Asset Mgmt Flashcards
After personnel costs, the largest expense for hospitals are _____ _____, which can represent _____ of expenses for hospitals.
supply costs; 25-30%
Chapter 12, p 211
Product selection should focus on looking for and _____ _____ and vendors that provide the greatest user productivity and best patient outcomes at the lowest possible price.
standardizing products
Chapter 12, p 212
GPO
Group purchasing organizations; negotiate group purchase contracts on behalf of multiple hospitals and health systems.
Chapter 12, p 213, 226
_____ _____ is uncontrolled spending outside negotiated contracts.
Maverick purchasing
Chapter 12, p 214
This practice occurs when vendors provide off-contract supply items directly to physicians at patient care settings and invoice the hospital at list price.
Back door selling.
Chapter 12, p 215
Predetermined level
Par level
Chapter 12, p 216
MMIS
management information system
ERP
enterprise resource planning system
_____ _____, a type of agreement used to reduce costs for supplies specifically for high-ticket items, will only be paid for by the healthcare facility when they are used. The items are owned by the supplier but located at the facility.
Consignment agreement
Chapter 12, p 219
For most products in the US, expiration dates range from ____ to ____ months from the time of original manufacture.
12 to 60 months
Chapter 12, p 221
PM
Preventive maintenance and repair
Chapter 10, p 163
OEM
original equipment manufacture
Chapter 10, p 163
ASP
Authorized Service Provider
Chapter 10, p 163
Life cycle costing, aka _____, is a procurement evaluation technique which determines the total cost of acquisition, operation, maintenance and disposal of items being acquired.
terotechnology
Chapter 10, p 164
Service cleaning, checking, adjusting, or making repairs to a piece of machinery to ensure that it works properly.
Service contract
Chapter 10, p 164
4 characteristics of a contract
- Agreement
- Consideration
- Legality
- Capacity
Chapter 10, p 165
BER
Beyond Economic Repair; repair cost would be equal to or greater than the replacement cost of the device
Chapter 10, p 165
BQR
Beyond Quality Repair; repair may be unreliable or unsafe for the end user
Chapter 10, p 165
ELF
Early Life Failure; a product found to be defective within a period defined by the manufacturer after purchase or initial installation.
Chapter 10
Up time Formula
Up time = (Base Time - Downtime) / Base Time
Base Time = Hours per day x hours per week x 52
Downtime = hours equipment is inoperable
Chapter 10
A program for the systematic monitoring and evaluation of the various aspects of a project, service, or facility to ensure that standards of quality are being met.
Quality Assurance
Chapter 11, p 183
An aggregate of activities (as design analysis and inspection for defects) designed to ensure adequate quality especially in manufactured products.
Quality Control
Chapter 11, p 183
Most imaging facilities aim for ____ (or less) downtime.
1-2%
Chapter 11, p 192
This modality is regulated by the NRC and individual state health departments.
Nuclear Medicine
Chapter 11, p 193
How often should the equipment matrix be updated?
a. Annually
b. Bi-annually
c. Every 2 years
d. Every 5 years
a. Annually
matrix lists the status of all of the facility’s imaging equipment and might include
After the expiration of an operational lease, who owns the asset?
a. Lessor
b. Lessee
c. Finance company
d. OEM
a. Lessor
The lessee pays the lessor a specific number of payments, at a specified
interest rate.Under an operational lease, on expiration of the lease, the asset belongs
to the lessor
Which of the following is not a benefit in the ASP versus purchase decision?
a. Usually includes updates and upgrades
b. Operational expense
c. Low to no upfront costs
d. Pay the same fee no matter the usage
d. Pay the same fee no matter the usag
An Application Service Provider (ASP) funds the asset, and the facility pays on a per-use basis. Two common examples in an imaging facility involve PACS and PET/CT scanners.
Private insurers traditionally follow CMS in regards to changes in
reimbursement. In which of the following cases has this not happened?
a. 3T MRI
b. Cardiac CTA
c. Digital mammography
d. 4D ultrasound
c. Digital mammography
The facility operating environment assessment includes:
a. Industry trends, technological advancement, competition,
reimbursement
b. Competition, reimbursement, political consideration, CON
c. Capital access, vendor input, new versus used, CON
d. Technological advancement, capital access, political consideration,
industry trends
d. Technological advancement, capital access, political consideration,
industry trends
With the exception of CCTA, a 4-detector CT scanner can meet all of the needs
of most facilities.
