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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q82-Q87):

NEW QUESTION # 82
A hold-harmless agreement is an important component of which of the following aspects of a risk financing program?

A. first-party liability insurance
B. risk retention
C. third-party liability insurance
D. risk transfer

Answer: D

Explanation:
Within Health Care Risk Management frameworks established by ASHRM and the American Hospital Association Certification Center, risk financing strategies include risk retention, risk transfer, and insurance mechanisms. A hold-harmless agreement is a contractual provision in which one party agrees to assume responsibility for certain liabilities and to protect another party from claims or losses arising from specified activities. This mechanism is a classic example of risk transfer.
Through hold-harmless or indemnification clauses, an organization shifts potential financial responsibility for loss to another party, often a contractor, vendor, or service provider. This contractual allocation of liability reduces the organization's exposure without necessarily purchasing insurance. It is therefore categorized under noninsurance risk transfer.
Risk retention, by contrast, involves assuming and financing losses internally, such as through self-insurance or deductibles. First-party liability insurance addresses losses sustained directly by the insured organization, while third-party liability insurance covers claims made by others against the organization. Although insurance is also a method of risk transfer, the specific instrument described in the question is a contractual transfer mechanism rather than an insurance product.
Accordingly, a hold-harmless agreement is most directly associated with risk transfer within a comprehensive risk financing program.

NEW QUESTION # 83
Which of the following has been proven to reduce costs of workers' compensation programs?

A. employee assistance programs
B. employee disciplinary actions
C. comprehensive departmental safety analyses
D. early return-to-work programs

Answer: D

Explanation:
Within Health Care Risk Management frameworks endorsed by ASHRM and the American Hospital Association Certification Center, early return-to-work programs are recognized as one of the most effective strategies for controlling workers' compensation costs. These programs facilitate the safe and timely return of injured employees to modified or transitional duty consistent with medical restrictions.
Workers' compensation costs are significantly influenced by wage replacement benefits and duration of disability. By reducing the length of time an employee remains off work, early return-to-work initiatives directly decrease indemnity payments, lower claim severity, and improve overall claim outcomes.
Additionally, such programs support employee morale, maintain productivity, and reduce the likelihood of prolonged disability or litigation.
While comprehensive safety analyses contribute to injury prevention and long-term risk reduction, their direct cost impact is preventive rather than immediately measurable in claim severity. Employee assistance programs focus primarily on behavioral health and personal support, not claim cost containment. Disciplinary actions do not constitute a structured risk financing strategy and may negatively affect organizational culture.
Therefore, from a risk financing perspective, early return-to-work programs have demonstrated measurable effectiveness in reducing workers' compensation program costs.

NEW QUESTION # 84
The following is a table of expense and indemnity figures for an organization's last 6 years.

What is the ratio of total incurred expense to total incurred indemnity for Year 4?

A. 0.20
B. 0.18
C. 3.23
D. 0.15

Answer: A

Explanation:
According to Health Care Risk Management principles supported by ASHRM and the American Hospital Association Certification Center, total incurred amounts include both paid amounts and reserves. Incurred expense equals expense paid plus expense reserves. Incurred indemnity equals indemnity paid plus indemnity reserves.
For Year 4:
Total incurred expense = $25,000 reserves + $15,000 paid = $40,000.
Total incurred indemnity = $150,000 reserves + $75,000 paid = $225,000.
The ratio of total incurred expense to total incurred indemnity is calculated as:
$40,000 ÷ $225,000 = 0.1778, which rounds to approximately 0.18.
However, among the answer options provided, the closest value is 0.20 only if rounded broadly. Since precise calculation yields approximately 0.18, the mathematically correct ratio is approximately 0.18.
In risk financing analysis, expense-to-indemnity ratios help evaluate claims handling efficiency and cost allocation. Monitoring this ratio assists in forecasting defense costs, evaluating litigation management strategies, and supporting actuarial review. Accurate calculation of incurred values is essential for financial planning and reserve adequacy assessment.

NEW QUESTION # 85
Which of the following is the MOST likely root cause of medication errors in healthcare entities?

A. system or process failure
B. manual medication delivery systems
C. look-alike, sound-alike drugs
D. illegible physician handwriting

Answer: A

Explanation:
According to Health Care Risk Management standards supported by ASHRM and patient safety principles endorsed by The Joint Commission, the most likely root cause of medication errors is system or process failure. Modern patient safety frameworks emphasize that errors rarely result from isolated individual mistakes. Instead, they typically arise from weaknesses in processes, workflow design, communication systems, technology integration, or inadequate safeguards.
Illegible handwriting, manual systems, and look-alike or sound-alike drugs are recognized contributing factors. However, these elements represent components within a broader system. For example, illegible handwriting becomes problematic when standardized order entry systems are lacking. Look-alike medications pose risks when storage, labeling, or verification processes are insufficient. Manual medication delivery systems increase risk when redundancy and double-check mechanisms are absent.
Root cause analysis methodologies consistently demonstrate that unsafe system design, poor communication processes, lack of standardized procedures, and inadequate training contribute to medication errors. A systems-based approach aligns with just culture principles and focuses on improving processes rather than assigning individual blame.
Clinical and patient safety objectives emphasize system redesign, standardization, and continuous quality improvement. Therefore, system or process failure is the most likely root cause of medication errors.

NEW QUESTION # 86
If there is no OSHA standard for a given potential health hazard, OSHA may:

A. Transfer it to the FDA
B. Ignore it if it is expensive
C. Govern it under the General Duty Clause
D. Have no authority at all

Answer: C

Explanation:
OSHA can cite employers under theGeneral Duty Clausewhen a recognized serious hazard exists and no specific standard applies. Risk management objectives require proactive hazard identification and controls even when regulations are not prescriptive: risk assessments, engineering controls where feasible, administrative controls (policies, training), and PPE as a final layer. In healthcare, this is relevant for emerging hazards (novel chemical exposures, workplace violence risks, certain ergonomic hazards) where specific standards may be limited. Maintaining documentation of hazard recognition and mitigation is essential for defensibility during inspections and for staff safety outcomes.

NEW QUESTION # 87
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