1|Page
Illinois LNHA Supplemental Exam
2026: Complete Study Guide
Prepare for the Illinois Licensed Nursing Home
Administrator (LNHA) Supplemental Exam with this
comprehensive study guide and practice test. Review
Illinois nursing home laws, regulations, resident rights,
medical services, facility administration, personnel
policies, and regulatory compliance. Strengthen your
understanding with original practice questions, detailed
answer explanations, and scenario-based learning
designed to improve your knowledge, build confidence,
and support effective exam preparation. Always verify
current requirements using official Illinois sources.
Question 1: What is the primary regulatory source for the Illinois LNHA
Supplemental Examination?
A. The Social Security Act
B. Title 77, Part 300 of the Illinois Administrative Code
C. The National Fire Protection Association Life Safety Code
D. Medicare Conditions of Participation
B. Title 77, Part 300 of the Illinois Administrative Code
The CTS Candidate's Guide explicitly states that the examination is based
on the Illinois Department of Public Health Rules and Regulations for
Skilled and Intermediate Care Facilities, which are codified at 77 Ill. Adm.
Code 300 .
,2|Page
Question 2: According to the exam content outline, which section carries
the highest percentage weight on the Illinois Supplemental Exam?
A. General Provisions and Administration (17%)
B. Policy and Personnel (15%)
C. Medical Services (35%)
D. Resident Services (remaining percentage)
C. Medical Services (35%)
The official CTS candidate guide divides the exam into four sections, with
Medical Services (covering Subparts E, F, and H) weighted at 35%, making
it the largest single content area .
Question 3: Under Illinois regulations, how much notice must an
administrator give before voluntarily closing a facility if the closure will
require the transfer or discharge of more than 10% of residents?
A. 30 days
B. 60 days
C. 90 days
D. 120 days
B. 60 days
Section 300.110(i) of Title 77 requires the administrator to give 60 days'
notice prior to voluntarily closing a facility or any part of a facility if
closing will require the transfer or discharge of more than 10% of
residents. Notice must go to IDPH, the State Long-Term Care Ombudsman,
the resident, the resident's representative, and a family member when
practicable .
,3|Page
Question 4: What is the time limit for the Illinois LNHA Supplemental
Examination?
A. 60 minutes
B. 90 minutes
C. 120 minutes
D. 180 minutes
B. 90 minutes
The CTS Candidate's Guide specifies that the time limit for this
examination is 90 minutes .
Question 5: Which entity administers the Illinois LNHA Supplemental
Examination on behalf of IDFPR?
A. The National Association of Long Term Care Administrator Boards
(NAB)
B. The Illinois Department of Public Health (IDPH)
C. Continental Testing Services, Inc. (CTS)
D. The Centers for Medicare & Medicaid Services (CMS)
C. Continental Testing Services, Inc. (CTS)
The CTS Candidate's Guide and the CTS website confirm that Continental
Testing Services administers the Illinois Supplemental Examination for
nursing home administrator licensure .
Question 6: Under the Illinois Skilled Nursing and Intermediate Care
Facilities Code, what is the minimum license period for an annual
license?
A. 3 months
B. 6 months
C. 12 months
D. 18 months
B. 6 months
, 4|Page
Section 300.110(b) provides that licenses will be issued for a period of not
less than six months nor more than 18 months for facilities with annual
licenses .
Question 7: If an administrator voluntarily closes a facility and the
closure requires transfer or discharge of more than 10% of residents,
who must receive the 60-day notice?
A. Only the Illinois Department of Public Health
B. The Department, the State Long-Term Care Ombudsman, the resident,
the resident's representative, and a family member when practicable
C. Only the residents and their physicians
D. The Department and the local fire marshal
B. The Department, the State Long-Term Care Ombudsman, the
resident, the resident's representative, and a family member when
practicable
Section 300.110(i) specifies the complete list of notice recipients, which
includes IDPH, the Ombudsman, the affected resident, the resident's
representative, and a family member when practicable .
Question 8: Under Section 300.1230, what is the minimum direct care
staffing ratio for a resident needing skilled care?
A. 2.5 hours per day
B. 3.0 hours per day
C. 3.8 hours per day
D. 4.5 hours per day
C. 3.8 hours per day
Section 300.1230(d) states: "The minimum staffing ratios shall be 3.8 hours
of nursing and personal care each day for a resident needing skilled care
Illinois LNHA Supplemental Exam
2026: Complete Study Guide
Prepare for the Illinois Licensed Nursing Home
Administrator (LNHA) Supplemental Exam with this
comprehensive study guide and practice test. Review
Illinois nursing home laws, regulations, resident rights,
medical services, facility administration, personnel
policies, and regulatory compliance. Strengthen your
understanding with original practice questions, detailed
answer explanations, and scenario-based learning
designed to improve your knowledge, build confidence,
and support effective exam preparation. Always verify
current requirements using official Illinois sources.
Question 1: What is the primary regulatory source for the Illinois LNHA
Supplemental Examination?
A. The Social Security Act
B. Title 77, Part 300 of the Illinois Administrative Code
C. The National Fire Protection Association Life Safety Code
D. Medicare Conditions of Participation
B. Title 77, Part 300 of the Illinois Administrative Code
The CTS Candidate's Guide explicitly states that the examination is based
on the Illinois Department of Public Health Rules and Regulations for
Skilled and Intermediate Care Facilities, which are codified at 77 Ill. Adm.
Code 300 .
,2|Page
Question 2: According to the exam content outline, which section carries
the highest percentage weight on the Illinois Supplemental Exam?
A. General Provisions and Administration (17%)
B. Policy and Personnel (15%)
C. Medical Services (35%)
D. Resident Services (remaining percentage)
C. Medical Services (35%)
The official CTS candidate guide divides the exam into four sections, with
Medical Services (covering Subparts E, F, and H) weighted at 35%, making
it the largest single content area .
Question 3: Under Illinois regulations, how much notice must an
administrator give before voluntarily closing a facility if the closure will
require the transfer or discharge of more than 10% of residents?
A. 30 days
B. 60 days
C. 90 days
D. 120 days
B. 60 days
Section 300.110(i) of Title 77 requires the administrator to give 60 days'
notice prior to voluntarily closing a facility or any part of a facility if
closing will require the transfer or discharge of more than 10% of
residents. Notice must go to IDPH, the State Long-Term Care Ombudsman,
the resident, the resident's representative, and a family member when
practicable .
,3|Page
Question 4: What is the time limit for the Illinois LNHA Supplemental
Examination?
A. 60 minutes
B. 90 minutes
C. 120 minutes
D. 180 minutes
B. 90 minutes
The CTS Candidate's Guide specifies that the time limit for this
examination is 90 minutes .
Question 5: Which entity administers the Illinois LNHA Supplemental
Examination on behalf of IDFPR?
A. The National Association of Long Term Care Administrator Boards
(NAB)
B. The Illinois Department of Public Health (IDPH)
C. Continental Testing Services, Inc. (CTS)
D. The Centers for Medicare & Medicaid Services (CMS)
C. Continental Testing Services, Inc. (CTS)
The CTS Candidate's Guide and the CTS website confirm that Continental
Testing Services administers the Illinois Supplemental Examination for
nursing home administrator licensure .
Question 6: Under the Illinois Skilled Nursing and Intermediate Care
Facilities Code, what is the minimum license period for an annual
license?
A. 3 months
B. 6 months
C. 12 months
D. 18 months
B. 6 months
, 4|Page
Section 300.110(b) provides that licenses will be issued for a period of not
less than six months nor more than 18 months for facilities with annual
licenses .
Question 7: If an administrator voluntarily closes a facility and the
closure requires transfer or discharge of more than 10% of residents,
who must receive the 60-day notice?
A. Only the Illinois Department of Public Health
B. The Department, the State Long-Term Care Ombudsman, the resident,
the resident's representative, and a family member when practicable
C. Only the residents and their physicians
D. The Department and the local fire marshal
B. The Department, the State Long-Term Care Ombudsman, the
resident, the resident's representative, and a family member when
practicable
Section 300.110(i) specifies the complete list of notice recipients, which
includes IDPH, the Ombudsman, the affected resident, the resident's
representative, and a family member when practicable .
Question 8: Under Section 300.1230, what is the minimum direct care
staffing ratio for a resident needing skilled care?
A. 2.5 hours per day
B. 3.0 hours per day
C. 3.8 hours per day
D. 4.5 hours per day
C. 3.8 hours per day
Section 300.1230(d) states: "The minimum staffing ratios shall be 3.8 hours
of nursing and personal care each day for a resident needing skilled care
