CPHRM CPHRM 2 — Questions and Answers
Question 1: Which risk financing technique involves the healthcare organization retaining financial risk internally rather than transferring it to an insurer?
- Self-insurance (Correct answer)
- Commercial insurance
- Reinsurance
- Captive fronting
Correct answer: Self-insurance
Self-insurance means the organization retains and funds its own losses rather than transferring risk to an external insurer.
Question 2: The 'Swiss Cheese Model' in patient safety is most directly associated with which concept?
- Active failures align with latent failures to cause harm (Correct answer)
- Individual practitioners bear sole responsibility for errors
- Multiple insurers share a single risk layer
- Root cause analysis is performed after every near-miss
Correct answer: Active failures align with latent failures to cause harm
James Reason's Swiss Cheese Model illustrates how multiple defense layers each have gaps, and harm occurs when holes align across all layers.
Question 3: A hospital's risk manager discovers a medication dispensing error that reached the patient but caused no harm. This is classified as a:
- Near-miss event
- Sentinel event
- Adverse event (Correct answer)
- Hazardous condition
Correct answer: Adverse event
An error that reaches the patient—even without causing harm—is an adverse event (no-harm event), distinguishing it from a near-miss that never reached the patient.
Question 4: Under HIPAA, the minimum necessary standard requires covered entities to:
- Limit PHI disclosures to the minimum needed to accomplish the intended purpose (Correct answer)
- Obtain written authorization for all PHI uses
- Destroy all PHI after 7 years
- Encrypt all PHI at rest and in transit
Correct answer: Limit PHI disclosures to the minimum needed to accomplish the intended purpose
HIPAA's minimum necessary standard obligates covered entities to disclose only the least amount of PHI required to accomplish the intended purpose.
Question 5: Which document formally delegates authority within an organization to manage and resolve claims up to a specified dollar threshold?
- Claims authority matrix (Correct answer)
- Incident command protocol
- Risk treatment plan
- Enterprise risk register
Correct answer: Claims authority matrix
A claims authority matrix specifies who within the organization has the authority to settle or reserve claims at various financial thresholds.
Question 6: A risk manager conducting a proactive failure analysis to identify vulnerabilities BEFORE harm occurs would use:
- Failure Mode and Effects Analysis (FMEA) (Correct answer)
- Root Cause Analysis (RCA)
- Claims trending report
- Occurrence screening
Correct answer: Failure Mode and Effects Analysis (FMEA)
FMEA is a prospective tool used to identify potential failure modes and their effects before an adverse event occurs.
Question 7: Which insurance policy provision responds when a claim is filed during the policy period, regardless of when the incident occurred?
- Claims-made policy (Correct answer)
- Occurrence policy
- Umbrella policy
- Excess liability policy
Correct answer: Claims-made policy
A claims-made policy provides coverage when the claim is reported during the active policy period, not necessarily when the incident occurred.
CPHRM CPHRM 2
Which risk financing technique involves the healthcare organization retaining financial risk internally rather than transferring it to an insurer?