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Content Outline for the CHCE Exam OLD

Certification for Home Care and Hospice Executives

The content outline identifies eight major content areas relevant to the responsibilities of home care and hospice executives, and related topics. The percentage of questions on the exam from each of the major content areas is indicated.

I. Finance and Reimbursement (18%)

A. Finance

1. Audits
    a. Purpose/need
    b. Types
    c. Components
    d. Policies, procedures, and controls
    e. Management letter
    f. Standards
2. Accounting
    a. Basic accounting/economic principles
    b. Standards
    c. Cash versus accrual methods
    d. Cost accounting
    e. Financial statements
    f. Accounts receivable
    g. Accounts payable
    h. Financial ratios
    i. General ledger
3. Budgets
    a. Types
    b. Break-even analysis
    c. Cash-flow analysis
    d. Management tool
    e. Variances
4. Contract management

5. Assets management
    a. Purchasing
    b. Request for proposal process
    c. Inventory control
    d. Facility management
    e. Capital equipment
6. Revenue enhancement
    a. New sources
    b. New business plan
7. Federal and state taxes

B. Reimbursement

1. Payment/coverage requirements
    a. Medicare home health
    b. Medicare hospice
    c. Medicaid
    d. Commercial plans
    e. Private pay
    f. Managed care organizations
2. Methods of reimbursement
    a. Medicare prospective pay (capitation, episode, per diem)
    b. Hospice Prospective pay (capitation, episode, per diem)
3. Controls for reimbursement to cost ratio

4. Resolution of payment issues
    a. Appeals
    b. ERISA limitations
    c. Managed care conflicts
    d. Uncompensated care
    e. Primary/secondary payor
II. Legal and Regulatory (18%)

A. Statutes

B. Regulations

C. Legislative process

D. Rulemaking process

E. Analysis of impact

F. Participating in the legislative process

G. Compliance with laws and regulations


1. Employment related
    a. Equal Employment Opportunity Act
    b. Affirmative action
    c. Americans with Disabilities Act
    d. Wage and hour
    e. IRS independent contractor
    f. Unemployment compensation
    g. Worker's compensation
    h. Collective bargaining
    i. OSHA
    j. Sexual harassment
    k. ERISA
    l. Benefits/COBRA
    m. Family Medical Leave Act
    n. Department of Transportation
2. Business related
    a. Antitrust
    b. State and federal tax
    c. Corporate and business law
3. Health care related
    a. Confidentiality
    b. Medicare home health
    c. Medicare hospice
    d. Medicaid home care
    e. Medicaid hospice
    f. State licensure
    g. Clinical Laboratory Improvement Act
    h. Biohazardous waste
    i. Medical device tracking and reporting
    j. Pharmacy
    k. Discipline practice acts
    l. Medical records
    m. Insurance laws
    n. Abuse and neglect
    o. Abandonment
    p. Civil Rights Act of 1964

H. Labor relations

I. Contracts

J. Legally required documentation

K. Hiring/supervision

III. Organization Planning and Management (16%)

A. Management functions

1. Control

2. Policy and procedure development

3. Problem solving

4. Planning

    a. Budget
    b. Business plan
    c. Strategic plan
    d. Marketing plan
5. Organizing, directing, coordinating, and communicating

B. Operations

1. Productivity and efficiency methods

2. Management systems

C. Organizational behavior

1. Negotiation

2. Collaboration

3. Leadership

4. Motivation

5. Conflict management

6. Organizational change

7. Team building

8. Group process
D. Strategic planning and development

1. Organization mission

2. Objectives/goals

3. Assessment
    a. Environment
    b. Strengths, weaknesses, opportunities, and threats
4. Plan

5. Implementation

6. Evaluation of achievement

E. Health care systems and issues

1. Relationship to other health care providers

2. Health care trends

3. Health policy development

IV. Human Resources (14%)

A. Job analysis

B. Recruitment strategies

C. Hiring

D. Credentialing

E. Competency assessment

F. Retention strategies

G. Performance evaluation

H. Staff development

I. Positive work environment

J. Conflict resolution

K. Salary and benefits
administration

L. Delegation and supervision

M. Unions

N. Termination

V. Quality and Risk Management (14%)

A. Quality management

1. Defining quality and quality management

2. Integration throughout the organization

    a. Role of leadership
    b. Relation to mission
3. Allocation of resources
4. Quality management program
    a. Quality vision statement
    b. Models
    c. Key processes and functions
    d. Standards of practice
    e. Quality indicators
    f. Data
    g. Outcome measures
    h. Quality improvement tools/activities
    i. Variation
    j. Customer satisfaction
    k. Quality controls
    l. Improvement activities
5. Regulatory requirements

6. Evaluation of program

B. Risk management

1. Programs and models

2. Risk identification
    a. Employees
    b. Patients
    c. Contracts
3. Risk prevention

4. Insurance needs
    a. Negligence
    b. Malpractice
    c. Casualty
    d. Errors and omissions
    e. Property
    f. Business interruption
    g. Directors and officers
    h. Worker's compensation
    i. Other appropriate types
VI. Public Relations, Marketing, and Education (7%)

A. Marketing concepts

B. Customer service

C. Marketing plan

1. Research

2. Product development

3. Pricing

4. Packaging

5. Distribution

6. Evaluation


D. Community education

1. Basic education concepts

2. Promotion of home care and hospice


E. Crisis communication

F. Networking

G. Truth in advertising

VII. Ethics (7%)

A. Basic principles

B. Ethical dilemmas

C. Ethics policy, committee, or process

D. Patient-care applications


1. Quality of life

2. Informed decision making

3. Human subjects

E. Business applications

1. Mergers, acquisitions, reorganization

2. Referral sources

3. Resource allocation

4. Employer-employee disclosure/confidentiality

5. Conflict of interest

6. Accurate documentation in organization records

7. Compliance program

VIII. Information Management (6%)

A. Assessment of information needs

B. Data collection, organization, and retrieval

C. Retention and archiving

D. Confidentiality and security issues

E. Automated information systems


1. Information technology

2. Interface and/or integration of systems

3. Selection of software/hardware


F. Information resources

1. Databases

2. Current references on standards of practice


G. Data

1. Basic statistics

2. Interpretation

3. Use in planning

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