ILLINOIS SUPPLEMENTAL NURSING HOME
ADMINISTRATOR EXAM (2026/2027) | ACTUAL
EXAM QUESTIONS AND ANSWERS
Illinois Department of Public Health (IDPH) Supplemental Nursing Home Administrator
(NHA) Licensing Examination | Core Domains: Illinois Nursing Home Care Act (210 ILCS 45)
& IDPH Administrative Code (Title 77, Part 300), Resident Rights & Quality of Life, Staffing &
Personnel Management (Licensing, Training), Financial Management & Reimbursement
(Medicaid/Medicare), Facility Operations & Physical Environment Standards, Survey &
Certification Process (Deficiencies, Plans of Correction), Emergency Preparedness & Safety,
and Ethical Leadership & Professional Conduct | State-Specific Nursing Home Administration
Licensure Focus | Supplemental Jurisprudence Exam Format
Exam Structure
The Illinois Supplemental NHA Exam for the 2026/2027 licensure cycle is a 75-question,
multiple-choice examination focusing exclusively on Illinois state laws, rules, and regulations
governing long-term care facilities.
Introduction
This Illinois Supplemental NHA Exam guide for the 2026/2027 licensure cycle prepares
candidates for the state-specific jurisprudence exam required in addition to the national NAB
exam. The content tests in-depth knowledge of the Illinois Nursing Home Care Act, the related
IDPH administrative rules, and the application of these state-specific standards to the daily
operation, management, and compliance of skilled nursing facilities in Illinois.
Answer Format
All correct answers and administrative standards must be presented in bold and green,
followed by detailed rationales that cite specific sections of the Illinois Nursing Home Care Act
(210 ILCS 45), the IDPH Administrative Code (Title 77, Part 300), and official IDPH policy
memoranda governing nursing home administration in Illinois.
1. Illinois Nursing Home Care Act – Purpose: What is the primary purpose of the Illinois
Nursing Home Care Act (210 ILCS 45)?
,A) To regulate staffing ratios only
B) To ensure that residents receive safe, respectful, and high-quality care in a
homelike environment
C) To reduce Medicaid costs
D) To license only administrators
Rationale: The Illinois Nursing Home Care Act (210 ILCS 45/1-101) states its purpose is “to
ensure that residents of nursing homes are afforded dignity, respect, and quality care in a safe
and homelike environment.” This foundational principle guides all regulatory provisions.
2. Resident Rights – Notice of Rights: When must a resident be provided with a written
copy of their rights under the Illinois Nursing Home Care Act?
A) At annual review
B) At the time of admission
C) Only upon request
D) After the first care plan meeting
Rationale: 210 ILCS 45/2-101 requires that a written statement of resident rights be provided
“at the time of admission” and posted conspicuously in the facility.
3. IDPH Administrative Code – Administrator Qualifications: Which of the following
is required to serve as a licensed nursing home administrator in Illinois?
A) A bachelor’s degree in any field
B) Successful completion of the NAB national exam and the Illinois Supplemental
Exam
, C) Five years of clinical experience
D) Illinois RN licensure
Rationale: Title 77, Part 300.200(a) mandates that applicants must pass both the National
Association of Long Term Care Administrator Boards (NAB) exam and the Illinois
Supplemental Jurisprudence Exam to obtain licensure.
4. Resident Rights – Restraint Use: Under Illinois law, physical restraints may be used
only when:
A) The family requests it
B) Less restrictive interventions have failed and there is an imminent risk of harm
to the resident or others
C) The resident is combative
D) During nighttime hours for safety
Rationale: 210 ILCS 45/2-110 prohibits the use of physical or chemical restraints for
discipline or convenience. Restraints are permitted only to treat medical symptoms or prevent
imminent harm after less restrictive measures fail.
5. Staffing – Nurse Aide Training: How many hours of training must a nurse aide complete
before working in an Illinois nursing home?
A) 40 hours
B) 75 hours, including 16 hours of supervised practical training
C) 120 hours
D) 60 hours
Rationale: Title 77, Part 300.400(b) adopts federal OBRA ’87 requirements: 75 hours of
training, with at least 16 hours of hands-on clinical instruction, prior to unsupervised contact
with residents.
