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ASHRM CPHRM Exam Syllabus Topics:

TopicDetails
Topic 1
  • 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 2
  • 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 3
  • 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 4
  • 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 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 (Q37-Q42):

NEW QUESTION # 37
A 22-year-old man has been treated at a hospital for a psychiatric condition. His mother requests that a copy of the patient's medical record be released to her. The risk manager's advice to the medical records department should be to

Answer: A

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, a 22-year-old patient is a legal adult and retains full rights to privacy and control over disclosure of protected health information under HIPAA and applicable state confidentiality laws. Psychiatric records are subject to heightened confidentiality protections in many jurisdictions.
Absent a court order or legal guardianship determination, a parent does not have automatic access to an adult child's medical records. Therefore, before releasing any information, the organization must verify that the patient has executed a valid, specific authorization for release of information that complies with HIPAA requirements. The authorization must clearly identify the recipient, the information to be disclosed, and be properly signed and dated.
Consulting legal counsel or a treating psychiatrist does not substitute for proper authorization. Similarly, requesting guardianship documentation would only be appropriate if the mother asserts legal guardianship status; however, in the absence of such documentation, release cannot occur.
Legal and regulatory objectives emphasize strict adherence to privacy laws, protection of psychiatric records, and proper authorization procedures. Therefore, verification of a signed release of information from the patient is required before disclosure.


NEW QUESTION # 38
Which of the following has been proven to reduce costs of workers' compensation programs?

Answer: D

Explanation:
Within Health Care Risk Management frameworks endorsed by ASHRM and the American Hospital Association Certification Center, early return-to-work programs are recognized as one of the most effective strategies for controlling workers' compensation costs. These programs facilitate the safe and timely return of injured employees to modified or transitional duty consistent with medical restrictions.
Workers' compensation costs are significantly influenced by wage replacement benefits and duration of disability. By reducing the length of time an employee remains off work, early return-to-work initiatives directly decrease indemnity payments, lower claim severity, and improve overall claim outcomes.
Additionally, such programs support employee morale, maintain productivity, and reduce the likelihood of prolonged disability or litigation.
While comprehensive safety analyses contribute to injury prevention and long-term risk reduction, their direct cost impact is preventive rather than immediately measurable in claim severity. Employee assistance programs focus primarily on behavioral health and personal support, not claim cost containment. Disciplinary actions do not constitute a structured risk financing strategy and may negatively affect organizational culture.
Therefore, from a risk financing perspective, early return-to-work programs have demonstrated measurable effectiveness in reducing workers' compensation program costs.


NEW QUESTION # 39
All of the following are valid reasons for performing risk management review of policies and procedures EXCEPT

Answer: D

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, periodic review of policies and procedures is essential to ensure alignment with current laws, regulatory standards, accreditation requirements, and best practices. Reviewing policies helps ensure consistency between written procedures and actual clinical practice, thereby reducing liability exposure.
Policy review also supports identification of potential risk exposures by detecting outdated language, conflicting guidance, or gaps in processes that could lead to adverse events. Additionally, monitoring compliance with standards-such as federal regulations, state statutes, and accreditation requirements-is a central purpose of policy review, ensuring that organizational practices meet required benchmarks.
Maintaining staff competency, however, is primarily addressed through education, training programs, credentialing, and performance evaluation processes. While policies provide guidance for staff conduct, competency assessment is not the primary objective of policy review itself.
Health Care Operations objectives emphasize governance oversight, regulatory compliance, and risk mitigation through clear, current policies. Therefore, maintaining staff competency is not a direct reason for performing risk management review of policies and procedures, making it the correct exception.


NEW QUESTION # 40
Which of the following risk management documents in a policy and procedure manual should be approved by an organization's board of directors?

Answer: D

Explanation:
According to Health Care Risk Management standards outlined by ASHRM and the American Hospital Association Certification Center, the governing board has ultimate responsibility for organizational oversight, quality of care, and patient safety. As part of its fiduciary and governance duties, the board approves high- level policies that establish the organization's philosophy, strategic direction, and commitment to safety and risk management.
A philosophy regarding medical error management reflects the organization's approach to disclosure, reporting, just culture principles, accountability, and system improvement. Because this philosophy sets the tone for organizational culture and impacts patient safety, legal exposure, and regulatory compliance, it requires board-level approval to ensure alignment with governance expectations and accreditation standards.
In contrast, the risk management department's annual budget is typically approved through financial governance processes rather than as a policy document. Risk analyses are operational tools conducted by management and do not require board approval. Departmental personnel job descriptions are administrative documents managed at the executive or human resources level.
Health Care Operations objectives emphasize board engagement in safety culture and oversight of enterprise risk management. Therefore, the philosophy regarding medical error management should be approved by the organization's board of directors.


NEW QUESTION # 41
The Joint Commission requires that after a healthcare organization becomes aware of a sentinel event, it must complete a root cause analysis and action plan within how many days?

Answer: B

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, The Joint Commission's sentinel event policy requires organizations to complete a thorough root cause analysis and develop an action plan within 45 days of becoming aware of the sentinel event.
The root cause analysis must identify underlying system failures and contributing factors rather than focusing solely on individual performance. The resulting action plan must outline specific corrective measures, assign responsibility, establish implementation timelines, and include mechanisms to monitor effectiveness. The emphasis is on sustainable system improvement to reduce the likelihood of recurrence.
Failure to complete the analysis and action plan within the required timeframe may result in additional review, accreditation consequences, or other follow-up actions by The Joint Commission. Timely completion demonstrates organizational accountability, leadership oversight, and commitment to patient safety.
Clinical and patient safety objectives emphasize structured investigation processes, documentation of corrective actions, and alignment with accreditation standards. Therefore, the required timeframe for completion of the root cause analysis and action plan following awareness of a sentinel event is 45 days.


NEW QUESTION # 42
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