SMQT EXAM /ACTUAL SURVEYOR MINIMUM QUALIFICATIONS
TEST (SMQT) 2026/2027 & STUDY GUIDE COMPLETE APPROVED
EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS PLUS
RATIONALES (100% CORRECT VERIFIED ANSWERS SOLUTIONS)
LATEST UPDATED VERSION 2026 EDITION |ALREADY GRADED A+
(BRAND NEW!) FULL REVISED
Question 1
A surveyor is reviewing a skilled nursing facility’s admission records. Under the
Centers for Medicare & Medicaid Services (CMS) requirements, which of the
following must be provided to a resident or their representative before or at the
time of admission?
A) A copy of the facility’s employee handbook
B) A notice of non-coverage appeal rights only after discharge
C) A written description of legal rights and the facility’s rules and regulations
D) A list of all other residents’ names for community integration
CORRECT ANSWER: C
Rationale: Under 42 CFR §483.10(c)(1)(i), facilities must provide each resident
with a written description of their legal rights and the facility’s rules and
regulations before or at the time of admission. Employee handbooks (A) are
internal documents. Appeal rights notice (B) is required at admission for Medicare
Part A stays, not just after discharge. Listing other residents (D) violates privacy
rights.
Question 2
During a life safety code inspection, a surveyor observes that a nursing home
corridor door does not latch properly. According to NFPA 101 (Life Safety Code),
what is the immediate concern?
,A) Reduced sound privacy between rooms
B) Compromised smoke compartmentation
C) Increased utility costs due to drafts
D) Difficulty for staff to move equipment
CORRECT ANSWER: B
Rationale: Corridor doors in healthcare occupancies must be self-closing and
latching to maintain smoke compartment boundaries (NFPA 101 §19.3.6.3). A
door that does not latch fails to prevent smoke spread, posing a life safety risk.
Privacy (A), utility costs (C), and equipment movement (D) are not primary life
safety concerns.
Question 3
A surveyor calculates the required nurse staffing hours for a 100-bed skilled
nursing facility based on the minimum data set (MDS) case-mix index. If the
facility’s weighted average case-mix index is 1.2, what is the total required direct
care nursing hours per day under the Patient Driven Payment Model (PDPM) for
compliance purposes?
A) 2.5 hours per resident day (HRD)
B) 3.0 hours per resident day (HRD)
C) 3.5 hours per resident day (HRD)
D) 4.0 hours per resident day (HRD)
CORRECT ANSWER: B
Rationale: While federal regulations do not mandate a specific HRD, CMS
interpretive guidance uses a threshold of 3.0 HRD (including RN, LPN, and CNA)
as a benchmark for adequate staffing in nursing facilities. Case-mix adjustment
modifies this, but 3.0 HRD is the baseline for surveyor evaluation when no state
requirement exists. Options A, C, and D are not the standard CMS benchmark.
,Question 4
A resident with a stage 3 pressure injury has refused wound care for two days
despite repeated education. The nurse documents the refusal and notifies the
physician. What must the facility do to remain compliant with resident rights?
A) Apply a restraint to prevent the resident from removing dressings
B) Continue to offer care and document ongoing refusals
C) Discharge the resident for non-compliance with the plan of care
D) Sedate the resident to provide necessary treatment
CORRECT ANSWER: B
Rationale: Under 42 CFR §483.10(e)(1), residents have the right to refuse
treatment. The facility must respect the refusal, document it, continue to offer care
(so refusal is informed), and not coerce treatment. Restraints (A) for refusal are
illegal. Discharge (C) for refusal requires proper notice and transfer only if facility
cannot meet needs. Sedation (D) violates consent.
Question 5
During a medication pass observation, a surveyor sees a licensed practical nurse
(LPN) crush an extended-release tablet and administer it through a percutaneous
endoscopic gastrostomy (PEG) tube. Which action should the surveyor take?
A) Ignore because crushing is allowed for tube feeding
B) Cite a deficiency for unsafe medication administration
C) Commend the nurse for creative problem-solving
D) Verify the order because crushing might be permitted by pharmacy
CORRECT ANSWER: B
, Rationale: Extended-release (ER/XR) tablets must not be crushed as it destroys the
controlled-release mechanism, potentially causing rapid absorption and toxicity
(e.g., overdose). Standard of care prohibits crushing ER formulations for any route.
Even if ordered, crushing is unsafe. Deficiency under F-tag F758 (unnecessary
drugs) or medication errors is appropriate.
Question 6
A nursing home has a policy requiring all staff to wear N95 respirators when
caring for residents on droplet precautions for influenza. What is the surveyor’s
most accurate evaluation of this policy?
A) Correct because influenza requires airborne precautions
B) Incorrect because influenza requires droplet precautions, not N95
C) Correct because N95 provides the highest level of protection
D) Incorrect but acceptable if staff prefer N95 over surgical masks
CORRECT ANSWER: B
Rationale: CDC 2007 Guideline for Isolation Precautions states that influenza
requires droplet precautions (surgical mask within 3 feet). N95 is for airborne
precautions (e.g., TB, measles). Using N95 unnecessarily may waste resources but
is not harmful; however, the policy indicates misunderstanding of transmission-
based precautions, which surveyors should correct through citation or education.
Question 7
Which of the following incidents must be reported to the state survey agency
within 24 hours under the Affordable Care Act’s nursing home reporting
requirements?
