KENTUCKY NURSING HOME ADMINISTRATOR EXAM 2026 | QUESTIONS, CORRECT ANSWERS & RATIONALES

KENTUCKY NURSING HOME
ADMINISTRATOR EXAM 2026 | QUESTIONS,
CORRECT ANSWERS & RATIONALES
KENTUCKY NURSING HOME ADMINISTRATOR EXAM 2026

QUESTIONS, CORRECT ANSWERS & RATIONALES



OVERVIEW

• This comprehensive 200-question study guide covers all major domains tested on
the Kentucky Nursing Home Administrator Exam, including regulations, resident
care, staff management, safety, and compliance standards.

• Study this material systematically by working through each question, reviewing
the rationale for both correct and incorrect answers to deepen understanding of
administrator responsibilities and regulatory requirements.



QUESTIONS



QUESTION 1

Nursing home administrators must ensure that all regulations outlined in
which federal law are followed at their facility?

A) The Americans with Disabilities Act (ADA)

B) The Occupational Safety and Health Act (OSHA)

C) The Centers for Medicare and Medicaid Services (CMS) Conditions of
Participation

D) The Family and Medical Leave Act (FMLA)

E) The Civil Rights Act of 1964

✓ CORRECT ANSWER: C) The Centers for Medicare and Medicaid Services (CMS)
Conditions of Participation

,RATIONALE: CMS Conditions of Participation are the specific federal requirements
that nursing homes must meet to participate in Medicare and Medicaid programs.
These conditions set standards for nursing care, resident rights, administration,
and quality assurance. While ADA, OSHA, FMLA, and Civil Rights Act apply to nursing
homes, CMS Conditions of Participation are the most comprehensive and direct
federal regulatory framework specifically designed for nursing home operations.
Administrators must ensure compliance with these conditions to maintain facility
certification and receive federal reimbursement.



QUESTION 2

Under Kentucky regulations, a nursing home administrator must have what
minimum level of education?

A) High school diploma

B) Associate's degree in healthcare

C) Bachelor's degree in nursing

D) High school diploma or GED with administrator licensure

E) Master's degree in health administration

✓ CORRECT ANSWER: D) High school diploma or GED with administrator
licensure

RATIONALE: Kentucky regulations require nursing home administrators to hold a
high school diploma or GED along with proper licensure as a nursing home
administrator. The state does not mandate a bachelor's degree or specific nursing
education, though administrators must pass the Kentucky Nursing Home
Administrator licensing examination. This allows qualified individuals with diverse
educational backgrounds to become administrators provided they meet the specific
licensing requirements and demonstrate competency through examination.



QUESTION 3

,Which of the following is NOT a requirement for resident admission to a
nursing home?

A) Assessment and comprehensive care planning

B) Execution of advance directives prior to admission

C) Documentation of all current medications

D) Notification of the Ombudsman office

E) Initial medical evaluation

✓ CORRECT ANSWER: B) Execution of advance directives prior to admission

RATIONALE: While nursing homes must provide information about advance
directives and give residents the opportunity to execute them, advance directives
are not a requirement for admission. Residents have the right to create or decline
to create advance directives. However, facilities must complete assessments,
document medications, obtain initial medical evaluations, and inform residents
about ombudsman services. Forcing execution of advance directives as a condition
of admission would violate resident rights and federal regulations.



QUESTION 4

A resident has the right to refuse medical treatment. What must the
administrator ensure the facility does?

A) Immediately discharge the resident

B) Document the refusal and ensure informed consent procedures are followed

C) Override the refusal if family members disagree

D) Isolate the resident from other patients

E) Report the refusal to law enforcement

✓ CORRECT ANSWER: B) Document the refusal and ensure informed consent
procedures are followed

, RATIONALE: Residents have a fundamental right to refuse treatment, and facilities
must respect this autonomy. The administrator must ensure proper documentation
of the refusal, that the resident or surrogate decision-maker understands the
consequences, and that informed consent procedures are followed. This protects
both resident rights and the facility legally. Discharge, override by family, isolation,
or law enforcement involvement would violate resident rights unless specific
circumstances warrant protective measures under law.



QUESTION 5

Which federal law specifically addresses resident rights in long-term care
facilities?

A) The Affordable Care Act (ACA)

B) The Nursing Home Reform Act (NHRA) under OBRA 1987

C) The Health Insurance Portability and Accountability Act (HIPAA)

D) The Patient Safety and Quality Improvement Act

E) The Balanced Budget Act

✓ CORRECT ANSWER: B) The Nursing Home Reform Act (NHRA) under OBRA
1987

RATIONALE: The Nursing Home Reform Act, enacted as part of the Omnibus Budget
Reconciliation Act (OBRA) of 1987, is the comprehensive federal legislation that
specifically mandates resident rights in nursing homes. It established rights
including dignity, privacy, autonomy in medical decisions, freedom from abuse and
restraints, and access to ombudsman services. While HIPAA addresses privacy,
HIPAA does not establish resident rights. The ACA, PSQI, and BBA have healthcare
impacts but do not specifically focus on resident rights as comprehensively as
NHRA.



QUESTION 6