Negligent Credentialing and Legal Risk Management Flashcards
7 cards from real CPCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Negligent Credentialing and Legal Risk Management flashcards as text
Which landmark case established the hospital's independent duty to ensure the competency of its medical staff, forming the foundation of corporate negligence in credentialing?
Answer: Darling v. Charleston Community Memorial Hospital
Darling v. Charleston (1965) established that hospitals have a direct corporate duty to oversee and supervise the quality of medical care, including credentialing.
A hospital's credentialing policy requires reverification of credentials every two years. A physician's license was revoked 18 months after initial appointment, but the hospital did not discover this until a patient was harmed at month 20. What risk management failure does this illustrate?
Answer: Failure to conduct ongoing monitoring between reappointment cycles
Continuous monitoring (e.g., license sanction alerts) between reappointment cycles is essential to catch mid-cycle adverse actions.
Which organization's accreditation standards require hospitals to have a process for granting temporary privileges in urgent situations while maintaining appropriate oversight?
Answer: The Joint Commission (TJC)
TJC Medical Staff standards explicitly address temporary privilege requirements including oversight and time limitations.
A credentialing specialist learns a physician applicant has an active malpractice suit. Under standard credentialing practice, what is the CORRECT response?
Answer: Request details and evaluate within the overall credentialing review process
A pending lawsuit alone is not disqualifying; it must be evaluated in context with the full credentialing file.
Proctoring a newly privileged physician for a defined number of cases is primarily intended to address which credentialing risk?
Answer: Verifying current clinical competence before granting full independent privileges
Proctoring validates that a practitioner can actually perform procedures safely in the hospital's specific environment before full independent practice.
A hospital's peer review records are subpoenaed in a malpractice lawsuit. Which federal law provides the primary protection for peer review documents from discovery?
Answer: Patient Safety and Quality Improvement Act (PSQIA)
PSQIA provides federal privilege and confidentiality protections for information reported to Patient Safety Organizations (PSOs), shielding quality improvement data from discovery.
Which of the following BEST describes 'focused professional practice evaluation' (FPPE) in the credentialing context?
Answer: Time-limited monitoring triggered by a question about a practitioner's competence or upon granting new privileges
FPPE is a focused, time-limited evaluation used when a concern arises about competence or when new privileges are initially granted.