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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q84-Q89):

NEW QUESTION # 84
An original contract could contain:

A. Effective date, insurance requirements, and contract terms
B. Only a price estimate without scope
C. Only verbal promises
D. Only a logo and slogan

Answer: A

Explanation:
Healthcare contracting is a risk control tool. Core terms include effective date, scope, responsibilities, performance standards, indemnification, andinsurance requirements(limits, additional insured, notice of cancellation). Clear terms reduce disputes, clarify liability allocation, and strengthen compliance (HIPAA BAAs, data security, subcontractor controls). Risk management objectives focus on preventing uninsured exposures and ensuring vendors meet safety, credentialing, and regulatory requirements-especially for clinical services, technology, and facility operations.

NEW QUESTION # 85
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?

A. notice of right to deny coverage
B. reservation of rights letter
C. notice of right to rescind
D. contingent acknowledgement of coverage

Answer: B

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 # 86
In a failure mode and effects analysis, the risk priority number is calculated by

A. adding the severity, occurrence, and detection scores.
B. adding the severity and occurrence scores.
C. multiplying the severity and detection scores.
D. multiplying the severity, occurrence, and detection scores.

Answer: D

Explanation:
According to Health Care Risk Management standards endorsed by ASHRM and the American Hospital Association Certification Center, Failure Mode and Effects Analysis FMEA is a proactive patient safety tool used to identify and prioritize potential process failures before harm occurs. Within FMEA methodology, each potential failure mode is evaluated using three separate scoring components: severity, occurrence, and detection.
Severity measures the potential impact of the failure if it occurs. Occurrence assesses the likelihood that the failure will happen. Detection evaluates the probability that the failure will be identified before causing harm.
Each component is typically assigned a numerical value based on predefined criteria.
The Risk Priority Number RPN is calculated by multiplying the three scores: severity multiplied by occurrence multiplied by detection. This multiplication approach produces a composite score that reflects both the seriousness of potential harm and the likelihood that the event will occur and escape detection. Higher RPN values indicate higher-priority risks requiring mitigation.
Clinical and patient safety objectives emphasize systematic risk prioritization to allocate resources effectively and reduce preventable adverse events. Therefore, the RPN is calculated by multiplying severity, occurrence, and detection scores.

NEW QUESTION # 87
An organization's chief of orthopedics has scheduled an implant of a new artificial hip for the next day. The chief developed the artificial hip while working as a consultant for a medical device company. The device has not yet been approved by the FDA or the Institutional Review Board. The risk manager's best immediate course of action is to

A. call a special meeting of the Institutional Review Board.
B. call the chief of surgery to discuss canceling the procedure.
C. contact the FDA to clarify the status of the device.
D. verify the informed consent for the procedure.

Answer: B

Explanation:
Under Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, the implantation of a medical device that lacks FDA approval and Institutional Review Board oversight presents significant legal and regulatory violations. Use of an unapproved device outside of an approved investigational protocol may violate federal regulations governing human subject research and medical device approval processes.
The risk manager's primary responsibility is to immediately mitigate regulatory and liability exposure.
Because the procedure is scheduled for the next day, urgent intervention is required. Contacting the FDA would not resolve the immediate risk. Verifying informed consent is insufficient, as patient consent cannot legitimize use of an unapproved device outside regulatory pathways. Calling a special IRB meeting would not retroactively authorize an unapproved device without appropriate investigational device exemption processes.
Escalating the issue to the chief of surgery to halt or cancel the procedure is the most appropriate immediate step. This ensures that organizational leadership addresses the compliance violation before patient harm occurs. Risk management objectives emphasize proactive prevention of regulatory breaches, protection of patient safety, and preservation of institutional integrity. Therefore, stopping the procedure is the correct and immediate action.

NEW QUESTION # 88
A 22-year-old man has been treated at a hospital for a psychiatric condition. His mother requests that a copy of the patient's medical record be released to her. The risk manager's advice to the medical records department should be to

A. check with the psychiatrist for a recommendation to release the medical record.
B. request evidence that the mother is the guardian of the patient and then release the medical record.
C. contact the hospital's legal counsel to authorize the release of the medical record.
D. verify that a specific release of information form has been signed by the patient and then release the medical record.

Answer: D

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, a 22-year-old patient is a legal adult and retains full rights to privacy and control over disclosure of protected health information under HIPAA and applicable state confidentiality laws. Psychiatric records are subject to heightened confidentiality protections in many jurisdictions.
Absent a court order or legal guardianship determination, a parent does not have automatic access to an adult child's medical records. Therefore, before releasing any information, the organization must verify that the patient has executed a valid, specific authorization for release of information that complies with HIPAA requirements. The authorization must clearly identify the recipient, the information to be disclosed, and be properly signed and dated.
Consulting legal counsel or a treating psychiatrist does not substitute for proper authorization. Similarly, requesting guardianship documentation would only be appropriate if the mother asserts legal guardianship status; however, in the absence of such documentation, release cannot occur.
Legal and regulatory objectives emphasize strict adherence to privacy laws, protection of psychiatric records, and proper authorization procedures. Therefore, verification of a signed release of information from the patient is required before disclosure.

NEW QUESTION # 89
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