MISSOURI STATE NURSING HOME ADMINISTRATOR EXAM — 2026/2027
| 150 QUESTIONS AND CORRECT ANSWERS | ALREADY GRADED A+ |
100% VERIFIED
Missouri State Nursing Home Administrator Examination | Core Domains: Federal & Missouri Long-Term Care Regulations, Nursing Home
Administration & Leadership, Resident Rights & Quality of Care, Financial & Budget Management, Human Resources & Staff Supervision,
Infection Control & Patient Safety, Risk Management & Quality Improvement, Survey Readiness & Regulatory Compliance, Ethics in Long-Term
Care Administration, and Evidence-Based Management of Skilled Nursing Facilities | Missouri State Licensure–Aligned Format
Table of Contents
• Section 1: Federal & Missouri Long-Term Care Regulations (Questions 1-15) • Section 2: Nursing Home Administration & Leadership
(Questions 16-30) • Section 3: Resident Rights & Quality of Care (Questions 31-45) • Section 4: Financial & Budget Management
(Questions 46-60) • Section 5: Human Resources & Staff Supervision (Questions 61-75) • Section 6: Infection Control & Patient Safety
(Questions 76-90) • Section 7: Risk Management & Quality Improvement (Questions 91-105) • Section 8: Survey Readiness & Regulatory
Compliance (Questions 106-120) • Section 9: Ethics in Long-Term Care Administration (Questions 121-135) • Section 10: Evidence-Based
Management of Skilled Nursing Facilities (Questions 136-150)
Exam Structure
The Missouri State Nursing Home Administrator Exam is commonly structured as follows:
• 150 multiple-choice questions
• Single-best-answer format
• Scenario-based long-term care administration and regulatory decision-making items
Introduction
This Missouri State Nursing Home Administrator Exam format for the 2026/2027 certification cycle reflects the standardized assessment used to
evaluate competency in long-term care facility management. The exam measures knowledge of regulatory compliance, leadership responsibilities,
financial oversight, staff management, resident care standards, and evidence-based strategies required to effectively operate and supervise nursing
home facilities.
Answer Format
All questions must be presented in bold text for clear distinction and readability.
All correct answers must be presented in bold and green, followed by clearly defined rationales explaining administrative priorities, regulatory
compliance considerations, resident safety standards, and evidence-based decision-making in long-term care management.
Section 1: Federal & Missouri Long-Term Care Regulations (Questions 1-15)
Question 1: Which federal law established the minimum standards for nursing home certification and
participation in Medicare/Medicaid?
A) HIPAA
B) OBRA 1987
C) ADA
, D) EMTALA
Correct Answer: B) OBRA 1987
Rationale: The Omnibus Budget Reconciliation Act (OBRA) of 1987 established comprehensive federal standards for nursing home certification,
resident rights, quality of care, and survey processes. This remains the foundation of nursing home regulation today.
Question 2: How often must standard surveys be conducted in Medicare/Medicaid certified nursing homes?
A) Every 6 months
B) Every 12 months
C) Every 15 months
D) Every 24 months
Correct Answer: C) Every 15 months
Rationale: Federal regulations require standard surveys to be conducted no less than every 15 months, though many states conduct them annually.
Missouri typically conducts annual surveys to ensure compliance with federal and state regulations.
Question 3: Which agency is responsible for licensing nursing home administrators in Missouri?
A) CMS
B) Missouri Department of Health and Senior Services
C) Missouri Board of Nursing
D) CDC
Correct Answer: B) Missouri Department of Health and Senior Services
Rationale: The Missouri Department of Health and Senior Services (DHSS) is responsible for licensing nursing home administrators in Missouri,
including administering the state administrator examination and maintaining licensure requirements.
Question 4: What is the minimum number of hours a nursing home administrator must work on-site per
week?
A) 20 hours
B) 30 hours
C) 40 hours
D) Full-time as required for facility management
Correct Answer: D) Full-time as required for facility management
Rationale: Federal regulations require the administrator to manage the facility full-time or designate a full-time administrator. The administrator
must be responsible for managing the day-to-day operations of the facility.
,Question 5: Which form must be filed to report a change of nursing home administrator in Missouri?
A) CMS-2567
B) Change of Administrator Notification Form
C) CMS-671
D) State licensure renewal
Correct Answer: B) Change of Administrator Notification Form
Rationale: Missouri requires facilities to submit a Change of Administrator Notification Form to DHSS within a specified timeframe when there is a
change in facility administration to maintain regulatory compliance.
Question 6: What is the minimum staffing requirement for licensed nurses in a Missouri nursing home?
