SMQT Exam Study Guide 2026/2027 | Survey Process, F-Tags, CMS
Regulations, QAPI, Abuse & Neglect
Questions 1–50: Survey Process and Surveyor Responsibilities
1. What is the primary purpose of the SMQT?
A. To license nursing-home administrators
B. To test surveyors' knowledge, skills, and abilities needed to
conduct LTC surveys
C. To certify nursing assistants
D. To determine Medicare reimbursement
Answer: B
Rationale: The SMQT evaluates the knowledge, skills, and
abilities required for long-term-care survey work. Successful
completion is required before a surveyor may conduct surveys
independently.
2. A surveyor who has not successfully completed the SMQT may
generally:
A. Conduct surveys independently
B. Serve on a survey team under appropriate supervision
C. Issue civil monetary penalties independently
D. Certify facilities without supervision
Answer: B
Rationale: CMS permits an unqualified surveyor to participate
as a team member under supervision by a qualified surveyor,
but independent surveying requires successful completion of
the required training and testing.
3. Which source establishes federal requirements for Medicare-
and Medicaid-participating nursing facilities?
A. 42 CFR Part 483, Subpart B
B. State traffic regulations
C. OSHA construction codes only
D. The facility employee handbook
Answer: A
Rationale: Federal requirements for long-term-care facilities
, participating in Medicare or Medicaid are primarily contained
in 42 CFR Part 483, Subpart B.
4. Which document provides interpretive guidance used by
surveyors?
A. Appendix PP of the State Operations Manual
B. A facility's marketing brochure
C. A resident's personal diary
D. A newspaper editorial
Answer: A
Rationale: Appendix PP contains federal long-term-care survey
guidance and interpretive guidelines used to clarify regulatory
requirements.
5. A surveyor should base a deficiency primarily on:
A. Personal preference
B. Facility reputation
C. Evidence showing noncompliance with a federal
requirement
D. A negative internet review
Answer: C
Rationale: CMS states that deficiencies are based on violations
of federal requirements and supported by evidence of the
facility's performance or practices.
6. Which is an appropriate surveyor evidence source?
A. Direct observation
B. Personal assumptions
C. Rumors unrelated to residents
D. Social media speculation
Answer: A
Rationale: Observation is a primary source of survey evidence.
Interviews, record review, and document review can
corroborate observations.
7. What is meant by "triangulation" during a survey?
A. Using three surveyors at all times
, B. Confirming information through multiple sources
C. Interviewing only administrators
D. Reviewing only three resident charts
Answer: B
Rationale: Triangulation strengthens evidence by comparing
observations, interviews, records, policies, and other relevant
sources.
8. A surveyor observes a medication pass and notices repeated
omissions. What should the surveyor do first?
A. Immediately threaten the nurse with discipline
B. Objectively document the observation and investigate
further
C. Tell the nurse how to correct every error
D. Ignore the observation
Answer: B
Rationale: Surveyors gather objective evidence and determine
whether the practice represents noncompliance. They should
avoid coaching staff during the survey.
9. Which interview question is generally most appropriate?
A. "You failed to follow the policy, didn't you?"
B. "Why are you always careless?"
C. "Please describe what you do when a resident refuses
medication."
D. "You know this is wrong, correct?"
Answer: C
Rationale: Open-ended, neutral questions encourage
respondents to provide factual information without being led
toward a desired answer.
10. A surveyor should avoid:
A. Asking open-ended questions
B. Documenting exact statements
C. Leading or argumentative questions
D. Conducting private interviews when appropriate
, Answer: C
Rationale: Leading questions can contaminate evidence and
make findings less reliable.
11. SNF/NF surveys are generally:
A. Announced months in advance
B. Unannounced
C. Conducted only during business hours
D. Conducted only once every five years
Answer: B
Rationale: CMS states that nursing-home surveys are not
announced and may occur at various times, including
weekends and around-the-clock. (Centers for Medicare &
Medicaid Services)
12. A surveyor arrives at 10 p.m. for an authorized survey.
Which statement is most accurate?
A. Surveys can never occur at night
B. Nursing-home surveys may occur 24 hours a day
C. Surveys must start at 8 a.m.
D. Only complaint surveys may occur at night
Answer: B
Rationale: CMS states that SNF/NF surveys may be conducted
at any time, including weekends and 24 hours a day.
13. The surveyor's primary responsibility is to:
A. Help the facility avoid citations
B. Determine compliance with applicable requirements
C. Train all facility employees
D. Rewrite facility policies
Answer: B
Rationale: The surveyor evaluates whether the facility complies
with federal requirements using established survey protocols.
