PASS AANAC RAC-CT MDS COORDINATOR CERTIFICATION
EXAM ACTUAL EXAM 2026/2027 – COMPLETE 200-
QUESTION SAMPLE WITH ANSWERS AND DETAILED
RATIONALES FOR HIGH-YIELD DOMAINS INCLUDING
OBRA, PPS, CAAs, FIVE-STAR, ICD-10, DISCHARGE, AND
ASSESSMENT COMPLETION STANDARDS
,Core Domains
1. RAI Process and MDS 3.0 Foundations
2. OBRA Assessment Types, Timing, and Scheduling
3. PPS Assessment Types, Timing, and Scheduling
4. MDS 3.0 Section-by-Section Coding Principles
5. Care Area Assessments (CAAs) and Care Planning
6. ICD-10-CM Coding for MDS Section I
7. Discharge Assessment Requirements and Tracking
8. Five-Star Quality Rating System and Quality Measures
9. Assessment Completion, Submission, and Correction Standards
10. Regulatory Compliance, Survey Readiness, and PDPM
Introduction
The AANAC RAC-CT MDS Coordinator Certification Examination is
the national standard for validating competency in the Resident
Assessment Instrument (RAI) process, MDS 3.0 coding, and the
Skilled Nursing Facility Prospective Payment System (SNF PPS).
This comprehensive assessment evaluates the MDS coordinator's
ability to accurately complete OBRA and PPS assessments, apply
Care Area Assessment (CAA) logic, code ICD-10-CM diagnoses,
navigate discharge tracking requirements, and understand the
Five-Star Quality Rating System. The multiple-choice and
scenario-based format requires candidates to demonstrate critical
thinking in assessment scheduling, regulatory compliance, and
clinical decision-making. This examination ensures that certified
RAC-CT professionals possess the knowledge and skills required
to lead the interdisciplinary assessment process and ensure
accurate reimbursement and quality reporting.
SECTION ONE: QUESTIONS 1–200
1. According to the RAI User's Manual, what is the first
step an MDS coordinator should take when encountering a
coding question?
,A. Ask a colleague for their opinion
B. Check the most recent version of the RAI User's Manual
C. Code based on previous experience
D. Submit a request to CMS
Correct Answer: B
RATIONALE: The RAI User's Manual is the authoritative source
for MDS coding guidance. Consulting the manual should always
be the first step when making coding decisions. The current
version contains over 1,000 pages, with Chapter 3 alone
accounting for more than 535 pages of item-by-item guidance.
2. How often does CMS typically update the RAI User's
Manual?
A. Monthly
B. Annually each October 1, with additional off-schedule updates
as needed
C. Every five years
D. Only when major regulatory changes occur
Correct Answer: B
RATIONALE: CMS makes revisions to the RAI User's Manual
that go into effect each October 1 in conjunction with the new
fiscal year. Off-schedule updates may also occur as needed.
Information learned from prior editions may no longer be
accurate.
3. What is the minimum passing score required for each
RAC-CT certification exam?
A. 70%
B. 75%
C. 80%
D. 85%
, Correct Answer: C
RATIONALE: Upon completion of the 10 RAC-CT courses,
candidates must pass the exams with a score of 80% or better to
earn the RAC-CT designation.
4. What is the primary purpose of the RAI process in long-
term care facilities?
A. To develop a comprehensive, standardized assessment that
drives individualized care planning and ensures appropriate
resource allocation and regulatory compliance
B. To generate billing codes for Medicare reimbursement without
regard to clinical accuracy
C. To satisfy minimum data set requirements for annual
recertification inspections only
D. To provide a communication tool that replaces the need for
progress notes
Correct Answer: A
RATIONALE: The RAI process is a comprehensive,
standardized approach that combines assessment, problem
identification, and care planning to ensure residents receive
individualized care. It goes beyond billing to encompass clinical
quality and regulatory compliance.
5. What is the standard Assessment Reference Date (ARD)
for an OBRA Admission assessment under MDS 3.0?
