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Long-Term Services and Supports

A Primer for Case Managers

Part 2

doi: 10.1097/NCM.0000000000000369
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Continuing Education Information for Certified Case Managers:

This Continuing Education (CE) activity is provided by Lippincott Professional Development and has been preapproved by the Commission for Case Manager Certification (CCMC) for 1.5 contact hours. This CE is approved for meeting the requirements for certification renewal.

Registration Deadline: May 1, 2020

Continuing Education Information for Certified Professionals in Healthcare Quality (CPHQ):

This continuing education (CE) activity is provided by Lippincott Professional Development and has been approved by the National Association for Healthcare Quality (NAHQ) for 1.5 CE Hours. CPHQ CE Hours are based on a 60-minute hour. This CE is approved for meeting requirements for certification renewal.

This CPHQ CE activity expires on May 1, 2020.

Continuing Education Information for Nurses:

Lippincott Professional Development will award 1.5 contact hours for this continuing nursing education activity.

LPD is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749. LPD is also an approved provider by the District of Columbia, Georgia, and Florida CE Broker #50-1223.

The ANCC's accreditation status of Lippincott Professional Development refers only to its continuing nursing educational activities and does not imply Commission on Accreditation approval or endorsement of any commercial product.

Registration Deadline for Nurses: May 1, 2020

Disclosure Statement:

The authors and planners have disclosed that they have no financial relationship related to this article.

Payment and Discounts:

  • The registration fee for this test is $17.95
  • CMSA members can save 25% on all CE activities from Professional Case Management! Contact your CMSA representative to obtain the discount code to use when payment for the CE is requested.
Back to Top | Article Outline


GENERAL PURPOSE STATEMENT: To provide an overview of how Long-Term Services and Supports (LTSS) settings are rated, regulated, and accredited.

LEARNING OBJECTIVES/OUTCOMES: After completing in this continuing education activity, you should be able to:

  1. Explain LTSS quality rating, regulation, and accreditation systems.
  2. Discuss quality measurement and outcomes including practice standards for case managers.
  3. Identify promising practices and best practices.
  1. What is the primary goal of case managers in home- and community-based settings (HCBS)?
    1. involving family members in decision making
    2. providing care continuity and quality services
    3. supporting clients to remain in the community setting safely
  2. The LTSS State Scorecard
    1. is a national system to address LTSS needs.
    2. ensures quality service for older adults and the physically disabled.
    3. highlights measures of state performance in the system of care.
  3. The main driver of regulations in the LTSS environment is
    1. the Centers for Medicare & Medicaid Services (CMS).
    2. Congress.
    3. the individual state.
  4. Which statement is accurate concerning the State Medicaid Integration Tracker?
    1. It provides resources pertaining to federal initiatives.
    2. It provides monthly updates of all state actions involving LTSS.
    3. It highlights the status of LTSS reform activities.
  5. Under the Financial Alignment Initiative,
    1. behavioral health services are not covered.
    2. Medicare partners with states to align financing services.
    3. Medicare–Medicaid services and support are integrated for dual-eligible enrollees.
  6. Initiatives designed to improve quality and reduce costs for dual-eligible enrollees
    1. provide savings to the state and to CMS.
    2. are administered under the capitated model.
    3. include a prospective, blended payment to the health plan.
  7. The Balancing Incentive Program is intended to
    1. improve access to nursing home and assisted living facilities.
    2. assure government payers support value-based care.
    3. match a state's spending on LTSS.
  8. Program accreditation doesnotdemonstrate that an organization
    1. meets baseline administrative and program standards.
    2. performs quality improvement of its services.
    3. emphasizes volume over value throughout the care continuum.
  9. Case managers in states requiring LTSS accreditation should be mindful of vendor accreditation status in order to avoid
    1. contracting with accredited service providers.
    2. creating a plan of care for an unqualified beneficiary.
    3. placing a beneficiary at financial risk.
  10. A board-certified case manager (CCM) charged with leading a local HCBS agency's accreditation application process should first
    1. identify the shorter list of standards in the distinction program.
    2. review the LTSS Roadmap to Success.
    3. register for the LTSS Best Practices Academy.
  11. Quality measures
    1. strengthen accountability and performance improvement initiatives.
    2. should align with the health care organization's annual goals.
    3. are limited to internal processes and treatment guidelines.
  12. Quality measures for LTSS received through managed care organizations
    1. do not apply to states or other stakeholders.
    2. focus on assessment and care planning processes.
    3. are established by the National Quality Forum.
  13. Which organization contributes performance measure selection for federal health programs?
    1. National Quality Forum
    2. Institute for Healthcare Improvement
    3. Institute for Medicaid Innovation
  14. The Playbook
    1. encourages users to test best practices in their own care settings.
    2. is focused on setting quality standards in LTSS.
    3. provides guidance for evaluating care quality.
  15. Which statement is true regarding studies examining cost savings?
    1. These study results are generalizable across populations.
    2. The Kaye et al. (2009) study showed both short- and long-term spending increases for HCBS.
    3. Meaningful outcomes will help determine future benefits funding.
  16. To be successful, a borrowed best practice process should
    1. be published for widespread knowledge.
    2. have full leadership support and commitment.
    3. not require significant customization.
  17. What is the concern about case managers in the Medicaid world?
    1. Their qualifications may not meet professional standards.
    2. They do not function within Medicaid guidelines.
    3. They are not prepared to advocate for clients' families or caregivers.
  18. The CCMC Code of Professional Conduct for CCMs
    1. governs conduct regardless of practice setting.
    2. allows the CCM to define “optimal” in each client situation.
    3. requires agency or organizational accreditation.


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