Exam 2 MGT 207

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?

• The Accreditation Commission for Health Care (ACHC), the American Academy of Home Care Physicians, and The Joint Commission

• The Community Health Accreditation Program (CHAP), The Joint Commission, and the National Association for Home Care & Hospice (NAHC)

• The American Academy of Home Care Physicians, The Joint Commission, and the National Association for Home Care & Hospice (NAHC)

• The Accreditation Commission for Health Care (ACHC), the Community Health Accreditation Program (CHAP), and the National Association for Home Care & Hospice (NAHC)

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

Answer explanation

The correct choice includes The Accreditation Commission for Health Care (ACHC), the Community Health Accreditation Program (CHAP), and The Joint Commission, all of which have deeming authority for Medicare certification in home health care.

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

• non-physician practitioner (NPP) services

• non-covered services for home care

• home health aide services

• skilled nursing services

Answer explanation

Medical-surgical nursing, intravenous therapy, and restorative nursing care are all types of skilled nursing services, which require professional nursing expertise to provide care and support to patients.

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

• MDS-3

• HHRG

• OASIS-1

• CMS-485

Answer explanation

OASIS-1 is a required data set under Medicare for home health services, used to assess patient needs and outcomes. The other options, while related, do not fulfill this specific requirement.

____________ are the basis for home health reimbursement under Medicare.

• CMGs

• HHRGs

• LTC-DRGs

• RUGs

Answer explanation

HHRGs, or Home Health Resource Groups, are the classification system used for home health reimbursement under Medicare, making them the correct choice for this question.

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

• once a year

• every six months

• weekly

• every 60 days

Answer explanation

Under Medicare, a physician must certify that home care is needed every 60 days to ensure ongoing eligibility for services. This frequent certification helps maintain the necessary oversight of patient care.

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

• be over age 55

• be in need of homemaker services

• be homebound

• have deemed status

Answer explanation

One of the criteria for Medicare home care payment is that the patient must be homebound, meaning they have difficulty leaving their home without assistance. This ensures that the services are necessary for their care.

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

• CHAP

• Meals on Wheels

• Elder Food

• National Association for Home Care & Hospice

Answer explanation

Meals on Wheels is a well-known charitable organization that specifically delivers meals to individuals who are unable to leave their homes, making it the correct choice for this question.

A wheelchair or hospital bed is an example of ___________________.

• a Medicare Part A benefit

• a non-covered service

• durable medical equipment

• a fixed cost

Answer explanation

A wheelchair or hospital bed is classified as durable medical equipment (DME) because they are designed for long-term use in medical care, making 'durable medical equipment' the correct choice.

The _________________________ provides care to the hospice patient in the patient’s place of residence (such as giving medications, dressing changes, reporting changes in patient’s condition) when hospice staff are not there.

• primary caregiver

• gatekeeper

• volunteer

• bereavement counselor

Answer explanation

The primary caregiver is responsible for providing care to the hospice patient at home, including administering medications and monitoring the patient's condition when hospice staff are not present.

Mr. Jones has elected the hospice benefit. Upon election of the hospice benefit, Mr. Jones _________________________.

• can continue to receive all other services covered under standard Medicare benefits

• agrees to pay all out-of-pocket hospice expenses should his hospice stay extend beyond the third benefit period

• waives standard Medicare coverage for services related to the terminal diagnosis

• can continue to receive other Medicare benefits except for inpatient hospitalization

Answer explanation

Upon electing the hospice benefit, Mr. Jones waives standard Medicare coverage for services related to his terminal diagnosis, meaning he will not receive Medicare coverage for those specific services.