Certified Assisted Living Administrator (CALA) — Questions and Answers

Question 1: Why is regulatory compliance important in assisted living facilities?

To improve marketing strategies
To reduce dietary options
To meet care and safety standards (Correct answer)
To eliminate resident activities

Correct answer: To meet care and safety standards

Compliance ensures that facilities meet state and federal standards for safety, care quality, and resident rights.

Question 2: Effective conflict resolution among interdisciplinary care teams MOST often requires the administrator to:

Remove conflicting team members from the case
Choose sides based on clinical expertise
Facilitate open dialogue, identify common ground, and focus on resident-centered outcomes (Correct answer)
Impose a top-down solution quickly

Correct answer: Facilitate open dialogue, identify common ground, and focus on resident-centered outcomes

Facilitative conflict resolution preserves team relationships while keeping the focus on resident welfare.

Question 3: A maintenance staff member discovers a significant water leak in the ceiling of a resident's room during night shift. What is the immediate priority?

Wait until the next shift change to assess the situation with more staff
Relocate the resident to a safe room and contain the leak as much as possible (Correct answer)
Document the leak in the maintenance log and schedule repair for morning
Call the administrator at home to get approval before taking any action

Correct answer: Relocate the resident to a safe room and contain the leak as much as possible

Resident safety is always the first priority; the resident must be moved immediately and the leak contained to prevent further damage or injury.

Question 4: What is the purpose of an 'employee handbook' in an assisted living facility?

To document facility policies, procedures, and employee rights and responsibilities (Correct answer)
To serve as a training manual for clinical care
To replace individual employment contracts
To list all resident care plans

Correct answer: To document facility policies, procedures, and employee rights and responsibilities

An employee handbook communicates facility policies, workplace expectations, employee rights, and benefits, serving as a reference guide for all staff.

Question 5: What is the primary purpose of conducting a background check on prospective assisted living employees?

To verify educational credentials only
To assess credit worthiness for benefit eligibility
To screen for criminal history that may pose a risk to vulnerable residents (Correct answer)
To confirm salary history

Correct answer: To screen for criminal history that may pose a risk to vulnerable residents

Background checks in assisted living primarily screen for criminal history—especially abuse, neglect, or exploitation—to protect the safety of vulnerable residents.

Question 6: What is the primary goal of restorative care in an assisted living setting?

To maintain or improve residents' functional abilities (Correct answer)
To treat acute medical conditions
To prepare residents for discharge to independent living
To reduce medication costs

Correct answer: To maintain or improve residents' functional abilities

Restorative care focuses on helping residents maintain or regain functional abilities to maximize independence.

Question 7: What does the term 'accounts payable' represent in assisted living facility accounting?

Money the facility owes to vendors and suppliers (Correct answer)
Resident trust fund balances
Long-term loan obligations
Money owed to the facility by residents

Correct answer: Money the facility owes to vendors and suppliers

Accounts payable represents money the facility owes to vendors, suppliers, and service providers for goods and services already received.

Question 8: What is the difference between quality assurance (QA) and quality improvement (QI) in assisted living?

QA focuses on meeting minimum standards and identifying deficiencies; QI focuses on continuously improving beyond minimum standards (Correct answer)
They are identical concepts with different names
QA applies only to clinical care; QI applies only to administrative processes
QA focuses on continuous proactive improvement; QI focuses on reactive compliance

Correct answer: QA focuses on meeting minimum standards and identifying deficiencies; QI focuses on continuously improving beyond minimum standards

QA is traditionally reactive, focused on identifying and correcting deficiencies to meet minimum standards, while QI is proactive, continuously seeking to improve performance beyond minimum compliance thresholds.

Question 9: An assisted living administrator is conducting a variance analysis. What does a negative variance in labor costs indicate?

There was no overtime incurred
Labor costs were higher than budgeted (Correct answer)
Labor costs were lower than budgeted
Staff turnover was below average

Correct answer: Labor costs were higher than budgeted

In expense categories, a negative variance means actual costs exceeded the budgeted amount, indicating overspending on labor.