a. True
b. False
a. True
According to the Innovations Center and the Edge Report, CT, PET/CT, and
MRI volume are expected to increase how much, respectively, between 2006
and 2016?
a. 13-120%, 13-50%, and 15-60%
b. 15-60%, 13-50%, and 12-120%
c. 15-60%, 13-120%, and 13-50%
d. 13-120%, 13-50%, and 15-60%
c. 15-60%, 13-120%, and 13-50%
Which item is an important part of the competitive assessment?
a. Location of competition
b. Price of equipment
c. Current backlogs
d. Both A and C
d. Both A and C
Which of the following should not be included in the equipment matrix?
a. Type of equipment
b. Volume of procedures done in department
c. Year installed
d. Serial number
b. Volume of procedures done in department
Which modality lends itself to improvements through software updgrades?
a. Ultrasound
b. MRI
c. Digital mammography
d. CT
b. MRI
MRI technology lends itself to improving performance through software
and gradient coil upgrades rather than through replacement of the entire MRI
magnet gantry.
Causes of obsolescence include all of the following except:
a. Broken equipment
b. Age of equipment
c. Competitor equipment
d. End of life status
c. Competitor equipment
When producing an MRI proforma, the administrator should take all of the
following into consideration in regards to potential volume except:
a. Existing population base
b. Number of existing scanners
c. Modality utilization
d. Changes in MRI reimbursement
d. Changes in MRI reimbursement
When a capital purchase is made for political purposes, a proforma is not
necessary.
a. True
b. False
b. False
When prioritizing a list of potential expenditures for administration, the
imaging administrator should put them in order of:
a. Best return to worst return to the organization
b. Favorite preferences of chief radiologist
c. Least expensive to most expensive in total cost of ownership
d. Most expensive to least expensive in total cost of ownership
a. Best return to worst return to the organization
Which of the following states does not require a CON as of July 4, 2008?
a. California
b. Louisiana
c. Rhode Island
d. Connecticut
a. California
The certificate of need (CON) process aims to reduce duplication of certain high-dollar services and equipment—and to maximize the healthcare dollars spent in a community. California facilities must meet seismic standards to protect people during earthquakes
Incremental volume is:
a. Total volume expected
b. Total paying volume expected
c. Total new volume expected
d. Total existing volume
c. Total new volume expected
imaging administrator must determine the incremental volume of
procedures that will be generated, that is, how many additional procedures (and presumably how much additional income) will result from the new asset.
According to the Congressional budget office, which factor will have the
greatest impact on the utilization of imaging services?
a. Changes in referral patterns
b. Changes in technologies
c. Changes in health coverage
d. Changes in demographics
b. Changes in technologies
Depreciation is used by for profit companies to:
a. Pay for capital over time
b. Lower their tax burdens
c. Increase their tax burdens
d. Hide spending
b. Lower their tax burdens
Not-for-profits use depreciation to spread the impact over multiple
financial statements and to allow for more accurate comparison of statements
from year to year. For-profit facilities benefit from substantially reduced annual
taxes, as shown in Tables 1.2 and 1.3
In large organizations, the present value factor is set by which department?
a. Administration
b. Radiology
c. Accounting
d. Finance
d. Finance
Using the depreciation method mentioned in this chapter, year 3 of an asset will be depreciated at what level? a. Same as year 1 b. Higher than year 1 c. Lower than year 1 d. None of the above
a. Same as year 1
imaging equipment has been depreciated over 5 years by the most commonly used method, straight-line depreciation. Thus, the income statement assigns 20% of the cost for each of the 5 years.
All of the following are now considered competitors of the traditional hospital based imaging departments except: a. Self referring physicians b. Radiologist run imaging centers c. County health department d. National imaging center chains
c. County health department
The two profitability ratios mentioned in this chapter are:
a. ROI and profit margin
b. ROI and NPV
c. NPV and profit margin
d. Profit margin and return on assets
b. ROI and NPV
ROI is the percentage return (after expenses) on the capital investment relative to the total capital expense. NPV takes into account the cost of financing and describes future revenue in terms of the present-day value of money
Which element(s), when included in the capital equipment purchasing plan,
will lessen the chance of failure?
a. Solid financial analysis
b. Consideration of the financing options
c. Competition
d. Both A and B
d. Both A and B
Medicare populations use imaging services in what relation to non-Medicare populations?
