Deck 12: Home Health Care

Question 1

Which of the following is a list of organizations that have deeming authority for home health care with regard to Medicare certification and the Conditions of Participation?

A) The Accreditation Commission for Health Care (ACHC), the American Academy of Home Care Physicians, and The Joint Commission
B) The American Academy of Home Care Physicians, The Joint Commission, and the National Association for Home Care & Hospice (NAHC)
C) The Accreditation Commission for Health Care (ACHC), the Community Health Accreditation Program (CHAP), and the National Association for Home Care & Hospice (NAHC)
D) The Community Health Accreditation Program (CHAP), The Joint Commission, and the National Association for Home Care & Hospice (NAHC)
E) The Accreditation Commission for Health Care (ACHC), the Community Health Accreditation Program (CHAP), and The Joint Commission

Answer 1

The Accreditation Commission for Health Care (ACHC), the Community Health Accreditation Program (CHAP), and The Joint Commission

Question 2

Medical-surgical nursing, intravenous therapy, and restorative nursing care are ___________________.

A) skilled nursing services
B) home health aide services
C) non-physician practitioner (NPP) services
D) non-covered services for home care

Answer 2

skilled nursing services

Question 3

____________ is a data set that is a requirement under Medicare for home health.

A) HHRG
B) MDS-3
C) OASIS-1
D) CMS-485

Answer 3

OASIS-1

Question 4

____________ are the basis for home health reimbursement under Medicare.

A) RUGs
B) CMGs
C) HHRGs
D) LTC-DRGs

Question 5

Under Medicare, approximately how often must a physician certify that home care is needed?

A) once a year
B) every six months
C) every 60 days
D) weekly

Question 6

One of the criteria for receiving Medicare payment for home care is that the patient being served must ____________________.

A) be over age 55
B) be homebound
C) have deemed status
D) be in need of homemaker services

Question 7

____________________ is a charitable organization that provides food services for those unable to leave home.

A) CHAP
B) Elder Food
C) Meals on Wheels
D) National Association for Home Care & Hospice

Question 8

A wheelchair or hospital bed is an example of ___________________

A) a fixed cost
B) a non-covered service
C) a Medicare Part A benefit
D) durable medical equipment

Question 9

In-home respite care __________________________________________.

A) is usually provided by a speech-language pathologist
B) allows the primary caregiver to have some free time
C) is respiratory therapy rendered in the home
D) must be provided by a registered nurse

Question 10

Labor costs and transportation costs associated with home care visits are examples of ______________________.

A) fixed costs
B) Part B costs
C) variable costs
D) non-reportable costs

Question 11

Software available from CMS which can be used for data entry, editing, and validation of OASIS data is called ________________.

A) HAVEN
B) RAVEN
C) IRVEN
D) DAVE

Question 12

The federal agency within the Department of Health and Human Services responsible for administering Medicare programs related to home health is the ____________________________.

A) National Association for Home Care & Hospice (NAHC)
B) Community Health Accreditation Program (CHAP)
C) Outcomes Bureau for Quality Improvement (OBQI)
D) Centers for Medicare & Medicaid Services (CMS)

Question 13

The rule used as a basis of comparison for measuring quantitative or qualitative value is _________.

A) audit
B) standard
C) outcome
D) assessment

Question 14

A _____________________________________ is a record organized in sections according to patient care departments and/or disciplines.

A) Medicare-certified record
B) problem-oriented record
C) source-oriented record
D) integrated record

Question 15

Physical therapy, occupational therapy, speech-language pathology, medical social services, and respiratory therapy are all examples of the various _________________________ that may provide services to home health patients.

A) non-physician practitioners
B) unlicensed professionals
C) direct care workers
D) disciplines

Question 16

Home health care is a service provided to recovering, disabled, or chronically ill patients who receive treatment in their homes.

Question 17

Medicare will only pay for home health services for persons who are homebound.

Question 18

A home care agency that opts to be surveyed for Medicare certification by The Joint Commission would be deemed to be in compliance with the Conditions of Participation upon accreditation by the commission.

Question 19

The Community Health Accreditation Program (CHAP) is responsible for the development of the OASIS data set and manages data collection using OASIS for home care providers nationwide.

Question 20

The Accreditation Commission for Health Care (ACHC) has deeming authority for Medicare in home health, hospice, and DMEPOS (durable medical equipment, prosthetics, orthotics, and supplies)

Question 21

The home care patient's physician must review, update, and recertify (if necessary) the plan of care at least every six months, a timeframe referred to as the certification period.

Question 22

The Outcome and Assessment Information Set (OASIS) is a data set that is used by Medicare for both payment and quality improvement purposes.

Question 23

An upcode occurs when the provision of care to a patient results in unusually high costs to the home care agency

Question 24

A home health care agency's payer mix is the ratio of various insurers and third party payers, such as government programs and commercial insurers.

Question 25

Home Health Resource Groups (HHRGs) are based on assessment data in three areas-clinical, functional, and service utilization.