Question 10: In ethical decision-making, the 'newspaper test' is used to evaluate whether a decision:

Would be considered appropriate if reported in a public news story (Correct answer)
Maximizes revenue for the facility
Receives majority staff approval
Complies with all applicable state regulations

Correct answer: Would be considered appropriate if reported in a public news story

The newspaper test asks whether you would be comfortable seeing your decision reported publicly, helping identify decisions that may be legal but ethically questionable.

Question 11: A facility notices its water heating system is not consistently reaching the required temperature to prevent Legionella bacteria growth. What is the recommended minimum hot water temperature at the water heater?

140°F (60°C) (Correct answer)
100°F (38°C)
110°F (43°C)
120°F (49°C)

Correct answer: 140°F (60°C)

Maintaining hot water at the heater at 140°F (60°C) kills Legionella bacteria; distribution to resident fixtures uses anti-scald mixing valves to prevent burns.

Question 12: What is the significance of 'at-will employment' in most US assisted living facilities?

Employees can only be dismissed with a formal hearing
Either the employer or employee can end the employment relationship at any time, for any lawful reason (Correct answer)
Only unionized employees have at-will status
Employees are entitled to 30 days' notice before termination

Correct answer: Either the employer or employee can end the employment relationship at any time, for any lawful reason

In at-will employment states, either the employer or employee may end the employment relationship at any time for any reason that is not illegal (such as discrimination or retaliation).

Question 13: What is a key trait of effective leadership in assisted living administration?

Avoiding resident interactions
Being unavailable for feedback
Strong communication skills (Correct answer)
Strictly delegating tasks

Correct answer: Strong communication skills

Strong communication skills enable leaders to clearly convey expectations, resolve conflicts, and foster teamwork.

Question 14: Which ratio is used to assess an assisted living facility's ability to meet short-term financial obligations?

Return on investment
Occupancy rate
Current ratio (Correct answer)
Debt-to-equity ratio

Correct answer: Current ratio

The current ratio (current assets divided by current liabilities) measures a facility's ability to pay its short-term obligations with its short-term assets.

Question 15: When disposing of unused or expired non-controlled medications in an assisted living facility, which method is most consistent with EPA and DEA guidelines?

Giving unused medications to other residents with similar diagnoses
Returning medications to a DEA-authorized take-back location or using an FDA-approved disposal method per facility policy (Correct answer)
Throwing all medications directly into the regular trash without any preparation
Flushing all medications down the toilet

Correct answer: Returning medications to a DEA-authorized take-back location or using an FDA-approved disposal method per facility policy

DEA and EPA guidelines recommend authorized take-back programs or approved disposal methods (such as mixing with coffee grounds in sealed bags) to prevent environmental contamination and diversion.

Question 16: A resident's physician calls to authorize a new medication verbally. What must assisted living staff do according to standard medication management protocols?

Have a family member sign consent before documenting
Refuse to administer until a written order is received in advance
Administer the medication immediately without any documentation
Document the verbal order and obtain a written or electronic order within the timeframe specified by state regulations (Correct answer)

Correct answer: Document the verbal order and obtain a written or electronic order within the timeframe specified by state regulations

Verbal orders must be documented immediately, signed by the receiving staff member, and followed up with a written or electronic order within the state-required timeframe.

Question 17: Which committee or team is typically responsible for overseeing the QAPI program in an assisted living facility?

A multidisciplinary quality improvement committee that includes leadership, clinical staff, and other stakeholders (Correct answer)
The marketing department
The maintenance team
The payroll department

Correct answer: A multidisciplinary quality improvement committee that includes leadership, clinical staff, and other stakeholders

A multidisciplinary quality committee—including administrators, clinical leaders, frontline staff, and ideally resident or family representation—provides oversight of the QAPI program.

Question 18: Which financial statement shows an assisted living facility's assets, liabilities, and equity at a specific point in time?

Cash flow statement
Balance sheet (Correct answer)
Income statement
Accounts payable report

Correct answer: Balance sheet

The balance sheet provides a snapshot of a facility's financial position, listing assets, liabilities, and owners' equity at a specific date.

Question 19: What is the primary source of revenue for most US assisted living facilities?

Long-term care insurance
Medicare reimbursements
Medicaid waiver payments
Private pay resident fees (Correct answer)

Correct answer: Private pay resident fees

Private pay resident fees are the primary revenue source for most assisted living facilities, as Medicare generally does not cover assisted living costs.

Question 20: What are the four core elements of a CMS-compliant emergency preparedness plan for an assisted living facility?

Incident command, medical records, vendor contracts, press releases
Risk assessment, communication plan, policies/procedures, training/testing (Correct answer)
Evacuation routes, food storage, staffing roster, insurance coverage
Fire drills, lockdown protocols, weather alerts, utility backup

Correct answer: Risk assessment, communication plan, policies/procedures, training/testing

CMS requires emergency preparedness plans to include a risk assessment, communication plan, policies and procedures, and a training and testing program.

Question 21: Which practice best ensures assisted living staff can effectively execute emergency procedures during an actual crisis?

Distributing emergency manuals at annual meetings
Hiring a safety consultant annually
Posting written procedures in break rooms
Conducting regular drills and tabletop exercises with after-action debriefs (Correct answer)

Correct answer: Conducting regular drills and tabletop exercises with after-action debriefs

Regular drills and tabletop exercises, followed by after-action reviews, build staff competency and identify gaps in emergency plans before a real event occurs.

Question 22: What is the purpose of an 'incident report' in assisted living quality assurance?

To report to families as a billing supplement
To record details of adverse events or near-misses for analysis, tracking, and quality improvement purposes (Correct answer)
To document events for potential legal action only
To satisfy marketing disclosure requirements

Correct answer: To record details of adverse events or near-misses for analysis, tracking, and quality improvement purposes

Incident reports document the details of adverse events and near-misses, providing data essential for trend analysis, root cause investigation, regulatory compliance, and quality improvement planning.

Question 23: Under OSHA, what is an assisted living administrator's obligation regarding workplace injury recordkeeping?

Only document incidents involving residents
Maintain OSHA 300 logs documenting all work-related injuries and illnesses that meet recording criteria (Correct answer)
Record only injuries requiring hospitalization
Report all minor incidents to the federal government immediately

Correct answer: Maintain OSHA 300 logs documenting all work-related injuries and illnesses that meet recording criteria

Covered employers must maintain OSHA 300 logs recording work-related injuries and illnesses that meet specific recording criteria, and post the OSHA 300A summary annually.

Question 24: Under person-centered care principles, who should be the primary decision-maker regarding a competent resident's daily routine?

The resident's physician
The resident's family
The resident themselves (Correct answer)
The facility administrator

Correct answer: The resident themselves

A competent resident retains the right to make decisions about their own daily life, including schedule, activities, and personal choices.

Question 25: Which cost is considered a fixed expense in an assisted living facility budget?

Dietary supplies based on census
Overtime labor during high census
Monthly building lease payment (Correct answer)
PRN medication costs

Correct answer: Monthly building lease payment

A monthly building lease payment remains constant regardless of census or service volume, making it a fixed expense.

Question 26: In assisted living billing, what is a 'level of care' fee structure?

A government-mandated pricing cap
A one-time admission fee
A flat monthly rate for all residents
A tiered pricing model where fees increase based on the amount of assistance a resident requires (Correct answer)

Correct answer: A tiered pricing model where fees increase based on the amount of assistance a resident requires

A level of care fee structure charges residents different rates depending on their assessed needs, with higher care needs resulting in higher fees.

Question 27: In an assisted living facility, who is ultimately responsible for ensuring that medication administration policies comply with state regulations?

The Licensed Administrator (Correct answer)
The Consulting Pharmacist
The Medical Director
The Director of Nursing

Correct answer: The Licensed Administrator

The Licensed Administrator bears ultimate accountability for all facility operations, including ensuring medication policies meet state regulatory requirements.

Question 28: Under the Americans with Disabilities Act (ADA), what is an employer required to provide to a qualified employee with a disability?

Promotion priority over non-disabled employees
Reasonable accommodation unless it causes undue hardship (Correct answer)
A separate workspace
Full medical leave without limit

Correct answer: Reasonable accommodation unless it causes undue hardship

The ADA requires employers to provide reasonable accommodations to qualified employees with disabilities, unless doing so would cause undue hardship to the organization.

Question 29: How does resident and family satisfaction data support quality improvement in an assisted living facility?

It provides direct feedback identifying care and service areas needing improvement and highlights what the facility does well (Correct answer)
It is used solely to determine staff bonuses
It replaces clinical quality indicators
It is only used for marketing brochures

Correct answer: It provides direct feedback identifying care and service areas needing improvement and highlights what the facility does well

Satisfaction surveys and feedback reveal residents' and families' perceptions of care quality, identifying specific service gaps and strengths that clinical metrics alone may not capture.

Question 30: Which financial control practice best reduces the risk of billing errors and fraud in an assisted living facility?

Having one employee manage all billing and collections
Implementing segregation of duties in financial processes (Correct answer)
Outsourcing all financial functions
Accepting only cash payments

Correct answer: Implementing segregation of duties in financial processes

Segregation of duties divides financial responsibilities among multiple staff members, reducing the risk of errors, fraud, and misappropriation of funds.

Question 31: An assisted living facility has a high rate of unplanned hospitalizations. What is the best first step in a quality improvement response?

Immediately change all care protocols facility-wide
Collect and analyze data to identify the most common diagnoses and circumstances leading to hospitalizations (Correct answer)
Blame the nursing staff for inadequate care
Add more marketing to offset census loss from hospitalizations

Correct answer: Collect and analyze data to identify the most common diagnoses and circumstances leading to hospitalizations

The first step is to collect and analyze data on hospitalization causes, timing, and circumstances to identify patterns that can be addressed with targeted interventions.

Question 32: Which of the following is an example of a conflict of interest an administrator must disclose?

Awarding a supply contract to a company in which the administrator holds a financial stake (Correct answer)
Hiring a qualified applicant who was previously unknown to the administrator
Promoting a staff member based solely on performance metrics
Selecting a vendor after a competitive bid process

Correct answer: Awarding a supply contract to a company in which the administrator holds a financial stake

A financial interest in a vendor creates a conflict of interest that must be disclosed and typically requires recusal from the decision.

Question 33: Which practice violates ethical standards in assisted living marketing?

Offering referral fees to hospital discharge planners for directing patients to the facility (Correct answer)
Advertising rates and available amenities
Publishing honest testimonials from satisfied residents with their consent
Providing facility tours to prospective residents and families

Correct answer: Offering referral fees to hospital discharge planners for directing patients to the facility

Paying referral fees or kickbacks to healthcare professionals for directing patients to a facility violates anti-kickback laws and professional ethics standards.

Question 34: Why is transparency important in leadership?

To reduce communication
To build trust and accountability (Correct answer)
To maintain secrecy
To avoid difficult conversations

Correct answer: To build trust and accountability

Transparency builds trust, ensures accountability, and fosters an open environment where staff feel informed and valued.

Question 35: Under HIPAA, which staff members in an assisted living facility are permitted to access a resident's protected health information (PHI)?

Only the resident's primary care nurse
Any licensed employee on duty
All staff listed in the resident's record
Staff with a legitimate treatment, payment, or operations need (Correct answer)

Correct answer: Staff with a legitimate treatment, payment, or operations need

HIPAA's minimum necessary standard limits PHI access to workforce members who need it for treatment, payment, or healthcare operations.

Question 36: How often must assisted living facilities typically conduct full emergency evacuation drills?

Annually, at minimum, with frequency varying by state regulations (Correct answer)
Monthly
Only when a new administrator is hired
Once every 3 years

Correct answer: Annually, at minimum, with frequency varying by state regulations

Most states require assisted living facilities to conduct emergency drills at least annually, though many states require quarterly drills, especially for fire emergencies.

Question 37: A resident refuses to take a prescribed medication. What is the legally and ethically correct first action for facility staff to take?

Obtain a court order to administer the medication
Contact the resident's family to persuade the resident
Crush the medication and mix it in food without the resident's knowledge
Document the refusal and notify the prescribing physician (Correct answer)

Correct answer: Document the refusal and notify the prescribing physician

Respecting resident autonomy requires documenting the refusal and notifying the physician so the care plan can be updated; covert administration is illegal and unethical.

Question 38: An assisted living employee reports that a supervisor is creating a hostile work environment based on their religion. Who should handle the initial investigation?

The resident care team
The HR department or a designated neutral investigator (Correct answer)
The state licensing board
The accused supervisor

Correct answer: The HR department or a designated neutral investigator

HR or a designated neutral party should investigate workplace harassment complaints to ensure objectivity and legal compliance.

Question 39: Under most state regulations, which record must be retained for the longest period after a resident's discharge or death?

Menu and dietary logs
Fire drill documentation
Resident medical and care records (Correct answer)
Employee training records

Correct answer: Resident medical and care records

Resident medical and care records typically have the longest mandated retention period, often 5–7 years or longer after discharge or death, depending on state law.

Question 40: What is the purpose of a medication administration record (MAR) in an assisted living facility?

To serve as the billing document for pharmacy services
To summarize quarterly pharmacist review findings
To provide a legal, chronological documentation of each medication given, refused, or held for each resident (Correct answer)
To track pharmacy inventory and reorder points

Correct answer: To provide a legal, chronological documentation of each medication given, refused, or held for each resident

The MAR is a legal document providing a complete, time-stamped record of medication administration, refusals, and holds, ensuring accountability and continuity of care.

Question 41: Which staffing metric measures the cost of losing and replacing one employee in an assisted living facility?

Turnover rate
Cost per hire / turnover cost (Correct answer)
Overtime percentage
Staff-to-resident ratio

Correct answer: Cost per hire / turnover cost

Turnover cost (or cost per hire) measures all expenses associated with losing and replacing an employee, including recruitment, training, and productivity loss.

Question 42: Which budget type projects revenues and expenses for a specific future period in an assisted living facility?

Operating budget (Correct answer)
Capital budget
Cash flow budget
Zero-based budget

Correct answer: Operating budget

An operating budget projects day-to-day revenues and expenses for a defined period, typically one fiscal year.

Question 43: What term describes the process of comparing a resident's medication orders against all medications the resident is actually receiving to identify discrepancies?

Medication pass audit
Drug utilization review
Medication reconciliation (Correct answer)
Formulary review

Correct answer: Medication reconciliation

Medication reconciliation is the formal process of comparing medication orders against what a resident is receiving to catch omissions, duplications, or dosing errors.

Question 44: What does 'person-centered care' mean in the context of assisted living quality improvement?

Care tailored to the individual resident's preferences, values, goals, and needs, with the resident as an active partner in decisions (Correct answer)
Care organized around staff convenience and facility efficiency
Care that prioritizes administrative efficiency over resident choice
Care standardized identically for all residents regardless of preference

Correct answer: Care tailored to the individual resident's preferences, values, goals, and needs, with the resident as an active partner in decisions

Person-centered care places the individual resident's preferences, values, and goals at the center of all care decisions, treating residents as active partners rather than passive recipients of care.

Question 45: Which federal law requires facilities to share emergency plans and coordinate with state and local emergency management agencies?

Occupational Safety and Health Act
Americans with Disabilities Act
CMS Emergency Preparedness Rule (Correct answer)
HIPAA

Correct answer: CMS Emergency Preparedness Rule

The CMS Emergency Preparedness Rule requires facilities to develop emergency plans in coordination with state and local emergency management systems and to share plans upon request.

Question 46: An assisted living facility is developing a digital marketing strategy. Which online platform is typically most effective for reaching adult children researching care options for aging parents?

TikTok
Gaming platforms
Facebook and Google search advertising (Correct answer)
Snapchat

Correct answer: Facebook and Google search advertising

Facebook reaches the adult children (typically ages 45–65) who make care decisions for aging parents, while Google search advertising captures high-intent searchers actively researching assisted living options.

Question 47: What information is a CALA administrator legally prohibited from requesting on an employment application under most US state laws?

