100+ Free C-SWHC Practice Questions

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Question 1

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According to the NASW Standards for Social Work Practice in Health Care Settings (2016), what professional document establishes the ethical baseline for every health care social worker?

The NASW Code of Ethics

The AMA Code of Medical Ethics

The Joint Commission Patient Rights Manual

The HIPAA Privacy Rule

to track

2026 Statistics

Key Facts: C-SWHC Exam

$165/$450

Application Fee (Member/Non-member)

NASW (2026)

3,000 hrs

Post-MSW Supervised Experience

NASW

20 hrs

CE Contact Hours in Health Care

NASW

Every 2 yrs

Renewal Cycle

NASW

NASW Health Care Standards

NASW 2016

42 CFR 482.43

Discharge Planning CoP

CMS 2019

The C-SWHC is a portfolio credential (no written exam) from NASW for MSW-level social workers in health care. Application fee: $165 NASW members / $450 non-members in 2026, with renewal every 2 years ($95/$350) and 20 CE contact hours. Requirements: MSW from a CSWE-accredited program, current state MSW-level license, 2 years (3,000 hours) of post-MSW supervised health care social work experience, 20 CE contact hours in health care, supervisor evaluation, and an MSW colleague reference. Our 100 free practice questions are mapped to the 2016 NASW Standards for Social Work Practice in Health Care Settings and cover psychosocial assessment, discharge planning under 42 CFR 482.43 (2019 Final Rule), advance care planning under the Patient Self-Determination Act, chronic illness adjustment (cancer, CHF, diabetes, ESRD), medical decision-making capacity, interprofessional collaboration, SDOH, cultural humility, NASW Code of Ethics, HIPAA/HITECH, Medicare/Medicaid basics, medical trauma and PICS, grief and palliative care, domestic violence screening, and SBIRT for substance use.

Sample C-SWHC Practice Questions

Try these sample questions to test your C-SWHC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to the NASW Standards for Social Work Practice in Health Care Settings (2016), what professional document establishes the ethical baseline for every health care social worker?

A.The NASW Code of Ethics

B.The AMA Code of Medical Ethics

C.The Joint Commission Patient Rights Manual

D.The HIPAA Privacy Rule

Explanation: The NASW Standards for Social Work Practice in Health Care Settings identify the NASW Code of Ethics as the primary ethical framework for health care social workers. While HIPAA governs confidentiality and the Joint Commission addresses patient rights, the NASW Code is the profession's own ethical baseline that applicants for the C-SWHC must agree to uphold.

2Which federal regulation establishes the Condition of Participation for hospital discharge planning in Medicare-participating hospitals?

A.42 CFR 482.43

B.42 CFR 483.10

C.45 CFR 164.502

D.42 CFR Part 2

Explanation: 42 CFR 482.43 is the Condition of Participation (CoP) for hospital discharge planning under the Medicare program, most recently revised by the 2019 CMS Discharge Planning Final Rule (84 FR 51836). 42 CFR 483.10 applies to long-term care resident rights, 45 CFR 164.502 is part of the HIPAA Privacy Rule, and 42 CFR Part 2 governs substance use disorder record confidentiality.

3A hospitalized patient asks the social worker to recommend a specific home health agency the hospital owns. Under the 2019 CMS Discharge Planning Final Rule, what must the social worker do?

A.Disclose the hospital's financial interest and provide a list of qualified Medicare-participating agencies so the patient can choose

B.Refer only to the hospital-owned agency because it offers seamless care

C.Refuse to discuss any agency and tell the patient to research options independently

D.Select whichever agency has the shortest wait time

Explanation: 42 CFR 482.43 requires hospitals to respect the patient's freedom to choose among Medicare-participating post-acute providers, disclose any hospital financial interest in a referral, and provide a list of qualified HHAs in the patient's geographic area. The social worker must disclose the relationship and honor patient choice.

4The Patient Self-Determination Act (PSDA) of 1990 requires Medicare- and Medicaid-participating facilities to:

A.Inform adult patients of their right to make medical decisions and to execute advance directives

B.Require every patient to complete a living will at admission

C.Provide legal representation to patients without advance directives

D.Override a patient's prior directive if family members disagree

Explanation: The PSDA requires hospitals, nursing homes, home health agencies, hospices, and HMOs that participate in Medicare or Medicaid to inform adult patients of their right to accept or refuse treatment and to execute advance directives, document whether a directive exists, provide written state-law information, and educate staff and community. The Act does not mandate that patients execute directives.

5Which four-prong model is most widely used in medicine and social work to assess a patient's capacity to make a specific treatment decision?

