CPHRM Practice Questions (2026) — Free Sample Questions with Answers

Answer: A

1. Rate = falls ÷ patient days × 1,000.
2. Rate = 12 ÷ 4,800 × 1,000.
3. 12 ÷ 4,800 = 0.0025; 0.0025 × 1,000 = 2.5 falls per 1,000 patient days.

2.5: Correct. 12 falls ÷ 4,800 patient days × 1,000 = 2.5 falls per 1,000 patient days.

10: Uses admissions (12 ÷ 1,200 × 1,000) as the denominator instead of patient days.

25: Multiplies by 10,000 instead of 1,000.

400: Inverts the ratio: 4,800 ÷ 12 gives patient days per fall, not falls per 1,000 patient days.

Event rate per 1,000 patient days = events ÷ patient days × 1,000; it allows comparison across units of different size.

Answer: D

proof that the lawsuit was filed in a court: A pending case is assumed; HIPAA still requires notice or a protective order for a subpoena without a court order.

a written request on the law firm's letterhead: A letterhead request adds no protection for the patient and is not a HIPAA condition.

a statement from the attorney on why the records are needed: Relevance statements are not the HIPAA safeguard for disclosures in response to a subpoena.

satisfactory assurance of notice or a qualified protective order: Correct. For a subpoena not accompanied by a court order, the hospital needs satisfactory assurance that the patient was notified and had a chance to object, or that a qualified protective order was sought.

A HIPAA disclosure in response to a subpoena without a court order requires satisfactory assurance of notice to the patient or of a qualified protective order.

Answer: C

close the action plan in the RCA file: Completing the tasks does not show they worked; closing now skips the effectiveness check.

report completion to the patient safety committee: The committee should hear whether errors fell, not only that the tasks were done.

measure labeling errors to confirm the actions worked: Correct. Follow-up means measuring an outcome or process metric (such as mislabeled specimens per 1,000 collections) to confirm the actions reduced the risk.

schedule refresher training on specimen labeling for staff: More training is a weak action and is not justified until the results are measured.

Corrective action plans need measures of effectiveness; completing the tasks is not the same as reducing the risk.

Answer: D

after the RCA identifies the causes: Waiting weeks for the RCA delays disclosure; the patient can be told what is known now and updated later.

once the carrier has approved the disclosure: Policy may require notice to the carrier, but disclosure of known facts to the patient should not wait for carrier approval.

after counsel reviews the likely liability exposure: Liability review is not a precondition to telling the patient the facts of what happened.

promptly, sharing known facts and promising follow-up: Correct. Communication-and-resolution programs call for prompt disclosure of the known facts, an expression of regret and a commitment to share what the analysis finds.

Disclose harmful events promptly with the facts known so far; do not wait for the analysis to finish, and commit to follow-up.

Answer: B

1. Retention: $2,000,000 (system).
2. Primary layer: next $3,000,000, exhausted at $5,000,000.
3. Excess layer: $9,000,000 − $5,000,000 = $4,000,000 (within its $10,000,000 limit).

$3,000,000: This is the primary layer's payment (its full limit), not the excess layer's.

$4,000,000: Correct. The excess layer attaches at $5,000,000 ($2,000,000 retained + $3,000,000 primary), so it pays $9,000,000 − $5,000,000 = $4,000,000.

$6,000,000: Uses the primary limit ($3,000,000) as the attachment point instead of $5,000,000.

$7,000,000: Attaches the excess layer at the retention, skipping the primary layer.

Each layer pays the part of a loss between its attachment point and its limit; the excess layer attaches where the layers below it are exhausted.

Answer: D

wait until a written claim is received: If the claim arrives after the policy ends, the current policy may not respond and the new policy may exclude known circumstances.

report it to the new carrier at inception: New claims-made policies typically exclude circumstances known before inception.

add it to the year-end loss run for the broker: A loss run entry is not notice to the carrier under the policy terms.

give the current carrier notice of circumstances now: Correct. Most claims-made policies let the insured report circumstances that may give rise to a claim; proper notice now attaches any later claim to the current policy.

Under claims-made coverage, report potential claims as a notice of circumstances before the policy expires, as the policy language requires.

Answer: B

1. Total affected = 470 + 150 = 620 individuals.
2. HHS: 620 ≥ 500, so notify HHS at the same time as individual notice (45 CFR 164.408).
3. Media: the largest single-state count is 470 residents, which is not more than 500, so no media notice (45 CFR 164.406).

an annual HHS log entry only: Treats each state separately; the HHS threshold uses the total of 620 affected individuals.

contemporaneous HHS notice, no media: Correct. 620 individuals meets the 500 threshold for notice to HHS at the same time as individual notice, but neither state has more than 500 affected residents, so no media notice is required.

media notice in both states and HHS now: Media notice needs more than 500 residents of one state; neither state reaches that.

media in the first state and an annual HHS log: Wrong on both counts: 470 is not more than 500, and the 620 total requires immediate HHS notice.

The HHS threshold counts all affected individuals; the media threshold counts residents of each state separately.

