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ASHRM CPHRM Exam Syllabus Topics:

TopicDetails
Topic 1
  • Healthcare Operations: This domain involves managing operational risk activities such as conducting risk assessments, developing policies, coordinating risk programs, supervising staff, and supporting patient safety initiatives.
Topic 2
  • Legal and Regulatory: This domain focuses on ensuring compliance with healthcare laws and regulations, protecting patient information, managing reporting requirements, and supporting accreditation and regulatory responses.
Topic 3
  • Claims and Litigation: This domain focuses on handling potential claims and legal cases, including claim reporting, litigation support, legal documentation management, and analyzing claims data to understand risk exposure.
Topic 4
  • Clinical
  • Patient Safety: This domain focuses on improving patient safety by promoting a safety culture, managing incident reporting, educating staff and patients, addressing ethical concerns, and implementing corrective actions to reduce risks and prevent harm.
Topic 5
  • Risk Financing: This domain covers managing financial risks through insurance programs, claims coordination, loss analysis, and developing strategies to reduce financial exposure.

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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q66-Q71):

NEW QUESTION # 66
The reporting requirements of the Safe Medical Devices Act SMDA apply to which of the following?
* nursing homes
* physician offices
* ambulatory surgery
* hospitals

Answer: A

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, the Safe Medical Devices Act SMDA establishes mandatory reporting requirements for certain healthcare facilities when a medical device has or may have caused or contributed to a patient death or serious injury. These requirements apply to device user facilities, which include hospitals, nursing homes, and ambulatory surgical facilities.
Hospitals are explicitly required to report device-related deaths to both the FDA and the manufacturer, and serious injuries to the manufacturer or the FDA if the manufacturer is unknown. Nursing homes and ambulatory surgery centers are also considered device user facilities under the Act and must comply with similar reporting obligations.
Physician offices, however, are generally not classified as device user facilities under SMDA reporting rules and therefore are not subject to the same mandatory reporting requirements, although voluntary reporting is encouraged.
Legal and regulatory objectives emphasize timely compliance with FDA reporting mandates, maintenance of documentation, and coordination with manufacturers and regulatory authorities to mitigate risk and enhance patient safety. Therefore, the SMDA reporting requirements apply to nursing homes, ambulatory surgery facilities, and hospitals.


NEW QUESTION # 67
A sentinel event is a patient safety event that reaches the patient and results in which of the following?

Answer: A

Explanation:
According to Health Care Risk Management standards supported by ASHRM and The Joint Commission's sentinel event policy, a sentinel event is defined as a patient safety event that results in death, permanent harm, or severe temporary harm. Severe temporary harm is harm that is critical, life-threatening, or requires major intervention to sustain life, even if the patient ultimately recovers.
Sentinel events signal the need for immediate investigation and response because of the seriousness of the outcome. The Joint Commission requires completion of a root cause analysis and development of an action plan within specified timeframes following awareness of such an event. The focus is on identifying system vulnerabilities and preventing recurrence.
Temporary or moderate harm alone does not meet the sentinel event threshold unless it rises to the level of severe temporary harm. Increased length of stay, without death or significant harm, does not qualify as a sentinel event under the formal definition.
Clinical and patient safety objectives emphasize accurate event classification, structured investigation, and corrective action. Therefore, a sentinel event is one that results in death, permanent harm, or severe temporary harm.


NEW QUESTION # 68
Which of the following concerns meets the CMS Hospital Conditions of Participation 42 CFR §482.12 classification as a grievance?

Answer: B

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, the CMS Hospital Conditions of Participation define a grievance as a formal or informal written or verbal complaint made by a patient or representative regarding care, abuse, neglect, compliance with regulations, or patient rights that is not resolved at the time of the complaint by staff present.
A verbal complaint that cannot be resolved immediately by current staff and whose resolution is postponed qualifies as a grievance under 42 CFR §482.12. Such grievances require formal investigation, documentation, and written response within established timeframes.
Billing issues generally fall outside the grievance definition unless they involve quality of care or patient rights concerns. Information from patient satisfaction surveys is not automatically classified as a grievance unless the patient specifically requests investigation or follow-up. Post-discharge verbal concerns may constitute grievances depending on context, but the key CMS criterion is whether the complaint could not be resolved at the time it was expressed.
Legal and regulatory objectives emphasize proper classification, timely response, documentation, and board oversight of grievance processes. Therefore, a verbal complaint that cannot be resolved immediately and is deferred meets CMS grievance criteria.


NEW QUESTION # 69
Which of the following wouldnotbe considered an emergency condition for EMTALA purposes (as a general example set)?

Answer: A

Explanation:
EMTALA applies when an individual comes to the ED and requires a medical screening exam to determine whether anemergency medical condition (EMC)exists. Conditions like myocardial infarction, ruptured appendix, and unstable labor can constitute EMCs because absence of immediate medical attention could reasonably be expected to place health in serious jeopardy. By contrast,stable chronic kidney failurewithout acute destabilization may not meet the EMC threshold-though the screening exam must be performed before that determination is made. Risk management objectives emphasize: never "triage out" without an appropriate screening exam, document findings and decision-making, and apply consistent policies to avoid discriminatory practice. EMTALA failures often stem from process breakdowns (delays, refusal, inadequate screening, improper transfer), so standardized ED workflows and training are critical.


NEW QUESTION # 70
An unstable patient in the emergency department needs transfer to another hospital. Which of the following statements is true regarding the refusal of an on-call physician to treat this patient?

Answer: D

Explanation:
Under Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, obligations under the Emergency Medical Treatment and Labor Act EMTALA govern on-call physician responsibilities. When a hospital maintains an on-call roster to provide specialty services for emergency department patients, physicians listed on call are required to respond and participate in the evaluation and stabilization of patients with emergency medical conditions.
An on-call physician may only be relieved of duty if legitimately unavailable due to circumstances beyond their control, such as actively caring for another patient or being otherwise unable to respond in accordance with hospital policy. Refusal to treat for convenience or non-clinical reasons may constitute an EMTALA violation and expose both the hospital and physician to regulatory penalties.
A blanket right to refuse care is inconsistent with EMTALA requirements. While financial discrimination is prohibited, refusal for other non-justifiable reasons may still violate federal law. Conversely, stating that a physician is never relieved of duty is inaccurate, as legitimate unavailability may excuse performance under specific circumstances.
Legal and regulatory objectives emphasize compliance with EMTALA, proper on-call coverage policies, and documentation of availability. Therefore, the correct statement is that relief occurs only when the physician is unavailable due to circumstances outside their control.


NEW QUESTION # 71
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