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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q110-Q115):

NEW QUESTION # 110
Who are most likelynotto report errors in typical incident reporting systems?

Answer: A

Explanation:
Multiple studies showphysicians report fewer incidentsthan nurses and other hospital staff in many voluntary reporting systems, influenced by cultural norms, fear of blame, time constraints, and preference to manage issues "in-house." This matters because underreporting distorts risk signals: leadership may miss trends in diagnostic delays, handoff failures, and near-misses that physicians uniquely observe. Risk management objectives therefore focus on reducing barriers: simplifying reporting, enabling quick mobile submissions, emphasizing psychological safety, and providing credible feedback that reporting leads to improvement (not punishment). Another proven strategy is integrating reporting into professional practice expectations and aligning medical leadership with "just culture" principles. Increasing physician reporting improves system learning, strengthens peer review insight, and supports defensibility by showing hazards were identified and addressed.


NEW QUESTION # 111
What are the types of quality problems identified by the Institute of Medicine's Roundtable on Health Care Quality?

Answer: C

Explanation:
The IOM's quality framing highlights three categories of quality problems:underuse(failing to provide beneficial care),overuse(providing care where harms outweigh benefits), andmisuse(errors/defects in delivering appropriate care). This triad matters to risk management because harm arises not only from mistakes (misuse) but also fromomissions(underuse) andunnecessary interventions(overuse). For example, missing a diagnostic test can cause deterioration (underuse), while ordering a risky, non-indicated procedure can cause avoidable complications (overuse). Misuse connects strongly to patient safety incident analysis and reliability engineering. Together, these categories provide a comprehensive lens for prioritizing improvement:
reduce preventable adverse events, close evidence-based gaps, and avoid low-value care that increases complications and cost. Using this IOM model supports a balanced quality/risk program that prevents harm across the full spectrum of clinical decision-making and care delivery.


NEW QUESTION # 112
Which of the following concerns meets the CMS Hospital Conditions of Participation 42 CFR §482.12 classification as a grievance?

Answer: A

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 # 113
A risk manager is investigating a claim that has been submitted to the malpractice carrier. There is some question as to whether or not there is coverage under the current malpractice policy. What might the risk manager expect to receive from the malpractice carrier?

Answer: C

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, when an insurer identifies potential issues regarding coverage under a liability policy, it commonly issues a reservation of rights letter. This letter informs the insured that the carrier will proceed with investigation or defense of the claim while reserving its right to later deny coverage if policy exclusions, conditions, or other limitations apply.
A reservation of rights protects the insurer from waiving its ability to contest coverage while fulfilling its duty to defend, depending on policy language. It also alerts the insured to potential conflicts of interest and may permit the insured to seek independent counsel in certain jurisdictions.
A contingent acknowledgment of coverage is not a standard legal instrument. A notice of right to deny coverage would typically follow a full coverage determination rather than precede it. A notice of right to rescind involves voiding a policy, usually due to material misrepresentation during underwriting, which is distinct from a routine coverage question.
Claims and litigation objectives emphasize careful review of policy terms and timely communication with insurers. Therefore, when coverage is uncertain, the risk manager should expect to receive a reservation of rights letter from the malpractice carrier.


NEW QUESTION # 114
Information from the Data Bank (NPDB; includes former HIPDB content) can be requested by:

Answer: B

Explanation:
Access to NPDB information is restricted to authorized entities for credentialing, privileging, and oversight- not public browsing. HRSA's NPDB rules identify who can query and report;professional societies with formal peer revieware listed among entities that may query under certain circumstances. This limited-access model supports patient safety objectives by enabling credentialing bodies to identify adverse licensure actions, certain negative clinical privilege actions, and other reportable events, while protecting due process and confidentiality. From a risk management perspective, proper querying supports defensible credentialing and reduces negligent credentialing exposure. Equally important: organizations must maintain secure handling of NPDB responses and follow permitted-use rules to avoid compliance violations.


NEW QUESTION # 115
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