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EXAM OVERVIEW & CORE DOMAINS
The NAB (National Association of Long Term Care Administrator Boards) exam is divided
into two main components: the Core of Knowledge Examination and the Nursing Home
Line of Service (NHA) Examination. Domains include Resident Care (28%), Human
Resources (23%), Finance (20%), Environment/Safety (17%), and
Leadership/Management (12%) .
SECTION 1: FEDERAL REGULATIONS & OBRA '87 (Questions 1-
25)
1. A nursing home resident is placed in wrist restraints without a physician's order.
This is a violation of which federal law?
A) HIPAA
B) ADA
,C) OBRA '87
D) OSHA
Rationale: OBRA '87 (Omnibus Budget Reconciliation Act) strictly requires that restraints
be used only with a physician's order, for specific medical necessity, and using the least
restrictive means. Restraint use without an order constitutes a violation of resident rights .
2. Under federal regulations, a comprehensive care plan must be completed within
how many days of admission?
A) 3 days
B) 7 days
C) 14 days
D) 21 days
Rationale: While the comprehensive MDS assessment must be completed by day 14, the
comprehensive care plan must be finalized within 7 days of admission. A baseline care
plan must be completed within 48 hours .
3. The Quality Assessment and Assurance (QAPI) committee must meet at a
minimum frequency of:
A) Monthly
B) Bi-monthly
C) Quarterly
D) Annually
,Rationale: Federal standards under OBRA 1987 require that the QAPI committee meet at
least quarterly to review facility performance metrics, identify systemic issues, and
implement corrective action plans .
4. Which federal agency oversees nursing home certification?
A) DHHS
B) CMS (Centers for Medicare & Medicaid Services)
C) FDA
D) OSHA
Rationale: CMS is the federal agency responsible for overseeing nursing home certification
and ensuring compliance with Medicare and Medicaid requirements. State survey agencies
conduct inspections on behalf of CMS .
5. Under federal regulations, the comprehensive Resident Assessment Instrument
(MDS) must be completed within how many calendar days of admission?
A) 7 days
B) 14 days
C) 21 days
D) 30 days
Rationale: Federal OBRA regulations mandate that the comprehensive Minimum Data Set
(MDS) assessment must be completed no later than 14 calendar days after admission. This
baseline data is critical for establishing the individualized care plan .
, 6. Which of the following is an example of a "resident right" under OBRA '87?
A) Freedom from restraints
B) Access to phone and mail
C) Choose own physician
D) All of the above
Rationale: OBRA guarantees multiple resident rights including freedom from restraints,
privacy, choice of physician, mail access, and the right to be free from discrimination .
7. A facility receives a "G-level" deficiency. What does this indicate?
A) Minimal harm
B) Actual harm that is not immediate jeopardy
C) Immediate jeopardy
D) No harm
Rationale: Severity G indicates actual harm that is not immediate jeopardy. Severity levels
range from A-B-C (minimal), D-E-F (moderate), to G-H-I (serious/jeopardy). A G tag or
above indicates substandard care .
8. What does the term "immediate jeopardy" mean in the survey process?
A) Minor violation with no harm
B) Potential for serious injury, harm, impairment, or death