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NCTRC EXAM - ADMINISTRATION OF TR
SERVICES QUESTIONS WITH CORRECT
ANSWERS
The letter in SWOT stand for: a. Strategies, work environment, outcomes, therapies b. Solution-based, written, objective, therapeutic c. Strengths, weaknesses, opportunities, threats d. Supervise, wield, organize, translate - Correct Answers -c. Strengths, weaknesses, opportunities, threats A strategic plan is a method of: a. Projecting future needs and activities of an organization b. Continuous quality improvement c. Protocol development and implementation d. Resource utilization - Correct Answers -a. Projecting future needs and activities of an organization One of the most typical ways to receive direct reimbursement for TR services is by "time units." This means that the patient is charged for: a. Per time intervals (ex: per 15 minutes) b. As part of the per diem rate c. By the procedures performed d. By the hospital's daily bed rate - Correct Answers -a. Per time intervals (ex: per 15 minutes) Current research has shown that the most common TR services billed for reimbursement include: a. Client assessment, leisure education, and community re-entry b. Client assessment, social skills training, and ADLs c. Stress management, group activities, and outpatient services d. Values clarification, leisure education, and functional skills training - Correct Answers -a. Client assessment, leisure education, and community re-entry The CTRS is asked to submit an annual budget that assumes she starts with no dollars and asks her to justify each dollar she then requests. This type of budgeting is called ____. a. Zero-based budgeting
b. Zero-sum score budgeting c. Revenue and expense budgeting d. NIL (no income or losses) budgeting - Correct Answers -a. Zero-based budgeting
- The difference between a vision statement and a statement of purpose for an organization is that a vision statement is: a. Never put into operation b. Created solely by the top-level managers c. Far-reaching and translates values into a desired future d. Is for the immediate future and is directly translated into operational goals - Correct Answers -c. Far-reaching and translates values into a desired future In a TR program accredited by Joint Commission (JCAHO), the goal would be to: a. Improve health care quality and patient safety b. Improve baseline, functional abilities of all clients c. Discharge all clients to their own homes/communities d. Reduce errors and improve confidence - Correct Answers -a. Improve health care quality and patient safety The statement that identifies the agency's basic values and beliefs, and thus defines how it wants to be perceived by the public is called a a. Mission statement b. Scope of care statement c. Marketing statement d. External monitoring statement - Correct Answers -a. Mission statement A written plan of operation for a TR department is most similar to a a. Policy and procedure manual b. Description of the department's quality performance initiatives c. Personnel maintenance record d. Summary of all departmental risk management activities for the past five years - Correct Answers -a. Policy and procedure manual In what document would the CTRS be MOST likely to find information on staff benefits? a. Quality improvement records b. Policy and procedure manual c. Intern manual d. Personnel files - Correct Answers -b. Policy and procedure manual All of the following may be found in a TR department's policy and procedure manual, EXCEPT: a. Instructions for checking out and driving agency vehicles b. Treatment protocols for disability groups served by the department c. Guidelines for prescribing medications d. Information about staff recruiting, hiring, supervision, and firing - Correct Answers -c. Guidelines for prescribing medications
What is an advantage of asking open-ended questions of clients for a program evaluation? a. The answers are easily quantifiable b. The clients are able to expand on their answers c. The CTRS needs to be skilled in interviewing people d. There is no advantage to open-ended questions - Correct Answers -b. The clients are able to expand on their answers The program evaluation is designed at the same time the program is planned so that the a. Specialist will know how and when to collect information as the program progresses b. Client will know from the activity calendar when activities are offered c. Treatment team can collect information about the continuity of care d. Activities are analyzed for their physical, social/affective, and intellectual requirements of clients - Correct Answers -a. Specialist will know how and when to collect information as the program progresses Which question is the BEST formative evaluation concern? a. How does the second day of the program need to be changed from the first day? b. Are the interventions appropriate for the content? c. What were the total resource costs of program delivery? d. What staff adequately prepared to deliver the services to this group of clients? - Correct Answers -a. How does the second day of the program need to be changed from the first day? The CTRS evaluated the 16-week summer programming sessions at 4-week, 8-week, and 12-week intervals to gather which of the following types of program evaluation information? a. Instantaneous time sampling b. Quality assurance health care monitoring c. Formative d. Summative - Correct Answers -c. Formative When serving a program evaluation function, the assessment tool or procedure and its results may be used to: a. Plan appropriate programs for client needs b. Provide an accurate and valid diagnosis for client treatment c. Monitor the continuing behavior of clients d. Ask for input from the other therapists on the treatment team - Correct Answers -c. Monitor the continuing behavior of clients Which of the following would be typical topics for specific program evaluation questions? a. Content of the assessment and content of the program b. Seasonal program offerings and timing of events