ADMINISTRATOR EXAM (2026/2027) | ACTUAL
EXAM QUESTIONS AND ANSWERS
Illinois Department of Public Health (IDPH) Supplemental Nursing Home Administrator
(NHA) Licensing Examination | Core Domains: Illinois Nursing Home Care Act (210 ILCS 45)
& IDPH Administrative Code (Title 77, Part 300), Resident Rights & Quality of Life, Staffing &
Personnel Management (Licensing, Training), Financial Management & Reimbursement
(Medicaid/Medicare), Facility Operations & Physical Environment Standards, Survey &
Certification Process (Deficiencies, Plans of Correction), Emergency Preparedness & Safety,
and Ethical Leadership & Professional Conduct | State-Specific Nursing Home Administration
Licensure Focus | Supplemental Jurisprudence Exam Format
Exam Structure
The Illinois Supplemental NHA Exam for the 2026/2027 licensure cycle is a 75-question,
multiple-choice examination focusing exclusively on Illinois state laws, rules, and regulations
governing long-term care facilities.
Introduction
This Illinois Supplemental NHA Exam guide for the 2026/2027 licensure cycle prepares
candidates for the state-specific jurisprudence exam required in addition to the national NAB
exam. The content tests in-depth knowledge of the Illinois Nursing Home Care Act, the related
IDPH administrative rules, and the application of these state-specific standards to the daily
operation, management, and compliance of skilled nursing facilities in Illinois.
Answer Format
All correct answers and administrative standards must be presented in bold and green,
followed by detailed rationales that cite specific sections of the Illinois Nursing Home Care Act
(210 ILCS 45), the IDPH Administrative Code (Title 77, Part 300), and official IDPH policy
memoranda governing nursing home administration in Illinois.
1. Illinois Nursing Home Care Act – Purpose: What is the primary purpose of the Illinois
Nursing Home Care Act (210 ILCS 45)?
,A) To regulate staffing ratios only
B) To ensure that residents receive safe, respectful, and high-quality care in a
homelike environment
C) To reduce Medicaid costs
D) To license only administrators
Rationale: The Illinois Nursing Home Care Act (210 ILCS 45/1-101) states its purpose is “to
ensure that residents of nursing homes are afforded dignity, respect, and quality care in a safe
and homelike environment.” This foundational principle guides all regulatory provisions.
2. Resident Rights – Notice of Rights: When must a resident be provided with a written
copy of their rights under the Illinois Nursing Home Care Act?
A) At annual review
B) At the time of admission
C) Only upon request
D) After the first care plan meeting
Rationale: 210 ILCS 45/2-101 requires that a written statement of resident rights be provided
“at the time of admission” and posted conspicuously in the facility.
3. IDPH Administrative Code – Administrator Qualifications: Which of the following
is required to serve as a licensed nursing home administrator in Illinois?
A) A bachelor’s degree in any field
B) Successful completion of the NAB national exam and the Illinois Supplemental
Exam
, C) Five years of clinical experience
D) Illinois RN licensure
Rationale: Title 77, Part 300.200(a) mandates that applicants must pass both the National
Association of Long Term Care Administrator Boards (NAB) exam and the Illinois
Supplemental Jurisprudence Exam to obtain licensure.
4. Resident Rights – Restraint Use: Under Illinois law, physical restraints may be used
only when:
A) The family requests it
B) Less restrictive interventions have failed and there is an imminent risk of harm
to the resident or others
C) The resident is combative
D) During nighttime hours for safety
Rationale: 210 ILCS 45/2-110 prohibits the use of physical or chemical restraints for
discipline or convenience. Restraints are permitted only to treat medical symptoms or prevent
imminent harm after less restrictive measures fail.
5. Staffing – Nurse Aide Training: How many hours of training must a nurse aide complete
before working in an Illinois nursing home?
A) 40 hours
B) 75 hours, including 16 hours of supervised practical training
C) 120 hours
D) 60 hours
Rationale: Title 77, Part 300.400(b) adopts federal OBRA ’87 requirements: 75 hours of
training, with at least 16 hours of hands-on clinical instruction, prior to unsupervised contact
with residents.
