Chapter 01: Health Care Delivery Systems
Davis & LaCour: Foundations of Health Information Management, 4th Edition

MULTIPLE CHOICE

Comparison of Facilities

	1.	Community Care Center has 200 beds. It has an average length of stay of  years. Most of the patients are elderly, but there are some younger patients with serious chronic illnesses. Community Care Center is most likely a(n) _____ facility.
a.	acute care	
b.	behavioral health	
c.	long-term care	
d.	rehabilitation	

ANS:	C	REF:	pp. 15-16	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	2.	A facility that focuses totally on palliative care is a(n):
a.	ambulatory care facility.	
b.	hospice.	
c.	long-term care facility.	
d.	managed care.	

ANS:	B	REF:	p. 16	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	3.	Chapone Health Care is an organization that owns a number of different health care facilities: three acute care hospitals, two long-term care facilities, and a number of physician offices. Chapone also owns a rehabilitation hospital and an assisted living facility, which also delivers home care. The organization delivers care to patients at every point along the continuum of care. Chapone Health Care can be described as a(n):
a.	hospital.	
b.	chain.	
c.	fiscal intermediary.	
d.	integrated health care delivery system.	

ANS:	D	REF:	pp. 20-21	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	4.	A patient will most likely receive physical therapy in which type of health care facility?
a.	Acute care	
b.	Long-term care	
c.	Rehabilitation	
d.	Hospice	

ANS:	C	REF:	p. 16	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	5.	The patient was admitted to the hospital on Tuesday morning and died Tuesday evening. This patient is classified as a(n):
a.	inpatient.	
b.	outpatient.	
c.	both a and b.	
d.	none of the above.	

ANS:	A	REF:	p. 13	
OBJ:	4. Explain the importance of patient admission status in a health care facility and describe the types of status.

	6.	The number of beds that the facility actually has set up, equipped, and staffed is the:
a.	licensed beds.	
b.	bed count.	
c.	registered beds.	
d.	certified count.	

ANS:	B	REF:	p. 17	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	7.	A hospitalist specializes in:
a.	patients in the home health care setting.	
b.	patients discharged from the hospital.	
c.	only patients in the acute care environment.	
d.	only reading x-rays.	

ANS:	C	REF:	p. 3	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	8.	Allied Health Professional Organizations exist to provide all of the following, EXCEPT:
a.	standards of professional practice and safety.	
b.	professional knowledge and support.	
c.	acute patient care facilities.	
d.	continuing professional education.	

ANS:	C	REF:	pp. 7-8	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	9.	Which one of the following is NOT considered a health care facility?
a.	Primary care physician’s office	
b.	Home health care agency	
c.	Gym	
d.	Skilled nursing facility	

ANS:	C	REF:	pp. 13-16	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	10.	Which of the following patients is considered an inpatient for an acute care facility?
a.	A patient who dies prior to arriving at the acute care facility	
b.	A patient who spent 10 hours in the emergency room and then returned home	
c.	A patient who checked in to complete an outpatient surgery, and then returned home	
d.	A patient who had an overnight stay to be evaluated and treated	

ANS:	D	REF:	p. 13	
OBJ:	4. Explain the importance of patient admission status in a health care facility and describe the types of status.

	11.	Acute care discharge includes the following, EXCEPT:
a.	a patient who did not have an overnight stay in the acute care facility.	
b.	a patient dies in the acute care facility.	
c.	patient is transferred to another health care facility.	
d.	patient left acute care facility against medical advice.	

ANS:	A	REF:	p. 13	
OBJ:	4. Explain the importance of patient admission status in a health care facility and describe the types of status.

	12.	Daisy Community Center is an acute care facility with 350 beds. On May 1, there were 305 inpatients. What is the percent occupancy?
a.	32%	
b.	87%	
c.	100%	
d.	85%	

ANS:	B	REF:	p. 17	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

Health Care Professionals

	13.	Another term for a consultation is a(n):
a.	therapy.	
b.	referral.	
c.	operation.	
d.	encounter.	

ANS:	B	REF:	p. 5	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	14.	Which of the following is an example of a diagnosis?
a.	Tonsillitis	
b.	Appendectomy	
c.	Chest x-ray	
d.	Physical therapy	

ANS:	A	REF:	p. 11	
OBJ:	4. Explain the importance of patient admission status in a health care facility and describe the types of status.

