ACM-RN study guide
ACM-RN · Work through your exam, one topic at a time.
The ACM-RN is a certification examination for registered nurses who practice in care management and care coordination roles. It is aimed at nurses who work as case managers, care coordinators, transition-of-care specialists, or complex-care nurses in health plans, hospitals, accountable care organizations, and community programs. The ACM-RN study guide has 7 sections and about 2,079 words.
01Care Management and Coordination
Care management is the systematic identification, assessment, planning, facilitation, and evaluation of services for a person with complex needs. Know the core workflow: case finding (risk stratification, predictive modeling, referral triggers), comprehensive assessment (medical, functional, social, behavioral, caregiver), individualized care plan with measurable goals, care coordination and referral management, monitoring, and reassessment with transition planning.
322 words, about 2 min02Patient Advocacy and Education
Advocacy means protecting and promoting a patient's rights, autonomy, and access to needed care, especially when the patient is vulnerable, marginalized, or in conflict with the system. Know the advocacy roles: patient self-advocacy (empowerment, teach-back, shared decision-making), nurse/CM advocacy (removing barriers, escalating grievances, ensuring informed consent), and system advocacy (policy and resource change).
310 words, about 2 min03Transitions of Care
Transitions of care are the movements of patients between settings (hospital, home, SNF, rehab, home health, hospice). Poor transitions cause readmissions, medication errors, and gaps.
297 words, about 1 min04Psychosocial and Behavioral Health
This domain covers the psychological, social, and behavioral factors that shape health: mental health conditions, substance use, cognitive impairment, caregiver stress, social determinants (housing, food, transportation, finances), and health behavior change. Know the biopsychosocial model and screen for depression (PHQ), anxiety, cognitive status, and substance use using validated tools.
274 words, about 1 min05Chronic and Complex Care Management
Chronic care management applies to ongoing conditions (diabetes, heart failure, COPD, CKD) and complex care to patients with multiple chronic conditions, functional limitations, and high utilization. Know the Chronic Care Model elements: health system, delivery system design, decision support, clinical information systems, self-management support, and community resources.
304 words, about 2 min06Program Evaluation, Quality, and Outcomes
Program evaluation judges whether a program is effective, efficient, and appropriate. Know the distinction between structure, process, and outcome measures (Donabedian) and between quality improvement (iterative, local) and research (generalizable, hypothesis-testing).
281 words, about 1 min07Legal, Ethical, and Professional Practice
This domain covers the legal and ethical framework of care management: autonomy, beneficence, nonmaleficence, justice, veracity, and fidelity. Know informed consent elements (capacity, disclosure, comprehension, voluntariness) and decisional capacity (understanding, appreciation, reasoning, expressing a choice).
291 words, about 1 min