A.Appelbaum's model: understanding, appreciation, reasoning, and expressing a choice

B.Kübler-Ross stages of adjustment

C.The Beauchamp and Childress four principles

D.Maslow's hierarchy of needs

Explanation: Appelbaum and Grisso's four-prong framework evaluates whether the patient can understand relevant information, appreciate how it applies to their situation, reason with that information, and communicate a consistent choice. Capacity is task-specific and clinical, distinct from legal competency, which is determined by a court.

6Under HIPAA, the 'minimum necessary' standard means that covered entities should:

A.Use or disclose only the protected health information reasonably needed for the intended purpose

B.Share the full medical record whenever any request is made

C.Withhold all information unless the patient provides written authorization

D.Disclose only the last 30 days of records regardless of clinical need

Explanation: Under 45 CFR 164.502(b), the minimum necessary standard requires covered entities to make reasonable efforts to limit the use, disclosure, and request of protected health information to the minimum necessary to accomplish the intended purpose. It does not apply to disclosures to the patient or to treatment-related disclosures between providers.

7A patient admitted with alcohol use disorder is receiving treatment in a federally assisted substance use disorder program. Which regulation imposes stricter confidentiality than HIPAA on these records?

A.42 CFR Part 2

B.42 CFR 482.43

C.45 CFR 164.512

D.Title VI of the Civil Rights Act

Explanation: 42 CFR Part 2 provides heightened confidentiality protections for records of patients in federally assisted substance use disorder treatment programs, generally requiring specific written consent before disclosure even to other treatment providers. This is stricter than HIPAA, which permits many disclosures for treatment, payment, and operations without authorization.

8Medicare Part A primarily covers which of the following services?

A.Inpatient hospital, skilled nursing facility, hospice, and some home health care

B.Physician office visits and outpatient mental health

C.Prescription drug plans only

D.Long-term custodial nursing home care

Explanation: Medicare Part A is the hospital insurance portion of Medicare and covers inpatient hospital stays, short-term skilled nursing facility care after a qualifying hospital stay, hospice care, and some home health services. Part B covers outpatient and physician services, Part D covers prescription drugs, and Medicare does not cover long-term custodial care.

9The Medicare Two-Midnight Rule is most relevant to which social work concern?

A.Whether a Medicare beneficiary's hospital stay is classified as inpatient or observation, which affects Part A coverage and SNF eligibility

B.The maximum length of a hospice stay under the Medicare hospice benefit

C.The deadline for filing an advance directive

D.The minimum age for Medicare eligibility

Explanation: The Two-Midnight Rule is a Medicare benchmark: hospital stays expected to cross two midnights are generally appropriate for inpatient admission under Part A, while shorter stays are usually billed as outpatient observation. Because SNF benefit eligibility requires a preceding 3-day inpatient stay, this classification directly affects discharge planning and out-of-pocket costs.

10To qualify for the Medicare skilled nursing facility (SNF) benefit under Part A, a patient generally must have:

A.A qualifying 3-day inpatient hospital stay and a skilled care need

B.A terminal diagnosis with life expectancy of 6 months or less

C.A household income below 138% of the federal poverty level

D.A referral from a primary care physician only

Explanation: The Medicare SNF benefit requires a qualifying inpatient hospital stay of at least 3 consecutive days (not counting the day of discharge) and a need for daily skilled nursing or rehabilitation services. Medical social workers must confirm inpatient status because observation days do not count toward the 3-day requirement.

About the C-SWHC Exam

The NASW Certified Social Worker in Health Care (C-SWHC) is an advanced specialty credential for master's-level social workers practicing in medical and health care settings. Candidates must hold an MSW from a CSWE-accredited program, a current state MSW-level license, document at least 2 years (3,000 hours) of post-MSW supervised health care social work experience, complete 20 continuing education contact hours relevant to health care, provide a supervisor evaluation and an MSW colleague reference, and commit to the NASW Code of Ethics. The credential is portfolio-based — there is no scored written exam — but holders must master the NASW Standards for Social Work Practice in Health Care Settings, Medicare discharge-planning Conditions of Participation under 42 CFR 482.43, HIPAA/HITECH privacy and security rules, the Patient Self-Determination Act, and the psychosocial, ethical, and cultural competencies described below. Renewal is every 2 years with 20 contact hours of CE, at $95 (member) or $350 (non-member).

Assessment

Portfolio credential — no scored written exam. Practice questions support self-assessment on NASW Standards for Social Work Practice in Health Care Settings and related federal regulations (HIPAA, 42 CFR 482.43, PSDA).

