BRAINSCAPE1
NEBC EXAM with complete
solutions latest version
For Profit Organizations - CORRECT ANSWER-Can lawfully release a patient who
does not have the ability to pay for services (after EMTALA). Serve lower income
populations. Owned by investors or shareholders. Large portion of budget
allocated to marketing and advertising.
not-for-profit organizations - CORRECT ANSWER-Must treat all conditions or
people regardless of insurance or ability to pay. Considered charities by IRS. Do
not pay federal or state/local property taxes. Obligation to the community.
Medicare - CORRECT ANSWER-National Health Insurance program for people 65
and older, disabled, and any age with ESRD.
Medicare A - CORRECT ANSWER-Covers inpatient hospital stays, some hospice
and home health care, no monthly premium
Medicare B - CORRECT ANSWER-Medical insurance, pays for doctor services
and outpatient services, PT/OT services. Monthly premium.
Medicare C - CORRECT ANSWER-Often called the advantage plan or choice plan.
Includes A and B, most include D. May offer dental, vision, and wellness
Medicare D - CORRECT ANSWER-Prescription drug coverage. Monthly premium.
Available to everyone, must join Medicare plan that includes part D
Medicaid - CORRECT ANSWER-A federal and state assistance program that pays
for health care services for people who cannot afford them. Low-income children,
pregnant women, and elderly. Pays long term care.
Affordable Care Act - CORRECT ANSWER-An expansion of medicaid, most of
employers must provide health insurance, have insurance or face surtax,
prevents rejection based on pre-existing condition. Also referred to as
"Obamacare", signed into law in 2010. Make affordable health insurance available
to more people.
Payors - CORRECT ANSWER-Employers, government, insurance companies,
people who pay for healthcare services
, BRAINSCAPE1
Charity Pay - CORRECT ANSWER-Healthcare system received no reimbursement
for services
Health Maintenance Organization (HMO) - CORRECT ANSWER-an organization
that provides comprehensive medical care to subscribers for a fixed fee. Cost
effective care focused on preventative care. Network, group, staff and
independent practice associations.
Preferred Provider Organization (PPO) - CORRECT ANSWER-Group of healthcare
providers that provide services to a specific group, often at a reduced rate. Cost
is higher to use out of network provider. Help negotiate cost of services between
the providers and purchasers.
Diagnosis Related Group (DRGs) - CORRECT ANSWER-classifies patients by age,
diagnosis, surgical procedure, and other information with hundreds of different
categories to predict the use of hospital resources, including length of stay,
resulting in a fixed payment amount
Prospective Payment Systems (PPS) - CORRECT ANSWER-Required facilities
providing services to Medicare clients to be reimbursed using a fixed-rate system
and included monetary incentives to reduce the length of hospital stays.
(Based on diagnosis-related group (DRG) categories)
Social Health Maintenance Organization (SHMO) - CORRECT ANSWER-special
type of health plan that provides the full range of Medicare benefits offered by
standard Medicare HMOs, plus other services that include the following:
prescription drug and chronic care benefits, respite care, and short-term nursing
home care; homemaker, personal care services, and medical transportation;
eyeglasses, hearing aids, and dental benefits
Pay for Performance (P4P) - CORRECT ANSWER-performance-oriented
incentives for hospitals and physicians to improve the quality of patient
healthcare. 4 quality measures - performance, outcomes, patient
satisfaction/experience, structures and technologies (EHR)
Value Based Purchasing - CORRECT ANSWER-A pay for performance
methodology used to reimburse hospitals based on outcomes. Provided by
Centers for Medicare and Medicaid Services. Incentive payments to acute-care
hospitals yearly based on total performance score (TPS)
Budget Cycle - CORRECT ANSWER-Includes development, monitoring, reporting,
justifying and variance analysis. Four types of budget - revenue, expense, capital,
and operating
Revenue - CORRECT ANSWER-anticipated amount of income during the budget
period
, BRAINSCAPE1
Expense - CORRECT ANSWER-salary and nonsalary, fixed costs (remain
constant such as rental fees and contract fees) and variable costs (fluctuate
based on unit activity such as census and acuity)
Capital - CORRECT ANSWER-equipment and renovation expenses. lifespan of 1
year of greater. consider cost of item, installation, shipping or delivery charges,
service contracts. Amortization (assigning cost of asset over its lifetime)
Depreciation (expensing fixed assets annually)
Operating Budget - CORRECT ANSWER-Annual budget. Based on past years unit
activity predicting for next year. Revenues and expenses for fiscal year.
How to create operating budget - CORRECT ANSWER-Need productivity goals,
patient days, workload (HHPD - hours per patient day), HPPD/shift and staffing
needs, non-productive hours, productive/non-productive hours over time, non-
labor costs. SALARY is number one expense.
Patient Days - CORRECT ANSWER-Total inpatient days for a year. Calculated by
adding together the daily patient census for 365 days. Daily census is typically
the unit census at midnight.
Average Daily Census (ADC) - CORRECT ANSWER-total patient days/number of
calendar days. Total patient days =3875. # of calendar days = 365. 3875/365 = 10.6
ADC.
Full Time Equivalency (FTE) - CORRECT ANSWER-Established by the health care
reform law to aid in determining tax credits for employees. Utilized by employer
to determine staffing needs and cost-effectiveness. 2080 hours/year = 1.0 FTE
Hours Per Patient Day (HPPD) - CORRECT ANSWER-Calculates the amount of
nursing care necessary per patient in a 24-hour period. Total productive
hours/Total volume (ADC). 8-hour shifts, 5 RNs, 1 LVN, 1 CNA and ADC of 28. 7
staff x 8 hours = 56 hours per shift. 56 hours x 3 shifts = 168 hours per day.
168/28 = 6 HPPD
Non-Productive Time - CORRECT ANSWER-varies by benefit package at each
organization. Average is 12-20%. Calculate non-productive time. FTE = 2080
hours annually. 20% benefit time. 2080 x 0.8 = 1664 hours of productive time for
patient care.
How many FTEs are needed to appropriately staff this unit? - CORRECT
ANSWER-ADC = 10.
Non-productive time is 12%.
HPPD = 15.
Calculate productive time per day 15x10=150.
Calculate productive time per year 150 x 365 = 54,750. Calculate FTE 54750/2080 =
26.3.
Calculate FTE utilizing non-productive time
2080 x 0.88 = 1830
NEBC EXAM with complete
solutions latest version
For Profit Organizations - CORRECT ANSWER-Can lawfully release a patient who
does not have the ability to pay for services (after EMTALA). Serve lower income
populations. Owned by investors or shareholders. Large portion of budget
allocated to marketing and advertising.
not-for-profit organizations - CORRECT ANSWER-Must treat all conditions or
people regardless of insurance or ability to pay. Considered charities by IRS. Do
not pay federal or state/local property taxes. Obligation to the community.
Medicare - CORRECT ANSWER-National Health Insurance program for people 65
and older, disabled, and any age with ESRD.
Medicare A - CORRECT ANSWER-Covers inpatient hospital stays, some hospice
and home health care, no monthly premium
Medicare B - CORRECT ANSWER-Medical insurance, pays for doctor services
and outpatient services, PT/OT services. Monthly premium.
Medicare C - CORRECT ANSWER-Often called the advantage plan or choice plan.
Includes A and B, most include D. May offer dental, vision, and wellness
Medicare D - CORRECT ANSWER-Prescription drug coverage. Monthly premium.
Available to everyone, must join Medicare plan that includes part D
Medicaid - CORRECT ANSWER-A federal and state assistance program that pays
for health care services for people who cannot afford them. Low-income children,
pregnant women, and elderly. Pays long term care.
Affordable Care Act - CORRECT ANSWER-An expansion of medicaid, most of
employers must provide health insurance, have insurance or face surtax,
prevents rejection based on pre-existing condition. Also referred to as
"Obamacare", signed into law in 2010. Make affordable health insurance available
to more people.
Payors - CORRECT ANSWER-Employers, government, insurance companies,
people who pay for healthcare services
, BRAINSCAPE1
Charity Pay - CORRECT ANSWER-Healthcare system received no reimbursement
for services
Health Maintenance Organization (HMO) - CORRECT ANSWER-an organization
that provides comprehensive medical care to subscribers for a fixed fee. Cost
effective care focused on preventative care. Network, group, staff and
independent practice associations.
Preferred Provider Organization (PPO) - CORRECT ANSWER-Group of healthcare
providers that provide services to a specific group, often at a reduced rate. Cost
is higher to use out of network provider. Help negotiate cost of services between
the providers and purchasers.
Diagnosis Related Group (DRGs) - CORRECT ANSWER-classifies patients by age,
diagnosis, surgical procedure, and other information with hundreds of different
categories to predict the use of hospital resources, including length of stay,
resulting in a fixed payment amount
Prospective Payment Systems (PPS) - CORRECT ANSWER-Required facilities
providing services to Medicare clients to be reimbursed using a fixed-rate system
and included monetary incentives to reduce the length of hospital stays.
(Based on diagnosis-related group (DRG) categories)
Social Health Maintenance Organization (SHMO) - CORRECT ANSWER-special
type of health plan that provides the full range of Medicare benefits offered by
standard Medicare HMOs, plus other services that include the following:
prescription drug and chronic care benefits, respite care, and short-term nursing
home care; homemaker, personal care services, and medical transportation;
eyeglasses, hearing aids, and dental benefits
Pay for Performance (P4P) - CORRECT ANSWER-performance-oriented
incentives for hospitals and physicians to improve the quality of patient
healthcare. 4 quality measures - performance, outcomes, patient
satisfaction/experience, structures and technologies (EHR)
Value Based Purchasing - CORRECT ANSWER-A pay for performance
methodology used to reimburse hospitals based on outcomes. Provided by
Centers for Medicare and Medicaid Services. Incentive payments to acute-care
hospitals yearly based on total performance score (TPS)
Budget Cycle - CORRECT ANSWER-Includes development, monitoring, reporting,
justifying and variance analysis. Four types of budget - revenue, expense, capital,
and operating
Revenue - CORRECT ANSWER-anticipated amount of income during the budget
period
, BRAINSCAPE1
Expense - CORRECT ANSWER-salary and nonsalary, fixed costs (remain
constant such as rental fees and contract fees) and variable costs (fluctuate
based on unit activity such as census and acuity)
Capital - CORRECT ANSWER-equipment and renovation expenses. lifespan of 1
year of greater. consider cost of item, installation, shipping or delivery charges,
service contracts. Amortization (assigning cost of asset over its lifetime)
Depreciation (expensing fixed assets annually)
Operating Budget - CORRECT ANSWER-Annual budget. Based on past years unit
activity predicting for next year. Revenues and expenses for fiscal year.
How to create operating budget - CORRECT ANSWER-Need productivity goals,
patient days, workload (HHPD - hours per patient day), HPPD/shift and staffing
needs, non-productive hours, productive/non-productive hours over time, non-
labor costs. SALARY is number one expense.
Patient Days - CORRECT ANSWER-Total inpatient days for a year. Calculated by
adding together the daily patient census for 365 days. Daily census is typically
the unit census at midnight.
Average Daily Census (ADC) - CORRECT ANSWER-total patient days/number of
calendar days. Total patient days =3875. # of calendar days = 365. 3875/365 = 10.6
ADC.
Full Time Equivalency (FTE) - CORRECT ANSWER-Established by the health care
reform law to aid in determining tax credits for employees. Utilized by employer
to determine staffing needs and cost-effectiveness. 2080 hours/year = 1.0 FTE
Hours Per Patient Day (HPPD) - CORRECT ANSWER-Calculates the amount of
nursing care necessary per patient in a 24-hour period. Total productive
hours/Total volume (ADC). 8-hour shifts, 5 RNs, 1 LVN, 1 CNA and ADC of 28. 7
staff x 8 hours = 56 hours per shift. 56 hours x 3 shifts = 168 hours per day.
168/28 = 6 HPPD
Non-Productive Time - CORRECT ANSWER-varies by benefit package at each
organization. Average is 12-20%. Calculate non-productive time. FTE = 2080
hours annually. 20% benefit time. 2080 x 0.8 = 1664 hours of productive time for
patient care.
How many FTEs are needed to appropriately staff this unit? - CORRECT
ANSWER-ADC = 10.
Non-productive time is 12%.
HPPD = 15.
Calculate productive time per day 15x10=150.
Calculate productive time per year 150 x 365 = 54,750. Calculate FTE 54750/2080 =
26.3.
Calculate FTE utilizing non-productive time
2080 x 0.88 = 1830
