Illinois Supplemental Nursing Home Administrator
Exam
2026-2027 • 50 Questions • 100% VERIFIED
Introduction
This assessment serves as a definitive examination evaluation resource for candidates preparing
for the Illinois Supplemental Nursing Home Administrator Exam (2026-2027) IDPH NHA Licensing
Comprehensive Assessment. Designed to measure regulatory mastery and executive operational
readiness, this question bank rigorously addresses key governing domains established under the
Illinois Nursing Home Care Act (210 ILCS 45) and Illinois Department of Public Health (IDPH)
Administrative Code Title 77. Key domains evaluated include the Illinois Nursing Home Care Act,
IDPH Regulations and Licensing Standards, Resident Rights and Dignity, Quality of Care and Quality
Assurance (QAPI), Infection Control, Emergency Preparedness, and Administrative Operations.
Mastery of these statutory frameworks and administrative standards is essential for obtaining state
licensure, ensuring facility compliance, maintaining high standards of resident care, and executing
effective leadership across long-term care operations in Illinois.
Question 1: Under the Illinois Nursing Home Care Act (210 ILCS 45), how frequently must a long-
term care facility license be renewed with the Illinois Department of Public Health (IDPH)?
A) Annually (every 12 months) unless a multi-year license is granted by IDPH.
B) Every 2 years automatically without inspection.
C) Every 3 years upon payment of renewal fees.
D) Every 5 years subject to county health department audit.
Correct Answer: A) Annually (every 12 months) unless a multi-year license is granted by
IDPH.
Rationale: Under the Illinois Nursing Home Care Act (210 ILCS 45/3-115), licenses issued by
the IDPH are valid for one year (12 months) from the date of issuance, unless revoked or
suspended earlier, or unless a two-year license is explicitly authorized by IDPH for eligible
compliant facilities.
Question 2: According to Illinois Administrative Code Title 77 Section 300, what is the mandatory
composition of the Resident Advisory Council in a licensed long-term care facility?
A) Composed exclusively of facility administrative staff and the Medical Director.
B) Composed of facility residents, with elected resident officers and open to resident family
members.
C) Composed of IDPH surveyors and local community Ombudsmen.
D) Composed of the Nursing Home Administrator, Director of Nursing, and Social Services
Director.
, Correct Answer: B) Composed of facility residents, with elected resident officers and
open to resident family members.
Rationale: Illinois Code Section 300.640 specifies that each facility must establish a Resident
Advisory Council composed of facility residents. The council elects its own officers, meets
independently, and promotes resident autonomy and self-governance.
Question 3: When the Resident Advisory Council submits written grievances or recommendations
to the Nursing Home Administrator, within what maximum timeframe must the facility provide a
formal written response?
A) 24 hours.
B) 3 business days.
C) 7 calendar days.
D) 30 calendar days.
Correct Answer: C) 7 calendar days.
Rationale: Under 77 Ill. Adm. Code 300.640, the facility administration must respond in writing
to written reports, grievances, or recommendations submitted by the Resident Advisory
Council within 7 calendar days of receipt.
Question 4: Under the Illinois Nursing Home Care Act, how is a 'Type A' violation defined by IDPH
surveyors during a facility survey?
A) A violation of administrative recordkeeping requirements with no threat to health.
B) A minor maintenance deficiency that presents low risk of harm.
C) A violation that creates a indirect threat to resident comfort.
D) A violation that creates a condition presenting a substantial probability that death or serious
mental or physical harm to a resident will result.
Correct Answer: D) A violation that creates a condition presenting a substantial
probability that death or serious mental or physical harm to a resident will result.
Rationale: Illinois Statute 210 ILCS 45/1-129 defines a Type A violation as a situation in which
a facility violation creates a condition or occurrence presenting a substantial probability that
death or serious mental or physical harm to a resident will result.
Question 5: What is the mandatory timeframe under Illinois law for reporting allegations of
resident abuse, neglect, or financial exploitation to the IDPH Hotline?
A) Immediately, but no later than 24 hours after the occurrence or discovery.
B) Within 48 hours following an internal facility investigation.
C) Within 5 business days during routine administrative reporting.
D) At the next quarterly Quality Assurance meeting.