a. More
b. Less
c. The same
d. There is no relationship between them
a. More
The first step in a successful capital equipment purchase is to:
a. Secure the funding
b. Identify and assemble the stakeholders
c. Select the equipment
d. Write a request for proposal (RFP)
b. Identify and assemble the stakeholders
One stakeholder often overlooked in the imaging equipment purchase process is: a. Radiologist b. Financial manager c. Physicist d. Technologist
c. Physicist
The success or failure of a capital equipment purchase is heavily dependent on: a. Referring physicians b. Physicists c. Financial managers d. Technologists
a. Referring physicians
The person usually charged in identifying biases among stakeholders is:
a. Radiologist
b. Physicist
c. Imaging administrator
d. Chief financial officer
c. Imaging administrator
PET and linear accelerator purchases will require considerable involvement by:
a. Financial managers
b. Physicists
c. Materials managers
d. Community
b. Physicists
Technologist involvement can assist the team with decisions such as:
a. Ergonomics
b. Potential training needs
c. User-friendly design
d. All of the above
d. All of the above
Which person/department plays a pivotal role in capital asset acquisition and
is usually the one to bring the stakeholders together?
a. Management
b. Physicist
c. Clinical engineering
d. Information systems
a. Management
management will be responsible for making the
final purchasing decision for the department or facility.
The radiologist selected for the needs assessment team should be:
a. The decision maker for the imaging group
b. Someone whose decision will be respected and supported
c. Someone who will be working with the modality under consideration
d. All of the above
d. All of the above
A new or expanded RIS or PACS will rely heavily on ____________ and they
should therefore be involved from initial vendor contact through installation
to “go live.”
a. Management
b. Clinical engineering
c. Information systems
d. Technologists
c. Information systems
The group that is not usually involved in the selection of equipment but are end users are:
a. Owners
b. Community
c. Management
d. Information systems
b. Community
Planning for technology implementation entails:
a. Incorporating process improvement techniques
b. Knowing that technology is stagnant
c. Understanding public policy
d. Both A and C
d. Both A and C
Being aware that technology is not stagnant
Knowing the needs of various stakeholders
Understanding public policy and its impact
Incorporating process improvement techniques
Addressing staff and user education
What factor may influence a modality volume forecast?
a. Changes in clinical practice
b. Key competitors
c. Referring physician patterns
d. All of the above
d. All of the above
Which of the following will provide historical data on currently installed equipment? a. Vendor perception b. Service records c. Staff perception d. The Internet
b. Service records
It is important to know the needs of various stakeholders and to whom benefits
of the technology accrue.
a. False
b. True
b. True
Which term refers to a device that has been overhauled to manufacturer’s
specifications with upgrades and improvements?
a. Rebuilt
b. Refinanced
c. Refurbished
d. Returned
a. Rebuilt
According to the FDA, a refurbished device may only have been repainted
or cleaned before reselling, while a rebuilt device has been completely overhauled to
return it to the manufacturer’s specifications along with any OEM upgrades or
improvements
One popular resource that can provide reliable information is a GPO, which stands for: a. Global planning organization b. Group planning option c. Group purchasing organization d. Guaranteed performance option
c. Group purchasing organization
GPOs negotiate group purchase contracts on behalf of multiple hospitals and health
systems. They are able to negotiate lower prices than individual buyers might get by
negotiating solo contracts with manufacturers.
GPOs consist of:
a. Associations
b. Corporations
c. Healthcare systems
d. All of the above
d. All of the above
If a level of technology exceeds the service line strategies of the facility, this
yields a rating of _____ on a radiology equipment dashboard.
a. Good
b. Average
c. Poor
d. None of the above
a. Good
Which modality is gradient coils a component of?
a. CR
b. CT
c. MR
d. RF
c. MR
Which modality is rotation speed a component of?
a. CR
b. CT
c. MR
d. RF
b. CT
Which modality is table mobility a component of?
a. RF
b. CT
c. MR
d. CR
a. RF
Which modality is worklist management a component of?
a. CR only
b. CT only
c. RF, CR, and CT
d. CR, CT, and MR
d. CR, CT, and MR
The cost of capital assets allocated on the income statement over a
predetermined period of time is known as:
a. Depreciation
b. Maintenance
c. Performa
d. Usage
a. Depreciation
One way to elicit specific details about vendor system capabilities is to send an RFI, which stands for: a. Recently furnished inquiry b. Reliable formulary insert c. Request for information d. Resource for issues
c. Request for information
A CT scanner that costs $1.4 million with a depreciable life of 7 years can be depreciated at a rate of: a. $200,000 per year b. $400,000 per year c. $500,000 per year d. $750,000 per year
a. $200,000 per year
Resources state that a unit refurbished by an independent company will cost less than one refurbished by a/an: a. GPO b. ISO c. OEM d. RFI
c. OEM
In what year was the first clinical use of computed tomography (CT)?