A) 8 hours per day, 7 days per week
B) 16 hours per day, 5 days per week
C) 24 hours per day, 7 days per week
D) 12 hours per day, 6 days per week
Correct Answer: A) 8 hours per day, 7 days per week
Rationale: Federal regulations require licensed nurse coverage for at least 8 consecutive hours per day, 7 days per week. A registered nurse must be
present for at least 8 consecutive hours per day, 5 days per week.
Question 7: Which federal regulation requires nursing homes to provide services to attain or maintain the
highest practicable physical, mental, and psychosocial well-being?
A) F-Tag 483
B) F-Tag 483.10
C) F-Tag 483.24
D) F-Tag 483.40
Correct Answer: B) F-Tag 483.10
Rationale: F-Tag 483.10 (Resident Rights) requires facilities to provide services and activities to attain or maintain the highest practicable physical,
mental, and psychosocial well-being of each resident as required by OBRA 1987.
Question 8: How many days does a facility have to submit a plan of correction after a survey deficiency is
cited?
A) 5 days
B) 10 days
, C) 15 days
D) 30 days
Correct Answer: B) 10 days
Rationale: Facilities must submit an acceptable plan of correction within 10 calendar days after the last day of the survey. The plan must address each
deficiency with specific corrective actions and completion dates.
Question 9: Which form is used to document the comprehensive resident assessment in nursing homes?
A) MDS (Minimum Data Set)
B) OASIS
C) UB-04
D) CMS-1500
Correct Answer: A) MDS (Minimum Data Set)
Rationale: The Minimum Data Set (MDS) 3.0 is the federally mandated comprehensive assessment tool for nursing home residents. It must be
completed within specific timeframes and drives care planning and reimbursement.
Question 10: Within how many days must the initial MDS assessment be completed after admission?
A) 7 days
B) 14 days
C) 21 days
D) 30 days
Correct Answer: B) 14 days
Rationale: The initial comprehensive MDS assessment (A0310A) must be completed within 14 days of admission. This assessment drives the initial
care plan and establishes the resident's baseline status.
Question 11: Which agency conducts complaint investigations in Missouri nursing homes?
A) CMS directly
B) Missouri Department of Health and Senior Services
C) Local health department
D) State survey agency under contract with CMS
Correct Answer: D) State survey agency under contract with CMS
Rationale: State survey agencies (in Missouri, DHSS) conduct complaint investigations under contract with CMS. They investigate complaints
| 150 QUESTIONS AND CORRECT ANSWERS | ALREADY GRADED A+ |
100% VERIFIED
Missouri State Nursing Home Administrator Examination | Core Domains: Federal & Missouri Long-Term Care Regulations, Nursing Home
Administration & Leadership, Resident Rights & Quality of Care, Financial & Budget Management, Human Resources & Staff Supervision,
Infection Control & Patient Safety, Risk Management & Quality Improvement, Survey Readiness & Regulatory Compliance, Ethics in Long-Term
Care Administration, and Evidence-Based Management of Skilled Nursing Facilities | Missouri State Licensure–Aligned Format
Table of Contents
• Section 1: Federal & Missouri Long-Term Care Regulations (Questions 1-15) • Section 2: Nursing Home Administration & Leadership
(Questions 16-30) • Section 3: Resident Rights & Quality of Care (Questions 31-45) • Section 4: Financial & Budget Management
(Questions 46-60) • Section 5: Human Resources & Staff Supervision (Questions 61-75) • Section 6: Infection Control & Patient Safety
(Questions 76-90) • Section 7: Risk Management & Quality Improvement (Questions 91-105) • Section 8: Survey Readiness & Regulatory
Compliance (Questions 106-120) • Section 9: Ethics in Long-Term Care Administration (Questions 121-135) • Section 10: Evidence-Based
Management of Skilled Nursing Facilities (Questions 136-150)
Exam Structure
The Missouri State Nursing Home Administrator Exam is commonly structured as follows:
• 150 multiple-choice questions
• Single-best-answer format
• Scenario-based long-term care administration and regulatory decision-making items
Introduction
This Missouri State Nursing Home Administrator Exam format for the 2026/2027 certification cycle reflects the standardized assessment used to
evaluate competency in long-term care facility management. The exam measures knowledge of regulatory compliance, leadership responsibilities,
financial oversight, staff management, resident care standards, and evidence-based strategies required to effectively operate and supervise nursing
home facilities.
Answer Format
All questions must be presented in bold text for clear distinction and readability.
All correct answers must be presented in bold and green, followed by clearly defined rationales explaining administrative priorities, regulatory
compliance considerations, resident safety standards, and evidence-based decision-making in long-term care management.
