CCM EXam, Questions and Tips

lynnintn · Oct 5, 2002

Vegas

Thanks for the test tips; reading it made me feel very unprepared.

I am so overworked right now, in the middle of reviewing a 1000 page file for an attorney, am getting another one next week that is over 300 pages, plus I have 23 full case management claimants; my boss is giving me 10/24 and 10/25 off to study...

If I think about this too much I will start to panic :eek:

hoolahan, ASN, RN · Oct 5, 2002

If this looks a tad out of "sequence" it is because I merged the threads, and I am going to make this topic sticky to stay at the top, at least until after the exam in October, and I will keep merging old and new threads to the topic, so we will have a large thread for reference. This topic comes up frequently here, so I thought we should keep all of the advice readily available.

OK with you guys??

LasVegasRN · Oct 6, 2002

Looks great, hoolahan. I'll try to post more tips as I remember them!

ryaninmtv, ADN, ASN, BSN, MSN, LPN, RN · Oct 23, 2002

Hoolahan-

Make sure to update us after you take the CCM exam on saturday. I'd love to know about the content, type of questions, etc.

Thanks.

lynnintn · Oct 26, 2002

Update on the CCM exam:

I just got home from taking it; I have to say, except for knowing different payor sources (private and government) you pretty much can't study for it.

One of the questions was what facility is appropriate for someone with a brain attack. A BRAIN ATTACK???? What nurse uses that type of terminology????

Lots of questions on communication/interviewing skills, negotiation skills.

Many of the questions were very ambiguous, with several possible answers, in my opinion.

Overall, it was nothing like I expected. The first half was the worst; the second half was much easier for me, because the questions made more sense, and were practical to case management. I knew several other nurses there, and we all pretty much agreed that the first half of the test seemed like it was designed to confuse and mislead.

That's my .02 worth.

I did study my backside off, BTW.

If I fail, I guess my masochistic side will go back for more in the spring:{

Kim

hoolahan, ASN, RN · Oct 26, 2002

Originally posted by kcwintn
Update on the CCM exam:
I just got home from taking it; I have to say, except for knowing different payor sources (private and government) you pretty much can't study for it.

Lots of questions on communication/interviewing skills, negotiation skills.
Many of the questions were very ambiguous, with several possible answers, in my opinion.

Kim

NO brain attack questions for me.

My whole first attempt to post was lost, so here is the edited version...

What the he!! is the 80/20 Rule?

Lots of questions about ada

1 on HIPPA

1 on ERISA

Lots on Medicaid and Medicare

The liquid vs gas oxygen was on there.

Lots on cost/benefits analysis.

Lots on work hardening vs functiona capacity exam and indications for same.

I thought the second half was worse.

Oh yeah, some guy w a hearing aide was taking an exam, and it was squealing at a pitch that was making me want to rip it right out of his ear and throw it into the nearest body of water.

Several people had to complain about it, make you feel like a low lfe, but it was unbearable!! The second half, he had turned it off after the instructions.

I am spent.

Overall, I really can't say how I did. The CCMC is very very vague about the grading process or what percentage you need to get right, how each section was weighted, etc, so who knows. I feel OK about it, but not great. Time will tell. 8-10 weeks to find out.

I am hoping I pass for my Christmas gift!

hoolahan, ASN, RN · Oct 26, 2002

Oh yeah, what the heck is spondylolithesis? And what kind of working conditions would they need?

lynnintn · Oct 26, 2002

I got this one right; it is a shifting of the vertebral body due to a defect in the pedicle or something- anyway, the answer was a sedentary job where they can change positions frequently.

It sounds like we got different tests; my a.m. testbook was blue, p.m was grey. I'm just glad its over; I hope you passed Hoolahan.

hoolahan, ASN, RN · Oct 27, 2002

Same test book colors for me kc! But yes, sounds like diff versions of same test. There are probably a lot of repeat questions, and then some that are thrown in for differences.

I picked that answer, but it was a complete guess!

We only had one stroke question, and it was the need for subacute rehab was based on, and it was either amount of brain tissue damged, or functional assessment. I picked func assessment, b/c why else would they go to rehab?

A lot of it was really careful reading of the questions. If there was any communication questions, I went with whatever answer promoted the pt/family's input. OR if the question asked about collaboration, I stayed away from answers that were focused on just the case manager, but picked the one that described a type of collaboration.

OK, I am sure you had this one, who is the case managaer's primary client? a) the payor ( one who hires you) or b) the consumer? I picked the consumer, but it was a hard choice b/c you are working for the insur co, but all the ethics criteria emphasized the good of the ct comes first.

OH yeah, here's another one, you find out the pt is in an inadequate faciity, do you a) move them to another facility? or b) act as the pt advocate? I picked advocate, b/c I felt you should first try to improve the situation.

Also we had one on if the case manager thinks care is substandard by a provider, the cm should discuss it first w who? a) your supervisor b) first the provider, then the pt, c) the insur co?

I pikced first the doc, then the pt. Only b/c I operate on the idea that you should be upfront, and go to the source before going behind their backs.

Did you notice a lot of ? focused on the cm/md relationship? Again, I picked the common sense answer, include them in the decision making process and answers like that.

hoolahan, ASN, RN · Oct 27, 2002

Darn got this one wrong!!! Liquid vs gas oxygen...

Improved Patient Ambulation. Liquid Oxygen Portables are widely recognized as the easiest, lightest and most comfortable O2 modality forAmbulatory Patients. Clinical studies indicate that the Patient's Health typically improves with increasedambulation. This is an extremely important issue with Physicians, Respiratory Therapists and Patients.

Improved Patient Quality of Life. Unlike Concentrators, a traditional LOX Reservoir does not generate any noise or heat, resulting in a betterliving environment for the patient. Again, this can be an important issue with Physicians, RespiratoryTherapists and Patients.

Saves the Patient Money. Unlike Concentrators, a traditional LOX does not consume any electricity. Therefore, the patient does nothave any additional monthly electrical bill expenses, due to powering a Concentrator. For Patient's on a fixedincome this can be a very important point because most Concentrators have relatively high power consumptionratings (i.e., 350 - 425 Watts). Typically, the additional monthly expense to the patient is in a range of $25 to$30.

Quality of Medical Oxygen. Liquid Oxygen systems always deliver 100% pure oxygen gas. A good-running Concentrator will typicallydeliver only 90 - 95% pure oxygen gas. A poor-running Concentrator (which is a relatively commonoccurrence) will be even less.

Lower Dealer Maintenance/Service Cost. When compared to Concentrators, traditional Liquid Oxygen systems typically require significantly lessmaintenance and service throughout the product life cycle. Liquid Oxygen systems are also widely recognizedas having a longer product life cycle than Concentrators.

No Back-Up System Required. Unlike Concentrators, the traditional Liquid Oxygen system does not require any type of back-up oxygen source, resulting in less required capital equipment for the Dealer. Also in the event of a power outage, thepatient isn't burdened with switching to the back-up source.

Saves the Dealer Money.For ambulatory patients, a liquid oxygen based system is typically the lowest cost modality alternative for theHome Healthcare Provider/Dealer. This is due to fewer required stops to fill the Liquid Oxygen Reservoir,versus dropping off several small, high-pressure cylinders.

Benefits Of Liquid Oxygen Respiratory SystemsCAIRE INC. * 3505 County Road 42 West, Burnsville, MN 55306-3803 U.S.A. * 1-800-482-2473© 1998 CAIRE, Inc. All rights reserved. Made in U.S.A. product specification subject to change without notice. Printed in U.S.A.

hoolahan, ASN, RN · Oct 27, 2002

OMG! I am soooooo anal, I had to find the answer to these questions before I go to sleep...at least I got it right, it just made the most sense to me....

The 80/20 Rule...

Pareto's Principle: The 80-20 Rule

By Arthur W. Hafner, Ph.D.

March 31, 2001

Vilfredo Pareto (1848-1923) was an Italian economist who, in 1906, observed that twenty percent of the Italian people owned eighty percent of their country's accumulated wealth. Over time and through application in a variety of environments, this analytic has come to be called Pareto's Principle, the 80-20 Rule, and the "Vital Few and Trivial Many Rule." Called by whatever name, this mix of 80%-20% reminds us that the relationship between input and output is not balanced. In a management context, this rule of thumb is a useful heuristic that applies when there is a question of effectiveness versus diminishing returns on effort, expense, or time.

