FACHE – ACHE BOARD OF GOVERNORS (BOG) EXAM | 2026/2027
American College of Healthcare Executives Board of Governors Examination for FACHE Credential
with Complete Questions & Verified Answers | Latest Version
Overview
This 2026/2027 updated resource contains the latest ACHE (American College of Healthcare
Executives) Board of Governors (BOG) Examination for the FACHE (Fellow of the American
College of Healthcare Executives) credential with the exact 230 questions and verified answers,
following current ACHE BOG exam content outline, healthcare leadership competencies, and
evidence-based executive management practices. Key Features
Actual ACHE BOG exam format with the official 230 questions
Comprehensive coverage of all six healthcare leadership domains
Updated 2026/2027 healthcare industry trends and regulatory changes
Strategic leadership and governance scenario applications
Financial management and healthcare economics integration
Core Content Areas (230 Total Questions)
● Communication & Relationship Management (40 Qs)
● Leadership & Professionalism (45 Qs)
● Knowledge of the Healthcare Environment (45 Qs)
● Business Skills & Knowledge (50 Qs)
● Strategic Planning & Marketing (25 Qs)
● Governance & Organizational Dynamics (25 Qs)
Detailed Content Breakdown • Healthcare Law, Ethics & Regulatory Compliance (30 Qs)
• Financial Management & Healthcare Economics (35 Qs)
• Human Resources & Organizational Development (30 Qs)
• Quality Improvement & Patient Safety (30 Qs)
• Information Management & Technology (25 Qs)
• Strategic Planning & Market Analysis (25 Qs)
• Governance & Board Relations (25 Qs)
• Community Health & Population Management (20 Qs)
• Risk Management & Crisis Leadership (10 Qs)
Answer Format: Correct answers are marked in bold green and include:
- ACHE Healthcare Executive Competencies Assessment Tool applications
- Evidence-based leadership practice citations and frameworks
,- Healthcare financial ratio analysis and interpretation
- Strategic planning process steps and implementation strategies
- Governance structure evaluations and board development approaches
- Ethical decision-making using ACHE Code of Ethics
Updates for 2026/2027
➢ Reflects 2026-2027 ACHE BOG exam content outline revisions
➢ Updated value-based care and alternative payment model requirements
➢ Enhanced healthcare equity and diversity leadership competencies
➢ New artificial intelligence and digital transformation in healthcare leadership
➢ Revised crisis leadership and emergency management protocols
➢ Updated telehealth integration and virtual care delivery models
➢ New environmental sustainability and climate resilience in healthcare
➢ Revised healthcare workforce development and retention strategies
ACHE Board of Governors (BOG) Examination for FACHE Credential – 230 Questions &
Verified Answers with Rationales
1. According to the ACHE Code of Ethics, which principle should guide a healthcare
executive’s decision when balancing organizational profitability with community health
needs?
A. Maximize shareholder value
B. Prioritize executive compensation
C. Ensure the organization serves the community’s health interests
D. Focus exclusively on clinical outcomes
Rationale: The ACHE Code of Ethics (Principle I) states that healthcare executives must “act in ways
that serve the health interests of the communities and populations they serve.” Community benefit and
mission alignment take precedence over pure profit motives in not-for-profit and public health settings.
2. A hospital’s current ratio has declined from 2.5 to 1.2 over the past year. What is the
most appropriate executive action?
A. Increase long-term debt
B. Analyze liquidity and adjust working capital management
,C. Reduce capital expenditures immediately
D. Issue new equity shares
Rationale: The current ratio (current assets ÷ current liabilities) measures short-term liquidity. A drop
to 1.2 indicates potential cash flow strain. The executive should assess accounts receivable, inventory,
and payables to optimize working capital before drastic measures like debt or equity issuance.
3. In leading a diversity, equity, and inclusion (DEI) initiative, which approach aligns with
ACHE leadership competencies?
A. Mandate participation without education
B. Integrate DEI into strategic planning and performance metrics
C. Delegate all responsibility to HR
D. Focus only on recruitment, not retention
Rationale: ACHE emphasizes that DEI must be embedded in organizational strategy, governance, and
operations—not treated as a peripheral HR program. Linking DEI goals to leadership accountability
and quality outcomes ensures sustainability and impact.