A) A resident’s unexpected weight loss of 3% in one month
B) Alleged neglect causing serious bodily injury
C) A verbal complaint about food temperature
TEST (SMQT) 2026/2027 & STUDY GUIDE COMPLETE APPROVED
EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS PLUS
RATIONALES (100% CORRECT VERIFIED ANSWERS SOLUTIONS)
LATEST UPDATED VERSION 2026 EDITION |ALREADY GRADED A+
(BRAND NEW!) FULL REVISED
Question 1
A surveyor is reviewing a skilled nursing facility’s admission records. Under the
Centers for Medicare & Medicaid Services (CMS) requirements, which of the
following must be provided to a resident or their representative before or at the
time of admission?
A) A copy of the facility’s employee handbook
B) A notice of non-coverage appeal rights only after discharge
C) A written description of legal rights and the facility’s rules and regulations
D) A list of all other residents’ names for community integration
CORRECT ANSWER: C
Rationale: Under 42 CFR §483.10(c)(1)(i), facilities must provide each resident
with a written description of their legal rights and the facility’s rules and
regulations before or at the time of admission. Employee handbooks (A) are
internal documents. Appeal rights notice (B) is required at admission for Medicare
Part A stays, not just after discharge. Listing other residents (D) violates privacy
rights.
Question 2
During a life safety code inspection, a surveyor observes that a nursing home
corridor door does not latch properly. According to NFPA 101 (Life Safety Code),
what is the immediate concern?
,A) Reduced sound privacy between rooms
B) Compromised smoke compartmentation
C) Increased utility costs due to drafts
D) Difficulty for staff to move equipment
CORRECT ANSWER: B
Rationale: Corridor doors in healthcare occupancies must be self-closing and
latching to maintain smoke compartment boundaries (NFPA 101 §19.3.6.3). A
door that does not latch fails to prevent smoke spread, posing a life safety risk.
Privacy (A), utility costs (C), and equipment movement (D) are not primary life
safety concerns.
Question 3
A surveyor calculates the required nurse staffing hours for a 100-bed skilled
nursing facility based on the minimum data set (MDS) case-mix index. If the
facility’s weighted average case-mix index is 1.2, what is the total required direct
care nursing hours per day under the Patient Driven Payment Model (PDPM) for
compliance purposes?
A) 2.5 hours per resident day (HRD)
B) 3.0 hours per resident day (HRD)
C) 3.5 hours per resident day (HRD)
D) 4.0 hours per resident day (HRD)
CORRECT ANSWER: B
Rationale: While federal regulations do not mandate a specific HRD, CMS
interpretive guidance uses a threshold of 3.0 HRD (including RN, LPN, and CNA)
as a benchmark for adequate staffing in nursing facilities. Case-mix adjustment
modifies this, but 3.0 HRD is the baseline for surveyor evaluation when no state
requirement exists. Options A, C, and D are not the standard CMS benchmark.
,Question 4
A resident with a stage 3 pressure injury has refused wound care for two days
despite repeated education. The nurse documents the refusal and notifies the
physician. What must the facility do to remain compliant with resident rights?
A) Apply a restraint to prevent the resident from removing dressings
B) Continue to offer care and document ongoing refusals
C) Discharge the resident for non-compliance with the plan of care
D) Sedate the resident to provide necessary treatment
CORRECT ANSWER: B
Rationale: Under 42 CFR §483.10(e)(1), residents have the right to refuse
treatment. The facility must respect the refusal, document it, continue to offer care
(so refusal is informed), and not coerce treatment. Restraints (A) for refusal are
illegal. Discharge (C) for refusal requires proper notice and transfer only if facility
cannot meet needs. Sedation (D) violates consent.
Question 5
During a medication pass observation, a surveyor sees a licensed practical nurse
(LPN) crush an extended-release tablet and administer it through a percutaneous
endoscopic gastrostomy (PEG) tube. Which action should the surveyor take?
A) Ignore because crushing is allowed for tube feeding
B) Cite a deficiency for unsafe medication administration
C) Commend the nurse for creative problem-solving
D) Verify the order because crushing might be permitted by pharmacy
CORRECT ANSWER: B
, Rationale: Extended-release (ER/XR) tablets must not be crushed as it destroys the
controlled-release mechanism, potentially causing rapid absorption and toxicity
(e.g., overdose). Standard of care prohibits crushing ER formulations for any route.
Even if ordered, crushing is unsafe. Deficiency under F-tag F758 (unnecessary
drugs) or medication errors is appropriate.
Question 6
A nursing home has a policy requiring all staff to wear N95 respirators when
caring for residents on droplet precautions for influenza. What is the surveyor’s
most accurate evaluation of this policy?
A) Correct because influenza requires airborne precautions
B) Incorrect because influenza requires droplet precautions, not N95
C) Correct because N95 provides the highest level of protection
D) Incorrect but acceptable if staff prefer N95 over surgical masks
CORRECT ANSWER: B
Rationale: CDC 2007 Guideline for Isolation Precautions states that influenza
requires droplet precautions (surgical mask within 3 feet). N95 is for airborne
precautions (e.g., TB, measles). Using N95 unnecessarily may waste resources but
is not harmful; however, the policy indicates misunderstanding of transmission-
based precautions, which surveyors should correct through citation or education.
Question 7
Which of the following incidents must be reported to the state survey agency
within 24 hours under the Affordable Care Act’s nursing home reporting
requirements?
A) A resident’s unexpected weight loss of 3% in one month
B) Alleged neglect causing serious bodily injury
C) A verbal complaint about food temperature
