Free CCM Practice Test Questions

A patient needs crisis intervention for family dynamics, family and cultural issues and resources, and requests for Complimentary and alternative medicine. Which case management knowledge domain applies?

When psychosocial issues may obstruct a patient’s timely and safe progression through an acute episode of care, which referral approach best promotes teamwork between the case manager and the social worker while preventing duplicated activities?

In the input-throughput-output model, which factor is classified as an output factor that can delay patient flow?

Which factor was the dominant driver behind the widespread adoption of Managed Care and the Centers for Medicare and Medicaid Services (CMS) Prospective Payment System (PPS)?

In an inpatient rehabilitation facility (IRF) audit, which documentation best supports frequent, direct, medically necessary physician involvement and periodic team conferences held at least every 2 weeks with decisions recorded?

A medically stable patient can tolerate intensive therapy and requires 24-hour nursing care. Which rehabilitation setting is most appropriate?

During interdisciplinary rounds, a patient says they do not understand post-discharge benefits and want to participate in care decisions. What is the nurse case manager’s next action?

During orientation for an RN working in case management, which content most directly establishes expectations for professional behavior while coordinating patient care across the continuum of care?

An RN case manager is coordinating care for a patient whose services are being reviewed and paid under two different payer programs. Which element most directly establishes mandatory practice requirements that may differ by state or by program?

After hospital discharge, which activity BEST represents care management within a community care program for a patient?

What is the primary purpose of a pre-discharge home visit for a patient returning home with decreased vision?

A patient plans to resume a job with frequent lifting after an illness. Which case management activity best guides return-to-work planning?

A nurse working in utilization review identifies repeated denied inpatient days and inconsistent admission reviews. Which action best supports maintaining Utilization Review Accreditation Commission (URAC) standards?

A case management program contracts with an external call center to complete after-hours patient outreach, and follow-up calls are being missed. Which organizational action best demonstrates oversight of a delegated function under the delegation of responsibilities standard?

In workers' compensation, which set of features best represents a managed care arrangement that steers care through a provider network, uses negotiated reimbursement, and applies standardized care pathways?