4. Which governance practice best supports board effectiveness in a healthcare system?
A. Annual board self-assessment only
B. Regular board education on healthcare trends and fiduciary duties
C. Limiting board committees to three
D. Appointing all board members from the same professional background
Rationale: The ACHE Governance Toolkit recommends ongoing board education to ensure members
understand evolving healthcare regulations, financial models, and quality standards. Diverse expertise
and committee structures enhance oversight and strategic guidance.
5. A health system is transitioning to a value-based care model. What is the executive’s
primary responsibility?
A. Negotiate higher fee-for-service rates
B. Align clinical, financial, and operational systems to support population health
, C. Reduce staffing to cut costs
D. Focus only on Medicare Advantage contracts
Rationale: Value-based care requires integration of care delivery, data analytics, care coordination,
and risk management. Executives must redesign workflows, invest in health IT, and foster clinician
engagement to succeed under shared savings or capitation models.
6. Which metric is most relevant for evaluating hospital operational efficiency?
A. Patient satisfaction score
B. Average length of stay (ALOS)
C. Net income margin
D. Board meeting attendance
Rationale: ALOS directly impacts bed turnover, resource utilization, and cost per case. While patient
satisfaction and margins are important, ALOS is a core operational indicator of clinical and care
management efficiency.
7. When responding to a public health emergency (e.g., pandemic), which leadership action
is most critical?
A. Suspend all strategic planning
B. Activate emergency operations center and maintain transparent communication
C. Wait for federal guidance before acting
D. Focus only on financial survival
Rationale: Crisis leadership requires rapid activation of incident command systems, clear
internal/external communication, and agile decision-making. ACHE emphasizes balancing immediate
response with long-term organizational resilience.
8. A hospital’s operating margin is negative for two consecutive quarters. What should the
executive prioritize?
A. Immediately cut nursing staff
B. Conduct a root-cause analysis of revenue and expense drivers
American College of Healthcare Executives Board of Governors Examination for FACHE Credential
with Complete Questions & Verified Answers | Latest Version
Overview
This 2026/2027 updated resource contains the latest ACHE (American College of Healthcare
Executives) Board of Governors (BOG) Examination for the FACHE (Fellow of the American
College of Healthcare Executives) credential with the exact 230 questions and verified answers,
following current ACHE BOG exam content outline, healthcare leadership competencies, and
evidence-based executive management practices. Key Features
Actual ACHE BOG exam format with the official 230 questions
Comprehensive coverage of all six healthcare leadership domains
Updated 2026/2027 healthcare industry trends and regulatory changes
Strategic leadership and governance scenario applications
Financial management and healthcare economics integration
Core Content Areas (230 Total Questions)
● Communication & Relationship Management (40 Qs)
● Leadership & Professionalism (45 Qs)
● Knowledge of the Healthcare Environment (45 Qs)
● Business Skills & Knowledge (50 Qs)
● Strategic Planning & Marketing (25 Qs)
● Governance & Organizational Dynamics (25 Qs)
Detailed Content Breakdown • Healthcare Law, Ethics & Regulatory Compliance (30 Qs)
• Financial Management & Healthcare Economics (35 Qs)
• Human Resources & Organizational Development (30 Qs)
• Quality Improvement & Patient Safety (30 Qs)
• Information Management & Technology (25 Qs)
• Strategic Planning & Market Analysis (25 Qs)
• Governance & Board Relations (25 Qs)
• Community Health & Population Management (20 Qs)
• Risk Management & Crisis Leadership (10 Qs)
Answer Format: Correct answers are marked in bold green and include:
- ACHE Healthcare Executive Competencies Assessment Tool applications
- Evidence-based leadership practice citations and frameworks
,- Healthcare financial ratio analysis and interpretation
- Strategic planning process steps and implementation strategies
- Governance structure evaluations and board development approaches
- Ethical decision-making using ACHE Code of Ethics
Updates for 2026/2027
➢ Reflects 2026-2027 ACHE BOG exam content outline revisions
➢ Updated value-based care and alternative payment model requirements
➢ Enhanced healthcare equity and diversity leadership competencies
➢ New artificial intelligence and digital transformation in healthcare leadership
➢ Revised crisis leadership and emergency management protocols
➢ Updated telehealth integration and virtual care delivery models
➢ New environmental sustainability and climate resilience in healthcare
➢ Revised healthcare workforce development and retention strategies
ACHE Board of Governors (BOG) Examination for FACHE Credential – 230 Questions &
Verified Answers with Rationales
1. According to the ACHE Code of Ethics, which principle should guide a healthcare
executive’s decision when balancing organizational profitability with community health
needs?