Applicant's availability to work
Applicant's professional references
Applicant's work history
Applicant's date of birth or age (Correct answer)

Correct answer: Applicant's date of birth or age

Requesting an applicant's date of birth or age on applications can expose employers to age discrimination claims under the ADEA and many state laws.

Question 48: How should administrators handle facility inspections?

Delay inspections indefinitely
Ignore inspector requests
Prepare documentation and ensure readiness (Correct answer)
Hide operational issues

Correct answer: Prepare documentation and ensure readiness

Administrators should prepare documentation, ensure cleanliness and compliance, and respond promptly to corrective actions.

Question 49: An assisted living facility charges a community fee upon admission. How is this fee typically classified?

One-time non-refundable or partially refundable admission revenue (Correct answer)
A deposit held in a trust account
Recurring monthly revenue
A government-regulated fee

Correct answer: One-time non-refundable or partially refundable admission revenue

Community fees are typically one-time charges collected at admission, which may be fully or partially non-refundable depending on the facility's policy and state regulations.

Question 50: Which of the following contributes to resident quality of life in assisted living?

Restricting daily schedules
Focusing only on physical health
Providing engaging social and recreational activities (Correct answer)
Isolating residents in their rooms

Correct answer: Providing engaging social and recreational activities

Activities and social engagement promote mental and emotional well-being, enhancing residents’ overall quality of life.

Question 51: During the admissions process, when must an assisted living facility provide a prospective resident with a written statement of their rights?

During the first care plan meeting after move-in
Only if the resident requests it
At the annual renewal of the admission agreement
Before or at the time of admission, prior to signing the admission agreement (Correct answer)

Correct answer: Before or at the time of admission, prior to signing the admission agreement

Residents must receive a written statement of their rights before or at the time of admission, prior to signing any admission agreement, so they can make an informed decision.

Question 52: What is the primary goal of a Quality Assurance and Performance Improvement (QAPI) program in an assisted living facility?

To reduce facility marketing costs
To satisfy state licensing requirements only
To generate data for financial audits
To systematically identify, measure, and improve the quality and safety of resident care and services (Correct answer)

Correct answer: To systematically identify, measure, and improve the quality and safety of resident care and services

QAPI programs systematically identify problems, measure performance, implement improvements, and monitor outcomes to continuously enhance the quality and safety of resident care.

Question 53: A resident newly admitted from a hospital has a wound VAC (negative pressure wound therapy) in place. What must the administrator verify first?

That the facility is licensed and staffed to provide this level of wound care (Correct answer)
That the wound has healed before accepting the resident
That Medicare will reimburse for the service
That the resident's family can manage the device

Correct answer: That the facility is licensed and staffed to provide this level of wound care

The facility must confirm it is licensed, trained, and equipped to meet the resident's wound care needs before admission.

Question 54: Which federal law prohibits employment discrimination based on race, color, religion, sex, or national origin for employers with 15 or more employees?

Family and Medical Leave Act (FMLA)
Americans with Disabilities Act (ADA)
Title VII of the Civil Rights Act of 1964 (Correct answer)
Age Discrimination in Employment Act (ADEA)

Correct answer: Title VII of the Civil Rights Act of 1964

Title VII of the Civil Rights Act of 1964 prohibits employment discrimination based on race, color, religion, sex, or national origin for covered employers.

Question 55: What document outlines the rights of residents in assisted living?

Insurance brochure
Facility maintenance log
Employee handbook
Resident rights policy (Correct answer)

Correct answer: Resident rights policy

The resident rights policy ensures dignity, privacy, and autonomy and is required by most state regulations.

Question 56: What is the standard minimum frequency for a pharmacist to conduct drug regimen reviews for residents in a licensed assisted living facility under most state regulations?

Weekly
Daily
Quarterly (Correct answer)
Monthly

Correct answer: Quarterly

Most state regulations require a consulting pharmacist to review each resident's drug regimen at least quarterly to detect problems and make recommendations.

Question 57: Which federal law entitles eligible employees to take up to 12 weeks of unpaid, job-protected leave per year for qualifying family or medical reasons?