c. Validity and reliability of the specific program evaluation questions d. Appropriateness of program content and process for clients who participated - Correct Answers -d. Appropriateness of program content and process for clients who participated Which of the following is a formative program evaluation question? a. What unanticipated events or outcomes occurred in this program that were not part of the program plan? b. Did the sequence of activities appear to be logical and appropriate? c. How much time will be allotted for the program next time it is offered? d. Are there enough resources for the remainder of the program? - Correct Answers -d. Are there enough resources for the remainder of the program? Evaluation is conducted on specific individual programs in order to: a. Provide systematic information for future program decisions b. Provide systematic information on client regression c. Increase validity and reliability of client assessment procedures d. Develop individual treatment plans - Correct Answers -a. Provide systematic information for future program decisions Which of the following is an appropriate program evaluation question to ask clients? a. How satisfied were you with the qualifications of the staff? b. What did you learn from your participation in this program? c. How do you spend your time with family? d. How satisfied were you with the activity analysis of this program? - Correct Answers - b. What did you learn from your participation in this program? Which question below addresses client evaluation? a. How consistent are the services being delivered to clients? b. How many programs did the client attend? c. Was the CTRS effective and efficient in delivering intervention services to the client? d. What proposed outcomes were achieved as the result of the client's involvement in the program? - Correct Answers -d. What proposed outcomes were achieved as the result of the client's involvement in the program? Two clients ran away during a community outing. After contacting the police, the CTRS complete which form? a. Incident report b. Revised treatment plan c. Discharge/referral summary d. Liability summary - Correct Answers -a. Incident report Which of the following is the BEST example of a client outcome measure collected as part of the TR department's quality improvement efforts? a. Change in client's health status or well-being b. Change in client's attendance at programs
c. Proportion of clients treated according to TR protocols d. Client achievement of social interaction skills objectives - Correct Answers -a. Proportion of CTRSs to other therapists Which of the following is an example of an "outcome" indicator in TR services? a. Proportion of CTRSs to other therapists b. Proportion of clients who receive TR services c. Proportion of clients treated according to TR protocols d. Client achievement of social interactions skills objectives - Correct Answers -d. Client achievement of social interactions skills objectives "Clinical indicators" are used in quality improvement to: a. Evaluate the degree of client satisfaction with services received b. Compare one discipline's outcomes to other disciplines' outcomes c. Measure how well the targets were achieved d. Provide a basis for evidence-based practice - Correct Answers -c. Measure how well the targets were achieved The process of comparing the quantity of services provided with the amount of resources such as staff and time used is called: a. Market segmenting b. Risk management c. Productivity measurement d. Analysis of care - Correct Answers -c. Productivity measurement Which statement describes an intent or purpose common to both systems planning and quality improvement plans? a. Each describes the relationship of the comprehensive program to individual treatment plans b. Each outlines the relationship between the agency and departmental procedures c. Both define the components of department programs d. Each provides a systematic method to evaluate service delivery - Correct Answers -d. Each provides a systematic method to evaluate service delivery Which of the following is NOT an example of a TR department's risk management plan? a. Requiring TR student interns to complete their own client assessments b. Requiring employees to park on hospital premises c. Conducting peer reviews by trained professionals d. Incorporating family into the assessment procedure - Correct Answers -a. Requiring TR student interns to complete their own client assessments All of the following may be part of the department's risk management plan, EXCEPT: a. Acceptable staff/client ratios for certain types of programs b. Qualifications and special certifications needed by staff c. Marketing brochures for fund raining purposes
d. Procedures for reporting emergencies, crises, and critical incidents - Correct Answers -c. Marketing brochures for fund raining purposes The TR department may determine if it was providing quality care by: a. Completing program evaluations with clients at the end of 10% of the programs b. Finding that 10% of all clients reviewed averaged at least two community involvements per month c. Measuring the total number of client community involvements and dividing by 10 d. Referring 10% of the clients to community-based TR programs post-discharge - Correct Answers -b. Finding that 10% of all clients reviewed averaged at least two community involvements per month The CTRS attended a conference session on efficacy research. Which of the following is likely a topic within the conference session? a. Comparing outcomes of different TR interventions b. Selecting a valid and reliable client assessment c. Choosing the correct TR service model d. Providing interdisciplinary treatment to clients most in need - Correct Answers -a. Comparing outcomes of different TR interventions One of the problems with outcome measurement is that it is: a. Seen as important by health care administrators b. Expensive c. Limited in the results that can be reported d. Difficult to determine which service leads to which outcome - Correct Answers -d. Difficult to determine which service leads to which outcome Which of the following is an example of a quality assurance indicator for client assessment? a. The client will complete the assessment as directed by the CTRS, 100% of the time b. The CTRS will complete client assessments within 72 hours of admission, 80% of the time c. The TRS will match the content of the assessment with the content of the program, 100% of the time d. None of the above - Correct Answers -b. The CTRS will complete client assessments within 72 hours of admission, 80% of the time The CTRS is concerned with determining whether program goals have been achieved and whether resources were used efficiently. He is concerned with _____. a. Evidence-based practice b. Benchmarking c. Accountability d. Service delivery - Correct Answers -c. Accountability The CTRS measures _____ by using a pre-test before intervention and a post-test after intervention.
