FACHE cheat sheet

Communication process elements: sender, encoding, channel, receiver, decoding, feedback, and noise; noise at any stage reduces fidelity.

Channel richness hierarchy (highest to lowest): face-to-face, video, telephone, written personal (memo/letter), written impersonal (bulletin/report).

Active listening components: attending, reflecting, clarifying, summarizing; reflection of feeling precedes problem-solving in conflict dialogue.

Conflict modes (Thomas-Kilmann): competing, collaborating, compromising, avoiding, accommodating; collaborating is high assertiveness plus high cooperativeness.

Grapevine is informal, fast, and largely accurate on non-controversial facts; formal channels remain the accountable source for decisions.

Stakeholder mapping plots interest against influence; high-influence/high-interest parties require managed, engaged communication.

Crew resource management: assertiveness, closed-loop communication, and speak-up culture reduce hierarchy-driven error.

Negotiation: BATNA is the best alternative to a negotiated agreement; reservation point is the walk-away threshold; ZOPA is the zone between reservation points.

SBAR handoff structure: Situation, Background, Assessment, Recommendation.

Transformational leadership: idealized influence, inspirational motivation, intellectual stimulation, individualized consideration.

Transactional leadership relies on contingent reward and management-by-exception; effective for routine, stable operations.

Situational leadership adjusts directive and supportive behavior to follower maturity/readiness (telling, selling, participating, delegating).

Lewin change model: unfreeze, change, refreeze; Kotter's 8 steps begin with urgency and end with anchoring in culture.

Servant leadership inverts the pyramid: leader removes barriers so frontline staff can serve patients.

Emotional intelligence (Goleman) domains: self-awareness, self-management, social awareness, relationship management.

Five bases of power (French and Raven): legitimate, reward, coercive, expert, referent; expert and referent power correlate with commitment.

Levels of leadership (Maxwell) progress from position and permission to production, people development, and pinnacle.

Span of control: narrower spans suit complex, high-variability work; wider spans require standardized, mature processes.

ACHE Code of Ethics core principles: integrity, respect, responsibility, and advancing the profession; ethical obligations extend to patients, community, and colleagues.

Conflict of interest: disclose, recuse from decision, and divest where a personal financial interest could bias judgment.

Ethical decision frameworks: utilitarian (greatest good), deontological (duty/rules), virtue (character), and justice (fair distribution).

Four principles of biomedical ethics: autonomy, beneficence, nonmaleficence, justice.

Informed consent requires capacity, voluntariness, disclosure of risks/benefits/alternatives, and comprehension.

Whistleblower protection: internal reporting before external escalation; retaliation against good-faith reporters is prohibited.

Professional self-regulation includes continuing education, board certification maintenance, and peer review participation.

Impaired colleague obligation: report through defined channels rather than confronting informally; patient safety takes precedence.

Documentation standards: contemporaneous, factual, objective entries; late entries are labeled as such.

Payer mix: Medicare (federal, Part A/B/D), Medicaid (federal-state match, state-administered), commercial, and self-pay; payer mix drives revenue cycle risk.

Medicare DRG prospective payment: fixed payment per discharge by DRG; outlier payments and transfer adjustments modify the base.

ACA coverage expansions: Medicaid expansion (state option post-NFIB), Marketplace subsidies, and dependent coverage to age 26.

Value-based programs: Hospital VBP, HRRP (readmissions), HAC Reduction Program; penalties are payment reductions, not add-ons.

Joint Commission accreditation is deemed status for Medicare Conditions of Participation; survey types include triennial, for-cause, and validation.

Managed care models: HMO (gatekeeping, closed network), PPO (open network, cost sharing), and high-deductible plans with HSAs.

Continuum of care settings: acute inpatient, ambulatory, post-acute (SNF, IRF, LTACH), home health, hospice; site-of-service shifts affect margins.

Population health metrics: incidence (new cases), prevalence (all cases), and attributable risk; social determinants drive utilization.

Health policy levers: certificate of need, licensure, scope-of-practice laws, and antitrust review of mergers.

Break-even volume = fixed costs / (price - variable cost per unit); contribution margin per unit is price minus variable cost.

Current ratio = current assets / current liabilities; quick ratio excludes inventory; both test short-term liquidity.

Days in accounts receivable = (accounts receivable / net credit revenue) x 365; lower values indicate faster cash conversion.

Operating margin = (operating revenue - operating expense) / operating revenue; excludes non-operating income such as investments.

Net present value discounts future cash flows at the cost of capital; accept projects with NPV greater than zero.

Capital budgeting: payback ignores time value; IRR is the discount rate yielding NPV of zero; IRR can mislead with nonconventional cash flows.

Full-time equivalent = paid hours / standard annual hours (e.g., 2,080); used for productivity and staffing benchmarks.

FTE per adjusted occupied bed normalizes staffing to volume and outpatient activity; higher values signal higher labor intensity.

Budget types: operating (annual), capital (multiyear), and cash; variance analysis separates volume, price, and mix effects.

Revenue cycle sequence: registration, charge capture, coding, claim submission, remittance posting, denial management, collections.