COBRA
ADA
FLSA
FMLA (Correct answer)

Correct answer: FMLA

The Family and Medical Leave Act (FMLA) provides up to 12 weeks of unpaid, job-protected leave per year for eligible employees at covered employers.

Question 58: An administrator discovers that a department head has been falsifying care documentation to meet compliance metrics. The ethical obligation is to:

Report the falsification internally and to the appropriate regulatory body (Correct answer)
Transfer the department head to a different role
Ignore it if resident outcomes appear unaffected
Coach the department head privately and allow self-correction

Correct answer: Report the falsification internally and to the appropriate regulatory body

Falsifying care records is a serious ethical and legal violation requiring mandatory reporting regardless of apparent outcomes.

Question 59: What is an 'alternate care site' agreement in assisted living emergency preparedness?

An insurance policy for property damage
A mutual aid agreement for shared equipment
A pre-arranged agreement with another facility to receive and care for evacuated residents when needed (Correct answer)
A contract with a staffing agency

Correct answer: A pre-arranged agreement with another facility to receive and care for evacuated residents when needed

An alternate care site agreement pre-establishes a relationship with another facility to accept residents if the primary facility must be evacuated and cannot immediately return to operation.

Question 60: An administrator learns that a competing facility has reported them for a licensing violation. The most appropriate first action is to:

Notify your state association
Hire legal counsel immediately
Review internal records and policies related to the alleged violation (Correct answer)
Contact the competing facility directly

Correct answer: Review internal records and policies related to the alleged violation

Before responding to any complaint, an administrator should conduct an internal review to understand the facility's actual practices and documentation.

Question 61: An administrator who consistently models ethical behavior, admits mistakes openly, and treats all staff equitably is demonstrating:

Risk-averse management
Ethical role modeling and integrity (Correct answer)
Passive leadership
Paternalistic leadership

Correct answer: Ethical role modeling and integrity

Consistent ethical role modeling by the administrator sets the moral tone and standards for the entire organization.

Question 62: Which document legally authorizes a specific person to make financial decisions on behalf of a resident who lacks capacity?

POLST form
Representative payee authorization
Durable power of attorney (financial) (Correct answer)
Living will

Correct answer: Durable power of attorney (financial)

A durable power of attorney for finances grants legal authority to a designated agent to manage a person's financial affairs.

Question 63: A participative leadership approach is MOST appropriate when:

A fire emergency requires immediate evacuation
A regulatory inspection is underway and compliance is critical
Experienced staff are being asked to help redesign a care protocol (Correct answer)
A new untrained employee needs step-by-step guidance

Correct answer: Experienced staff are being asked to help redesign a care protocol

Participative leadership leverages staff expertise and increases buy-in, making it ideal for protocol development with experienced teams.

Question 64: Which of the following BEST demonstrates ethical marketing for an assisted living facility?

Using testimonials from paid actors without disclosure
Advertising amenities that are planned but not yet available
Accurately representing services, costs, and quality outcomes to prospective residents and families (Correct answer)
Highlighting competitor weaknesses without factual basis

Correct answer: Accurately representing services, costs, and quality outcomes to prospective residents and families

Ethical marketing requires truthful, accurate representation of what the facility actually provides to support informed decision-making.

Question 65: Which type of emergency plan specifically addresses what a facility will do if it must move residents to another location?

Incident command plan
Business continuity plan
Shelter-in-place plan
Relocation/evacuation plan (Correct answer)

Correct answer: Relocation/evacuation plan

A relocation or evacuation plan details the process for safely moving residents to pre-identified alternate care sites when the facility must be vacated.

Question 66: What does ethical leadership in healthcare emphasize?

Demonstrating fairness and integrity (Correct answer)
Avoiding responsibility
Limiting staff input
Focusing only on profits

Correct answer: Demonstrating fairness and integrity

Ethical leadership promotes integrity, fairness, and respect in decision-making and staff-resident relationships.

Question 67: What should an assisted living facility's communication plan include during a pandemic or infectious disease outbreak?

