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Chapter 8 - Legal Issues in Case Management

Terms in this set (23)

The failure to act as a reasonable person in a given situation is
negligence
All of the following are inclusive of the four elements of negligence except
competency
Which statement is true regarding malpractice?
Malpractice is considered professional negligence
Before a professional malpractice case can be filed in court,
an Affidavit of Merit must also be filed, otherwise the lawsuit will be dismissed
Which of the following is an example of the appropriate use of the recommended documentation guidelines?
"When I returned from a 'Code Blue' in another room, I found Mr. J on the floor"
Which is true about using abbreviations?
Use abbreviations that The Joint Commission (TJC) has approved
If the case manager forgot to chart a note and remembers a day later, what should he/she do?
Chart at the present date and time, and explain why the entry was delayed
Which statement is an example of appropriate documentation?
"The condition of Mrs. X's home made mobility difficult"
Why is documentation scrutinized by third-party reimbursement payers?
to determine whether a procedure was medically necessary
The best discharge planning starts
at admission to the hospital or medical facility
Charges of premature discharge or patient abandonment occur more often due to
adverse payment decisions by third-party payers
All of the following are included in the discharge planning of a patient by a case manager except the
documentation of
core measures that are not needed for medication or discharge planning
Which is an appropriate statement for discharge planning documentations?
"Written and verbal wound care instructions were given to Mr. L prior to discharge today"
Informed consent is a legal requirement that is the responsibility of the
physician
Implied consent for medical interventions includes
unconscious patients
A patient can be found to be legally incompetent only by
a court of law and judge's order
Counseling patients on the right to accept or refuse treatment in hospitals, sub-acute care facilities, hospices, and home health agencies is federally mandated through compliance with the
Patient Self-Determination Act (ADA)
The two most recognized advanced directives are the living will and the
durable power of attorney (POA) for healthcare
Potential case manager negligence cases include
negligent hiring and retention of employees
If the case manager is named in a lawsuit and being served with a summons and complaint, he/she should
immediately report receipt of the summons and complaint to the employer and attorney
In most states, how many years is the statute of limitations for adults involved in personal injury cases?
2
How can case managers minimize lawsuit risk-due to negligent referrals?
Allow the patient to make the final decision after giving him/her multiple referral options
To avoid negligent utilization review activities, the case manager should
apply criteria used by the health insurance plan, such as InterQual
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