,Missouri State Nursing Home Administrator Exam — 2026/2027 | 250
Questions And Correct Answers | Already Graded A+ | 100% Verified
Section 1: Federal & Missouri Long-Term Care Regulations (Questions 1–40)
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) Stark Law
Correct Answer: B
Rationale: The Omnibus Budget Reconciliation Act of 1987 (OBRA 1987) established comprehensive
federal requirements for nursing home quality, resident rights, and survey processes. HIPAA addresses
privacy, ADA addresses disability discrimination, and Stark Law addresses physician referrals.
2. Under Missouri state regulations, how often must a nursing home conduct a full fire drill?
A) Monthly
B) Quarterly
C) Annually
D) Every six months
Correct Answer: B
Rationale: Missouri regulations require quarterly fire drills for all shifts. This ensures all staff are familiar
with evacuation procedures and emergency protocols. Annual drills are insufficient, and monthly drills,
while beneficial, are not the minimum state requirement.
3. Which federal agency is primarily responsible for enforcing nursing home regulations under
Medicare?
A) DEA
B) CMS (Centers for Medicare & Medicaid Services)
C) FDA
D) OSHA
Correct Answer: B
Rationale: CMS oversees all Medicare/Medicaid certification and enforcement actions for nursing
homes. DEA handles controlled substances, FDA regulates drugs/medical devices, and OSHA oversees
workplace safety—not certification.
, 4. In Missouri, a nursing home administrator license must be renewed every how many years?
A) 1 year
B) 2 years
C) 3 years
D) 5 years
Correct Answer: B
Rationale: Missouri requires biennial (every two years) renewal of nursing home administrator licenses,
including completion of continuing education credits. This aligns with the state's licensing board
requirements.
5. What is the minimum number of licensed nursing staff required on a skilled nursing facility's night
shift per federal regulations?
A) At least one RN
B) Based on acuity, but minimum 1 full-time equivalent for 120+ beds
C) At least one LPN
D) At least one RN and one LPN
Correct Answer: B
Rationale: Federal regulations require licensed nursing staff based on resident acuity, with a minimum
of one full-time equivalent for facilities with 120 or more beds. The specific staffing must be sufficient to
meet resident needs.
6. Which Missouri regulation addresses the physical environment and life safety code compliance in
nursing homes?
A) Missouri Nursing Home Fire Safety Act
B) Missouri Life Safety Code (adopts NFPA 101)
C) Missouri Building Code
D) Missouri Environmental Health Act
Correct Answer: B
Rationale: Missouri adopts the National Fire Protection Association (NFPA) 101 Life Safety Code as the
standard for nursing home physical plant requirements, including fire alarms, sprinklers, and evacuation
routes.
7. Under federal regulations, which of the following is NOT a required component of the
comprehensive resident care plan?
Questions And Correct Answers | Already Graded A+ | 100% Verified
Section 1: Federal & Missouri Long-Term Care Regulations (Questions 1–40)
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) Stark Law
Correct Answer: B
Rationale: The Omnibus Budget Reconciliation Act of 1987 (OBRA 1987) established comprehensive
federal requirements for nursing home quality, resident rights, and survey processes. HIPAA addresses
privacy, ADA addresses disability discrimination, and Stark Law addresses physician referrals.
2. Under Missouri state regulations, how often must a nursing home conduct a full fire drill?
A) Monthly
B) Quarterly
C) Annually
D) Every six months
Correct Answer: B
Rationale: Missouri regulations require quarterly fire drills for all shifts. This ensures all staff are familiar
with evacuation procedures and emergency protocols. Annual drills are insufficient, and monthly drills,
while beneficial, are not the minimum state requirement.
3. Which federal agency is primarily responsible for enforcing nursing home regulations under
Medicare?
A) DEA
B) CMS (Centers for Medicare & Medicaid Services)
C) FDA
D) OSHA
Correct Answer: B
Rationale: CMS oversees all Medicare/Medicaid certification and enforcement actions for nursing
homes. DEA handles controlled substances, FDA regulates drugs/medical devices, and OSHA oversees
workplace safety—not certification.
, 4. In Missouri, a nursing home administrator license must be renewed every how many years?
A) 1 year
B) 2 years
C) 3 years
D) 5 years
Correct Answer: B
Rationale: Missouri requires biennial (every two years) renewal of nursing home administrator licenses,
including completion of continuing education credits. This aligns with the state's licensing board
requirements.
5. What is the minimum number of licensed nursing staff required on a skilled nursing facility's night
shift per federal regulations?
A) At least one RN
B) Based on acuity, but minimum 1 full-time equivalent for 120+ beds
C) At least one LPN
D) At least one RN and one LPN
Correct Answer: B
Rationale: Federal regulations require licensed nursing staff based on resident acuity, with a minimum
of one full-time equivalent for facilities with 120 or more beds. The specific staffing must be sufficient to
meet resident needs.
6. Which Missouri regulation addresses the physical environment and life safety code compliance in
nursing homes?
A) Missouri Nursing Home Fire Safety Act
B) Missouri Life Safety Code (adopts NFPA 101)
C) Missouri Building Code
D) Missouri Environmental Health Act
Correct Answer: B
Rationale: Missouri adopts the National Fire Protection Association (NFPA) 101 Life Safety Code as the
standard for nursing home physical plant requirements, including fire alarms, sprinklers, and evacuation
routes.
7. Under federal regulations, which of the following is NOT a required component of the
comprehensive resident care plan?