	15.	Which of the following is an example of a procedure?
a.	Diabetes	
b.	Pneumonia	
c.	Tonsillectomy	
d.	Appendicitis	

ANS:	C	REF:	p. 3	
OBJ:	4. Explain the importance of patient admission status in a health care facility and describe the types of status.

	16.	A synonym for “vocational nurse” is:
a.	registered nurse.	
b.	licensed practical nurse.	
c.	nurse practitioner.	
d.	advanced practice nurse.	

ANS:	B	REF:	p. 6	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	17.	All of the following are ancillary services, EXCEPT the _____ department.
a.	radiology	
b.	laboratory	
c.	emergency	
d.	mammography	

ANS:	C	REF:	p. 15	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	18.	Care that is consistent while a patient is receiving care from multiple medical specialties is called:
a.	care plan.	
b.	integrated delivery.	
c.	continuum of care.	
d.	none of the above.	

ANS:	C	REF:	p. 20	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	19.	Rehabilitation facilities are LEAST likely to have:
a.	inpatients.	
b.	outpatients.	
c.	laboratories.	
d.	operating rooms.	

ANS:	D	REF:	p. 20	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	20.	How are physicians categorized?
a.	Geographic location	
b.	Hospital	
c.	Medical specialty	
d.	Age	

ANS:	C	REF:	pp. 2-3	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	21.	Which health care professionals are responsible for orders that create the treatment plan?
a.	Nurses	
b.	Physicians	
c.	Physical therapists	
d.	Medical assistants	

ANS:	B	REF:	p. 2	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	22.	A primary care physician will usually NOT:
a.	provide specialty medical care.	
b.	evaluate and consult.	
c.	refer patients to a specialist.	
d.	coordinate all patient care.	

ANS:	A	REF:	p. 5	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	23.	A nurse is responsible for:
a.	delivering and managing patient care.	
b.	ordering prescriptions.	
c.	ordering the patient to be admitted or discharged.	
d.	developing a patient treatment care plan.	

ANS:	A	REF:	pp. 5-6	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	24.	Nurse midwives and nurse anesthetists are examples of a(n):
a.	licensed vocational nurse (LVN).	
b.	registered nurse (RN).	
c.	Licensed Practical Nurse (LPN).	
d.	Advanced Practice Registered Nurse (APRN).	

ANS:	D	REF:	p. 6	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	25.	Which is not an example of an allied health professional?
a.	Respiratory therapist	
b.	Surgical technologist	
c.	Gastroenterologist	
d.	Dietician	

ANS:	C	REF:	pp. 7-8	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	26.	Which health care professional is responsible for educating patients about medication regimens from the patient care plan?
a.	Health information technologist	
b.	Physician	
c.	Psychologist	
d.	Nurse	

ANS:	D	REF:	p. 11	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	27.	Which health care professional is responsible to assist in exercises under a patient care plan?
a.	Nurse anesthetist	
b.	Gastroenterologist	
c.	Behavioral specialist	
d.	Physical therapist	

ANS:	D	REF:	p. 8	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	28.	A primary care physician will be most likely to perform which of the following?
a.	Remove breast tumor	
b.	Take a chest x-ray	
c.	Analyze routine blood test results	
d.	A colonoscopy	

ANS:	C	REF:	p. 5	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

Legal and Regulatory Environment

	29.	Which of the following agencies can qualify an acute care facility for “deemed status”?
a.	State departments of health	
b.	Commission on Accreditation of Rehabilitation Facilities (CARF)	
c.	The Joint Commission (TJC)	
d.	Conditions of Participation (COP)	

ANS:	C	REF:	p. 23	
OBJ:	6. Understand the importance of government involvement in health care and policy-making as it relates to the health care delivery system.		

	30.	Medicare is administered by:
a.	Food and Drug Administration (FDA).	
b.	Centers for Medicare and Medicaid (CMS).	
c.	individual states.	
d.	National Committee for Quality Assurance (NCQA).	

ANS:	B	REF:	p. 27	
OBJ:	6. Understand the importance of government involvement in health care and policy-making as it relates to the health care delivery system.		