The CTRS supervisor using a formative evaluation of the TR student intern. Which of the following is a key characteristic of formative evaluation? a. Allows for a summary of all strengths and weaknesses b. Focuses on only the intern's areas of accomplishment c. Forms the basis of the student's grade d. Allows for corrective action to come after evaluation - Correct Answers -d. Allows for corrective action to come after evaluation All of the following documents should be evaluated and updated on a regular basis EXCEPT: a. Job announcement b. Performance appraisal c. Job description d. Written plan of operation - Correct Answers -a. Job announcement Which of the following is an example of clinical supervision? a. Overseeing clients on a community out-trip b. Overseeing clients during an in-house discussion group c. Helping a junior professional become a better practitioner d. Performing personnel evaluations on staff at least once per year - Correct Answers - c. Helping a junior professional become a better practitioner Which of the following may be used as a technique to motivate employees on a long- term basis? a. Make them boss for a day b. Ask them to do more with fewer resources c. Encourage their donations to the agency's charity fund d. Encourage cross training into new areas of job responsibility - Correct Answers -d. Encourage cross training into new areas of job responsibility The CTRS is a supervisor of a large TR department in a community mental health center. When staff cutbacks were ordered in the TR department by the center's administrators, she ignored the memos and continued to staff the units on regular schedules. The conflict resolution strategy employed by the CTRS is called: a. Avoidance b. Defusion c. Containment d. Confrontation - Correct Answers -a. Avoidance Which of the following is a team-building strategy for personnel within a TR department? a. Establish goals that are to be accomplished as a group b. Implement policies without staff input c. Keep the information flow to a minimum d. Make unilateral decisions - Correct Answers -a. Establish goals that are to be accomplished as a group
Which of the following is NOT a characteristic of "high performance teams" of people working in a health care environment? a. Decisions are made by group members b. Each person shares in the responsibility for success c. Each person works in his or her "work silo" d. Responses to requests are timely and efficient - Correct Answers -c. Each person works in his or her "work silo" One of the primary components of a job description is the listing of: a. Past work experiences b. Job duties to be performed c. References d. Educational institutions attended - Correct Answers -b. Job duties to be performed An advantage of calling someone's references before hiring him is that the supervisor can: a. Ask the reference to compare qualifications of several applicants b. Ask about personal issues such as family status, drug and alcohol history and religion c. Verify information from the resume or interview d. Orient the employee to hospital procedures and introduce staff of different departments - Correct Answers -c. Verify information from the resume or interview Under the condition of active treatment, the CTRS must be able to: a. Provide written documentation regarding the outcomes of activity analysis b. Justify the cost billed to third-party insurance c. Project a reasonable expectation timeline for achievement of outcomes d. Assess recreation and leisure interests - Correct Answers -c. Project a reasonable expectation timeline for achievement of outcomes Which of the following is true about active treatment? a. Participation in programs is restricted to those for whom the program has been prescribed b. All clients can participate in all programs c. Programs must be designed based on gender preferences d. All of the above - Correct Answers -a. Participation in programs is restricted to those for whom the program has been prescribed The CTRS uses the concept of active treatment in planning his TR programs. Which of the following describes this approach? a. Medically necessary, outcome-oriented interventions that specify intensity, frequency, and duration b. Focus is on self-determination and enhancement of enjoyment c. Interventions that are based on research, best practice, and, when possible, program protocols
