Care Coordination & Resource Management Flashcards
7 cards from real CCM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Care Coordination & Resource Management flashcards as text
A care manager working in a managed care organization receives a request to discharge a client prematurely to reduce costs. The care manager's FIRST obligation is to:
Answer: Advocate for the client's medically necessary care needs
The care manager's primary ethical obligation is client advocacy, even when organizational financial pressures conflict with client needs.
Which care setting BEST describes a skilled nursing facility (SNF) in terms of care intensity?
Answer: Intermediate level providing skilled therapy and nursing post-acute care
An SNF provides a post-acute level of care including skilled nursing and rehabilitation services not available in custodial or home settings.
A care manager is coordinating care for a patient with limited English proficiency. The MOST appropriate interpreter resource is:
Answer: A trained medical interpreter service
Trained medical interpreters ensure accurate clinical communication and protect patient confidentiality and rights under Title VI.
During a home visit, a care manager observes unsanitary living conditions that may endanger the client. After addressing immediate safety, the care manager should:
Answer: File an Adult Protective Services (APS) report if abuse or neglect is suspected
Reporting suspected abuse, neglect, or self-neglect to APS is a mandatory duty in most states and protects the client's wellbeing.
Which care coordination framework emphasizes the relationship between a prepared, proactive practice team and an informed, activated patient?
Answer: Chronic Care Model (CCM)
The Chronic Care Model's central interaction is between a prepared practice team and an activated patient to produce better outcomes.
A care manager is evaluating the effectiveness of a care plan. Which outcome measure reflects the MOST meaningful improvement for a client with COPD?
Answer: Reduction in emergency department visits and hospitalizations
Reduced acute care utilization directly reflects improved disease management and quality of life for COPD patients.
A client with dementia lives alone and repeatedly forgets to take medications. The MOST sustainable care coordination solution is to:
Answer: Arrange for a daily visiting home health aide to supervise medications
A daily aide provides consistent, supervised medication administration, which is more reliable than cognitive reminder strategies for dementia patients.