14. A facility administrator offers a surveyor an expensive
gift. The surveyor should:
A. Accept it after the survey
Regulations, QAPI, Abuse & Neglect
Questions 1–50: Survey Process and Surveyor Responsibilities
1. What is the primary purpose of the SMQT?
A. To license nursing-home administrators
B. To test surveyors' knowledge, skills, and abilities needed to
conduct LTC surveys
C. To certify nursing assistants
D. To determine Medicare reimbursement
Answer: B
Rationale: The SMQT evaluates the knowledge, skills, and
abilities required for long-term-care survey work. Successful
completion is required before a surveyor may conduct surveys
independently.
2. A surveyor who has not successfully completed the SMQT may
generally:
A. Conduct surveys independently
B. Serve on a survey team under appropriate supervision
C. Issue civil monetary penalties independently
D. Certify facilities without supervision
Answer: B
Rationale: CMS permits an unqualified surveyor to participate
as a team member under supervision by a qualified surveyor,
but independent surveying requires successful completion of
the required training and testing.
3. Which source establishes federal requirements for Medicare-
and Medicaid-participating nursing facilities?
A. 42 CFR Part 483, Subpart B
B. State traffic regulations
C. OSHA construction codes only
D. The facility employee handbook
Answer: A
Rationale: Federal requirements for long-term-care facilities
, participating in Medicare or Medicaid are primarily contained
in 42 CFR Part 483, Subpart B.
4. Which document provides interpretive guidance used by
surveyors?
A. Appendix PP of the State Operations Manual
B. A facility's marketing brochure
C. A resident's personal diary
D. A newspaper editorial
Answer: A
Rationale: Appendix PP contains federal long-term-care survey
guidance and interpretive guidelines used to clarify regulatory
requirements.
5. A surveyor should base a deficiency primarily on:
A. Personal preference
B. Facility reputation
C. Evidence showing noncompliance with a federal
requirement
D. A negative internet review
Answer: C
Rationale: CMS states that deficiencies are based on violations
of federal requirements and supported by evidence of the
facility's performance or practices.
6. Which is an appropriate surveyor evidence source?
A. Direct observation
B. Personal assumptions
C. Rumors unrelated to residents
D. Social media speculation
Answer: A
Rationale: Observation is a primary source of survey evidence.
Interviews, record review, and document review can
corroborate observations.
7. What is meant by "triangulation" during a survey?
A. Using three surveyors at all times
, B. Confirming information through multiple sources
C. Interviewing only administrators
D. Reviewing only three resident charts
Answer: B
Rationale: Triangulation strengthens evidence by comparing
observations, interviews, records, policies, and other relevant
sources.
8. A surveyor observes a medication pass and notices repeated
omissions. What should the surveyor do first?
A. Immediately threaten the nurse with discipline
B. Objectively document the observation and investigate
further
C. Tell the nurse how to correct every error
D. Ignore the observation
Answer: B
Rationale: Surveyors gather objective evidence and determine
whether the practice represents noncompliance. They should
avoid coaching staff during the survey.
9. Which interview question is generally most appropriate?
A. "You failed to follow the policy, didn't you?"
B. "Why are you always careless?"
C. "Please describe what you do when a resident refuses
medication."
D. "You know this is wrong, correct?"
Answer: C
Rationale: Open-ended, neutral questions encourage
respondents to provide factual information without being led
toward a desired answer.
10. A surveyor should avoid:
A. Asking open-ended questions
B. Documenting exact statements
C. Leading or argumentative questions
D. Conducting private interviews when appropriate
, Answer: C
Rationale: Leading questions can contaminate evidence and
make findings less reliable.
11. SNF/NF surveys are generally:
A. Announced months in advance
B. Unannounced
C. Conducted only during business hours
D. Conducted only once every five years
Answer: B
Rationale: CMS states that nursing-home surveys are not
announced and may occur at various times, including
weekends and around-the-clock. (Centers for Medicare &
Medicaid Services)
12. A surveyor arrives at 10 p.m. for an authorized survey.
Which statement is most accurate?
A. Surveys can never occur at night
B. Nursing-home surveys may occur 24 hours a day
C. Surveys must start at 8 a.m.
D. Only complaint surveys may occur at night
Answer: B
Rationale: CMS states that SNF/NF surveys may be conducted
at any time, including weekends and 24 hours a day.
13. The surveyor's primary responsibility is to:
A. Help the facility avoid citations
B. Determine compliance with applicable requirements
C. Train all facility employees
D. Rewrite facility policies
Answer: B
Rationale: The surveyor evaluates whether the facility complies
with federal requirements using established survey protocols.
14. A facility administrator offers a surveyor an expensive
gift. The surveyor should:
A. Accept it after the survey