a. 1946
b. 1967
c. 1971
d. 1973
c. 1971
In what way can the imaging administrator keep up with equipment supply and demand? a. Literature b. Professional conferences c. Web sites d. All of the above
d. All of the above
Life expectancy of capital imaging equipment is influenced by which of the following? a. Availability of replacement parts b. Changes in clinical practice c. Changes in technologists d. Both A and B
d. Both A and B
Used and refurbished equipment is gaining greater acceptance in the imaging
community.
a. False
b. True
a. False
Avoiding a hodgepodge of building construction types, floor levels, outward
appearances, and internal infrastructure would be considered part of a(n):
a. Immediate/emergent need
b. Mid-range/planned need
c. Long-range/strategic need
d. None of the above
c. Long-range/strategic need
many buildings that have long been used by healthcare providers are
frozen testaments to serial small-scale projects that were not integrated into the
larger context of a long-range or strategic development plan
Which question might be asked when determining capital equipment need?
a. What are the past imaging needs of the patient population?
b. Does the hospital support Level 1, 2, or 3 trauma services?
c. Are employee satisfaction scores acceptable?
d. What is the payer mix?
a. What are the past imaging needs of the patient population?
Most needs are identified months or years prior to any critical need.
a. True
b. False
a. True
In addition to raw square footage, what are some other considerations when siting imaging equipment? a. Power supply b. Cooling loads c. Environmental factors d. All of the above
d. All of the above
“Bubble diagrams” show:
a. Industry trends, technological advancement, competition,
reimbursement
b. The referring physician base
c. Hypothetical conversations between departments
d. The different areas of a facility in relationship to each other
d. The different areas of a facility in relationship to each other
In the imaging department, net square footage would include:
a. Exam rooms, patient waiting areas, offices, and interpretation room
b. Exam rooms, patient waiting areas, and interpretation room
c. Exam rooms, conference rooms, emergency department, and
interpretation room
d. Exam rooms, main lobby, offices, and interpretation room
a. Exam rooms, patient waiting areas, offices, and interpretation room
Based on contemporary vendor templates, an MRI scanner room will only require approximately: a. 1600 square feet b. 1000 square feet c. 600 square feet d. None of the above
c. 600 square feet
The amount by which the net area needs to be increased to allow for such
infrastructure as electrical closets, pipe and duct chases, corridors, stairs, and
elevators is known as the:
a. Equipment needs factor
b. Grossing factor
c. Installation factor
d. Net area factor
b. Grossing factor
Square footage above that which is indicated in vendor prototypes would include storage for: a. Coils b. Infection control supplies c. Guide wires d. All of the above
d. All of the above
What is often underrepresented in early planning stages?
a. Support areas for patients and staff
b. Net square footage
c. Operational requirements
d. Regulatory requirements
a. Support areas for patients and staff
Current clinical MRI gantries can weigh up to ______ pounds for
superconductive magnets and up to ______ pounds for midfield open MRI
machines with permanent magnets.
a. 18,000 / 76,000
b. 24,000 / 96,000
c. 36,000 / 52,000
d. 37,000 / 108,000
b. 24,000 / 96,000
To assist a facility in the initial planning stages to identify space and
programmatic needs for areas within imaging departments, free guides are
available from:
a. The American Institute of Architects
b. The Department of Veterans Affairs
c. The Department of Health and Human Services
d. The Food and Drug Administration
b. The Department of Veterans Affairs
Many state and local jurisdictions are requiring that all construction projects be designed and built to save: a. Space and time b. Time and money c. Energy and resources d. Money and staff
c. Energy and resources
The following examples show how operational and physical issues beyond the
immediate scope of the equipment manufacturer can have a significant
impact on the efficacy and accuracy of imaging equipment except:
a. Lack of an IV preparation area
b. Inadequate number of changing rooms
c. Placement of an MRI scanner too close to high-voltage electrical panels
d. Placement of an ultrasound room too close to an elevator
c. Placement of an MRI scanner too close to high-voltage electrical panels
A material being developed as a lead-free alternative that facilitates absorption of x-rays is: a. LNP Thermotuf PC-1006 b. LNP Thermocomp HSG PH1100B c. LNP Thermotuf PC-HSG 1100B d. LNP Thermocomp HSG-PC 2300A
b. LNP Thermocomp HSG PH1100B