Practice Management, Regulatory Compliance, and Emergency Preparedness
Governance, compliance, and readiness
Practice management questions test the rules that keep an urgent care open and safe: HIPAA privacy and security, CLIA certification, OSHA requirements, informed consent, mandatory reporting, scope of practice, billing and coding accuracy, and emergency preparedness. Know that CLIA-waived tests require a Certificate of Waiver and adherence to manufacturer instructions; microscopy and most complex testing are not waived. HIPAA requires minimum necessary use and disclosure, patient access to records, and breach notification.
Emergency preparedness: written emergency action plan, fire safety and evacuation routes, AED availability and training, anaphylaxis and crash cart supplies, oxygen, and regular drills. Know how to activate EMS and transfer patients under EMTALA if the facility is hospital-affiliated or an emergency department.
Traps: releasing records without authorization; discussing patients in public areas; performing non-waived testing under a waiver; failing to report communicable diseases or suspected abuse; and missing expiration dates on emergency equipment.
Worked example: a clinic wants to add urine microscopy. Because microscopy is not CLIA-waived, the clinic must obtain the appropriate CLIA certificate and meet proficiency testing requirements before offering it. Rule of thumb: if a test is not explicitly waived, verify the certificate before you offer it.