Correct Answer: A) Immediately, but no later than 24 hours after the occurrence or
discovery.
, Rationale: Under 210 ILCS 45/2-107 and IDPH reporting regulations, facility personnel who
suspect abuse, neglect, or financial exploitation must report the incident immediately to the
IDPH Central Complaint Registry hotline, and no later than 24 hours after discovery.
Question 6: Under 77 Ill. Adm. Code 300.1210, what is the minimum required timeline for
developing a initial preliminary care plan for a newly admitted resident?
A) Within 12 hours of admission.
B) Within 24 hours of admission.
C) Within 72 hours of admission.
D) Within 14 calendar days of admission.
Correct Answer: B) Within 24 hours of admission.
Rationale: Illinois regulations require that an initial preliminary care plan addressing
immediate health and safety needs must be formulated within 24 hours of admission. The
comprehensive care plan based on the full assessment must be completed within 7 days after
completing the MDS assessment.
Question 7: According to IDPH standards for skilled nursing facilities, what is the maximum
permissible time interval allowed between the evening meal and breakfast the following morning?
A) 12 hours.
B) 13 hours.
C) 14 hours (or 15 hours if a substantial evening snack is served).
D) 16 hours.
Correct Answer: C) 14 hours (or 15 hours if a substantial evening snack is served).
Rationale: Under 77 Ill. Adm. Code 300.2010, at least three meals or their equivalent must be
served daily at regular times. No more than 14 hours may elapse between a substantial evening
meal and breakfast, unless a nourishing evening snack is provided, which extends the limit to
15 hours.
Question 8: What temperature range is legally required at resident-accessible hot water
handwashing taps and bathing fixtures in an Illinois long-term care facility?
A) 85°F to 95°F.
B) 90°F to 100°F.
C) 115°F to 125°F.
D) 100°F to 110°F.
Correct Answer: D) 100°F to 110°F.
Rationale: Illinois Administrative Code Title 77 Section 300.2840 mandates that hot water
delivered to resident-accessible handwashing basins, tubs, and showers must be
thermostatically controlled within a safe temperature range of 100°F to 110°F to prevent
scalding burns.
Exam
2026-2027 • 50 Questions • 100% VERIFIED
Introduction
This assessment serves as a definitive examination evaluation resource for candidates preparing
for the Illinois Supplemental Nursing Home Administrator Exam (2026-2027) IDPH NHA Licensing
Comprehensive Assessment. Designed to measure regulatory mastery and executive operational
readiness, this question bank rigorously addresses key governing domains established under the
Illinois Nursing Home Care Act (210 ILCS 45) and Illinois Department of Public Health (IDPH)
Administrative Code Title 77. Key domains evaluated include the Illinois Nursing Home Care Act,
IDPH Regulations and Licensing Standards, Resident Rights and Dignity, Quality of Care and Quality
Assurance (QAPI), Infection Control, Emergency Preparedness, and Administrative Operations.
Mastery of these statutory frameworks and administrative standards is essential for obtaining state
licensure, ensuring facility compliance, maintaining high standards of resident care, and executing
effective leadership across long-term care operations in Illinois.
Question 1: Under the Illinois Nursing Home Care Act (210 ILCS 45), how frequently must a long-
term care facility license be renewed with the Illinois Department of Public Health (IDPH)?
A) Annually (every 12 months) unless a multi-year license is granted by IDPH.
B) Every 2 years automatically without inspection.
C) Every 3 years upon payment of renewal fees.
D) Every 5 years subject to county health department audit.
Correct Answer: A) Annually (every 12 months) unless a multi-year license is granted by
IDPH.
Rationale: Under the Illinois Nursing Home Care Act (210 ILCS 45/3-115), licenses issued by
the IDPH are valid for one year (12 months) from the date of issuance, unless revoked or
suspended earlier, or unless a two-year license is explicitly authorized by IDPH for eligible
compliant facilities.
Question 2: According to Illinois Administrative Code Title 77 Section 300, what is the mandatory
composition of the Resident Advisory Council in a licensed long-term care facility?
A) Composed exclusively of facility administrative staff and the Medical Director.
B) Composed of facility residents, with elected resident officers and open to resident family
members.
