Federal Nursing Home Administrator ACTUAL
EXAM 2026/2027 | Complete Study Guide &
Practice Questions | Verified Q&A | Pass
Guaranteed - A+ Graded
DOMAIN 1: CARE & QUALITY (Q1–Q35)
Q1: The Minimum Data Set (MDS) 3.0 comprehensive assessment must be completed within how many
days of a resident’s admission to a Medicare-certified skilled nursing facility?
A. 7 days
B. 14 days
C. 21 days
D. 30 days
Correct Answer: B
Rationale: Under 42 CFR §483.20, the MDS 3.0 comprehensive assessment must be completed no later
than 14 calendar days after admission, with the assessment reference date set within this window to
establish the resident’s baseline care needs and initiate the care planning process.
Q2: As the NHA, you are reviewing the facility’s QAPI program. Which federal regulation mandates that
nursing homes develop, implement, and maintain an effective, comprehensive, data-driven QAPI
program?
A. 42 CFR §483.55
B. 42 CFR §483.65
C. 42 CFR §483.75
D. 42 CFR §483.85
Correct Answer: C
Rationale: 42 CFR §483.75 specifically requires the QAPI program to focus on indicators of care
outcomes and quality of life, ensuring continuous systemic improvement through data collection,
analysis, and action planning.
Q3: A resident develops a new Stage 3 pressure ulcer after admission. The facility failed to conduct a
skin assessment upon admission and did not implement turning protocols per professional standards.
Which F-tag is most likely cited?
A. F686
B. F690
C. F696
,D. F700
Correct Answer: A
Rationale: F686 (formerly F314 under prior guidance) addresses the requirement that a resident
receives treatment and care in accordance with professional standards of practice to prevent pressure
ulcers/injuries, including risk assessment, skin inspection, and preventative interventions.
Q4: A nursing home is cited during a survey for failing to ensure a resident with diabetes receives
adequate nutrition and hydration consistent with their care plan. Which F-tag applies?
A. F692
B. F800
C. F812
D. F825
Correct Answer: A
Rationale: F692 corresponds to 42 CFR §483.60 and §483.25, requiring facilities to ensure residents
maintain acceptable parameters of nutritional status, including nutritive value, food temperatures, and
therapeutic diets, unless the resident’s clinical condition demonstrates that this is not possible.
Q5: A facility’s medication pass audit reveals that PRN pain medications are not being administered
within the prescribed timeframes, and pain reassessments are missing from the medical record. Which
regulation governs this deficiency?
A. 42 CFR §483.40
B. 42 CFR §483.45
C. 42 CFR §483.50
D. 42 CFR §483.55
Correct Answer: B
Rationale: 42 CFR §483.45 governs medication management and administration, requiring facilities to
establish processes for accurate preparation, administration, documentation, and monitoring of drug
regimens, including pain management protocols and unnecessary drug prevention.
Q6: The interdisciplinary team must develop a baseline care plan within how many days of admission?
A. 24 hours
B. 48 hours
C. 7 days
D. 14 days
Correct Answer: B
Rationale: Per 42 CFR §483.21, a baseline care plan must be developed within 48 hours of admission to
ensure immediate, person-centered interventions are in place while the comprehensive care plan is
being finalized.
Q7: A resident with advanced dementia is prescribed haloperidol for agitation without documented
medical necessity or attempted non-pharmacological interventions. Which F-tag is most likely cited?
A. F329
B. F741
, C. F758
D. F780
Correct Answer: B
Rationale: F741 addresses unnecessary drugs, specifically psychotropic medications, requiring that they
be administered only when medically necessary, in the lowest practicable dose, and with documented
gradual dose reduction attempts unless clinically contraindicated.
Q8: Under the 2024 CMS final staffing rule effective in phases through 2026/2027, what is the minimum
daily direct care hours per resident required?
A. 2.50 hours
B. 3.00 hours
C. 3.48 hours
D. 4.00 hours
Correct Answer: C
Rationale: The CMS final staffing rule mandates 3.48 hours of daily direct care per resident, with 0.55
hours required from registered nurses and 2.45 hours from nurse aides, to ensure adequate staffing for
quality care delivery.
Q9: A resident receiving hospice services in the nursing home requires coordination between the facility
staff and the hospice interdisciplinary team. Who is responsible for ensuring this coordination occurs?
A. The hospice medical director only
B. The facility director of nursing
C. The nursing home administrator
D. The attending physician
Correct Answer: C
Rationale: As the overall manager of facility operations, the NHA must ensure that written agreements
and care coordination protocols are in place between the nursing home and hospice providers,
guaranteeing seamless care transitions and communication per 42 CFR §483.70 and hospice conditions
of participation.
Q10: A facility’s infection control program fails to implement proper hand hygiene protocols, resulting in
a Clostridioides difficile outbreak. Which F-tag is most likely cited?
A. F880
B. F882
C. F885
D. F890
Correct Answer: B
Rationale: F882 corresponds to the infection control program requirements under 42 CFR §483.80,
which mandates that facilities establish, implement, and maintain an infection prevention and control
program, including hand hygiene, standard precautions, and outbreak management protocols.
Q11: The QAPI program must include which mandatory component to satisfy federal requirements?
A. Annual satisfaction surveys only
EXAM 2026/2027 | Complete Study Guide &
Practice Questions | Verified Q&A | Pass
Guaranteed - A+ Graded
DOMAIN 1: CARE & QUALITY (Q1–Q35)
Q1: The Minimum Data Set (MDS) 3.0 comprehensive assessment must be completed within how many
days of a resident’s admission to a Medicare-certified skilled nursing facility?
A. 7 days
B. 14 days
C. 21 days
D. 30 days
Correct Answer: B
Rationale: Under 42 CFR §483.20, the MDS 3.0 comprehensive assessment must be completed no later
than 14 calendar days after admission, with the assessment reference date set within this window to
establish the resident’s baseline care needs and initiate the care planning process.
Q2: As the NHA, you are reviewing the facility’s QAPI program. Which federal regulation mandates that
nursing homes develop, implement, and maintain an effective, comprehensive, data-driven QAPI
program?
A. 42 CFR §483.55
B. 42 CFR §483.65
C. 42 CFR §483.75
D. 42 CFR §483.85
Correct Answer: C
Rationale: 42 CFR §483.75 specifically requires the QAPI program to focus on indicators of care
outcomes and quality of life, ensuring continuous systemic improvement through data collection,
analysis, and action planning.
Q3: A resident develops a new Stage 3 pressure ulcer after admission. The facility failed to conduct a
skin assessment upon admission and did not implement turning protocols per professional standards.
Which F-tag is most likely cited?
A. F686
B. F690
C. F696
,D. F700
Correct Answer: A
Rationale: F686 (formerly F314 under prior guidance) addresses the requirement that a resident
receives treatment and care in accordance with professional standards of practice to prevent pressure
ulcers/injuries, including risk assessment, skin inspection, and preventative interventions.
Q4: A nursing home is cited during a survey for failing to ensure a resident with diabetes receives
adequate nutrition and hydration consistent with their care plan. Which F-tag applies?
A. F692
B. F800
C. F812
D. F825
Correct Answer: A
Rationale: F692 corresponds to 42 CFR §483.60 and §483.25, requiring facilities to ensure residents
maintain acceptable parameters of nutritional status, including nutritive value, food temperatures, and
therapeutic diets, unless the resident’s clinical condition demonstrates that this is not possible.
Q5: A facility’s medication pass audit reveals that PRN pain medications are not being administered
within the prescribed timeframes, and pain reassessments are missing from the medical record. Which
regulation governs this deficiency?
A. 42 CFR §483.40
B. 42 CFR §483.45
C. 42 CFR §483.50
D. 42 CFR §483.55
Correct Answer: B
Rationale: 42 CFR §483.45 governs medication management and administration, requiring facilities to
establish processes for accurate preparation, administration, documentation, and monitoring of drug
regimens, including pain management protocols and unnecessary drug prevention.
Q6: The interdisciplinary team must develop a baseline care plan within how many days of admission?
A. 24 hours
B. 48 hours
C. 7 days
D. 14 days
Correct Answer: B
Rationale: Per 42 CFR §483.21, a baseline care plan must be developed within 48 hours of admission to
ensure immediate, person-centered interventions are in place while the comprehensive care plan is
being finalized.
Q7: A resident with advanced dementia is prescribed haloperidol for agitation without documented
medical necessity or attempted non-pharmacological interventions. Which F-tag is most likely cited?
A. F329
B. F741
, C. F758
D. F780
Correct Answer: B
Rationale: F741 addresses unnecessary drugs, specifically psychotropic medications, requiring that they
be administered only when medically necessary, in the lowest practicable dose, and with documented
gradual dose reduction attempts unless clinically contraindicated.
Q8: Under the 2024 CMS final staffing rule effective in phases through 2026/2027, what is the minimum
daily direct care hours per resident required?
A. 2.50 hours
B. 3.00 hours
C. 3.48 hours
D. 4.00 hours
Correct Answer: C
Rationale: The CMS final staffing rule mandates 3.48 hours of daily direct care per resident, with 0.55
hours required from registered nurses and 2.45 hours from nurse aides, to ensure adequate staffing for
quality care delivery.
Q9: A resident receiving hospice services in the nursing home requires coordination between the facility
staff and the hospice interdisciplinary team. Who is responsible for ensuring this coordination occurs?
A. The hospice medical director only
B. The facility director of nursing
C. The nursing home administrator
D. The attending physician
Correct Answer: C
Rationale: As the overall manager of facility operations, the NHA must ensure that written agreements
and care coordination protocols are in place between the nursing home and hospice providers,
guaranteeing seamless care transitions and communication per 42 CFR §483.70 and hospice conditions
of participation.
Q10: A facility’s infection control program fails to implement proper hand hygiene protocols, resulting in
a Clostridioides difficile outbreak. Which F-tag is most likely cited?
A. F880
B. F882
C. F885
D. F890
Correct Answer: B
Rationale: F882 corresponds to the infection control program requirements under 42 CFR §483.80,
which mandates that facilities establish, implement, and maintain an infection prevention and control
program, including hand hygiene, standard precautions, and outbreak management protocols.
Q11: The QAPI program must include which mandatory component to satisfy federal requirements?
A. Annual satisfaction surveys only
