1|Page
NAB-NHA Line of Service Exam Review 2025 Actual
Exam Test Bank| Complete 300 Real Exam Questions
and Correct Detailed Answers (Verified Answers)
Graded A+|| Brand New!!
What is PDPMP? – ANSWER - e Patient Driven Payment Model
How does PDPM improve payments to SNF's? – ANSWER - Improves
payment accuracy and appropriateness by focusing on the patient, rather
than the volume of services provided, Significantly reduces
administrative burden on providers, & Improves SNF payments to
currently underserved beneficiaries without increasing total Medicare
payments
How is RUG-IV different from PDPM? – ANSWER - Under RUG-IV,
the number of PT, OT, and SLP therapy treatment minutes are combined
for a total number of treatment minutes that is used to classify a given
patient into a given therapy RUG
What is CB? – ANSWER - Consolidated Billing
What is MAC? – ANSWER - Medicare Administrative Contractor,
where Medicare payments are made through.
What does Medicare Part A cover? – ANSWER - Medicare-certified
SNF Skilled care services.
pg. 1
,2|Page
What is the maximum amount of days Medicare part A covers for SNF
services? – ANSWER - Up to 100 days of SNF care per benefit period,
but it pays the full amount only for the first 20 days. For each day from
the 21st through the 100th, the beneficiary must pay the ''coinsurance''
How long is the Medicare Part A interruption period? – ANSWER - A 3-
day period beginning on the first non-covered day after a part A covered
SNF stay and ending at 11:59 PM on the third consecutive non-covered
day.
What is a Prospective Payment Systems? – ANSWER - A method of
reimbursement in which Medicare payment is made based on a
predetermined, fixed amount.
What is Medicare Fee-for-Service? – ANSWER - Fee-for-service is a
system of health care payment in which a provider is paid separately for
each particular service rendered.
What is value-based purchasing? – ANSWER - Linking provider
payments to improved performance by health care providers. The SNF
VBP Program is a Centers for Medicare & Medicaid Services (CMS)
program that awards incentive payments to SNFs based on their
performance on a single measure of all-cause hospital readmissions.
What are the SNF financial reporting requirements? – ANSWER - A
SNF must prepare annual consolidated financial statements of related
entities and have those statements reviewed by a Certified Public
Accountant (CPA), unless already audited.
pg. 2
,3|Page
How often must Medicare-certified institutional providers are required
to submit a cost report to a Medicare Administrative Contractor (MAC).
– ANSWER - Annually
What must a cost report contain that is being submitted to Medicare? –
ANSWER - Provider information such as facility characteristics,
utilization data, cost and charges by cost center (in total and for
Medicare), Medicare settlement data, and financial statement data.
Why should an administrator get department heads involved in the
budget-making process? – ANSWER - To obtain more accurate cost
estimates and more control over costs.
Medicare Part A coverage of skilled nursing facility (SNF) care entails
out-of-pocket payment by the resident of a daily amount for which days
of SNF care in a benefit period? – ANSWER - 21st through 100th
The process by which an individual becomes eligible for Medicaid by
incurring medical expenses until personal resources fall below a
specified ceiling is called: – ANSWER - Spend down
Part A Medicare eligibility requirements include the resident: –
ANSWER - Needing skilled nursing care on a daily basis.
Under the Patient Driven Payment Model (PDPM), a nursing home must
set an assessment reference date (ARD) within how many days of the
beneficiary's admission? – ANSWER - 8 days
pg. 3
, 4|Page
A care recipient residing in a skilled nursing facility has elected hospice
care. Shortly thereafter the patient experiences a significant weight
decline and develop pressure injuries. The interdisciplinary team
suggests an alternating pressure air mattress for comfort. Who will be
responsible for the rental charge of this mattress? – ANSWER - The
hospice agency
A care recipient with traditional Medicare coverage is receiving skilled
therapy after a back surgery in a skilled nursing facility. The recipient
needs to go to a follow-up appointment with the surgeon. An ambulance
transport is medically necessary and reasonable for the recipient. Under
consolidated billing, will the nursing facility have to pay for the
ambulance transportation? – ANSWER - No, if the ambulance
transportation is a medical necessity, the transport may be excluded.
For care recipients receiving psychotropic medications, it is important
for the facility to perform laboratory testing to check on which of the
following metabolic side-effects? – ANSWER - Unstable blood sugars
Nursing facilities operating under a Medicare license must promptly
refer care recipients with lost or damaged dentures for dental services
within how many days? – ANSWER - Referral must be made within 3
days.
What is true regarding Non-Physician Practitioner (NPP) visits to care
recipients residing in a skilled nursing facility (SNF)? – ANSWER -
NPPs may perform every other required visit, after the initial visit is
conducted by the physician.
pg. 4
NAB-NHA Line of Service Exam Review 2025 Actual
Exam Test Bank| Complete 300 Real Exam Questions
and Correct Detailed Answers (Verified Answers)
Graded A+|| Brand New!!
What is PDPMP? – ANSWER - e Patient Driven Payment Model
How does PDPM improve payments to SNF's? – ANSWER - Improves
payment accuracy and appropriateness by focusing on the patient, rather
than the volume of services provided, Significantly reduces
administrative burden on providers, & Improves SNF payments to
currently underserved beneficiaries without increasing total Medicare
payments
How is RUG-IV different from PDPM? – ANSWER - Under RUG-IV,
the number of PT, OT, and SLP therapy treatment minutes are combined
for a total number of treatment minutes that is used to classify a given
patient into a given therapy RUG
What is CB? – ANSWER - Consolidated Billing
What is MAC? – ANSWER - Medicare Administrative Contractor,
where Medicare payments are made through.
What does Medicare Part A cover? – ANSWER - Medicare-certified
SNF Skilled care services.
pg. 1
,2|Page
What is the maximum amount of days Medicare part A covers for SNF
services? – ANSWER - Up to 100 days of SNF care per benefit period,
but it pays the full amount only for the first 20 days. For each day from
the 21st through the 100th, the beneficiary must pay the ''coinsurance''
How long is the Medicare Part A interruption period? – ANSWER - A 3-
day period beginning on the first non-covered day after a part A covered
SNF stay and ending at 11:59 PM on the third consecutive non-covered
day.
What is a Prospective Payment Systems? – ANSWER - A method of
reimbursement in which Medicare payment is made based on a
predetermined, fixed amount.
What is Medicare Fee-for-Service? – ANSWER - Fee-for-service is a
system of health care payment in which a provider is paid separately for
each particular service rendered.
What is value-based purchasing? – ANSWER - Linking provider
payments to improved performance by health care providers. The SNF
VBP Program is a Centers for Medicare & Medicaid Services (CMS)
program that awards incentive payments to SNFs based on their
performance on a single measure of all-cause hospital readmissions.
What are the SNF financial reporting requirements? – ANSWER - A
SNF must prepare annual consolidated financial statements of related
entities and have those statements reviewed by a Certified Public
Accountant (CPA), unless already audited.
pg. 2
,3|Page
How often must Medicare-certified institutional providers are required
to submit a cost report to a Medicare Administrative Contractor (MAC).
– ANSWER - Annually
What must a cost report contain that is being submitted to Medicare? –
ANSWER - Provider information such as facility characteristics,
utilization data, cost and charges by cost center (in total and for
Medicare), Medicare settlement data, and financial statement data.
Why should an administrator get department heads involved in the
budget-making process? – ANSWER - To obtain more accurate cost
estimates and more control over costs.
Medicare Part A coverage of skilled nursing facility (SNF) care entails
out-of-pocket payment by the resident of a daily amount for which days
of SNF care in a benefit period? – ANSWER - 21st through 100th
The process by which an individual becomes eligible for Medicaid by
incurring medical expenses until personal resources fall below a
specified ceiling is called: – ANSWER - Spend down
Part A Medicare eligibility requirements include the resident: –
ANSWER - Needing skilled nursing care on a daily basis.
Under the Patient Driven Payment Model (PDPM), a nursing home must
set an assessment reference date (ARD) within how many days of the
beneficiary's admission? – ANSWER - 8 days
pg. 3
, 4|Page
A care recipient residing in a skilled nursing facility has elected hospice
care. Shortly thereafter the patient experiences a significant weight
decline and develop pressure injuries. The interdisciplinary team
suggests an alternating pressure air mattress for comfort. Who will be
responsible for the rental charge of this mattress? – ANSWER - The
hospice agency
A care recipient with traditional Medicare coverage is receiving skilled
therapy after a back surgery in a skilled nursing facility. The recipient
needs to go to a follow-up appointment with the surgeon. An ambulance
transport is medically necessary and reasonable for the recipient. Under
consolidated billing, will the nursing facility have to pay for the
ambulance transportation? – ANSWER - No, if the ambulance
transportation is a medical necessity, the transport may be excluded.
For care recipients receiving psychotropic medications, it is important
for the facility to perform laboratory testing to check on which of the
following metabolic side-effects? – ANSWER - Unstable blood sugars
Nursing facilities operating under a Medicare license must promptly
refer care recipients with lost or damaged dentures for dental services
within how many days? – ANSWER - Referral must be made within 3
days.
What is true regarding Non-Physician Practitioner (NPP) visits to care
recipients residing in a skilled nursing facility (SNF)? – ANSWER -
NPPs may perform every other required visit, after the initial visit is
conducted by the physician.
pg. 4