C) Composed of IDPH surveyors and local community Ombudsmen.
D) Composed of the Nursing Home Administrator, Director of Nursing, and Social Services
Director.
, Correct Answer: B) Composed of facility residents, with elected resident officers and
open to resident family members.
Rationale: Illinois Code Section 300.640 specifies that each facility must establish a Resident
Advisory Council composed of facility residents. The council elects its own officers, meets
independently, and promotes resident autonomy and self-governance.
Question 3: When the Resident Advisory Council submits written grievances or recommendations
to the Nursing Home Administrator, within what maximum timeframe must the facility provide a
formal written response?
A) 24 hours.
B) 3 business days.
C) 7 calendar days.
D) 30 calendar days.
Correct Answer: C) 7 calendar days.
Rationale: Under 77 Ill. Adm. Code 300.640, the facility administration must respond in writing
to written reports, grievances, or recommendations submitted by the Resident Advisory
Council within 7 calendar days of receipt.
Question 4: Under the Illinois Nursing Home Care Act, how is a 'Type A' violation defined by IDPH
surveyors during a facility survey?
A) A violation of administrative recordkeeping requirements with no threat to health.
B) A minor maintenance deficiency that presents low risk of harm.
C) A violation that creates a indirect threat to resident comfort.
D) A violation that creates a condition presenting a substantial probability that death or serious
mental or physical harm to a resident will result.
Correct Answer: D) A violation that creates a condition presenting a substantial
probability that death or serious mental or physical harm to a resident will result.
Rationale: Illinois Statute 210 ILCS 45/1-129 defines a Type A violation as a situation in which
a facility violation creates a condition or occurrence presenting a substantial probability that
death or serious mental or physical harm to a resident will result.
Question 5: What is the mandatory timeframe under Illinois law for reporting allegations of
resident abuse, neglect, or financial exploitation to the IDPH Hotline?
A) Immediately, but no later than 24 hours after the occurrence or discovery.
B) Within 48 hours following an internal facility investigation.
C) Within 5 business days during routine administrative reporting.
D) At the next quarterly Quality Assurance meeting.
Correct Answer: A) Immediately, but no later than 24 hours after the occurrence or
discovery.
, Rationale: Under 210 ILCS 45/2-107 and IDPH reporting regulations, facility personnel who
suspect abuse, neglect, or financial exploitation must report the incident immediately to the
IDPH Central Complaint Registry hotline, and no later than 24 hours after discovery.
Question 6: Under 77 Ill. Adm. Code 300.1210, what is the minimum required timeline for
developing a initial preliminary care plan for a newly admitted resident?
A) Within 12 hours of admission.
B) Within 24 hours of admission.
C) Within 72 hours of admission.
D) Within 14 calendar days of admission.
Correct Answer: B) Within 24 hours of admission.
Rationale: Illinois regulations require that an initial preliminary care plan addressing
immediate health and safety needs must be formulated within 24 hours of admission. The
comprehensive care plan based on the full assessment must be completed within 7 days after
completing the MDS assessment.
Question 7: According to IDPH standards for skilled nursing facilities, what is the maximum
permissible time interval allowed between the evening meal and breakfast the following morning?
A) 12 hours.
B) 13 hours.
C) 14 hours (or 15 hours if a substantial evening snack is served).
D) 16 hours.
Correct Answer: C) 14 hours (or 15 hours if a substantial evening snack is served).
Rationale: Under 77 Ill. Adm. Code 300.2010, at least three meals or their equivalent must be
served daily at regular times. No more than 14 hours may elapse between a substantial evening
meal and breakfast, unless a nourishing evening snack is provided, which extends the limit to
15 hours.
Question 8: What temperature range is legally required at resident-accessible hot water
handwashing taps and bathing fixtures in an Illinois long-term care facility?
A) 85°F to 95°F.
B) 90°F to 100°F.
C) 115°F to 125°F.
D) 100°F to 110°F.
Correct Answer: D) 100°F to 110°F.
Rationale: Illinois Administrative Code Title 77 Section 300.2840 mandates that hot water
delivered to resident-accessible handwashing basins, tubs, and showers must be
thermostatically controlled within a safe temperature range of 100°F to 110°F to prevent
scalding burns.