In 1983, a cost-cutting Medicare hospital payment system was initiated that included: a. A retrospective payment system b. Direct reimbursement for TR services c. The Centers for Medicare and Medicaid Services (CMS) d. Diagnostic-related groups (DRGs) - Correct Answers - Many private hospitals followed the federal government in adhering to a prospective payment system. This means that: a. Hospitals receive the same fee for each diagnostic-related group (DRG) they treat b. Insurance companies will pay whatever hospitals charge for a service c. Individuals pay 80% of health care charges d. Psychiatric services are available to individuals within their own community - Correct Answers -a. Hospitals receive the same fee for each diagnostic-related group (DRG) they treat The Centers for Medicare and Medicaid Services (CMS) is the governmental agency responsible for: a. Building collaborative initiatives between private and public hospitals b. Ensuring that patients within these programs pay their bills in a timely manner c. Reporting medical errors to the American Medical Association d. Regulatory review of hospitals that bill for federally insured recipients - Correct Answers -d. Regulatory review of hospitals that bill for federally insured recipients The basic premise behind "managed care" in the health care industry is: a. Positive client outcomes produced at low cost b. Less focus on the individual, more focus on the diagnosis c. Sustaining a person's life at all costs d. That insurance companies will pay whatever the clinical facility charges for a service - Correct Answers -a. Positive client outcomes produced at low cost In health care, the term "capitation" means the health care provider a. Agrees to a preset dollar amount per person and to not ask for further reimbursement b. Is reimbursed only for expenses that the client can pay for c. Must itemize all charges on the bill and relate each to a specific diagnosis code d. Is a member of a fee-for-service organization that agrees on charges prior to admission - Correct Answers -a. Agrees to a preset dollar amount per person and to not ask for further reimbursement An insurance carrier's cost control method of paying a prearranged amount for specific service, no matter what the actual cost of those services might be, is called: a. Third-party reimbursement b. Prospective payment c. Cost allocation d. Unit cost - Correct Answers -b. Prospective payment
The Centers for Medicare and Medicaid Services (CMS) monitors quality assessment and performance improvement in facilities that: a. Serve individuals covered by the federal government's health insurance program b. Use the Therapeutic Recreation Accountability Model c. Adhere to the American Therapeutic Recreation Association's Standards of Practice d. Are located in low-income, urban areas - Correct Answers -a. Serve individuals covered by the federal government's health insurance program Knowing the payer mix of the agency is important because it: a. Influences how external accreditation agencies review the various departments b. Requires an extensive knowledge of insurance company forms c. Influences how the agency gets reimbursed for services d. Shortens the patient's length of stay - Correct Answers -c. Influences how the agency gets reimbursed for services Managed care is an effort on behalf of insurance companies to: a. Increase patient's length of stay b. Control costs of caring for clients c. Reduce the paperwork involved in client care d. Decrease the number of preferred provider organizations (PPOs) - Correct Answers - b. Control costs of caring for clients For a service to be reimbursable, in many instances' insurance companies require the therapist to provide what information or evidence? a. Assessment tools sanctioned by JCAHO, HCFA, or CARF b. Source-oriented medical records c. Physician's orders d. Risk management plan for the activity - Correct Answers -c. Physician's orders Managed care has shifted the responsibility of determining the services a patient need from the providers of server to the: a. State governments b. Payers of service c. Patient d. Middle class - Correct Answers -b. Payers of service In a prospective payment of system health care, the hospital knows that a specific amount will be paid by the insurance company for a particular surgery, regardless of the: a. Skill of the surgeon b. Ethnicity of the patient c. Actual cost of the surgery d. Intended outcomes - Correct Answers -c. Actual cost of the surgery The CTRS checks each piece of recreation equipment each week during a routine maintenance and safety check. The CTRS is involved in what kind of action?
a. Includes large expenditures of any kind over $ b. Covers all revenues and expenditures, except personnel c. Covers day-to-day revenues and expenditures for a one-year period d. Has line items that can be vetoed by the agency president - Correct Answers -c. Covers day-to-day revenues and expenditures for a one-year period
