NAB EXAM 2026/2027 PRACTICE Q&A | NURSING
HOME ADMINISTRATOR BOARD PREP | VERIFIED
ANSWERS WITH RATIONALES
• This practice Q&A contains 200 verified questions with EXPERT RATIONALE
designed to mirror the real NAB Nursing Home Administrator Board Exam — use it
by attempting each question before checking the correct answer and EXPERT
RATIONALE below it.
• Work through sections systematically, revisit questions you got wrong, and pay
special attention to the EXPERT RATIONALE as they explain the "why" behind each
correct answer — this is where real exam mastery is built.
NAB EXAM 2026/2027 PRACTICE Q&A
NURSING HOME ADMINISTRATOR BOARD PREP | VERIFIED ANSWERS WITH
EXPERT RATIONALE
1. A nursing home administrator is responsible for ensuring that the facility
complies with which federal regulation that governs the operation of skilled
nursing facilities?
A. The Americans with Disabilities Act (ADA)
B. The Occupational Safety and Health Act (OSHA)
C. The Omnibus Budget Reconciliation Act (OBRA) of 1987
D. The Health Insurance Portability and Accountability Act (HIPAA)
E. The Social Security Act Title XVIII
CORRECT ANSWER: C. The Omnibus Budget Reconciliation Act (OBRA) of
1987
EXPERT RATIONALE: OBRA 1987 is the landmark federal legislation that established
comprehensive standards for nursing home care, including resident rights, quality of
care requirements, staffing standards, and survey and certification processes for skilled
nursing facilities.
,2. Which federal agency is primarily responsible for the oversight and
certification of nursing homes participating in Medicare and Medicaid?
A. The Department of Veterans Affairs (VA)
B. The Food and Drug Administration (FDA)
C. The Centers for Disease Control and Prevention (CDC)
D. The Centers for Medicare & Medicaid Services (CMS)
E. The Joint Commission on Accreditation
CORRECT ANSWER: D. The Centers for Medicare & Medicaid Services (CMS)
EXPERT RATIONALE: CMS is the federal agency responsible for administering Medicare
and Medicaid programs, including the certification and oversight of nursing facilities
that participate in these programs.
3. A resident's care plan must be developed within how many days of
admission to a skilled nursing facility?
A. 7 days
B. 14 days
C. 21 days
D. 28 days
E. 30 days
CORRECT ANSWER: C. 21 days
EXPERT RATIONALE: Under federal regulations, a comprehensive care plan must be
developed within 21 days of a resident's admission to a skilled nursing facility,
incorporating input from the interdisciplinary team and the resident.
,4. Which of the following best describes the role of the Long-Term Care
Ombudsman?
A. Conducting state licensure surveys of nursing facilities
B. Investigating Medicaid fraud and abuse
C. Advocating for the rights and quality of life of nursing home residents
D. Credentialing nursing home administrators
E. Approving facility budgets and financial plans
CORRECT ANSWER: C. Advocating for the rights and quality of life of
nursing home residents
EXPERT RATIONALE: The Long-Term Care Ombudsman Program, established under the
Older Americans Act, is responsible for investigating complaints and advocating on
behalf of residents in nursing facilities to protect their rights and improve quality of care.
5. Under HIPAA, which of the following is considered Protected Health
Information (PHI)?
A. General health statistics published in medical journals
B. De-identified patient data used for research
C. A resident's medical record containing their name and diagnosis
D. Aggregated data without personal identifiers
E. Publicly available health information
CORRECT ANSWER: C. A resident's medical record containing their name
and diagnosis
EXPERT RATIONALE: PHI under HIPAA includes any individually identifiable health
information that relates to a person's past, present, or future health condition, including
medical records containing names, diagnoses, and other identifying details.
, 6. The Minimum Data Set (MDS) is used in nursing facilities primarily for
which purpose?
A. Tracking employee performance evaluations
B. Determining staffing ratios for each shift
C. Comprehensive assessment of residents to guide care planning and
reimbursement
D. Reporting facility financial performance to the state
E. Scheduling resident activities and therapy sessions
CORRECT ANSWER: C. Comprehensive assessment of residents to guide
care planning and reimbursement
EXPERT RATIONALE: The MDS is a standardized, comprehensive assessment tool
required by CMS for all nursing home residents. It collects data on residents' functional
status, health conditions, and care needs, which drives care planning and Medicare
reimbursement under PDPM.
7. What is the primary purpose of the Patient-Driven Payment Model (PDPM)
in skilled nursing facilities?
A. To base reimbursement on the volume of therapy services provided
B. To reimburse facilities based on individual resident clinical characteristics
C. To standardize staffing ratios across all SNFs
D. To eliminate the need for the MDS assessment
E. To provide flat-rate payments for all Medicare residents
CORRECT ANSWER: B. To reimburse facilities based on individual resident
clinical characteristics
EXPERT RATIONALE: PDPM, which replaced RUG-IV in October 2019, bases Medicare
reimbursement on the resident's clinical condition and care needs rather than the
HOME ADMINISTRATOR BOARD PREP | VERIFIED
ANSWERS WITH RATIONALES
• This practice Q&A contains 200 verified questions with EXPERT RATIONALE
designed to mirror the real NAB Nursing Home Administrator Board Exam — use it
by attempting each question before checking the correct answer and EXPERT
RATIONALE below it.
• Work through sections systematically, revisit questions you got wrong, and pay
special attention to the EXPERT RATIONALE as they explain the "why" behind each
correct answer — this is where real exam mastery is built.
NAB EXAM 2026/2027 PRACTICE Q&A
NURSING HOME ADMINISTRATOR BOARD PREP | VERIFIED ANSWERS WITH
EXPERT RATIONALE
1. A nursing home administrator is responsible for ensuring that the facility
complies with which federal regulation that governs the operation of skilled
nursing facilities?
A. The Americans with Disabilities Act (ADA)
B. The Occupational Safety and Health Act (OSHA)
C. The Omnibus Budget Reconciliation Act (OBRA) of 1987
D. The Health Insurance Portability and Accountability Act (HIPAA)
E. The Social Security Act Title XVIII
CORRECT ANSWER: C. The Omnibus Budget Reconciliation Act (OBRA) of
1987
EXPERT RATIONALE: OBRA 1987 is the landmark federal legislation that established
comprehensive standards for nursing home care, including resident rights, quality of
care requirements, staffing standards, and survey and certification processes for skilled
nursing facilities.
,2. Which federal agency is primarily responsible for the oversight and
certification of nursing homes participating in Medicare and Medicaid?
A. The Department of Veterans Affairs (VA)
B. The Food and Drug Administration (FDA)
C. The Centers for Disease Control and Prevention (CDC)
D. The Centers for Medicare & Medicaid Services (CMS)
E. The Joint Commission on Accreditation
CORRECT ANSWER: D. The Centers for Medicare & Medicaid Services (CMS)
EXPERT RATIONALE: CMS is the federal agency responsible for administering Medicare
and Medicaid programs, including the certification and oversight of nursing facilities
that participate in these programs.
3. A resident's care plan must be developed within how many days of
admission to a skilled nursing facility?
A. 7 days
B. 14 days
C. 21 days
D. 28 days
E. 30 days
CORRECT ANSWER: C. 21 days
EXPERT RATIONALE: Under federal regulations, a comprehensive care plan must be
developed within 21 days of a resident's admission to a skilled nursing facility,
incorporating input from the interdisciplinary team and the resident.
,4. Which of the following best describes the role of the Long-Term Care
Ombudsman?
A. Conducting state licensure surveys of nursing facilities
B. Investigating Medicaid fraud and abuse
C. Advocating for the rights and quality of life of nursing home residents
D. Credentialing nursing home administrators
E. Approving facility budgets and financial plans
CORRECT ANSWER: C. Advocating for the rights and quality of life of
nursing home residents
EXPERT RATIONALE: The Long-Term Care Ombudsman Program, established under the
Older Americans Act, is responsible for investigating complaints and advocating on
behalf of residents in nursing facilities to protect their rights and improve quality of care.
5. Under HIPAA, which of the following is considered Protected Health
Information (PHI)?
A. General health statistics published in medical journals
B. De-identified patient data used for research
C. A resident's medical record containing their name and diagnosis
D. Aggregated data without personal identifiers
E. Publicly available health information
CORRECT ANSWER: C. A resident's medical record containing their name
and diagnosis
EXPERT RATIONALE: PHI under HIPAA includes any individually identifiable health
information that relates to a person's past, present, or future health condition, including
medical records containing names, diagnoses, and other identifying details.
, 6. The Minimum Data Set (MDS) is used in nursing facilities primarily for
which purpose?
A. Tracking employee performance evaluations
B. Determining staffing ratios for each shift
C. Comprehensive assessment of residents to guide care planning and
reimbursement
D. Reporting facility financial performance to the state
E. Scheduling resident activities and therapy sessions
CORRECT ANSWER: C. Comprehensive assessment of residents to guide
care planning and reimbursement
EXPERT RATIONALE: The MDS is a standardized, comprehensive assessment tool
required by CMS for all nursing home residents. It collects data on residents' functional
status, health conditions, and care needs, which drives care planning and Medicare
reimbursement under PDPM.
7. What is the primary purpose of the Patient-Driven Payment Model (PDPM)
in skilled nursing facilities?
A. To base reimbursement on the volume of therapy services provided
B. To reimburse facilities based on individual resident clinical characteristics
C. To standardize staffing ratios across all SNFs
D. To eliminate the need for the MDS assessment
E. To provide flat-rate payments for all Medicare residents
CORRECT ANSWER: B. To reimburse facilities based on individual resident
clinical characteristics
EXPERT RATIONALE: PDPM, which replaced RUG-IV in October 2019, bases Medicare
reimbursement on the resident's clinical condition and care needs rather than the
