Michigan NHA Practice Exam 2026/2027
State of Michigan Nursing Home Administrator Test Exam
Practice 2026/2027
Michigan NHA Licensure Examination Practice Questions
Total Questions: 100 | Expert-Aligned Structure | Comprehensive Practice Exam
Answer Format: All correct answers appear in bold and cyan blue, accompanied by concise rationales
explaining the specific Michigan Public Health Code section or Administrative Rule (e.g., Act 368, Part 217, R
325.19101), the correct federal regulation (42 CFR Part 483) or OBRA requirement, the appropriate quality
improvement or risk management action, the correct survey and enforcement procedure (scope and severity, plan
of correction), the proper financial or staffing practice, and why alternative options violate Michigan and federal
nursing home regulations, resident rights, or professional standards.
1. Under the Michigan Public Health Code, Act 368 of 1978, Part 217, which entity is responsible for the
licensure and regulation of nursing home administrators in Michigan?
A. Michigan Department of Licensing and Regulatory Affairs (LARA)
B. Michigan Department of Health and Human Services (MDHHS)
C. Michigan Board of Nursing Home Administrators
D. Michigan Attorney General's Office
Answer: C. The Michigan Board of Nursing Home Administrators, operating under LARA, is the specific regulatory
body authorized by Act 368 of 1978, Part 217 (MCL 333.21701 et seq.) to license and discipline nursing home
administrators. While LARA is the parent agency, the Board itself has direct authority over NHA licensure.
2. A Michigan nursing home administrator's license expires on December 31 of the renewal year. The
administrator must complete how many hours of continuing education to be eligible for renewal?
A. 20 hours every 2 years
B. 30 hours every 2 years
C. 50 hours every 2 years
D. 40 hours every 2 years
Answer: D. Under Michigan Administrative Rule R 325.19117, an NHA must complete a minimum of 40 hours of
approved continuing education within each 2-year licensure period. At least 2 of these hours must relate to laws and
rules pertaining to the practice of nursing home administration in Michigan.
3. Under Michigan Administrative Rules (R 325.19101 – R 325.19915), which of the following is a requirement
for initial NHA licensure in Michigan?
A. Completion of a bachelor's degree in any field
B. A minimum of 5 years of direct nursing home employment experience
C. Successful completion of the NAB examination and a 1,500-hour Administrator-in-Training
(AIT) program
D. Passing a Michigan-specific jurisprudence exam only
Answer: C. Michigan Administrative Rules require candidates to complete an approved AIT program of at least 1,500
hours and pass the NAB (National Association of Long-Term Care Administrator Boards) examination. These are core
prerequisites under R 325.19109 for initial NHA licensure in Michigan.
1
, Michigan NHA Practice Exam 2026/2027
4. A Michigan nursing home facility is hiring a new administrator. Under state law, which type of background
check must be completed through the Michigan State Police before the administrator can begin practice?
A. ICHAT (Internet Criminal History Access Tool) criminal background check
B. FBI fingerprint check only
C. Local county sheriff's report only
D. Credit history check through the Department of Treasury
Answer: A. Michigan requires an ICHAT criminal background check through the Michigan State Police for nursing
home administrator licensure applicants under Part 217 of Act 368. This is a standard component of the LARA
application process to ensure patient safety and regulatory compliance.
5. Under the Omnibus Budget Reconciliation Act of 1987 (OBRA '87), as codified in 42 CFR Part 483, what is
the minimum requirement for a pre-admission screening and annual resident review (PASRR) for individuals with
serious mental illness (SMI) or intellectual disabilities (ID)?
A. Screening is required only if the resident exhibits behavioral issues
B. Screening is at the discretion of the admitting physician
C. Only residents with a prior psychiatric hospitalization require screening
D. All prospective nursing home residents must be screened for SMI and ID before admission, and
those identified must receive an annual review
Answer: D. OBRA '87 established the PASRR requirement (42 CFR §483.100-§483.128), mandating that all
individuals seeking admission to a Medicaid-certified nursing facility be screened for serious mental illness and
intellectual disabilities. Those who screen positive must receive specialized services and an annual review of their need
for NF level of care.
6. The Michigan Public Health Code, Part 217, defines the 'practice of nursing home administration.' Which of the
following activities falls outside the statutory definition?
A. Planning, organizing, directing, and controlling the operation of a nursing home
B. Supervising and evaluating the performance of nursing home staff
C. Providing direct medical treatment or nursing care to individual residents
D. Ensuring compliance with federal and state regulations
Answer: C. Under MCL 333.21703, the practice of nursing home administration includes planning, organizing,
directing, and controlling the operation of a nursing home and supervising staff. Direct medical treatment or nursing
care to individual residents is outside the scope of NHA practice and falls within the scope of licensed healthcare
professionals.
7. Under LARA regulations, if a Michigan NHA is found to have violated the Public Health Code, which of the
following disciplinary actions may the Board impose?
A. Revocation of the facility's Medicare certification
B. Criminal prosecution and imprisonment of the administrator
C. Suspension, limitation, or revocation of the administrator's license and/or a civil fine up to
$10,000 per violation
D. Closure of the nursing home facility
Answer: C. Under MCL 333.21713, the Board of Nursing Home Administrators may discipline a licensee through
revocation, suspension, limitation of license, or imposition of a civil fine not exceeding $10,000 for each violation.
Criminal prosecution and facility closure are outside the Board's direct authority and would involve other agencies.
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, Michigan NHA Practice Exam 2026/2027
8. Under 42 CFR §483.70, what is the federal requirement regarding the nursing home administrator's hours of
availability in the facility?
A. The administrator must be on-site 24 hours per day, 7 days per week
B. The administrator must designate a qualified person to be in charge of the facility in the
administrator's absence
C. The administrator may manage the facility remotely with no on-site presence required
D. The administrator must be on-site at least 20 hours per week
Answer: B. 42 CFR §483.70(b) requires the facility to designate a licensed administrator who is responsible for the
management of the facility and must designate a qualified person to be in charge in the administrator's absence. This
ensures continuous competent leadership and regulatory compliance.
9. Michigan Administrative Rule R 325.19117 specifies continuing education requirements for NHA license
renewal. How many of the 40 required CE hours must relate specifically to laws and rules pertaining to the
practice of nursing home administration?
A. 1 hour
B. 5 hours
C. 2 hours
D. 10 hours
Answer: C. R 325.19117 requires that of the 40 continuing education hours completed during each 2-year licensure
period, at least 2 hours must relate to Michigan laws and rules pertaining to nursing home administration. This ensures
administrators stay current on regulatory changes affecting their practice.
10. Under federal regulations at 42 CFR §483.75, which of the following is required regarding a nursing home's
compliance with federal participation requirements?
A. The facility must submit an annual self-assessment survey
B. The facility must only comply with state-specific regulations
C. The facility is exempt from federal requirements if it does not accept Medicare residents
D. The facility must comply with all federal participation requirements applicable to its type of
facility and maintain required documentation
Answer: D. 42 CFR §483.75 requires that a nursing facility must be in compliance with all applicable federal
participation requirements to participate in Medicare or Medicaid. Any facility receiving federal funds must comply
with these standards regardless of whether it admits Medicare residents specifically, as Medicaid participation alone
triggers compliance.
11. Under 42 CFR §483.10, a nursing facility resident has the right to be free from which of the following?
A. Any verbal, mental, sexual, and physical abuse, including injuries of unknown source, as well as
misappropriation of property
B. Physical restraint only when it is used as a disciplinary measure
C. Chemical restraints administered by a licensed physician
D. All forms of seclusion regardless of clinical justification
Answer: A. 42 CFR §483.10(c) grants residents the right to be free from verbal, mental, sexual, and physical abuse,
including corporal punishment, and involuntary seclusion. It also covers injuries of unknown source and
misappropriation of property. Chemical restraints and physical restraints have separate regulatory provisions that
allow use under specific clinical circumstances with physician orders.
3
State of Michigan Nursing Home Administrator Test Exam
Practice 2026/2027
Michigan NHA Licensure Examination Practice Questions
Total Questions: 100 | Expert-Aligned Structure | Comprehensive Practice Exam
Answer Format: All correct answers appear in bold and cyan blue, accompanied by concise rationales
explaining the specific Michigan Public Health Code section or Administrative Rule (e.g., Act 368, Part 217, R
325.19101), the correct federal regulation (42 CFR Part 483) or OBRA requirement, the appropriate quality
improvement or risk management action, the correct survey and enforcement procedure (scope and severity, plan
of correction), the proper financial or staffing practice, and why alternative options violate Michigan and federal
nursing home regulations, resident rights, or professional standards.
1. Under the Michigan Public Health Code, Act 368 of 1978, Part 217, which entity is responsible for the
licensure and regulation of nursing home administrators in Michigan?
A. Michigan Department of Licensing and Regulatory Affairs (LARA)
B. Michigan Department of Health and Human Services (MDHHS)
C. Michigan Board of Nursing Home Administrators
D. Michigan Attorney General's Office
Answer: C. The Michigan Board of Nursing Home Administrators, operating under LARA, is the specific regulatory
body authorized by Act 368 of 1978, Part 217 (MCL 333.21701 et seq.) to license and discipline nursing home
administrators. While LARA is the parent agency, the Board itself has direct authority over NHA licensure.
2. A Michigan nursing home administrator's license expires on December 31 of the renewal year. The
administrator must complete how many hours of continuing education to be eligible for renewal?
A. 20 hours every 2 years
B. 30 hours every 2 years
C. 50 hours every 2 years
D. 40 hours every 2 years
Answer: D. Under Michigan Administrative Rule R 325.19117, an NHA must complete a minimum of 40 hours of
approved continuing education within each 2-year licensure period. At least 2 of these hours must relate to laws and
rules pertaining to the practice of nursing home administration in Michigan.
3. Under Michigan Administrative Rules (R 325.19101 – R 325.19915), which of the following is a requirement
for initial NHA licensure in Michigan?
A. Completion of a bachelor's degree in any field
B. A minimum of 5 years of direct nursing home employment experience
C. Successful completion of the NAB examination and a 1,500-hour Administrator-in-Training
(AIT) program
D. Passing a Michigan-specific jurisprudence exam only
Answer: C. Michigan Administrative Rules require candidates to complete an approved AIT program of at least 1,500
hours and pass the NAB (National Association of Long-Term Care Administrator Boards) examination. These are core
prerequisites under R 325.19109 for initial NHA licensure in Michigan.
1
, Michigan NHA Practice Exam 2026/2027
4. A Michigan nursing home facility is hiring a new administrator. Under state law, which type of background
check must be completed through the Michigan State Police before the administrator can begin practice?
A. ICHAT (Internet Criminal History Access Tool) criminal background check
B. FBI fingerprint check only
C. Local county sheriff's report only
D. Credit history check through the Department of Treasury
Answer: A. Michigan requires an ICHAT criminal background check through the Michigan State Police for nursing
home administrator licensure applicants under Part 217 of Act 368. This is a standard component of the LARA
application process to ensure patient safety and regulatory compliance.
5. Under the Omnibus Budget Reconciliation Act of 1987 (OBRA '87), as codified in 42 CFR Part 483, what is
the minimum requirement for a pre-admission screening and annual resident review (PASRR) for individuals with
serious mental illness (SMI) or intellectual disabilities (ID)?
A. Screening is required only if the resident exhibits behavioral issues
B. Screening is at the discretion of the admitting physician
C. Only residents with a prior psychiatric hospitalization require screening
D. All prospective nursing home residents must be screened for SMI and ID before admission, and
those identified must receive an annual review
Answer: D. OBRA '87 established the PASRR requirement (42 CFR §483.100-§483.128), mandating that all
individuals seeking admission to a Medicaid-certified nursing facility be screened for serious mental illness and
intellectual disabilities. Those who screen positive must receive specialized services and an annual review of their need
for NF level of care.
6. The Michigan Public Health Code, Part 217, defines the 'practice of nursing home administration.' Which of the
following activities falls outside the statutory definition?
A. Planning, organizing, directing, and controlling the operation of a nursing home
B. Supervising and evaluating the performance of nursing home staff
C. Providing direct medical treatment or nursing care to individual residents
D. Ensuring compliance with federal and state regulations
Answer: C. Under MCL 333.21703, the practice of nursing home administration includes planning, organizing,
directing, and controlling the operation of a nursing home and supervising staff. Direct medical treatment or nursing
care to individual residents is outside the scope of NHA practice and falls within the scope of licensed healthcare
professionals.
7. Under LARA regulations, if a Michigan NHA is found to have violated the Public Health Code, which of the
following disciplinary actions may the Board impose?
A. Revocation of the facility's Medicare certification
B. Criminal prosecution and imprisonment of the administrator
C. Suspension, limitation, or revocation of the administrator's license and/or a civil fine up to
$10,000 per violation
D. Closure of the nursing home facility
Answer: C. Under MCL 333.21713, the Board of Nursing Home Administrators may discipline a licensee through
revocation, suspension, limitation of license, or imposition of a civil fine not exceeding $10,000 for each violation.
Criminal prosecution and facility closure are outside the Board's direct authority and would involve other agencies.
2
, Michigan NHA Practice Exam 2026/2027
8. Under 42 CFR §483.70, what is the federal requirement regarding the nursing home administrator's hours of
availability in the facility?
A. The administrator must be on-site 24 hours per day, 7 days per week
B. The administrator must designate a qualified person to be in charge of the facility in the
administrator's absence
C. The administrator may manage the facility remotely with no on-site presence required
D. The administrator must be on-site at least 20 hours per week
Answer: B. 42 CFR §483.70(b) requires the facility to designate a licensed administrator who is responsible for the
management of the facility and must designate a qualified person to be in charge in the administrator's absence. This
ensures continuous competent leadership and regulatory compliance.
9. Michigan Administrative Rule R 325.19117 specifies continuing education requirements for NHA license
renewal. How many of the 40 required CE hours must relate specifically to laws and rules pertaining to the
practice of nursing home administration?
A. 1 hour
B. 5 hours
C. 2 hours
D. 10 hours
Answer: C. R 325.19117 requires that of the 40 continuing education hours completed during each 2-year licensure
period, at least 2 hours must relate to Michigan laws and rules pertaining to nursing home administration. This ensures
administrators stay current on regulatory changes affecting their practice.
10. Under federal regulations at 42 CFR §483.75, which of the following is required regarding a nursing home's
compliance with federal participation requirements?
A. The facility must submit an annual self-assessment survey
B. The facility must only comply with state-specific regulations
C. The facility is exempt from federal requirements if it does not accept Medicare residents
D. The facility must comply with all federal participation requirements applicable to its type of
facility and maintain required documentation
Answer: D. 42 CFR §483.75 requires that a nursing facility must be in compliance with all applicable federal
participation requirements to participate in Medicare or Medicaid. Any facility receiving federal funds must comply
with these standards regardless of whether it admits Medicare residents specifically, as Medicaid participation alone
triggers compliance.
11. Under 42 CFR §483.10, a nursing facility resident has the right to be free from which of the following?
A. Any verbal, mental, sexual, and physical abuse, including injuries of unknown source, as well as
misappropriation of property
B. Physical restraint only when it is used as a disciplinary measure
C. Chemical restraints administered by a licensed physician
D. All forms of seclusion regardless of clinical justification
Answer: A. 42 CFR §483.10(c) grants residents the right to be free from verbal, mental, sexual, and physical abuse,
including corporal punishment, and involuntary seclusion. It also covers injuries of unknown source and
misappropriation of property. Chemical restraints and physical restraints have separate regulatory provisions that
allow use under specific clinical circumstances with physician orders.
3
