to deny this claim?

1. The fall was an act of God since it rained earlier.
2. The sidewalk that was replaced the day after her fall was not the proximate cause of her fall.
3. The damages were minimal so no compensation was warranted.
4. There was no breach of duty.

As a claim matures, new information from experts, defense counsel or adjusters may develop. In that case, which of the following is TRUE?

Freestanding behavioral health organizations are considered to be those that are not hospital based and! Or not considered to be part of the services offered by an acute care general hospital’ or behavioral health inpatient hospital. Which of the following statements regarding risk control practices in a freestanding behavioral health organization are TRUE?

1. The organization must require formal, written contracts with all independent contractors.
2. The organization must require all independent practitioners to maintain professional liability insurance in amounts deemed appropriate by the organization and in accordance with any state requirements and taking into account the local litigation climate.
3. The organization must maintain general liability and premises insurance policies in sufficient amounts.
4. There should be an on-site professional designated to develop the risk control program and implement risk control activities.

A contract involving professional services should always include minimum amounts of which of the following Coverages?

1. Professional liability
2. Workers’ compensation
3. Directors and officers
4. General liability

The report “To Err Is Human” concluded that approximately 44,000 to 98,000 inpatients J.ie annually as a result of medical errors. This report was originated by: