Compliance
A healthcare provider bills Medicare for services that were not rendered, inflating client's counts to receive higher reimbursements.
What is fraud.
A healthcare provider alters patient records to cover up mistakes made during treatment.
What is falsifying medical records
You notice a colleague accessing a high-profile patient’s records without involvement in their care.
What is a unauthorized access
According to HHSC, clients have the right to meet with staff responsible for their care and be told what when asked?
What is their name, job title, and responsibilities.
Metrocare provides this resource organizational guidance for employee conduct.
What is the Employee Code of Conduct Handbook.
A nurse develops a romantic relationship with a patient.
What are boundaries.
A healthcare organization experienced an attack where hackers encrypted the EMR system and demanded a ransom for their release.
What is a privacy/security breach.
According to HHSC, when previously provided, clients have the right to withdraw permission what?
What is Consent.
A nurse continues to practice after their nursing license has expired.
What is breach of state nursing board regulations.
A healthcare provider pressures vulnerable patients into undergoing unnecessary procedures for financial gain.
What is exploitation.
When sending out a fax containing Protected Health Information (PHI), you are required to do what?
What is wait by the fax machine for a confirmation printout.
According to HHSC, if requested in writing, clients have the right to receive a list of prescribed medications when?
What is four (4) hours.
A provider did not properly inform the patient about the risks, benefits, and alternatives of the procedure before obtaining their consent.
What is negligence.
A Metrocare staff member provides inferior care to patients based on their race or socioeconomic status.
What is discrimination.
A patient received lab results not pertaining to her treatment.
What is breach of confidentiality
According to HHSC, clients have the right to be treated with what?
What is Respect and Dignity.
A social group called the First Amendment Auditors gather in the parking lot to exercise their First Amendment rights. They approach you with cameras, taking your picture, and start filming while telling you that your facility is not clean enough to treat clients. They intend to provoke a response. How do you respond?
What is be calm, welcoming and friendly. Do not ask them to stop recording, threaten them with arrest, or ask them to leave the property. Do not touch them but advise that you must get to your work area. Should you answer any questions, be helpful and advise that you do not speak for Metrocare.
An employee completes their time sheet recording a day of working when they did not show up. Under the Employee Code of Conduct Handbook, where can I find information on this type of misconduct?
What is Financial Reporting under Protection of Assets.
A client's family member calls the hospital to inquire about the client's condition and is given detailed information without the client's consent.
What is unauthorized disclosure.
According to HHSC, clients have a right to be told an estimated cost of their what, when requested?
What is Cost of charges/services provided