PASS AANAC RAC-CT MDS
COORDINATOR CERTIFICATION
EXAM V1 ACTUAL EXAM 2026/2027 –
COMPLETE 100-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
• RAI Process and MDS 3.0 Fundamentals
• OBRA Assessment Schedule and Completion Timelines
• Care Area Assessments (CAAs) and Care Planning
• Medicare Part A PPS and PDPM Reimbursement
• Five-Star Quality Rating System
• Discharge Assessment Determination and Tracking
• ICD-10 Coding and Clinical Documentation
• Regulatory Compliance and Survey Readiness
Introduction
This examination assesses the knowledge and competency required of MDS
Coordinators for certification under the AANAC RAC-CT program. The exam
evaluates understanding of the Resident Assessment Instrument process,
OBRA and Medicare assessment schedules, Care Area Assessments,
,reimbursement methodologies, and quality reporting systems. Items are
presented in multiple-choice format with scenario-based questions designed
to simulate real-world MDS coordination tasks. Emphasis is placed on
accurate coding, regulatory timelines, and the integration of assessment
data into individualized care planning. The examination challenges
candidates to apply the RAI User's Manual to clinical and administrative
decision-making.
Section One: Questions 1–100
1. 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
the clinical accuracy of the documented findings
C. To satisfy the minimum data set requirements established by the state
survey agency for annual recertification inspections only
D. To provide a communication tool between nursing staff and physicians
that replaces the need for progress notes in the medical record
A. To develop a comprehensive, standardized assessment that drives
individualized care planning and ensures appropriate resource allocation and
regulatory compliance
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 .
2. 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, counting the
day of admission as day 1
B. The ARD must be set exactly on day 7 of the facility stay, with no
flexibility to adjust the date
,C. The ARD must be set on the day the resident is admitted to the facility,
which is always day 0
D. The ARD must be set no later than day 30 of the facility stay, allowing
extended observation time
A. The ARD must be set no later than day 14 of the facility stay, counting
the day of admission as day 1
RATIONALE: The ARD for an admission assessment must be set no later
than day 14, allowing the coordinator sufficient time to observe the resident
while ensuring timely completion. The day of admission is counted as Day 1 .
3. What is the relationship between the three components of the RAI
process: MDS assessment, CAAs, and care plan?
A. The MDS assessment triggers CAAs, which identify potential care issues
that must be addressed through individualized care planning interventions
B. The MDS assessment, CAAs, and care plan are independent documents
that serve different regulatory purposes and do not need to be cross-
referenced
C. The CAAs replace the need for an MDS assessment by providing a more
focused clinical evaluation of the resident's conditions
D. The care plan is completed first, then the MDS assessment is filled out to
match the care plan goals, and CAAs are optional appendices
A. The MDS assessment triggers CAAs, which identify potential care
issues that must be addressed through individualized care planning
interventions
RATIONALE: The RAI process is sequential: the MDS assessment
identifies conditions, the CAAs evaluate triggered areas in detail, and the
care plan implements interventions. Each component builds on the previous
one to create a comprehensive care approach .
4. When a resident is unable to complete the BIMS interview due to
severe dementia, how should the MDS coordinator code Section C?
A. Code the BIMS as unable to complete and proceed to staff assessment of
mental status using the resident's direct care staff as the information source
, B. Leave the BIMS section blank since the resident could not participate
C. Code all BIMS items as zero to indicate severe impairment
D. Complete only the recall portion of the BIMS and skip the orientation
questions
A. Code the BIMS as unable to complete and proceed to staff assessment
of mental status using the resident's direct care staff as the information
source
RATIONALE: When a resident cannot complete the BIMS, the coordinator
must code the BIMS as unable to complete and proceed to the staff
assessment for mental status .
5. 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
B. Annually each October 1, with additional off-schedule updates as
needed
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 .
6. What is the minimum passing score required for each RAC-CT
certification exam?
A. 70%
B. 75%
C. 80%
D. 85%
C. 80%
RATIONALE: The passing score for RAC-CT certification exams is 80% (80
questions correct out of 100) .