Communication process elements: sender, encoding, channel, receiver, decoding, feedback, and noise; noise at any stage reduces fidelity.

Channel richness hierarchy (highest to lowest): face-to-face, video, telephone, written personal (memo/letter), written impersonal (bulletin/report).

Active listening components: attending, reflecting, clarifying, summarizing; reflection of feeling precedes problem-solving in conflict dialogue.

Conflict modes (Thomas-Kilmann): competing, collaborating, compromising, avoiding, accommodating; collaborating is high assertiveness plus high cooperativeness.

Grapevine is informal, fast, and largely accurate on non-controversial facts; formal channels remain the accountable source for decisions.

Stakeholder mapping plots interest against influence; high-influence/high-interest parties require managed, engaged communication.

Crew resource management: assertiveness, closed-loop communication, and speak-up culture reduce hierarchy-driven error.

Negotiation: BATNA is the best alternative to a negotiated agreement; reservation point is the walk-away threshold; ZOPA is the zone between reservation points.

SBAR handoff structure: Situation, Background, Assessment, Recommendation.

Transformational leadership: idealized influence, inspirational motivation, intellectual stimulation, individualized consideration.

Transactional leadership relies on contingent reward and management-by-exception; effective for routine, stable operations.

Situational leadership adjusts directive and supportive behavior to follower maturity/readiness (telling, selling, participating, delegating).

Lewin change model: unfreeze, change, refreeze; Kotter's 8 steps begin with urgency and end with anchoring in culture.

Servant leadership inverts the pyramid: leader removes barriers so frontline staff can serve patients.

Emotional intelligence (Goleman) domains: self-awareness, self-management, social awareness, relationship management.

Five bases of power (French and Raven): legitimate, reward, coercive, expert, referent; expert and referent power correlate with commitment.

Levels of leadership (Maxwell) progress from position and permission to production, people development, and pinnacle.

Span of control: narrower spans suit complex, high-variability work; wider spans require standardized, mature processes.

ACHE Code of Ethics core principles: integrity, respect, responsibility, and advancing the profession; ethical obligations extend to patients, community, and colleagues.

Conflict of interest: disclose, recuse from decision, and divest where a personal financial interest could bias judgment.

Ethical decision frameworks: utilitarian (greatest good), deontological (duty/rules), virtue (character), and justice (fair distribution).

Four principles of biomedical ethics: autonomy, beneficence, nonmaleficence, justice.

Informed consent requires capacity, voluntariness, disclosure of risks/benefits/alternatives, and comprehension.

Whistleblower protection: internal reporting before external escalation; retaliation against good-faith reporters is prohibited.

Professional self-regulation includes continuing education, board certification maintenance, and peer review participation.

Impaired colleague obligation: report through defined channels rather than confronting informally; patient safety takes precedence.

Documentation standards: contemporaneous, factual, objective entries; late entries are labeled as such.

Payer mix: Medicare (federal, Part A/B/D), Medicaid (federal-state match, state-administered), commercial, and self-pay; payer mix drives revenue cycle risk.

Medicare DRG prospective payment: fixed payment per discharge by DRG; outlier payments and transfer adjustments modify the base.

ACA coverage expansions: Medicaid expansion (state option post-NFIB), Marketplace subsidies, and dependent coverage to age 26.

Value-based programs: Hospital VBP, HRRP (readmissions), HAC Reduction Program; penalties are payment reductions, not add-ons.

Joint Commission accreditation is deemed status for Medicare Conditions of Participation; survey types include triennial, for-cause, and validation.

Managed care models: HMO (gatekeeping, closed network), PPO (open network, cost sharing), and high-deductible plans with HSAs.

Continuum of care settings: acute inpatient, ambulatory, post-acute (SNF, IRF, LTACH), home health, hospice; site-of-service shifts affect margins.

Population health metrics: incidence (new cases), prevalence (all cases), and attributable risk; social determinants drive utilization.

Health policy levers: certificate of need, licensure, scope-of-practice laws, and antitrust review of mergers.

Break-even volume = fixed costs / (price - variable cost per unit); contribution margin per unit is price minus variable cost.

Current ratio = current assets / current liabilities; quick ratio excludes inventory; both test short-term liquidity.

Days in accounts receivable = (accounts receivable / net credit revenue) x 365; lower values indicate faster cash conversion.

Operating margin = (operating revenue - operating expense) / operating revenue; excludes non-operating income such as investments.

Net present value discounts future cash flows at the cost of capital; accept projects with NPV greater than zero.

Capital budgeting: payback ignores time value; IRR is the discount rate yielding NPV of zero; IRR can mislead with nonconventional cash flows.

Full-time equivalent = paid hours / standard annual hours (e.g., 2,080); used for productivity and staffing benchmarks.

FTE per adjusted occupied bed normalizes staffing to volume and outpatient activity; higher values signal higher labor intensity.

Budget types: operating (annual), capital (multiyear), and cash; variance analysis separates volume, price, and mix effects.

Revenue cycle sequence: registration, charge capture, coding, claim submission, remittance posting, denial management, collections.