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ASHRM CPHRM Exam Syllabus Topics:

TopicDetails
Topic 1
  • Claims and Litigation: This domain focuses on handling potential claims and legal cases, including claim reporting, litigation support, legal documentation management, and analyzing claims data to understand risk exposure.
Topic 2
  • Clinical
  • Patient Safety: This domain focuses on improving patient safety by promoting a safety culture, managing incident reporting, educating staff and patients, addressing ethical concerns, and implementing corrective actions to reduce risks and prevent harm.
Topic 3
  • Risk Financing: This domain covers managing financial risks through insurance programs, claims coordination, loss analysis, and developing strategies to reduce financial exposure.
Topic 4
  • Healthcare Operations: This domain involves managing operational risk activities such as conducting risk assessments, developing policies, coordinating risk programs, supervising staff, and supporting patient safety initiatives.
Topic 5
  • Legal and Regulatory: This domain focuses on ensuring compliance with healthcare laws and regulations, protecting patient information, managing reporting requirements, and supporting accreditation and regulatory responses.

ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q17-Q22):

NEW QUESTION # 17
An employer is not required to offer a reasonable accommodation to a job applicant with a qualified disability unless

Answer: C

Explanation:
Under Health Care Risk Management principles aligned with ASHRM and the American Hospital Association Certification Center, compliance with the Americans with Disabilities Act ADA requires employers to provide reasonable accommodations to qualified individuals with disabilities. However, the obligation to provide accommodation is generally triggered when the applicant or employee makes the employer aware of the need for accommodation.
The interactive process required by the ADA begins once the applicant requests an accommodation or discloses a need related to a disability. Employers are not required to speculate about potential disabilities or initiate accommodations without notice. While documentation may be requested to verify the disability in certain circumstances, proof is not the triggering requirement. Instead, the request itself initiates the employer' s duty to engage in good faith discussion to determine reasonable accommodation.
Withholding accommodation that creates an unsafe condition may raise separate workplace safety concerns, but that is not the threshold requirement under the ADA. Similarly, an employer's recognition alone does not automatically impose an obligation absent a request or clear disclosure.
Legal and regulatory objectives emphasize proper documentation, consistent application of ADA standards, and engagement in the interactive process once accommodation is requested. Therefore, the employer's duty arises when the applicant requests the accommodation.


NEW QUESTION # 18
An interrogatory requests insurance policy information. A risk manager should

Answer: C

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, insurance policy information is generally discoverable in litigation. Most jurisdictions require disclosure of applicable liability coverage, including policy limits, pursuant to civil procedure rules governing discovery. Therefore, when an interrogatory properly requests insurance policy information, the organization should provide the specifically requested information in coordination with defense counsel.
Providing more information than requested, such as automatically including excess limits if not asked, may exceed the scope of the interrogatory and should be guided by legal counsel. A certificate of insurance is not a substitute for responding to formal discovery requests, as it may not contain all required details regarding coverage, limits, and applicable policy periods.
Objecting to the interrogatory without valid legal grounds is generally inappropriate, as insurance coverage information is typically relevant to potential satisfaction of judgment.
Claims and litigation objectives emphasize cooperation with counsel, compliance with discovery rules, and accurate disclosure of coverage information. Therefore, the appropriate response is to provide the specifically requested insurance policy information in accordance with legal guidance.


NEW QUESTION # 19
Which of the following is an essential component of a risk management policy and procedure manual?

Answer: B

Explanation:
According to Health Care Risk Management standards outlined by ASHRM and the American Hospital Association Certification Center, a risk management policy and procedure manual should clearly define the structure, authority, and operational framework of the risk management program. An organizational chart is an essential component because it identifies reporting relationships, lines of authority, and accountability within the department and in relation to executive leadership and governing bodies.
A clearly documented organizational structure supports regulatory compliance, facilitates communication, and ensures that responsibilities for event reporting, claims management, patient safety initiatives, and regulatory oversight are properly assigned. It also demonstrates governance alignment and helps accrediting bodies evaluate program effectiveness.
Medical staff bylaws are separate governance documents that outline credentialing, peer review, and clinical governance standards. Actuarial reports are financial analyses used in risk financing decisions but are not part of a policy and procedure manual. Loss run reports summarize historical claims activity and support financial review but do not define program structure.
Health Care Operations objectives emphasize formal documentation of authority, processes, and accountability within the risk management framework. Therefore, inclusion of the department organizational chart is an essential element of a comprehensive risk management policy and procedure manual.


NEW QUESTION # 20
Which of the following items should be part of a claim file?
* peer review reports or data
* correspondence with attorneys and investigators
* literature search
* verification of settlement authority

Answer: D

Explanation:
According to Health Care Risk Management standards outlined by ASHRM and the American Hospital Association Certification Center, claim files must be carefully structured to preserve confidentiality, protect privilege, and support effective defense strategy. A claim file typically includes correspondence with attorneys and investigators, as this documentation reflects legal strategy, communications, and case development. Literature searches relevant to standards of care may also be included to assist counsel in evaluating clinical issues and expert testimony preparation. Verification of settlement authority is essential documentation to confirm that appropriate approvals were obtained before resolving a claim.
Peer review reports or data, however, should not be included in the claim file. Peer review materials are generally protected under state peer review statutes and federal patient safety privilege provisions.
Commingling peer review documents within the claims file may jeopardize privilege protections and increase the risk of discoverability in litigation. Maintaining separation between peer review files and claim files is a critical risk management practice.
Claims and litigation objectives emphasize preservation of privilege, organized documentation, and compliance with legal standards. Therefore, correspondence, literature searches, and settlement authority verification belong in the claim file, while peer review reports should be maintained separately.


NEW QUESTION # 21
When considering the proper insurance to purchase for an organization and its practitioners, a risk manager should understand which of the following about specific types of coverage?

Answer: A

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, occurrence coverage provides protection for incidents that occur during the policy period, regardless of when the claim is reported. The triggering event is the date of the occurrence. As long as the alleged act or omission took place while the policy was in force, coverage applies even if the claim is filed years later.
Option A is incorrect because occurrence coverage does not extend to incidents that occur prior to the policy's effective date. Coverage is strictly tied to the policy period.
Option C is incorrect because in claims-made coverage, the retroactive date is critical. Coverage applies only to claims made during the policy period for incidents that occurred on or after the retroactive date.
Option D is incorrect because the "nose" period, also known as prior acts coverage, is highly significant in claims-made policies. It determines whether earlier acts are covered when switching carriers.
Risk financing objectives emphasize understanding policy triggers, retroactive dates, and reporting requirements. Therefore, occurrence coverage applies to incidents that occur while the policy is in effect.


NEW QUESTION # 22
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