Time Limit

Self-paced practice

Passing Score

Portfolio review (no scored exam)

Exam Fee

$165 member / $450 non-member (NASW Credentialing Center)

C-SWHC Exam Content Outline

14%

Psychosocial Assessment in Medical Settings

Biopsychosocial-spiritual assessment, functional status, social history, caregiver capacity, safety and suicide screening, screening tools (PHQ-9, GAD-7, AUDIT, CAGE), and documentation per NASW Standard 5

12%

Discharge Planning & Care Transitions

Medicare Conditions of Participation 42 CFR 482.43 (2019 Final Rule), IMPACT Act quality measures, post-acute level-of-care decisions (home health, SNF, IRF, LTCH), freedom of choice, financial interest disclosure, caregiver involvement

10%

Advance Care Planning & End-of-Life

Patient Self-Determination Act, living wills, DPOA-HC, MOLST/POLST, hospice eligibility (Medicare hospice benefit), palliative care integration, five wishes, surrogate decision-making hierarchies

10%

Ethics, NASW Code & Medical Decision-Making

NASW Code of Ethics (2021), informed consent, decision-making capacity assessment vs competency, Appelbaum four-prong capacity model, boundaries, dual relationships, conflicts of interest, ethical use of self

HIPAA, HITECH & Confidentiality

HIPAA Privacy and Security Rules, minimum necessary standard, 164.508 authorizations, 164.512 permitted disclosures, HITECH breach notification, psychotherapy notes, 42 CFR Part 2 for SUD records

Medicare, Medicaid & Health Insurance

Medicare Parts A/B/C/D, dual eligibles, Medicaid waivers (HCBS), Medicare Savings Programs, LIS/Extra Help, ACA marketplace, observation vs inpatient status, Two-Midnight Rule, Medicare skilled-need requirements

Chronic Illness Adjustment

Psychosocial adjustment to cancer, CHF, COPD, diabetes, ESRD, stroke, dementia; Kübler-Ross and contemporary grief models; illness trajectories per Lynn & Adamson; stages of behavior change

Interprofessional Collaboration

Team roles (physician, nurse, PT/OT/SLP, chaplain, pharmacist, case manager), IPEC core competencies, TeamSTEPPS, huddles, SBAR communication, conflict and advocacy within teams, social worker scope

Social Determinants of Health & Health Disparities

Healthy People 2030 SDOH framework, food and housing insecurity screening (Hunger Vital Sign, PRAPARE), SDOH Z-codes (Z55–Z65), structural racism, ACEs, health equity and community resources

Cultural Humility & Linguistic Competence

NASW Standard 4, Campinha-Bacote and Tervalon cultural humility models, CLAS Standards, qualified medical interpreters (Title VI), religious and spiritual considerations, LGBTQ+ affirming care

Medical Trauma & PICS

ICU post-intensive care syndrome (PICS and PICS-F), medical PTSD, pediatric medical traumatic stress, trauma-informed care principles per SAMHSA, delirium vs dementia, psychological first aid

Grief, Loss & Palliative Care

Anticipatory grief, complicated grief, prolonged grief disorder in DSM-5-TR, bereavement support, palliative vs hospice, WHO analgesic ladder basics, total pain concept, caregiver burden

Substance Use Screening & SBIRT

Screening, Brief Intervention, and Referral to Treatment model; AUDIT, DAST-10, NIDA Quick Screen; MI-based brief intervention; ASAM level-of-care criteria basics; 42 CFR Part 2 SUD confidentiality

Domestic Violence & Mandated Reporting

Futures Without Violence universal education, HITS screen, safety planning, mandated reporting of child abuse (CAPTA) and elder/dependent adult abuse, intimate partner violence in pregnancy

Patient Education & Health Literacy

Teach-back method, Ask Me 3, REALM-SF and TOFHLA, plain-language materials, medication adherence models, self-management support, motivational interviewing in chronic disease

How to Pass the C-SWHC Exam

What You Need to Know

Passing score: Portfolio review (no scored exam)
Assessment: Portfolio credential — no scored written exam. Practice questions support self-assessment on NASW Standards for Social Work Practice in Health Care Settings and related federal regulations (HIPAA, 42 CFR 482.43, PSDA).
Time limit: Self-paced practice
Exam fee: $165 member / $450 non-member

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

C-SWHC Study Tips from Top Performers

1Download and study the 2016 NASW Standards for Social Work Practice in Health Care Settings cover to cover — every practice question is anchored in one of the 12 standards

2Master 42 CFR 482.43 and the 2019 CMS Discharge Planning Final Rule — know the specific CoP requirements for patient choice, post-acute provider lists, and financial interest disclosure

3Memorize the Appelbaum four-prong model of medical decision-making capacity: understanding, appreciation, reasoning, and expressing a choice

4Know the difference between capacity (clinical, task-specific) and competency (legal, global) and when to request a psychiatry or ethics consult

5Study HIPAA Privacy Rule permitted disclosures under 45 CFR 164.512 and the stricter confidentiality rules of 42 CFR Part 2 for substance use disorder records

6Review the Medicare Parts A/B/C/D structure, the Two-Midnight Rule for inpatient status, and the Medicare hospice benefit eligibility criteria

7Learn the SBIRT model, validated screening tools (AUDIT, DAST-10, PHQ-9, GAD-7, PC-PTSD-5), and Healthy People 2030 SDOH domains for the assessment section

Frequently Asked Questions

Is the C-SWHC a written exam or a portfolio credential?