	31.	A facility is reviewing its policies and procedures to ensure that it complies with The Joint Commission (TJC) standards. This facility is concerned about its:
a.	accreditation.	
b.	certification.	
c.	licensure.	
d.	registration.	

ANS:	A	REF:	pp. 26-27	
OBJ:	6. Understand the importance of government involvement in health care and policy-making as it relates to the health care delivery system.		

	32.	Which of the following is NOT an American Health Information Management Association (AHIMA) credential?
a.	Registered Health Information Technician (RHIT)	
b.	Certified Coding Specialist (CCS)	
c.	Certified in Healthcare Policy (CHP)	
d.	CHPS Certified in Healthcare Privacy and Security (CHPS)	

ANS:	D	REF:	p. 10	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	33.	The state approves the number of beds a hospital is allowed to have as part of its:
a.	licensure.	
b.	accreditation.	
c.	registration.	
d.	certification.	

ANS:	A	REF:	p. 16	
OBJ:	7. Differentiate between accreditation and licensure, and identify the organizations responsible for both.

	34.	All health care professionals must adhere to their medical discipline’s ____ standards.
a.	accreditation	
b.	certification	
c.	professional	
d.	licensure	

ANS:	C	REF:	p. 29	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	35.	How is the support from the American Health Information Management Association (AHIMA) different from the American Academy of Professional Coders (AAPC)?
a.	The AAPC only supports coders.	
b.	AHIMA supports health information management professionals whereas AAPC supports billing professionals.	
c.	AAPC supports health information management professionals whereas AHIMA supports billing professionals.	
d.	Both organizations support only medical coding and billing activities.	

ANS:	B	REF:	p. 8	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	36.	Health information management professionals are responsible for all of the following, EXCEPT:
a.	medical coding and billing.	
b.	management of all health records.	
c.	privacy, confidentiality, and security of patient information.	
d.	patient admission.	

ANS:	D	REF:	pp. 8-9	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	37.	Which of the following is a requirement of obtaining the Registered Health Information Technician (RHIT) credential?
a.	Having an Associate’s Degree in Health Information Technology	
b.	Medical coding experience	
c.	Obtaining an Associate’s degree from a CAHIIM accredited Health Information Technology Program	
d.	Having work experience in Health Information Technology	

ANS:	C	REF:	p. 9	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	38.	HIT Pro Courses and Examinations are used to prepare professionals to:
a.	manage paper-based health records.	
b.	address issues related to patient health care confidentiality and privacy.	
c.	design a medical records department.	
d.	implement an electronic health records (EHR) system.	

ANS:	D	REF:	p. 11	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	39.	Unlike Medicare, eligibility for Medicaid is primarily based on:
a.	age.	
b.	disability.	
c.	economic circumstances.	
d.	military service.	

ANS:	C	REF:	p. 26	
OBJ:	6. Understand the importance of government involvement in health care and policy-making as it relates to the health care delivery system.		

	40.	Nonprofit health care facilities have the following characteristics, EXCEPT:
a.	surplus income belongs to shareholders.	
b.	have a board of directors.	
c.	all income beyond net income is used for charitable purposes.	
d.	receive federal tax breaks.	

ANS:	A	REF:	p. 20	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	41.	HIM professionals do all of the following, EXCEPT:
a.	secure health information.	
b.	report health information.	
c.	develop and implement EHRs.	
d.	document patient care in health records.	

ANS:	D	REF:	pp. 8-9	
OBJ:	3. Summarize health information related leadership roles.		

	42.	HIM professionals may provide leadership in which of the following areas?
a.	Health information security	
b.	EHR development and implementation	
c.	Patient registration	
d.	All of the above	

ANS:	D	REF:	pp. 8-9	
OBJ:	3. Summarize health information related leadership roles.		

COMPLETION

Health Care Professionals

	1.	The broad range of services that may be required by a patient in his or her lifetime is referred to as the __________.

ANS:	continuum of care

REF:	p. 20	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	2.	Health care professionals must adhere to their discipline’s ____________.

ANS:	code of ethics

REF:	p. 30	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	3.	When one physician asks another physician for an opinion regarding the care of a patient, the first physician is asking for a(n) ____________.

ANS:	consultation

REF:	p. 5	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

Legal and Regulatory Environment

	4.	Medicare waives compliance audits for appropriately accredited facilities by granting them _________.

ANS:	deemed status

REF:	p. 27	
OBJ:	6. Understand the importance of government involvement in health care and policy-making as it relates to the health care delivery system.		

	5.	Voluntary compliance with a set of standards developed by an independent agency is part of the _________ process.

ANS:	accreditation

REF:	p. 27	
OBJ:	7. Differentiate between accreditation and licensure, and identify the organizations responsible for both.

	6.	An ________ provides care to patients at all or most points along the continuum of care.

ANS:	integrated delivery system

REF:	p. 22	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	7.	Occupational therapy is an example of a(n) ________.

ANS:	
allied health profession
rehabilitation therapy
health-related occupation

REF:	p. 8	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

Comparison of Facilities

	8.	The actual number of beds that a hospital has available for inpatients is called the _________.

ANS:	bed count

REF:	p. 17	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	9.	A health care organization that has permanent facilities, 24-hour nursing care, and an organized medical staff is a type of _________.

ANS:	hospital

REF:	p. 13	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	10.	A specialty inpatient facility that focuses on the treatment of individuals who are not adults is a(n) _________.

ANS:	children’s hospital

REF:	p. 17	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	11.	A hospital with an average length of stay of less than 30 days, an emergency department, operating suite, and clinical departments to handle a broad range of diagnoses and treatments is most likely a(n) ________.

ANS:	acute care facility

REF:	p. 13	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	12.	_________ focuses on treating patients where they reside.

ANS:	Home health care

REF:	p. 16	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	13.	Palliative care for the terminally ill is the focus of ________care.

ANS:	hospice

REF:	p. 16	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

MATCHING

Match the following terms with their definitions.
a.	Administers substances that cause loss of sensation	
b.	Specializes in patients with cancer	
c.	Care related to the female reproductive system	
d.	Cares for women before, during, and after delivery	
e.	Delivers primary health care for children	
f.	Delivers primary health care for patients of all ages	
g.	Diseases and abnormal conditions of newborns	
h.	Diseases of the digestive system	
i.	Diseases of the heart and blood vessels	
j.	Diseases of the muscles and bones	
k.	Disorders of the skin	
l.	Diseases of the mind	
m.	Eye diseases	
n.	Patients who have strong reactions to pollen and insect bites	
o.	Studies changes in cells, tissues, and organs	

	1.	Allergist

	2.	Anesthesiologist

	3.	Cardiologist

	4.	Dermatologist

	5.	Family practitioner

	6.	Gastroenterologist

	7.	Gynecologist

	8.	Neonatologist

	9.	Obstetrician

	10.	Oncologist

	11.	Ophthalmologist

	12.	Orthopedist

	13.	Pathologist

	14.	Pediatrician

	15.	Psychiatrist

	1.	ANS:	N	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	2.	ANS:	A	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	3.	ANS:	I	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	4.	ANS:	K	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	5.	ANS:	F	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	6.	ANS:	H	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	7.	ANS:	C	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	8.	ANS:	G	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	9.	ANS:	D	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	10.	ANS:	B	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	11.	ANS:	M	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	12.	ANS:	J	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	13.	ANS:	O	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	14.	ANS:	E	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	15.	ANS:	L	REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

ESSAY

	1.	List six medical specialties and describe what they do.

ANS:	
Refer to Table 1-1 in the text for a complete list. Answers may include the following:
· Anesthesiologist—Administers substances that cause loss of sensation.
· Oncologist—Treats cancer patients.
· Gynecologist—Provides care related to the female reproductive system.
· Obstetrician—Cares for women before, during, and after delivery.
· Pediatrician—Delivers primary health care for children.
· Family practitioner—Delivers primary health care for patients of all ages.
· Neonatologist—Treats diseases and abnormal conditions of newborns.
· Gastroenterologist—Treats diseases of the digestive system.
· Cardiologist—Treats diseases of the heart and blood vessels.
· Orthopedist—Treats diseases of the muscles and bones.
· Dermatologist—Treats diseases of the skin.
· Psychiatrist—Treats disorders of the mind.
· Ophthalmologist—Treats eye diseases.
· Allergist—Treats patients who have strong reactions to pollen and insect bites.
· Pathologist—Studies changes in cells, tissues, and organs.

