Unit 4 Exam

Question 1

When a mistake in the patient health record occurs, whether on paper or electronically, who should make the needed corrections?

Answer 1

The person who made the original entry must make corrections to the record.

Question 2

What is the proper method to correct a paper-based health record?

Answer 2

Draw a single line through the entry and write “error” next to it along with the date, time, and initials of the person making the correction. The line should be drawn so that whatever was written can be read.

Where appropriate, the reason for the correction should be noted. For example: “Wrong patient record.”

Question 3

In an electronic system, patient record correction involves what?

Answer 3

An addendum to the electronic record.

Question 4

When correcting an electronic patient record, what should the original document be left in?

Answer 4

An unaltered state.

Question 5

What is added to the electronic record when a correction is made?

Answer 5

A new document showing the correction is created.

Question 6

What is required to authenticate the addendum made to an electronic record?

Answer 6

An electronic signature.

Question 7

What is another way to indicate a correction made to an electronic record?

Answer 7

Tracking mechanisms such as a flag or notation.

Question 8

When there is inaccuracy or incompleteness in the patient health record, correction by the patient is a matter governed by what?

Answer 8

Federal and state law.

Question 9

What grants patients the right to amend their health record?

Answer 9

The Privacy Rule in HIPAA.

Question 10

What are record retention requirements?

Answer 10

The general principles that determine the length of time health data and health records storage must be maintained by the healthcare provider.

Question 11

What addresses retention requirements?

Answer 11

State statutes and state and federal regulations.

Some state statutes establish specific time frames to retain the health record after the death or discharge of a patient.

Question 12

When may the time frames for a retention period differ?

Answer 12

They may differ if the patient is an adult, a minor, or has a mental disability.

Question 13

Do regulations or statutes provide the specific time frames for record retention?

Answer 13

Usually regulations.

Question 14

At the federal level, the Conditions of Participation in the Medicare Program require what?

Answer 14

hospitals to maintain health records for the period of the state’s applicable statute of limitations, or if there is no applicable statute, 5 years after discharge.

Question 15

Retention decisions may also be influenced by what?

Answer 15

Statutes of limitations in contract and tort actions.

Question 16

Retention of healthcare business records, which include books of accounts, vouchers, canceled checks, and correspondence, is based on what?

Answer 16

Federal and state statutes and regulations.

Question 17

The American Health Information Management Association (AHIMA) recommends what for the retention period?

Answer 17

A 10-year retention period for adult patient records, measured from the date of the patient’s last encounter.

Question 18

In the case of minors, AHIMA recommends retaining records until when?

Answer 18

Until the patient reaches the age of majority, plus the statute of limitations period that governs medical malpractice lawsuits.

Question 19

The American Hospital Association (AHA) suggests what for retention periods?

Answer 19

A 10-year retention period for clinical records of the patient’s last encounter.

Question 20

The AHA policy permits storage of inactive records, in the hospital or off-site if what?

Answer 20

Permitted by law or the licensing body.

Question 21

What is the percentage breakdown for the five types of employee related lawsuits?

Answer 21

1.) Wrongful Termination - 33%
2.) Retaliation - 12%
3.) Failure to Promote - 12%
4.) Discrimination - 16%
5.) Harassment - 27%

Question 22

How much does it cost a healthcare organization to litigate an employee related lawsuit?

Answer 22

Costs $150,000 or more to defend, with the average jury verdict being $250,000.

Question 23

There is an estimated cost $1B per year in losses to employers because of what?

Answer 23

1.) Absenteeism
2.) Low Morale
3.) New employee training and replacement costs due to sexual harassment and discrimination.

Question 24

Employers must treat all employees the same regardless of their what?

Answer 24

Status in the context of a protected class.

Question 25

A hostile work environment is also known as what?

Answer 25

Harassment.

Question 26

Harassment pertains to what?

Answer 26

Verbal, physical, or nonverbal conduct which is based on a person’s gender (or other protected characteristic), and which is unwelcome, severe, pervasive, and offensive to a reasonable person.

Question 27

What does Title VII of the Civil Rights Act of 1964 entail?

Answer 27

Prohibits employment discrimination based on race, color, religion, sex, or national origin.

Question 28

What is the Pregnancy Discrimination Act?

Answer 28

Amendment to Title VII of the Civil Rights Act of 1964. Discrimination on the basis of pregnancy, childbirth, or related medical conditions constitutes unlawful sexual discrimination under Title VII.