The NASW C-SWHC is a portfolio credential — there is no scored written exam. NASW reviews a complete application including proof of MSW from a CSWE-accredited program, current state MSW-level license, documentation of at least 2 years (3,000 hours) of post-MSW supervised health care social work experience, 20 contact hours of CE relevant to health care, a supervisor evaluation, and a reference from an MSW colleague. Our 100 practice questions are designed for self-assessment and professional development against the NASW Standards for Social Work Practice in Health Care Settings — they are not a mock NASW exam.

What are the C-SWHC eligibility requirements?

To apply for the C-SWHC, you need: (1) an MSW from a Council on Social Work Education (CSWE) accredited program, (2) a current state MSW-level social work license (or an ASWB exam-passing score credential), (3) at least 2 years or 3,000 hours of paid, post-MSW supervised social work experience in a health care setting, (4) 20 contact hours of continuing education relevant to health care social work within the last 2 years, (5) a supervisor evaluation from a supervisor with at least 2 years post-MSW health care social work experience, (6) a reference from an MSW colleague (not your supervisor or supervisee), and (7) agreement to abide by the NASW Code of Ethics.

How much does the C-SWHC cost in 2026?

As of 2026, the C-SWHC application fee is $165 for NASW members and $450 for non-members. Renewal is required every 2 years and costs $95 for members and $350 for non-members. Renewal also requires 20 contact hours of continuing education and active MSW-level state licensure. There are additional indirect costs — CE courses, NASW membership if you choose to join, and time spent preparing the application packet. Processing typically takes about six weeks after a complete application is received.

What does the NASW Standard for Social Work Practice in Health Care Settings cover?

The 2016 NASW Standards for Social Work Practice in Health Care Settings define 12 core standards: ethics and values, qualifications, knowledge, cultural and linguistic competence, screening and assessment, care planning and intervention, advocacy, interdisciplinary and interorganizational collaboration, practice evaluation and quality improvement, record keeping and confidentiality, workload sustainability, and professional development and supervision. Our practice questions are mapped to each of these standards, with additional coverage of the federal regulations (HIPAA, 42 CFR 482.43 discharge planning, Patient Self-Determination Act) and clinical frameworks (SDOH, SBIRT, trauma-informed care) that health care social workers must know.

What does 42 CFR 482.43 require about discharge planning?

42 CFR 482.43 is the Medicare Condition of Participation for hospital discharge planning, most recently updated by the 2019 CMS Final Rule (84 FR 51836). It requires hospitals to identify patients likely to suffer adverse health outcomes without adequate discharge planning, develop a discharge plan focused on the patient's goals and treatment preferences, involve the patient and caregivers as active partners, provide a list of Medicare-participating post-acute providers (HHA, SNF, IRF, LTCH), respect the patient's freedom of choice, disclose any hospital financial interest in a referral, and share quality and resource-use data to support informed selection. Medical social workers often lead or co-lead this process, which is why discharge planning is a high-yield topic on the C-SWHC content.

How is C-SWHC different from QCSW and CSW-G?

NASW offers several advanced practice credentials. C-SWHC (Certified Social Worker in Health Care) is specific to medical and health care settings. QCSW (Qualified Clinical Social Worker) is a foundational credential for clinical MSW practice. CSW-G (Certified Social Worker in Gerontology) is specific to older adults. CHP-SW (Certified Hospice and Palliative Social Worker) is for end-of-life care. Each has its own MSW, licensure, experience, CE, and reference requirements, but all share the portfolio review format and the commitment to the NASW Code of Ethics. A social worker in an oncology or ICU setting may hold both C-SWHC and CHP-SW.

What is the Patient Self-Determination Act and why does it matter?

The Patient Self-Determination Act (PSDA) of 1990 requires hospitals, nursing homes, home health agencies, hospices, and HMOs that participate in Medicare or Medicaid to inform adult patients of their right to make medical decisions, including the right to accept or refuse treatment and to execute advance directives (living wills, durable power of attorney for health care). Facilities must document whether the patient has an advance directive, provide written information about state law, and educate staff and the community. Medical social workers are commonly responsible for initiating advance care planning conversations under this federal mandate.