Only internal staff memos
A list of media contacts for press releases
Protocols for communicating with residents, families, staff, regulators, and the public about the outbreak and protective measures (Correct answer)
Social media marketing strategy only

Correct answer: Protocols for communicating with residents, families, staff, regulators, and the public about the outbreak and protective measures

A pandemic communication plan must address timely, accurate communication with residents, families, staff, regulatory agencies, and the public about the situation and protective measures in place.

Question 68: Which marketing tool allows prospective residents and families to virtually experience a facility's amenities before visiting in person?

Print newspaper advertisements
Radio advertisements
Direct mail postcards
Virtual tours embedded on the facility website (Correct answer)

Correct answer: Virtual tours embedded on the facility website

Virtual tours allow prospective residents and families to explore the facility's rooms, common areas, and amenities online, increasing inquiry rates and attracting out-of-town decision-makers.

Question 69: A resident with Parkinson's disease has an increased fall risk. Which environmental modification is most appropriate?

Install non-slip flooring and ensure adequate lighting (Correct answer)
Restrict the resident to their room
Place the resident in a wheelchair at all times
Remove grab bars to reduce trip hazards

Correct answer: Install non-slip flooring and ensure adequate lighting

Environmental modifications like non-slip surfaces and proper lighting reduce fall risk while preserving mobility.

Question 70: A direct care worker is found to have abused a resident. What is the administrator's immediate legal obligation in most US states?

Terminate the employee and report to the state registry and appropriate authorities (Correct answer)
Transfer the employee to a non-resident-facing role
Counsel the employee privately before taking any action
Wait for a formal investigation before acting

Correct answer: Terminate the employee and report to the state registry and appropriate authorities

Most states require administrators to immediately report substantiated abuse to the state adult protective services, licensing agency, and add the perpetrator to the abuse registry, while also terminating employment.

Question 71: What is the purpose of a resident trust fund in an assisted living facility?

To hold and manage personal funds on behalf of residents who request this service (Correct answer)
To pay staff bonuses
To fund facility capital improvements
To collect security deposits from all residents

Correct answer: To hold and manage personal funds on behalf of residents who request this service

Resident trust funds are accounts managed by the facility that hold personal funds belonging to residents who choose to have the facility manage their money.

Question 72: What is the purpose of a 'waitlist' in assisted living facility management?

A list of staff awaiting performance reviews
A registry of residents who have requested additional services
A list of residents awaiting discharge
A roster of prospective residents interested in admission when a unit becomes available (Correct answer)

Correct answer: A roster of prospective residents interested in admission when a unit becomes available

A waitlist maintains contact with prospective residents interested in the facility so the admissions team can quickly fill vacancies when units become available.

Question 73: A resident's physician orders physical therapy. Who is responsible for coordinating the referral in an assisted living facility?

The administrator or designated care coordinator (Correct answer)
The direct care aide
The physical therapist independently
The resident's family

Correct answer: The administrator or designated care coordinator

The administrator or care coordinator is responsible for facilitating and coordinating ancillary service referrals.

Question 74: Which quality indicator is most directly associated with resident safety in an assisted living facility?

Staff overtime hours
Fall rate and fall-with-injury rate (Correct answer)
Occupancy percentage
Marketing inquiry volume

Correct answer: Fall rate and fall-with-injury rate

Fall rate and fall-with-injury rate are critical safety quality indicators because falls are among the most common and serious adverse events for assisted living residents.

Question 75: Which federal agency requires assisted living facilities that participate in Medicare and Medicaid to have an emergency preparedness plan?

FEMA
CDC
CMS (Centers for Medicare & Medicaid Services) (Correct answer)
OSHA

Correct answer: CMS (Centers for Medicare & Medicaid Services)

CMS requires facilities participating in Medicare and Medicaid to develop and maintain comprehensive emergency preparedness plans meeting federal requirements.

Certified Assisted Living Administrator (CALA)

The CALA exam assesses competency of residential care and assisted living administrators across five domains: resident care management, organizational management, human resources, financial management, and environmental management. It is administered through the National Association of Long-Term Care Administrator Boards (NAB) as the RC/AL line-of-service exam.

Questions

90 min

Time Limit

75%

To Pass

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Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds