MISSOURI NURSING HOME
ADMINISTRATOR (NHA) EXAM
Official State Healthcare Licensing Board –
2026/2027
300+ Practice Questions with Verified
Answers & Detailed Rationales
EXAM OVERVIEW
Component Details
Missouri Board of Nursing Home Administrators (under Missouri Department of
Governing Body
Health and Senior Services)
Governing Statutes Chapter 344, RSMo (Revised Statutes of Missouri)
Governing
19 CSR 73 (Missouri Code of State Regulations) – Board Rules
Regulations
Exam Components National NAB Exam + Missouri State-Specific Exam
Exam Fee $50 for examination
Exam Window Must be taken within 12 months of board evaluation notice
Attempt Limit 3 attempts; after 3 failures, must complete board-prescribed instruction
,Core Exam Domains
Domain Approximate Weight
Leadership & Governance 25–30%
Federal & Missouri Long-Term Care Regulations Significant emphasis
Financial Management & Reimbursement 15–20%
Human Resources & Staff Management 10–15%
Resident Care & Quality of Life 15–20%
Physical Environment & Safety 10–15%
Key Regulatory References
• OBRA 1987 (Omnibus Budget Reconciliation Act) – Federal nursing home
regulations
• 19 CSR 30-85, 19 CSR 30-86, 19 CSR 30-88 – Missouri state regulations
• CFR 483.70 – Federal regulation defining NHA responsibilities
• 19 CSR 73-2.070 – Examination rules and procedures
• 19 CSR 73-2.020 – Licensure procedures and requirements
SECTION 1: LEADERSHIP & GOVERNANCE
Questions 1–50
,Q1. What is the primary role of a Nursing Home Administrator (NHA) as defined
by federal regulation (CFR 483.70)?
A) Provide direct nursing care to residents
B) Manage overall facility operations and ensure compliance with all federal and
state regulations
C) Prescribe medications and treatments
D) Perform administrative tasks only
Rationale: Under CFR 483.70, the NHA is responsible for the overall management of the
facility, ensuring that it operates in compliance with all applicable federal, state, and
local laws and regulations. The NHA provides leadership and oversight, not direct
clinical care.
Q2. Which body has the authority to grant, suspend, or revoke a Missouri Nursing
Home Administrator's license?
A) Missouri Board of Nursing
B) Missouri Board of Nursing Home Administrators (under DHSS)
C) Missouri Department of Mental Health
D) Centers for Medicare & Medicaid Services (CMS)
Rationale: The Missouri Board of Nursing Home Administrators, operating under the
Missouri Department of Health and Senior Services (DHSS), has the statutory authority
to grant, suspend, or revoke NHA licenses. The Board is established under Chapter 344,
RSMo.
, Q3. Under Missouri law (RSMo Chapter 344), which of the following is a required
element for initial nursing home administrator licensure?
A) Proof of U.S. citizenship
B) Completed application form with fee, evidence of education, and verification of
experience
C) Only a high school diploma
D) Recommendation from a current NHA
Rationale: Chapter 344, RSMo requires applicants to file a completed application with
the board, accompanied by the application fee, evidence of required education, and
verification of experience in healthcare administration.
Q4. What is the minimum educational requirement for Missouri Nursing Home
Administrator licensure?
A) Associate's degree
B) Bachelor's degree (preferably in healthcare administration or related field)
C) Master's degree
D) No formal education requirement
Rationale: Missouri requires at minimum a Bachelor's degree from an accredited
college or university, with a preferred emphasis in Healthcare Administration or a related
field.
Q5. According to 19 CSR 73-2.070, within how many months of receiving board
evaluation notice must an applicant take the examination?
A) 6 months
B) 12 months
ADMINISTRATOR (NHA) EXAM
Official State Healthcare Licensing Board –
2026/2027
300+ Practice Questions with Verified
Answers & Detailed Rationales
EXAM OVERVIEW
Component Details
Missouri Board of Nursing Home Administrators (under Missouri Department of
Governing Body
Health and Senior Services)
Governing Statutes Chapter 344, RSMo (Revised Statutes of Missouri)
Governing
19 CSR 73 (Missouri Code of State Regulations) – Board Rules
Regulations
Exam Components National NAB Exam + Missouri State-Specific Exam
Exam Fee $50 for examination
Exam Window Must be taken within 12 months of board evaluation notice
Attempt Limit 3 attempts; after 3 failures, must complete board-prescribed instruction
,Core Exam Domains
Domain Approximate Weight
Leadership & Governance 25–30%
Federal & Missouri Long-Term Care Regulations Significant emphasis
Financial Management & Reimbursement 15–20%
Human Resources & Staff Management 10–15%
Resident Care & Quality of Life 15–20%
Physical Environment & Safety 10–15%
Key Regulatory References
• OBRA 1987 (Omnibus Budget Reconciliation Act) – Federal nursing home
regulations
• 19 CSR 30-85, 19 CSR 30-86, 19 CSR 30-88 – Missouri state regulations
• CFR 483.70 – Federal regulation defining NHA responsibilities
• 19 CSR 73-2.070 – Examination rules and procedures
• 19 CSR 73-2.020 – Licensure procedures and requirements
SECTION 1: LEADERSHIP & GOVERNANCE
Questions 1–50
,Q1. What is the primary role of a Nursing Home Administrator (NHA) as defined
by federal regulation (CFR 483.70)?
A) Provide direct nursing care to residents
B) Manage overall facility operations and ensure compliance with all federal and
state regulations
C) Prescribe medications and treatments
D) Perform administrative tasks only
Rationale: Under CFR 483.70, the NHA is responsible for the overall management of the
facility, ensuring that it operates in compliance with all applicable federal, state, and
local laws and regulations. The NHA provides leadership and oversight, not direct
clinical care.
Q2. Which body has the authority to grant, suspend, or revoke a Missouri Nursing
Home Administrator's license?
A) Missouri Board of Nursing
B) Missouri Board of Nursing Home Administrators (under DHSS)
C) Missouri Department of Mental Health
D) Centers for Medicare & Medicaid Services (CMS)
Rationale: The Missouri Board of Nursing Home Administrators, operating under the
Missouri Department of Health and Senior Services (DHSS), has the statutory authority
to grant, suspend, or revoke NHA licenses. The Board is established under Chapter 344,
RSMo.
, Q3. Under Missouri law (RSMo Chapter 344), which of the following is a required
element for initial nursing home administrator licensure?
A) Proof of U.S. citizenship
B) Completed application form with fee, evidence of education, and verification of
experience
C) Only a high school diploma
D) Recommendation from a current NHA
Rationale: Chapter 344, RSMo requires applicants to file a completed application with
the board, accompanied by the application fee, evidence of required education, and
verification of experience in healthcare administration.
Q4. What is the minimum educational requirement for Missouri Nursing Home
Administrator licensure?
A) Associate's degree
B) Bachelor's degree (preferably in healthcare administration or related field)
C) Master's degree
D) No formal education requirement
Rationale: Missouri requires at minimum a Bachelor's degree from an accredited
college or university, with a preferred emphasis in Healthcare Administration or a related
field.
Q5. According to 19 CSR 73-2.070, within how many months of receiving board
evaluation notice must an applicant take the examination?
A) 6 months
B) 12 months