REF:	p. 4	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	2.	Distinguish between diagnosis and procedure. Give examples of both.

ANS:	
The diagnosis is the medical nomenclature for what is wrong with the patient; this can represent a disease or a symptom. A procedure can be a test to help determine any abnormalities or disease conditions, or a procedure can be an operation or therapy to diagnose or treat the condition or disease.

REF:	p. 12	
OBJ:	4. Explain the importance of patient admission status in a health care facility and describe the types of status.

	3.	List six health-related (allied health) professions and describe what they do.

ANS:	
· Occupational therapist—Return of patient to maximum activities of daily living (ADLs).
· Physical therapist—Also ADLs: focuses on strength, gait, and range of motion.
· Registered health information technician—Collection, retention, and reporting of health information.
· Respiratory therapist—Breathing therapy.
· Phlebotomist—Draws blood.
· Dietician—Nutritional and other food services.

REF:	p. 8	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	4.	Is a physician an allied health professional? Why or why not?

ANS:	
A physician is not an allied health professional. The role of allied health professionals includes supporting the health care plan that the physician has developed for the patient, thus they support the accomplishing of health care goals instead of establishing these goals.

REF:	p. 7	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	5.	Is there a difference between an MD and a DO? What kind of professionals are these?

ANS:	
Professionals with either an MD or a DO are considered medical doctors. Both professionals are licensed and accredited to prescribe medical treatment to patients and order patients to undergo therapeutic care. The difference between these two suffixes is a reflection of the medical school education they complete.

REF:	pp. 2-3	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

	6.	List at least six duties that the Health Information Management Department is responsible for.

ANS:	
· Medical coding.
· Medical billing.
· Health information storage, protection, accessibility, accountability.
· Release of information.
· Ensuring all health care departments meet the documentation standards established by TJC.
· Design and maintain the medical records department.
· Privacy officer.
· Maintaining code of ethics.
· Chart assembly and analysis.

REF:	pp. 8-9	
OBJ:	1. Identify and describe the major medical specialties and medical occupations.

Comparison of Facilities

	7.	What problems arise in an acute care facility in distinguishing between an outpatient and an inpatient?

ANS:	
Answers will vary, but they should focus on the fact that the location of the patient is not the only criterion. Some examples follow: An inpatient may be admitted but still be located in the emergency department while a bed is being prepared. Observation patients retain that status for only 24 hours, after which they are either admitted as an inpatient or discharged from observation. Patients intended for admission may expire in the emergency department prior to completion of an admission order; unless an admitting order has been given, they are considered outpatients. Patients who leave against medical advice are recorded as outpatients or inpatients, depending on their status at the time that they left.

REF:	p. 13	
OBJ:	4. Explain the importance of patient admission status in a health care facility and describe the types of status.

	8.	Compare and contrast acute care and ambulatory care.

ANS:	
With the increase in the ability to treat patients on an outpatient basis, some of the traditional lines of demarcation, such as surgery, have blurred. Fundamentally, outpatients are treated and released on the same day (or within a 24-hour period, depending on the type of outpatient). Ambulatory care is any health care rendered within this parameter. This includes physician office visits, ambulatory surgery, radiology tests, and many therapies.

Acute care is a hospital that offers a variety of services, including emergency and operating departments, ancillary departments, 24-hour nursing, and medical services. By definition, an acute care facility provides services on an inpatient basis. However, increasingly, acute care facilities also offer ambulatory services such as surgery, clinic, ancillary testing, and therapies.

REF:	pp. 13-15	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	9.	List and describe in your own words how facilities can be different from each other.

ANS:	
Answers will vary but should focus on size (number of beds and discharges), ownership (private, government, religious), financial orientation (for profit or not for profit), patient population, length of stay, and services.

REF:	pp. 13-20	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

	10.	List and define three health care settings other than acute care and ambulatory care.

ANS:	
Answers will vary, but should include three of the following:
· Rehabilitation—Physical medicine and rehabilitation. Focuses on returning patients to the community at their maximum potential ADLs. Common diagnoses include joint replacement, stroke, head injury, and spinal cord injury.
· Behavioral health—Treatment of patients with diseases of the mind. May be inpatient or outpatient. Includes drug and alcohol detoxification and rehabilitation.
· Respite—Temporary care for home care patients to relieve the primary caregiver.
· Hospice—Care for the terminally ill and their families.
· Long-term care—Resident care for patients who need 24-hour care, but not at an acute level.

REF:	pp. 15-16	
OBJ:	2. Describe the differing types of organizations, services, and personnel and their interrelationships across the health care delivery system.

Legal and Regulatory Environment

	11.	What is licensure?

ANS:	
Licensure is a mandatory government-regulated process. Licensure regulations define facilities, their operating requirements, their organizational requirements, and reporting requirements.

REF:	p. 25	
OBJ:	7. Differentiate between accreditation and licensure, and identify the organizations responsible for both.

	12.	What is accreditation?

ANS:	
Accreditation is a voluntary process of evidencing compliance with minimum standards set by independent organizations.

REF:	pp. 26-27	
OBJ:	7. Differentiate between accreditation and licensure, and identify the organizations responsible for both.

	13.	What is the difference between licensure and accreditation?

ANS:	
Licensure is a mandatory government-regulated process. Licensure deals with the minimum requirements for operating a facility. Accreditation is a voluntary process of evidencing compliance with minimum standards set by independent organizations. Accreditation deals primarily with best practices and the quality of the facility’s operations.

REF:	pp. 26-27	
OBJ:	7. Differentiate between accreditation and licensure, and identify the organizations responsible for both.

	14.	List four accrediting bodies and which health care facilities or professionals they can accredit.

ANS:	
Table 1-8 in the text lists the major accrediting bodies. Answers will vary but should include four of the following:
Organization	Facilities Accredited	
AAAHC	Ambulatory care facilities	
AOA	Osteopathic hospitals 	
CARF	Rehabilitation facilities, home health care	
CHAP	Home health	
TJC	Acute care, ambulatory care, long-term care, behavioral health, rehabilitation	
NCQA	Managed care organizations	

REF:	p. 27	
OBJ:	7. Differentiate between accreditation and licensure, and identify the organizations responsible for both.

	15.	Describe how government regulates and pays for health care.

ANS:	
See Table 1-7 in the text for a list of federal involvement. The federal government regulates health care through the Medicare and Medicaid programs, which also provide funding for care, and through the U.S. Food and Drug Administration. The federal government also provides regulation and funding through the Veterans Administration, armed forces, and Indian health agencies. Safe work environments are regulated through the Occupational Safety and Health Administration.

State government regulates health care through the Medicaid program, which also provides funding, and through the licensure of facilities. State government may also fund and administer community health services.

REF:	p. 24	
OBJ:	6. Understand the importance of government involvement in health care and policy-making as it relates to the health care delivery system.		

	16.	Describe ways in which HIM professionals may provide leadership in health care organizations.

ANS:	
HIM encompasses all the tasks, jobs, titles, and organizations involved in the administration of health information, including collection, storage, retrieval, securing/protecting, and reporting of that information. HIM professionals perform or oversee the functions that support these activities and frequently expand their practice to related activities, encompassing the financial and technical operations of a health care practitioner or organization. For example, HIM professionals may assist in the development and implementation of EHRs, oversee the maintenance of those databases, provide support services such as patient registration, retrieve data for reporting and continuing patient care, and participate in the billing process.

REF:	pp. 8-9	OBJ:	3. Summarize health information related leadership roles.

	17.	Describe a health industry change and how HIM professionals may provide leadership in managing the change.

ANS:	
The consolidation of two organizations into one and the expansion of an organization’s services beyond its original configuration are examples of changes that are occurring frequently in health care today. Leadership requires the understanding of such changes and the ability to influence colleagues to weather such changes and help the new configuration to succeed. Thus, HIM professionals are often called upon to assist in managing the various processes that must be analyzed and combined or re-designed to accommodate the changes.

Knowledgeable students may also cited the conversion of ICD-9-CM to ICD-10-CM/PCS as another example of change in which HIM professionals played a leading role in not only managing the change within their organizations through raising awareness and training, but also through influencing public policy

REF:	p. 14	
OBJ:	5. Recognize the impact of change management on processes, people, and systems.