A. Maximize shareholder value
B. Prioritize executive compensation
C. Ensure the organization serves the community’s health interests
D. Focus exclusively on clinical outcomes
Rationale: The ACHE Code of Ethics (Principle I) states that healthcare executives must “act in ways
that serve the health interests of the communities and populations they serve.” Community benefit and
mission alignment take precedence over pure profit motives in not-for-profit and public health settings.
2. A hospital’s current ratio has declined from 2.5 to 1.2 over the past year. What is the
most appropriate executive action?
A. Increase long-term debt
B. Analyze liquidity and adjust working capital management
,C. Reduce capital expenditures immediately
D. Issue new equity shares
Rationale: The current ratio (current assets ÷ current liabilities) measures short-term liquidity. A drop
to 1.2 indicates potential cash flow strain. The executive should assess accounts receivable, inventory,
and payables to optimize working capital before drastic measures like debt or equity issuance.
3. In leading a diversity, equity, and inclusion (DEI) initiative, which approach aligns with
ACHE leadership competencies?
A. Mandate participation without education
B. Integrate DEI into strategic planning and performance metrics
C. Delegate all responsibility to HR
D. Focus only on recruitment, not retention
Rationale: ACHE emphasizes that DEI must be embedded in organizational strategy, governance, and
operations—not treated as a peripheral HR program. Linking DEI goals to leadership accountability
and quality outcomes ensures sustainability and impact.
4. Which governance practice best supports board effectiveness in a healthcare system?
A. Annual board self-assessment only
B. Regular board education on healthcare trends and fiduciary duties
C. Limiting board committees to three
D. Appointing all board members from the same professional background
Rationale: The ACHE Governance Toolkit recommends ongoing board education to ensure members
understand evolving healthcare regulations, financial models, and quality standards. Diverse expertise
and committee structures enhance oversight and strategic guidance.
5. A health system is transitioning to a value-based care model. What is the executive’s
primary responsibility?
A. Negotiate higher fee-for-service rates
B. Align clinical, financial, and operational systems to support population health
, C. Reduce staffing to cut costs
D. Focus only on Medicare Advantage contracts
Rationale: Value-based care requires integration of care delivery, data analytics, care coordination,
and risk management. Executives must redesign workflows, invest in health IT, and foster clinician
engagement to succeed under shared savings or capitation models.
6. Which metric is most relevant for evaluating hospital operational efficiency?
A. Patient satisfaction score
B. Average length of stay (ALOS)
C. Net income margin
D. Board meeting attendance
Rationale: ALOS directly impacts bed turnover, resource utilization, and cost per case. While patient
satisfaction and margins are important, ALOS is a core operational indicator of clinical and care
management efficiency.
7. When responding to a public health emergency (e.g., pandemic), which leadership action
is most critical?
A. Suspend all strategic planning
B. Activate emergency operations center and maintain transparent communication
C. Wait for federal guidance before acting
D. Focus only on financial survival
Rationale: Crisis leadership requires rapid activation of incident command systems, clear
internal/external communication, and agile decision-making. ACHE emphasizes balancing immediate
response with long-term organizational resilience.
8. A hospital’s operating margin is negative for two consecutive quarters. What should the
executive prioritize?
A. Immediately cut nursing staff
B. Conduct a root-cause analysis of revenue and expense drivers