A. The ARD must be set no later than day 14 of the facility stay
B. The ARD must be set exactly on day 7 of the facility stay
C. The ARD must be set on the day of admission, which is day 0
D. The ARD must be set no later than day 30 of the facility stay
Correct Answer: A
RATIONALE: The ARD for an admission assessment must be
set no later than day 14, allowing sufficient time to observe the
EXAM ACTUAL EXAM 2026/2027 – COMPLETE 200-
QUESTION SAMPLE WITH ANSWERS AND DETAILED
RATIONALES FOR HIGH-YIELD DOMAINS INCLUDING
OBRA, PPS, CAAs, FIVE-STAR, ICD-10, DISCHARGE, AND
ASSESSMENT COMPLETION STANDARDS
,Core Domains
1. RAI Process and MDS 3.0 Foundations
2. OBRA Assessment Types, Timing, and Scheduling
3. PPS Assessment Types, Timing, and Scheduling
4. MDS 3.0 Section-by-Section Coding Principles
5. Care Area Assessments (CAAs) and Care Planning
6. ICD-10-CM Coding for MDS Section I
7. Discharge Assessment Requirements and Tracking
8. Five-Star Quality Rating System and Quality Measures
9. Assessment Completion, Submission, and Correction Standards
10. Regulatory Compliance, Survey Readiness, and PDPM
Introduction
The AANAC RAC-CT MDS Coordinator Certification Examination is
the national standard for validating competency in the Resident
Assessment Instrument (RAI) process, MDS 3.0 coding, and the
Skilled Nursing Facility Prospective Payment System (SNF PPS).
This comprehensive assessment evaluates the MDS coordinator's
ability to accurately complete OBRA and PPS assessments, apply
Care Area Assessment (CAA) logic, code ICD-10-CM diagnoses,
navigate discharge tracking requirements, and understand the
Five-Star Quality Rating System. The multiple-choice and
scenario-based format requires candidates to demonstrate critical
thinking in assessment scheduling, regulatory compliance, and
clinical decision-making. This examination ensures that certified
RAC-CT professionals possess the knowledge and skills required
to lead the interdisciplinary assessment process and ensure
accurate reimbursement and quality reporting.
SECTION ONE: QUESTIONS 1–200
1. According to the RAI User's Manual, what is the first
step an MDS coordinator should take when encountering a
coding question?
,A. Ask a colleague for their opinion
B. Check the most recent version of the RAI User's Manual
C. Code based on previous experience
D. Submit a request to CMS
Correct Answer: B
RATIONALE: The RAI User's Manual is the authoritative source
for MDS coding guidance. Consulting the manual should always
be the first step when making coding decisions. The current
version contains over 1,000 pages, with Chapter 3 alone
accounting for more than 535 pages of item-by-item guidance.
2. How often does CMS typically update the RAI User's
Manual?
A. Monthly
B. Annually each October 1, with additional off-schedule updates
as needed
C. Every five years
D. Only when major regulatory changes occur
Correct Answer: B
RATIONALE: CMS makes revisions to the RAI User's Manual
that go into effect each October 1 in conjunction with the new
fiscal year. Off-schedule updates may also occur as needed.
Information learned from prior editions may no longer be
accurate.
3. What is the minimum passing score required for each
RAC-CT certification exam?
A. 70%
B. 75%
C. 80%
D. 85%
, Correct Answer: C
RATIONALE: Upon completion of the 10 RAC-CT courses,
candidates must pass the exams with a score of 80% or better to
earn the RAC-CT designation.
4. What is the primary purpose of the RAI process in long-
term care facilities?
A. To develop a comprehensive, standardized assessment that
drives individualized care planning and ensures appropriate
resource allocation and regulatory compliance
B. To generate billing codes for Medicare reimbursement without
regard to clinical accuracy
C. To satisfy minimum data set requirements for annual
recertification inspections only
D. To provide a communication tool that replaces the need for
progress notes
Correct Answer: A
RATIONALE: The RAI process is a comprehensive,
standardized approach that combines assessment, problem
identification, and care planning to ensure residents receive
individualized care. It goes beyond billing to encompass clinical
quality and regulatory compliance.
5. What is the standard Assessment Reference Date (ARD)
for an OBRA Admission assessment under MDS 3.0?
A. The ARD must be set no later than day 14 of the facility stay
B. The ARD must be set exactly on day 7 of the facility stay
C. The ARD must be set on the day of admission, which is day 0
D. The ARD must be set no later than day 30 of the facility stay
Correct Answer: A
RATIONALE: The ARD for an admission assessment must be
set no later than day 14, allowing sufficient time to observe the