The Rule and Its Corollary

Pareto's rule states that a small number of causes is responsible for a large percentage of the effect, in a ratio of about 20:80. Expressed in a management context, 20% of a person's effort generates 80% of the person's results. The corollary to this is that 20% of one's results absorb 80% of one's resources or efforts. For the effective use of resources, the manager's challenge is to distinguish the right 20% from the trivial many.

Practical Applications

Some examples about the allocation of time, effort, and resources are the following:

- Costs. To reduce costs, identify which 20% are using 80% of the resources. If members of this segment are not top profit generators, consider charging them for the resources they consume or shift services away from this sector.

- Personal Productivity. To maximize personal productivity, realize that 80% of one's time is spent on the trivial many activities. Analyze and identify which activities produce the most value to your company and then shift your focus so that you concentrate on the vital few (20%). What do you do with those that are left over? Either delegate them or discontinue doing them.

- Product Mix. Marketers and advertisers engage in market segmentation by identifying groups of people/organization with shared characteristics and then aggregate these groups into larger market segments. This segmentation may be behavioristic, demographic, geographic, or psychographic. The rule predicts that 80% of the profits are derived from 20% of the segments. If costs are allocated to segments and the segments are then rank-ordered by profit, overall profits will increase if the less profitable segments are discontinued, sold, or traded.

- Profits. To increase profits, focus attention on the vital few (top 20%) by first identifying and ranking customers in order of profits and then focusing sales activities on them. The 80-20 Rule predicts that 20% of the customers generate 80% of the revenues, and 20% yield 80% of the profits, but these two groups are not necessarily the same 20%.

More Examples of the 80-20 Rule:

80% of a manager's interruptions come from the same 20% of the people

80% of a problem can be solved by identifying the correct 20% of the issues

80% of advertising results come from 20% of your campaign.

80% of an equipment budget comes from 20% of the items

80% of an instructor's time is taken up by 20% of the students

80% of benefit comes from the first 20% of effort

80% of customer complains are about the same 20% of your projects, products, services.

80% of network traffic stays within the LAN while 20% needs to cross the backbone.

80% of our personal telephone calls are to 20% of the people in our address book

80% of our shipments utilize 20% of your inventory.

80% of sales time is spent on 20% of the customers, who may not be the profitable 20%

80% of the decisions made in meetings come from 20% of the meeting time

80% of the outfits we wear come from 20% of the clothes in our closets and drawers

80% of the traffic in town travels over 20% of the roads

80% of what we produce is generated during 20% of our working hours

80% of your annual sales come from 20% of your sales force

80% of your future business comes from 20% of your customers

80% of your growth comes from 20% of your products

80% of your innovation comes from 20% of your employees or customers

80% of your profits come from 20% of your customers

80% of your staff headaches come from 20% of our employees

80% of your success comes from 20% of your efforts

80% of your website traffic comes from 20% of your pages

From studying these examples of the 80-20 Rule, managers in both profit and not-for-profit enterprise can increase their effective and efficient use of resources by analyzing the inputs required to produce the outputs that they experience.

Final Thought: The 20-20-60 Rule

When I began my librarian career as an administrator in higher education, the dean to whom I reported told me that there was a rule of thumb that had served him well. It was the 20-20-60 Rule, a special case of 80-20 Rule that he applied to a wide variety of problems and situations. His rule was that 20% of most prospects are avid supporters and 20% are avidly not supporters. The persons in these two 20% tails are basically fixed and no amount of persuasion will change their view or attitude. Prospects in the remaining 60% are persons who are interested but need to be convinced or "sold." Application of the 20-20-60 Rule means that our outcome is best if we focus on the 60% group by answering their concerns, doubts, and questions. The persons in the 60% group are the ones who most likely will become our clients and customers.

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lynnintn · Oct 28, 2002

Hoolahan

It sounds like you did fine on the test; I guess we will just hold our breath for 8-10 weeks now; doesn't that seem ridiculously long???? I guess Mr. Chauncey grades them individually:uhoh3: