NAB EXAM STUDY GUIDE 2026 – COMPLETE
CONCEPT REVIEW & PRACTICE MATERIALS
(LATEST EDITION)
(Nursing Home Administrator Licensing Exam)
I. Resident Care & Quality of Life (20 Qs)
1. Q: What is the primary focus of Person-Centered Care (PCC)?
A: Care that is individualized to each resident’s preferences, values, and needs, putting
them at the center of all decisions.
2. Q: Name three mandatory components of a comprehensive resident assessment (MDS
3.0).
A: Cognitive patterns, mood, behavior, functional status, medications, skin condition.
3. Q: What federal regulation requires facilities to provide necessary care to attain the
highest practicable well-being?
A: F-Tag 677 (Quality of Life) and F-Tag 678 (Quality of Care), under 42 CFR §483.
4. Q: What is the purpose of an advance directive?
A: Allows a resident to document health care wishes (e.g., living will, DNR, healthcare
proxy) before they become incapacitated.
5. Q: Define “aging in place” in a SNF/NF context.
A: Providing services and adaptations so residents can remain in the facility despite
changing care needs, when safely possible.
6. Q: What is a “significant change” requiring a comprehensive assessment?
A: A major decline or improvement in a resident’s physical, mental, or psychosocial
status.
7. Q: Who is responsible for developing the resident’s care plan?
A: The interdisciplinary team (IDT), including the resident, family, RN, DON, therapist,
dietary, social services, and activities.
,8. Q: What are the “Five Rights” of medication administration?
A: Right resident, right medication, right dose, right route, right time.
9. Q: What is the goal of a falls prevention program?
A: To identify risk factors (like medications, mobility) and implement interventions to
reduce fall frequency and injury.
10. Q: What is “informed consent”?
A: The process where a resident is provided information about a treatment/procedure,
including risks/benefits/alternatives, before agreeing.
11. Q: What is “unnecessary drug” as defined by regulations?
A: Any drug used in excessive dose, duration, without indication, or despite adverse
consequences.
12. Q: What does “transfer/discharge rights” (F-Tag 622) protect?
A: Residents can only be transferred/discharged for specific reasons (medical needs,
safety, non-payment) with proper notice and planning.
13. Q: What is “pain management” a key indicator of?
A: Quality of care and quality of life. Facilities must assess, manage, and reassess pain.
14. Q: Define “abuse” as per OBRA.
A: Willful infliction of injury, intimidation, or punishment resulting in physical harm, pain,
or mental anguish.
15. Q: What is the role of the Ombudsman?
A: An advocate for residents’ rights, health, safety, and welfare; investigates complaints.
16. Q: What is “resident council”?
A: A resident-led group to discuss concerns, suggestions, and facility policies.
17. Q: What does “privacy and confidentiality” (F-Tag 561) entail?
A: Right to private communications, visits, and treatment; records kept confidential.
18. Q: What is “involuntary seclusion”?
A: Separating a resident from others against their will; prohibited except in emergency
safety situations.
, 19. Q: What is the key principle behind “restraint-free care”?
A: Use least restrictive alternatives; physical/chemical restraints only for acute medical
symptoms, never for discipline/convenience.
20. Q: What are “activities of daily living” (ADLs)?
A: Basic self-care tasks: bathing, dressing, toileting, transferring, continence, eating.
II. Financial & Operations Management (20 Qs)
21. Q: What is the primary source of reimbursement for most nursing home care?
A: Medicare (Part A for SNF post-hospital) and Medicaid (long-term custodial).
22. Q: Define “Medicare Part A SNF benefit period.”
A: A spell of illness beginning with hospital stay; covers up to 100 days of SNF care per
period after a 3-day qualifying stay.
23. Q: What is “Medicaid eligibility” based on?
A: Financial need (income/assets below state thresholds) and functional/medical need
for nursing level care.
24. Q: What is the “cost report”?
A: Annual filing to Medicare/Medicaid detailing facility costs to determine
reimbursement rates.
25. Q: Define “prospective payment system” (PPS) for Medicare SNF.
A: Reimbursement based on per-diem rates set by resident’s RUG-IV/PDPM
classification, not actual daily costs.
26. Q: What is “PDPM” (2026 likely still relevant)?
A: Patient-Driven Payment Model – Medicare SNF payment system based on clinical
characteristics, not therapy volume.
27. Q: What is a “bed hold” policy?
A: Payment/reservation of a bed for a resident during a temporary hospitalization or
leave; Medicaid rules vary by state.
28. Q: What is “accounts receivable” (A/R) management?
A: Billing, collection, and tracking of payments due from residents, Medicare, Medicaid,
and insurers.
, 29. Q: What is a “budget variance analysis”?
A: Comparing actual financial performance to budget, investigating differences, and
taking corrective action.
30. Q: What is “FTE” (Full-Time Equivalent)?
A: A measure of workforce = one employee working full-time (e.g., two 0.5 FTE part-
timers = 1.0 FTE).
31. Q: What is “payroll burden”?
A: Total cost beyond wages: taxes, insurance, benefits.
32. Q: What is “inventory turnover ratio”?
A: How quickly inventory is used/replaced; high turnover indicates efficient
management.
33. Q: What is “capital expenditure”?
A: Major purchase of long-term assets (building, equipment) exceeding a set dollar
threshold.
34. Q: What is “deferred revenue”?
A: Payment received in advance for services not yet rendered (e.g., private pay advance).
35. Q: What is the “triple aim” in healthcare?
A: Improving patient experience, improving population health, reducing per capita costs.
36. Q: What is “accounts payable” (A/P)?
A: Money owed by the facility to suppliers/vendors for goods/services received.
37. Q: What is “managed care” in LTC?
A: Prepaid, capitated plans that contract with facilities for post-acute or long-term care
services.
38. Q: What is “direct vs. indirect costs”?
A: Direct costs relate specifically to a department/resident (nursing wages). Indirect
support entire facility (administrative salaries).
39. Q: What is “break-even analysis”?
A: Determining the point where total revenue equals total costs.
CONCEPT REVIEW & PRACTICE MATERIALS
(LATEST EDITION)
(Nursing Home Administrator Licensing Exam)
I. Resident Care & Quality of Life (20 Qs)
1. Q: What is the primary focus of Person-Centered Care (PCC)?
A: Care that is individualized to each resident’s preferences, values, and needs, putting
them at the center of all decisions.
2. Q: Name three mandatory components of a comprehensive resident assessment (MDS
3.0).
A: Cognitive patterns, mood, behavior, functional status, medications, skin condition.
3. Q: What federal regulation requires facilities to provide necessary care to attain the
highest practicable well-being?
A: F-Tag 677 (Quality of Life) and F-Tag 678 (Quality of Care), under 42 CFR §483.
4. Q: What is the purpose of an advance directive?
A: Allows a resident to document health care wishes (e.g., living will, DNR, healthcare
proxy) before they become incapacitated.
5. Q: Define “aging in place” in a SNF/NF context.
A: Providing services and adaptations so residents can remain in the facility despite
changing care needs, when safely possible.
6. Q: What is a “significant change” requiring a comprehensive assessment?
A: A major decline or improvement in a resident’s physical, mental, or psychosocial
status.
7. Q: Who is responsible for developing the resident’s care plan?
A: The interdisciplinary team (IDT), including the resident, family, RN, DON, therapist,
dietary, social services, and activities.
,8. Q: What are the “Five Rights” of medication administration?
A: Right resident, right medication, right dose, right route, right time.
9. Q: What is the goal of a falls prevention program?
A: To identify risk factors (like medications, mobility) and implement interventions to
reduce fall frequency and injury.
10. Q: What is “informed consent”?
A: The process where a resident is provided information about a treatment/procedure,
including risks/benefits/alternatives, before agreeing.
11. Q: What is “unnecessary drug” as defined by regulations?
A: Any drug used in excessive dose, duration, without indication, or despite adverse
consequences.
12. Q: What does “transfer/discharge rights” (F-Tag 622) protect?
A: Residents can only be transferred/discharged for specific reasons (medical needs,
safety, non-payment) with proper notice and planning.
13. Q: What is “pain management” a key indicator of?
A: Quality of care and quality of life. Facilities must assess, manage, and reassess pain.
14. Q: Define “abuse” as per OBRA.
A: Willful infliction of injury, intimidation, or punishment resulting in physical harm, pain,
or mental anguish.
15. Q: What is the role of the Ombudsman?
A: An advocate for residents’ rights, health, safety, and welfare; investigates complaints.
16. Q: What is “resident council”?
A: A resident-led group to discuss concerns, suggestions, and facility policies.
17. Q: What does “privacy and confidentiality” (F-Tag 561) entail?
A: Right to private communications, visits, and treatment; records kept confidential.
18. Q: What is “involuntary seclusion”?
A: Separating a resident from others against their will; prohibited except in emergency
safety situations.
, 19. Q: What is the key principle behind “restraint-free care”?
A: Use least restrictive alternatives; physical/chemical restraints only for acute medical
symptoms, never for discipline/convenience.
20. Q: What are “activities of daily living” (ADLs)?
A: Basic self-care tasks: bathing, dressing, toileting, transferring, continence, eating.
II. Financial & Operations Management (20 Qs)
21. Q: What is the primary source of reimbursement for most nursing home care?
A: Medicare (Part A for SNF post-hospital) and Medicaid (long-term custodial).
22. Q: Define “Medicare Part A SNF benefit period.”
A: A spell of illness beginning with hospital stay; covers up to 100 days of SNF care per
period after a 3-day qualifying stay.
23. Q: What is “Medicaid eligibility” based on?
A: Financial need (income/assets below state thresholds) and functional/medical need
for nursing level care.
24. Q: What is the “cost report”?
A: Annual filing to Medicare/Medicaid detailing facility costs to determine
reimbursement rates.
25. Q: Define “prospective payment system” (PPS) for Medicare SNF.
A: Reimbursement based on per-diem rates set by resident’s RUG-IV/PDPM
classification, not actual daily costs.
26. Q: What is “PDPM” (2026 likely still relevant)?
A: Patient-Driven Payment Model – Medicare SNF payment system based on clinical
characteristics, not therapy volume.
27. Q: What is a “bed hold” policy?
A: Payment/reservation of a bed for a resident during a temporary hospitalization or
leave; Medicaid rules vary by state.
28. Q: What is “accounts receivable” (A/R) management?
A: Billing, collection, and tracking of payments due from residents, Medicare, Medicaid,
and insurers.
, 29. Q: What is a “budget variance analysis”?
A: Comparing actual financial performance to budget, investigating differences, and
taking corrective action.
30. Q: What is “FTE” (Full-Time Equivalent)?
A: A measure of workforce = one employee working full-time (e.g., two 0.5 FTE part-
timers = 1.0 FTE).
31. Q: What is “payroll burden”?
A: Total cost beyond wages: taxes, insurance, benefits.
32. Q: What is “inventory turnover ratio”?
A: How quickly inventory is used/replaced; high turnover indicates efficient
management.
33. Q: What is “capital expenditure”?
A: Major purchase of long-term assets (building, equipment) exceeding a set dollar
threshold.
34. Q: What is “deferred revenue”?
A: Payment received in advance for services not yet rendered (e.g., private pay advance).
35. Q: What is the “triple aim” in healthcare?
A: Improving patient experience, improving population health, reducing per capita costs.
36. Q: What is “accounts payable” (A/P)?
A: Money owed by the facility to suppliers/vendors for goods/services received.
37. Q: What is “managed care” in LTC?
A: Prepaid, capitated plans that contract with facilities for post-acute or long-term care
services.
38. Q: What is “direct vs. indirect costs”?
A: Direct costs relate specifically to a department/resident (nursing wages). Indirect
support entire facility (administrative salaries).
39. Q: What is “break-even analysis”?
A: Determining the point where total revenue equals total costs.