Section 1: Federal & Missouri Long-Term Care Regulations (Questions 1-15)
Question 1: Which federal law established the minimum standards for nursing home certification and
participation in Medicare/Medicaid?
A) HIPAA
B) OBRA 1987
C) ADA
, D) EMTALA
Correct Answer: B) OBRA 1987
Rationale: The Omnibus Budget Reconciliation Act (OBRA) of 1987 established comprehensive federal standards for nursing home certification,
resident rights, quality of care, and survey processes. This remains the foundation of nursing home regulation today.
Question 2: How often must standard surveys be conducted in Medicare/Medicaid certified nursing homes?
A) Every 6 months
B) Every 12 months
C) Every 15 months
D) Every 24 months
Correct Answer: C) Every 15 months
Rationale: Federal regulations require standard surveys to be conducted no less than every 15 months, though many states conduct them annually.
Missouri typically conducts annual surveys to ensure compliance with federal and state regulations.
Question 3: Which agency is responsible for licensing nursing home administrators in Missouri?
A) CMS
B) Missouri Department of Health and Senior Services
C) Missouri Board of Nursing
D) CDC
Correct Answer: B) Missouri Department of Health and Senior Services
Rationale: The Missouri Department of Health and Senior Services (DHSS) is responsible for licensing nursing home administrators in Missouri,
including administering the state administrator examination and maintaining licensure requirements.
Question 4: What is the minimum number of hours a nursing home administrator must work on-site per
week?
A) 20 hours
B) 30 hours
C) 40 hours
D) Full-time as required for facility management
Correct Answer: D) Full-time as required for facility management
Rationale: Federal regulations require the administrator to manage the facility full-time or designate a full-time administrator. The administrator
must be responsible for managing the day-to-day operations of the facility.
,Question 5: Which form must be filed to report a change of nursing home administrator in Missouri?
A) CMS-2567
B) Change of Administrator Notification Form
C) CMS-671
D) State licensure renewal
Correct Answer: B) Change of Administrator Notification Form
Rationale: Missouri requires facilities to submit a Change of Administrator Notification Form to DHSS within a specified timeframe when there is a
change in facility administration to maintain regulatory compliance.
Question 6: What is the minimum staffing requirement for licensed nurses in a Missouri nursing home?
A) 8 hours per day, 7 days per week
B) 16 hours per day, 5 days per week
C) 24 hours per day, 7 days per week
D) 12 hours per day, 6 days per week
Correct Answer: A) 8 hours per day, 7 days per week
Rationale: Federal regulations require licensed nurse coverage for at least 8 consecutive hours per day, 7 days per week. A registered nurse must be
present for at least 8 consecutive hours per day, 5 days per week.
Question 7: Which federal regulation requires nursing homes to provide services to attain or maintain the
highest practicable physical, mental, and psychosocial well-being?
A) F-Tag 483
B) F-Tag 483.10
C) F-Tag 483.24
D) F-Tag 483.40
Correct Answer: B) F-Tag 483.10
Rationale: F-Tag 483.10 (Resident Rights) requires facilities to provide services and activities to attain or maintain the highest practicable physical,
mental, and psychosocial well-being of each resident as required by OBRA 1987.
Question 8: How many days does a facility have to submit a plan of correction after a survey deficiency is
cited?
A) 5 days
B) 10 days
, C) 15 days
D) 30 days
Correct Answer: B) 10 days
Rationale: Facilities must submit an acceptable plan of correction within 10 calendar days after the last day of the survey. The plan must address each
deficiency with specific corrective actions and completion dates.
Question 9: Which form is used to document the comprehensive resident assessment in nursing homes?
A) MDS (Minimum Data Set)
B) OASIS
C) UB-04
D) CMS-1500
Correct Answer: A) MDS (Minimum Data Set)
Rationale: The Minimum Data Set (MDS) 3.0 is the federally mandated comprehensive assessment tool for nursing home residents. It must be
completed within specific timeframes and drives care planning and reimbursement.
Question 10: Within how many days must the initial MDS assessment be completed after admission?
A) 7 days
B) 14 days
C) 21 days
D) 30 days
Correct Answer: B) 14 days
Rationale: The initial comprehensive MDS assessment (A0310A) must be completed within 14 days of admission. This assessment drives the initial
care plan and establishes the resident's baseline status.
Question 11: Which agency conducts complaint investigations in Missouri nursing homes?
A) CMS directly
B) Missouri Department of Health and Senior Services
C) Local health department
D) State survey agency under contract with CMS
Correct Answer: D) State survey agency under contract with CMS
Rationale: State survey agencies (in Missouri, DHSS) conduct complaint investigations under contract with CMS. They investigate complaints
