Medicaid Compliance Test
Name
Date
1. A nurse who has been a friend since nursing school has told you they have been paid for shifts that they did not work. What should you do?
You don’t report it because it was only happening for six months or so.
You tell the nurse they need to stop accepting pay for shifts they didn’t work, or you will inform the family of the fraud.
You don’t report it because you will be held responsible for the unworked time.
You follow agency policy and contact your nursing supervisor to inform them about this nurse committing fraud.
2. If your patient doesn’t need hands-on care for part of your shift you do not need to write narrative notes for that time.
True
False
3. If the agency reports a parent for suspected Medicaid fraud, the agency will receive a percentage of the money the parent has stolen.
True
False
4. If a fellow nurse has been 30 minutes late to shift for the last month and you report them to the agency, you will be in trouble for not informing the agency sooner.
True
False
5. Once an oncoming nurse arrives, you can stay and clock out after you complete your notes.
True
False
6. Since you can take your break at the end of your shift, it is ok to clock out 30 minutes early if there is a caregiver present to attend to the patient.
True
False
7. If a nurse is working a 7a–7p shift and they arrive at 7a and leave at 7p they should:
Have a check-in time of 7a and the first narrative note labeled 7a; have a check-out time of 7p and the last narrative note labeled 6p.
Have a check-in time of 7a and the first narrative note labeled 7a; have a check-out time of 7p and the last narrative note labeled 7p.
Check-in and first narrative note only at the time they begin nursing services.
Check-in time on arrival, check-out time after finishing the nursing note.
8. To save time documenting, it’s OK to copy my last narrative since all my shifts are the same.
True
False
9. If you need to complete corrections or other documentation at home, it’s OK if your spouse and children see the patient records because they are family and you trust them to keep the details private.
True
False
10. If the family asks me to arrive to my shift an hour late and then make up the time another time during the week, I should:
Do what they ask and enter my check-in and check-out time to match the planned schedule, since I’m working the same amount of time over the week there shouldn’t be a problem.
Do what they ask and enter my check-in and check-out time to match when I worked, then inform the agency at the end of the week.
Politely tell the parents to contact the schedulers directly so the agency can alter the times in the system, as nurses are not allowed to alter the schedule on their own.
Agree to their request but ask them for cash to compensate you for the inconvenience.
11. During your shift you discover that there are no diapers left in the home. You inform your patient’s mother, and she gives you money to go to the store to buy more diapers and a few other items. You should:
Agree and ask for a cash fee to compensate you for the trip.
Agree to run the errand but do not alter the times documented for your shift.
Agree, but document the times of the errand as a gap in nursing services.
Do not agree, stating running errands goes against agency policy, and later inform the nursing supervisor that you were asked to run an errand.
12. Your patient had to be admitted to the hospital during your shift and the parents won’t be able to get there until the next morning. You may stay with the patient until the parents arrive and document this as nursing services.
True
False
13. You are supposed to work a 6a–4p shift, but at 2p the parents ask you to leave early because they decide to take the patient with them to visit a family member. Your check-out time should still be 4p because it wouldn’t be fair for you to lose pay for those hours.
True
False
14. If your patient is sleeping and there are no changes to their condition, you do not have to write hourly narrative notes.
True
False
15. If a nurse doesn’t have internet access at home, it is OK for them to access the patient records while getting coffee at Starbucks.
True
False
16. EVV (electronic visit verification) is used to:
Verify visits on a real-time basis, including date, location, type of service, individual(s) providing and receiving services, and duration of service(s)
Validate hours of work for home health employees
Eliminate billing data entry mistakes
Reduce costs related to paper billing and payroll
Help combat fraud, waste, and abuse
All of the above
Both A and C
17. When I arrived at my shift, I forgot to clock in using EVV. Medicaid will understand because I usually clock in.
True
False
18. I always forget to clock in using EVV. It is not a big deal because my agency can adjust the time for me and manually clock me in after my shift.
Agency will adjust my EVV data and I am not truly required to clock in and out at my actual arrival or departure times.
Incorrect, EVV requires verification of actual location, arrival and departure times.
19. I am scheduled to work until 4:00 pm however, my patient left with their family at 3:00 pm. The parents have asked me to stay and clean up my patient’s room. I can clock out of EVV at 4:00 pm because I should not lose an hour of pay because the parents decided to leave, Medicaid will not mind paying me to clean my patient’s room.
True
False
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