Question 29

What is the Equal Pay Act of 1963?

Answer 29

Protects men and women doing equal work in the same establishment from sex-based discrimination.

Question 30

What is the Age Discrimination in Employment Act of 1967?

Answer 30

Protects individuals forty years or older who are discriminated against in favor of someone younger.

Question 31

What is the Americans with Disabilities Act of 1990?

Answer 31

Prohibits employment discrimination against qualified individuals with disabilities in the private sector in state, and in local government.

Question 32

What are examples of accomodation under the ADA?

Answer 32

1.) Modification of desk for wheelchair access. 2.) Adjustment of schedule for medical treatment. 3.) Transfer, re-assignment. 4.) Unpaid leave.

Question 33

What are the protected classes?

Answer 33

1.) Age (Over 40) 2.) Gender 3.) Pregnancy 4.) Sexual Orientation 5.) Race or National Origin 6.) Religion 7.) Marital Status 8.) Disability 9.) Conscientious Employee: Whistleblower

Question 34

What are allegations of discrimination present in?

Answer 34

1.) Hiring 2.) Assignment of Work Shifts 3.) Overtime 4.) Promotions 5.) Salary 6.) Performance Evaluations 7.) Discipline

Question 35

What are Sections 501 and 505 of the Rehabilitation Act of 1973?

Answer 35

Prohibits discrimination against qualified individuals with disabilities who work in the federal government.

Question 36

What is the Family and Medical Leave Act of 1993?

Answer 36

1.) Entitles eligible employees to take up to 12 weeks of unpaid job-protected leave for family and medical reasons. 2.) It applies to the birth/adoption of a child or a “serious health condition” of a spouse, child, parent, or self. 3.) It requires 1,000 hours of work in a 12-month period to be eligible. 4.) It requires “reasonable” or “practicable” notice.

Question 37

What are the common issues related to leave?

Answer 37

1.) Denial and improper calculation of leave. 2.) Denial of leave because it is not a “serious health condition.” 3.) Failure to reinstate to same or equivalent job. 4.) Retaliation for taking leave. 5.) Another group protected from retaliation are whistleblowers, or employees who in good faith make complaints of discrimination or harassment 6.) Witnesses in discrimination/harassment proceedings exercise any rights under most statutes.

Question 38

What is the Uniformed Services Employment and Reemployment Rights Act?

Answer 38

Applies to persons who serve in the armed services.

Question 39

What is the National Labor Relations Act of 1935?

Answer 39

1.) Private law governing relation between unions and employers in the private sector. 2.) Protects the rights of employees in forming, attempting to form, and joining unions. 3.) Employees have a right to engage in union-related activities and the their Weingarten Rights.

Question 40

Union employees have remedies of what?

Answer 40

1.) Grievance/Arbitration process - binding 2.) Filing Unfair Labor Practices harge with the National Labor Relations Board. 3.) Visual (Nonverbal conduct)

Question 41

What are the implications of company-owned electronics and harassment?

Answer 41

1.) Jokes, innuendos, conversation, email with computers in the workplace. 2.) An employer must have a policy about usage. 3.) Employer can be liable to third parties. 4.) Employer has the right to monitor and review use of computer by employees.

Question 42

Under the NLRA, non-union employees have the right to engage in what?

Answer 42

“Protected concerted activity” for “mutual aid or protection.”

Question 43

In the late 1990s, what percentage of all petitions filed with the NLRB for union representative elections were for nurses seeking collective bargaining units?

Answer 43

28%

Question 44

Some jurisdictions held that nurses are considered what?

Answer 44

Supervisors: 1.) For Example: Edgewood Nursing Center vs. NLRB 2.) However, in Beverly Enterprises, West Virginia Inc. v. the 4th Circuit found that certain charge nurses were not supervisors.

Question 45

Whether nurses can unionize depends on whether they are what?

Answer 45

Employees or supervisors.

Question 46

The 4th Circuit, which covers Maryland, has held that certain charge nurses were what?

Answer 46

Not supervisors.

Question 47

Federal regulations provide that an employee is not “qualified” for employment if what?

Answer 47

They pose a direct threat to the threat to the safety of patients that cannot be eliminated by reasonable accommodation.

Question 48

What are two examples of unqualified employment?

Answer 48

1.) A request by a psychologist not to have contact with patients with violent behavior was not reasonable because patient care was essential to job function. 2.) Alcoholic physician could not perform essential job functions because he posed risk to patients, and potential relapses cannot be reasonably accommodated.

Question 49

This case law that holds that physicians are supervisors.

Answer 49

National Union of Hospital and Healthcare Employees vs. County of Cook.

Question 50

As the prestige of physicians who are salaried increases, physician what is also rising?

Answer 50

Unionization.

Question 51

If a hospital is unionized, what are the five steps to manage a labor dispute?

Answer 51

1.) Develop a plan. 2.) Evaluate which services may be deferred, reduced, or suspended. 3.) Secure the facility for patients. 4.) Engage competent legal advisor with healthcare labor experience. 5.) Seek arbitration, injunction, and/or protection under the states’ Public Health Authority.

Question 52

What was the matter is the case of Ligenza v. Genesis Health Ventures?

Answer 52

In this case, the plaintiff, a respiratory therapist, was sexually harassed by a patient. She reported this to the hospital, which took steps to mitigate, She was discharged for slapping the patient when he looked up her blouse. She sued under Title VII alleging a hostile work environment.

Question 53

What did the court rule in the case of Ligenza v. Genesis Health Ventures?

Answer 53

The court ruled in favor of the hospital because it had addressed the issue in a professional manner.

Question 54

What was the matter in the case of O'Connor v. Davis?

Answer 54

In this case, a college intern who volunteered at a state psychiatric hospital was sexually harassed by a doctor.

Question 55

What was the result of the case of O'Connor v. Davis?

Answer 55

The plaintiff lost an employment discrimination suit against the hospital because the 2nd Circuit found that was not an employee of the hospital under Title VII.

Question 56

What was the matter in the case of Carter v. Three Springs Residential Treatment?

Answer 56

In this case, an African-American plaintiff was passed over for a promotion. The plaintiff sued under Title VII for race-based employment discrimination.

Question 57

What did the court rule in the case of Carter v. Three Springs Residential Treatment?

Answer 57

The 8th Circuit reversed summary judgment for the defendant because the center failed to promulgate hiring and promotion practices and also failed to follow published policies.

Question 58

What was the matter in the case of Frison v. Southeast Missouri Community Treatment Center?

Answer 58

In this case, the plaintiff, an African-American, was subject to “stray, racist remarks” and initially assigned to work with mainly African-American patients. The hospital fired her for making long distance calls while working.

Question 59

What did the court decide in the case of Frison v. Southeast Missouri Community Treatment Center?

Answer 59

The 8th Circuit found indirect evidence of racial discrimination against her.

Question 60

What was the matter in the case of Mauro v. Borgess Medical Center as it pertained to the ADA?

Answer 60

In this case, the plaintiff was HIV-positive and the hospital re-assigned him. He refused the re-assignment and was terminated because his presence in the operating room as a surgical technician post a risk.

Question 61

What did the court decide in the case of Mauro v. Borgess Medical Center?

Answer 61

The 6th Circuit agreed with the hospital's defense.

Question 62

What was the matter in the case of Thompson v. The Ohio State University Hospital?

Answer 62

In this case, the court looked at whether the plaintiff could sue a state-supported hospital under the FMLA. The hospital moved to dismiss under 12(b)1 for lack of subject matter jurisdiction, claiming sovereign immunity under the 11th Amendement of the US Constitution.

Question 63

What did the court decide in the case of Thompson v. The Ohio State Unversity Hospital?

Answer 63

The court agreed with hospital, holding that Congress has not abrogated the 11th Amendment immunity of states under the FMLA.

Question 64

What is are the 9 responsibilities of the employer in hostile work environment complaints?

Answer 64

1.) Investigate 2.) Interview Witnesses 3.) Take Prompt Remedial Action 4.) Determine is Harassment Occured 5.) Take Action to Correct and Stop Harassment 6.) Training 7.) Reprimand Harasser 8.) Terminate 9.) Re-Assign Employees

Question 65

What is a defense for a healthcare employer against liability for harassment in the workplace?

Answer 65

Employer is not vicariously liable for workplace harassment if employer has an effective anti-harassment program.

Question 66

What are the 5 characteristics of an effective anti-harassment program?

Answer 66

1.) Formal and informal complaint structure. 2.) Training mandatory for management and available to all employees. 3.) No tolerance policy. 4.) Monitoring mechanisms. 5.) Strong commitment from management.