Question 26

A physician must have a face-to-face encounter with a home health patient within seven days prior to the start of home health care, or within three days after the start of care.

Question 27

Medicare-certified home health agencies are required to use OASIS-1 for evaluating children and maternity patients.

Question 28

HIM home care positions require knowledge of finance, quality improvement, utilization review, and information systems.

Question 29

Risk management, in general terms, is a program that monitors the liability and accountability of home care services delivered to customers.

Question 30

A(n) _____________________ is an outline for patient care based on a comprehensive assessment and the patient's specific needs that includes goals, objectives, and those responsible for completing the plan.​

Question 31

The ________________________ is a document that is completed on the first visit to the patient's home. The document should include the patient's present illness, significant past history, review of all systems/physical assessment, medications, psychological, social, and economic factors, emergency plans, and skilled nursing performed that day, and incorporate the required OASIS data elements.​

Question 32

_________________________ are costs that do not change in proportion to changes in volume of services​

Question 33

When an individual is physically or mentally limited and is able to leave his or her home only infrequently and with great effort, generally requiring assistance, this individual is considered to be​ _________________________.

Question 34

A(n) ________________________ refers to a unit of service in which medical and nonmedical treatments are provided to patients within the privacy and comfort of their own homes.​

Question 35

A(n) ____________________ is a certified staff person who is able to enhance the patient's care by assisting with the patient's activities of daily living, such as checking vital signs, bathing, grooming, meal preparation, and so on.​

Question 36

The _____________________________________ are federal regulations with which home health agencies must comply in order to participate in the Medicare program.​

Question 37

​The _____________________________________ is an association for organizations and individuals who provide health care and supportive services on an outreach basis to patients in their homes.

Question 38

The _____________________________________ is a federal agency that develops criteria meant to provide a safe work environment for all employees.​

Question 39

The _____________________________ is a ratio of an agency's various patient insurers and third­party payers.​

Question 40

​When the physician writes additional orders continuing home health services after the initial 60 -day certification period, this is called _____________________________.

Question 41

Patients who need medical-surgical nursing, intravenous therapy, enterostomal therapy, psychiatric or mental health, maternity, or restorative nursing may need the services of a(n) ______________________ agency​

Question 42

Match each description with the correct item

- An associate or member of a particular business

A) Audit
B) Denial
C) Outcome
D) OASIS-C1
E) Affiliate
F) Incident

Question 43

Match each description with the correct item

- A formal way of checking financial and other records

A) Audit
B) Denial
C) Outcome
D) OASIS-C1
E) Affiliate
F) Incident

Question 44

Match each description with the correct item

- Lack of payment for services rendered due to failure to meet requirements or some other reason

A) Audit
B) Denial
C) Outcome
D) OASIS-C1
E) Affiliate
F) Incident

Question 45

Match each description with the correct item

- Any happening that is not consistent with routine operations

A) Audit
B) Denial
C) Outcome
D) OASIS-C1
E) Affiliate
F) Incident

Question 46

Match each description with the correct item

- Data set required of home health care agencies

A) Audit
B) Denial
C) Outcome
D) OASIS-C1
E) Affiliate
F) Incident

Question 47

Match each description with the correct item

- End result or consequence; the patient's health and functional status after a period of treatment

A) Audit
B) Denial
C) Outcome
D) OASIS-C1
E) Affiliate
F) Incident

Question 48

Match each description with the correct item

- Assist patients who suffer from strokes or adverse effects of feeding tubes or endotracheal tubes; teach proper swallowing techniques and so on

A) Physical therapists
B) Respiratory therapists
C) Medical social services
D) Occupational therapists
E) Speech-language pathologists

Question 49

Match each description with the correct item

- Assist the patient to become independent with personal care duties such as dressing, bathing, and other normal activities of daily living.

A) Physical therapists
B) Respiratory therapists
C) Medical social services
D) Occupational therapists
E) Speech-language pathologists

Question 50

Match each description with the correct item

- Establish a home exercise and maintenance program for the patient, assisting with exercise routines and ambulating devices

A) Physical therapists
B) Respiratory therapists
C) Medical social services
D) Occupational therapists
E) Speech-language pathologists

Question 51

Match each description with the correct item

- Help patients and family members cope with a patient's disease process through placement and involvement with community services; help find appropriate resources and make suggestions for long-range planning.

A) Physical therapists
B) Respiratory therapists
C) Medical social services
D) Occupational therapists
E) Speech-language pathologists

Question 52

Match each description with the correct item

- Teach techniques to increase efficiency in the lungs, such as pursed-lip breathing, and safety precautions when using oxygen equipment in the home.

A) Physical therapists
B) Respiratory therapists
C) Medical social services
D) Occupational therapists
E) Speech-language pathologists

Question 53

?List the four key principles for Medicare/ Medicaid standards:

Question 54

​List two of the key principles for CHAP standards.

Question 55

Describe three key elements for reporting incidents.?

Question 56

List three items needed when a home health agency hires a new employee.?

Question 57

List three types of policies and procedures that should be reviewed and approved by the agency's legal counsel.?