Ch. 8

1. Inpatient care consists of a. Services delivered by a hospital. b. Treatment of acute conditions. c. Health care delivered in conjunction with an overnight stay in a facility. d. Care delivered in a licensed facility.

2. To be called a hospital, a facility must have at least ____ beds. a. 3 b. 6 c. 12 d. 18

3. The biggest share of national health spending is attributed to a. hospitals b. physicians c. prescription drugs d. nursing home care

4. The first hospitals in the United States served mainly a. the poor b. the wealthy c. those needing surgery d. government officials

5. The first voluntary hospitals in the United States were financed a. through general taxes b. by physicians c. by private insurers d. through local philanthropy

6. Unlike the United States, the first hospitals in Europe were established by a. the government b. religious orders c. rich donors d. trade unions

7. The first proprietary hospitals in the United States were established by a. business corporations b. wealthy industrialists c. physicians d. religious organizations

8. Which primary factor was the trigger that made hospitals limit care to the more acute periods of illness rather than the full course of the disease? a. Technology b. Physician training c. Shortage of beds d. Pressure to contain costs

9. What is the meaning of "excess capacity" in the health care inpatient sector? a. Hospital consolidation b. Few hospitals c. Large institutions d. Empty beds

10. What has been the effect of intense consolidation in certain hospital markets? a. Increased competition b. Better access c. Dilution of competition d. Improved quality

11. Who pioneered the transformation of nursing into a recognized profession? a. Madame Curie b. Florence Nightingale c. Cicely Saunders d. Sylvia Lack

12. The Hill-Burton Act was passed to a. make it mandatory for private insurers to cover hospital services b. relieve shortage of hospitals c. curtail the utilization of hospital beds d. have federal control over community hospitals

13. Under the Hospital Survey and Construction Act of 1946, the responsibility for hospital planning a. remained in the hands of the federal government b. was delegated to local county and city governments c. was given to the states d. was given to private insurers

14. Under the Hill-Burton Act, federal grants were given on the basis of a. bed-to-population ratios b. poverty ranking for each state c. number of hospital beds already in existence d. hospital size needed to adequately serve each community

15. Which factor was the most instrumental in the growth of nonprofit community hospitals in the United States? a. Hill-Burton Act b. Growth of private health insurance c. Medical technology d. Tax Equity and Fiscal Responsibility Act

16. How did the PPS based on DRGs lead to hospital downsizing in the United States? a. It mandated closure of beds based on occupancy rates b. It led to greater competition among hospitals c. It created financial incentives to perform surgeries in outpatient settings d. It created financial incentives to minimize the patient's length of stay

17. Why are discharge statistics more accurate than admission statistics as a count of inpatients served by a hospital? a. Deaths are not counted as discharges b. Deaths are counted as discharges c. Babies are born in hospitals d. Some newborn infants need critical care

18. ALOS is an indicator of a. use of hospital capacity b. frequency of use c. severity of illness d. access

19. How is average length of stay calculated? a. Days of care/discharges b. By cumulating patient days c. Inpatient days/capacity d. Discharges X inpatient days

20. Average daily census is a measure of a hospital's a. daily capacity b. average admissions per day c. days of care d. number of inpatients served daily

21. The proportion of a hospital's capacity that is actually utilized. a. Days of care b. ALOS c. Average daily census d. Occupancy rate

22. Which of these hospitals does not serve the general public? a. County and city hospitals b. Proprietary hospitals c. Federal hospitals d. Community hospitals

23. Which ownership type constitutes the largest group of hospitals and hospital beds in the United States? a. Private for-profit b. Federal c. Private nonprofit d. State and local government

24. For whose financial benefit are proprietary hospitals operated? a. Stockholders b. The American public c. The local community d. The governing body

25. In a hospital classified as short stay, the ALOS is not more than a. 5 days b. 10 days c. 15 days d. 25 days

26. Which hospitals provide services to children in communities that do not have specialty children's hospitals. a. Rehabilitation hospitals b. General hospitals c. Long-term care hospitals d. Specialized hospitals

27. To be classified as a community hospital, the hospital must be a. a public hospital b. a nonfederal hospital c. a nonprofit hospital d. a nongovernmental hospital

28. Which of the following cannot be classified as a community hospital? a. Specialty hospital b. Proprietary hospital c. Long-stay hospital d. Children's hospital

29. What does the swing bed program allow rural hospitals to do? a. Provide emergency services or psychiatric care b. Use the same beds for acute care or long-term care c. Receive partial payment from Medicare for unused beds d. Obtain higher reimbursement for outpatient services

30. To be classified as a Critical Access Hospital, the number of acute care beds should not exceed a. 20 b. 25 c. 35 d. 50

31. What financial benefit does a small rural hospital gain by qualifying for the designation, Critical Access Hospital? a. It can receive specific federal grants for serving vulnerable populations b. It can use its beds for either acute care or long-term care as needed c. It can increase its profitability by receiving special payments for emergency services d. It can receive cost-plus reimbursement under Medicare Part A

32. Which of the following is true about church-affiliated hospitals? a. They may emphasize the sponsoring organization's spiritual and dietary principles b. They are not open to the general public c. They do not provide emergency services d. They require special license to legally operate

33. According to US law, nonprofit organizations a. can make only a limited amount of profit b. are tax exempt c. cannot have a governing body d. must pay taxes only if they are profitable

34. Institutional theory predicts that a. for-profit and nonprofit organizations will imitate each other when faced with similar regulatory and legal constraints b. as an enterprise increases in size, its unit overhead costs would decrease c. as a hospital increases in size, its economies of scale dissipate d. in competitive markets, both for-profit and nonprofit organizations would deliver certain essential community benefits

35. Which entity in hospital governance is legally responsible for the hospital's operations? a. The CEO b. The board of trustees c. The chief of staff d. The chief operating officer

36. Which entity oversees the licensure of health care facilities? a. The Joint Commission b. Federal government c. State government d. Local county or city government

37. To participate in Medicare and Medicaid, a health care facility must be a. conditioned b. accredited c. certified d. licensed

38. A hospital that is accredited by the Joint Commission a. is deemed to have met licensure requirements b. receives the designation of 'magnet hospital' c. must comply with the conditions of participation d. is deemed to have met certification requirements

39. Magnet hospitals have been found to a. attract and retain well-qualified nurses b. attract privately-insured patients c. serve a disproportionately high number of seriously ill patients d. excel in innovative processes of care delivery

40. Which principle of ethics requires caregivers to involve the patient in medical decision making? a. Paternalism b. Fidelity c. Beneficence d. Autonomy

41. The ethical principle of fidelity requires a medical practitioner to a. keep all patient information confidential b. perform his or her duty c. seek consent for treatment d. tell the truth

42. What is the main drawback of a living will? a. It cannot cover all possible situations b. The patient's agent may not act in the patient's best interest c. The person formulating a living will must have a court appointed guardian d. It becomes invalid when the patient becomes incompetent

43. Ethics committees are a. fiduciary b. legally bound c. multidisciplinary d. regulatory

1. The downsizing of hospitals in the United States began in the mid-1980s.

2. Managed care has emphasized the use of alternative services to acute hospital care whenever appropriate.

3. Women incur higher use of hospital services than men, even after childbirth-related utilization is factored out.

4. Children, in general, incur higher use of hospital services than the elderly.

5. The affluent use hospital services more intensively than the poor.

6. By definition, a public hospital is one that is open to the general public.

7. In recent years, the nonprofit hospital sector has continued to gain market share.

8. The ACA of 2010 places severe limitations on new physician-owned hospitals and on the expansion of existing ones.

9. Quality of health care is the main distinguishing factor between a general hospital and a specialty hospital.

10. Stark Laws prohibit self-referrals except when a referring physician has an ownership interest in the whole hospital.

11. Large hospitals do not realize efficiencies due to economies of scale.

12. According to guidelines established by the AMA, osteopaths cannot practice in non-osteopathic general hospitals.

13. A nonprofit hospital is prohibited by law from making a profit.

14. The CEO has the primary responsibility for defining a hospital's mission and its long-term direction.

15. Licensure of a health care facility is directly tied to the quality of care it delivers.

16. Not all health care organizations receive deemed status after they have been accredited by the Joint Commission.

17. Patients have the legal right to refuse medical treatment.