Answer: D

names the patient as a suspect in a crime.: Suspect status alone does not authorize disclosure; the location exception for suspects permits only limited identifying information.

is co-signed by the agency's own legal counsel.: No counsel signature is required; the request must instead meet the three-part test.

follows notice to the patient, who did not object.: Notice and an opportunity to object is the satisfactory assurance used for subpoenas in judicial proceedings, not the test for an administrative request.

is relevant, specific and limited, and needs identifiable data.: Correct. Under 45 CFR 164.512(f)(1)(ii)(C), the information must be relevant and material to a legitimate inquiry, the request specific and limited in scope, and de-identified information not reasonably usable.

An administrative request from law enforcement permits disclosure only when it meets the three-part test: relevant and material, specific and limited, and de-identified data would not do.

Answer: D

none, since the restraint was not a cause: Deaths within 24 hours after removal from restraint are reportable whatever staff believe about causation.

a report to the state agency within 10 work days: Ten work days is the SMDA device-report deadline, not the CMS restraint rule.

an entry in the internal restraint log within 7 days: The internal log applies only to deaths in soft, two-point wrist restraints with no seclusion.

a report to CMS by close of business the next business day: Correct. 42 CFR 482.13(g) requires a report to CMS by close of business on the next business day for any death within 24 hours after removal from restraint or seclusion; a vest is outside the soft-wrist exception.

Deaths in restraint or seclusion, within 24 hours of removal, or within a week where restraint likely contributed go to CMS by the next business day, except soft wrist-only cases, which are logged internally.

Answer: D

a state telemedicine waiver: A state waiver does not change the CMS credentialing requirements.

renewed temporary privileges: Temporary privileges are for short-term needs, not for an ongoing telemedicine service.

approval by the vendor's medical director: The hospital's governing body and medical staff grant privileges, not a vendor.

credentialing by proxy under a written agreement: Correct. The CoPs let the governing body rely on a Medicare-participating distant-site hospital's credentialing and privileging decisions under a written agreement, while the hospital still grants privileges and shares performance information.

Telemedicine credentialing by proxy needs a written agreement, a qualifying distant site and the hospital's own privileging decision.

Answer: D

report the hospitalist to the NPDB: No adverse privileging action has been taken, so there is nothing to report.

suspend privileges pending investigation: Summary suspension is for imminent danger; an outlier data trend calls for focused review first.

share the data at the next annual reappointment: Waiting until reappointment leaves a possible quality problem unaddressed.

start a time-limited FPPE to review the hospitalist's cases: Correct. A concerning OPPE trend is a standard trigger for focused professional practice evaluation, a time-limited case review that determines whether further action is needed.

OPPE detects trends; FPPE investigates them before any adverse action.

Answer: A

1, 2, and 3 only: Correct. OSHA's guidelines list management commitment and worker participation, worksite analysis, hazard prevention and control, safety and health training, and recordkeeping and program evaluation; prosecuting every assailant is not an element.

1, 2, and 4 only: Drops hazard prevention and control, a core element, and adds mandatory prosecution, which is not one.

1, 3, and 4 only: Drops worksite analysis, a core element, and adds mandatory prosecution, which is not one.

2, 3, and 4 only: Drops management commitment and worker participation and adds mandatory prosecution, which is not an element.

OSHA's five program elements: leadership commitment and worker participation, worksite analysis, hazard prevention and control, training, and recordkeeping and evaluation.

Answer: C

1. Retention: hospital pays $500,000.
2. Excess layer: $500,000 to $2,500,000, so the policy pays $2,000,000.
3. Above the excess: $2,800,000 − $2,500,000 = $300,000, paid by the hospital.
4. Hospital total = $500,000 + $300,000 = $800,000.

$300,000: Counts only the amount above the excess limit and leaves out the retention.

$500,000: Counts only the retention and leaves out the amount above the excess limit.

$800,000: Correct. The hospital pays the $500,000 retention, the excess policy pays the next $2,000,000, and the hospital pays the $300,000 above $2,500,000.

$1,300,000: Treats the retention as part of the $2,000,000 excess limit, so the excess pays only $1,500,000.

An excess layer attaches at the top of the retention; anything above the layer's limit returns to the insured.

Answer: C

the full RCA and its action plan: The RCA is usually protected analysis; sending it outside the protected process risks waiver and is not what notice requires.

the risk manager's view of who was at fault: Fault opinions in a routine notice may be discoverable and are not needed; the notice reports facts.

the facts known, the parties and any demand made: Correct. Notice should give the carrier the date, the facts known, the people involved and any demand or legal papers, as the policy requires, without attaching privileged analyses or opinions.

a settlement recommendation with a proposed reserve: Reserves and settlement strategy come later, after the carrier or TPA investigates; they are not part of the initial notice.

An initial notice to the carrier reports the facts, parties and any demand promptly; privileged analyses and fault opinions stay out of it.

Answer: D

add the note, dated as of the surgery: Backdating an entry is falsification of the record.

add the note with today's date and time: A properly dated late entry is acceptable in ordinary practice, but once suit is filed it looks self-serving and can damage the defense.

replace the report with a clearer version: Replacing the original is alteration and invites spoliation claims.

leave the record unchanged and tell defense counsel: Correct. Once litigation begins, the record should not be changed; the surgeon's explanation belongs in privileged discussion with defense counsel, who can use it in testimony.

After a claim or suit, never alter or add to the record; channel explanations to defense counsel.