COORDINATOR CERTIFICATION
EXAM V1 ACTUAL EXAM 2026/2027 –
COMPLETE 100-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
• RAI Process and MDS 3.0 Fundamentals
• OBRA Assessment Schedule and Completion Timelines
• Care Area Assessments (CAAs) and Care Planning
• Medicare Part A PPS and PDPM Reimbursement
• Five-Star Quality Rating System
• Discharge Assessment Determination and Tracking
• ICD-10 Coding and Clinical Documentation
• Regulatory Compliance and Survey Readiness
Introduction
This examination assesses the knowledge and competency required of MDS
Coordinators for certification under the AANAC RAC-CT program. The exam
evaluates understanding of the Resident Assessment Instrument process,
OBRA and Medicare assessment schedules, Care Area Assessments,
,reimbursement methodologies, and quality reporting systems. Items are
presented in multiple-choice format with scenario-based questions designed
to simulate real-world MDS coordination tasks. Emphasis is placed on
accurate coding, regulatory timelines, and the integration of assessment
data into individualized care planning. The examination challenges
candidates to apply the RAI User's Manual to clinical and administrative
decision-making.
Section One: Questions 1–100
1. 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
the clinical accuracy of the documented findings
C. To satisfy the minimum data set requirements established by the state
survey agency for annual recertification inspections only
D. To provide a communication tool between nursing staff and physicians
that replaces the need for progress notes in the medical record
A. To develop a comprehensive, standardized assessment that drives
individualized care planning and ensures appropriate resource allocation and
regulatory compliance
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 .
2. 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, counting the
day of admission as day 1
B. The ARD must be set exactly on day 7 of the facility stay, with no
flexibility to adjust the date
,C. The ARD must be set on the day the resident is admitted to the facility,
which is always day 0
D. The ARD must be set no later than day 30 of the facility stay, allowing
extended observation time
A. The ARD must be set no later than day 14 of the facility stay, counting
the day of admission as day 1
RATIONALE: The ARD for an admission assessment must be set no later
than day 14, allowing the coordinator sufficient time to observe the resident
while ensuring timely completion. The day of admission is counted as Day 1 .
3. What is the relationship between the three components of the RAI
process: MDS assessment, CAAs, and care plan?
A. The MDS assessment triggers CAAs, which identify potential care issues
that must be addressed through individualized care planning interventions
B. The MDS assessment, CAAs, and care plan are independent documents
that serve different regulatory purposes and do not need to be cross-
referenced
C. The CAAs replace the need for an MDS assessment by providing a more
focused clinical evaluation of the resident's conditions
D. The care plan is completed first, then the MDS assessment is filled out to
match the care plan goals, and CAAs are optional appendices
A. The MDS assessment triggers CAAs, which identify potential care
issues that must be addressed through individualized care planning
interventions
RATIONALE: The RAI process is sequential: the MDS assessment
identifies conditions, the CAAs evaluate triggered areas in detail, and the
care plan implements interventions. Each component builds on the previous
one to create a comprehensive care approach .
4. When a resident is unable to complete the BIMS interview due to
severe dementia, how should the MDS coordinator code Section C?
A. Code the BIMS as unable to complete and proceed to staff assessment of
mental status using the resident's direct care staff as the information source
, B. Leave the BIMS section blank since the resident could not participate
C. Code all BIMS items as zero to indicate severe impairment
D. Complete only the recall portion of the BIMS and skip the orientation
questions
A. Code the BIMS as unable to complete and proceed to staff assessment
of mental status using the resident's direct care staff as the information
source
RATIONALE: When a resident cannot complete the BIMS, the coordinator
must code the BIMS as unable to complete and proceed to the staff
assessment for mental status .
5. 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
B. Annually each October 1, with additional off-schedule updates as
needed
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 .
6. What is the minimum passing score required for each RAC-CT
certification exam?
A. 70%
B. 75%
C. 80%
D. 85%
C. 80%
RATIONALE: The passing score for RAC-CT certification exams is 80% (80
questions correct out of 100) .
