Certified Assisted Living Administrator (CALA) — Questions and Answers

Question 1: In a quality meeting, an administrator presents data showing the fall rate increased after a staffing change. What should the quality team do next?

Analyze possible causal relationships between the staffing change and falls, then test a targeted intervention (Correct answer)
Immediately return to the previous staffing model without analysis
Blame individual staff members for the increase
Ignore the data if the increase is less than 10%

Correct answer: Analyze possible causal relationships between the staffing change and falls, then test a targeted intervention

The team should analyze the potential relationship between the staffing change and the fall rate increase, then design and test a targeted intervention to address the identified root cause.

Question 2: Which of the following best describes the purpose of a Resident Bill of Rights in an assisted living facility?

To document discharge criteria
To establish financial billing expectations
To outline the facility's liability limitations
To define residents' legal and civil protections while in care (Correct answer)

Correct answer: To define residents' legal and civil protections while in care

The Resident Bill of Rights enumerates the legal protections, dignity standards, and civil rights guaranteed to individuals receiving care.

Question 3: What is the purpose of a resident trust fund in an assisted living facility?

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

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 4: Which quality improvement concept focuses on reducing unnecessary variation in care processes to improve consistency and outcomes?

Standardization of care processes and protocols (Correct answer)
Individualized care planning for each resident
Decentralized decision-making
Staff self-scheduling

Correct answer: Standardization of care processes and protocols

Standardizing care processes reduces unnecessary variation, ensuring that evidence-based practices are consistently applied across all staff and shifts, which improves resident outcomes.

Question 5: What is the purpose of a 'go-bag' or emergency kit maintained for each resident in an assisted living facility?

To hold essential documents, medications, and supplies needed if the resident must evacuate quickly (Correct answer)
To store personal valuables in the facility safe
To organize laundry for facility transport
To carry daily activity supplies

Correct answer: To hold essential documents, medications, and supplies needed if the resident must evacuate quickly

A go-bag contains essential items a resident would need during rapid evacuation, including medications, medical records summaries, identification, and comfort items.

Question 6: Which staffing approach uses a pool of trained facility staff who can work in different departments or positions as needed?

Float pool (Correct answer)
Agency staffing
PRN staffing
Contract staffing

Correct answer: Float pool

A float pool consists of trained facility employees who are cross-trained to work in multiple areas or departments based on daily census and staffing needs.

Question 7: What role does staff education play in an assisted living quality improvement program?

It is an ongoing mechanism for translating quality improvement findings into improved practice across all staff (Correct answer)
It is primarily used for regulatory compliance training only
It replaces the need for performance monitoring
It is only required for new employees during orientation

Correct answer: It is an ongoing mechanism for translating quality improvement findings into improved practice across all staff

Ongoing staff education translates quality improvement insights—such as new evidence-based practices or lessons learned from adverse events—into consistent daily practice across all staff and shifts.

Question 8: Which financial statement shows an assisted living facility's assets, liabilities, and equity at a specific point in time?

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

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 9: When a controlled substance is wasted or a partial dose is administered, best practice in assisted living requires:

The administrator to be notified before disposal
A single nurse to document the waste in the medication administration record
The unused portion to be returned to the pharmacy immediately
Two authorized staff members to witness and co-sign the waste documentation (Correct answer)

Correct answer: Two authorized staff members to witness and co-sign the waste documentation

Two-person witness and co-signature for controlled substance waste is the industry standard to prevent diversion and ensure accurate accountability records.

Question 10: Which federal act prohibits discrimination in federally assisted housing programs and directly affects many assisted living facilities?

Fair Housing Act (Correct answer)
Americans with Disabilities Act
Rehabilitation Act of 1973
Civil Rights Act of 1964

Correct answer: Fair Housing Act

The Fair Housing Act prohibits housing discrimination based on race, color, national origin, religion, sex, familial status, and disability.

Question 11: An assisted living administrator wants to improve the facility's online reputation. What is the most effective ethical strategy?

Disputing all negative reviews regardless of validity
Paying for positive reviews on Google and Yelp
Hiring a company to post fake positive reviews
Encouraging satisfied residents and families to voluntarily share their experiences in online reviews (Correct answer)

Correct answer: Encouraging satisfied residents and families to voluntarily share their experiences in online reviews

The most effective and ethical approach is to encourage genuinely satisfied residents and families to voluntarily share their honest experiences through online review platforms.

Question 12: During an emergency evacuation, what is the assisted living administrator's top priority?

Notifying the media
Protecting financial records
Ensuring the safety and accounting of all residents and staff (Correct answer)
Securing facility equipment

Correct answer: Ensuring the safety and accounting of all residents and staff

The safety and accurate accounting of all residents and staff is always the top priority during any emergency evacuation.

Question 13: Which federal law requires facilities to share emergency plans and coordinate with state and local emergency management agencies?

Americans with Disabilities Act
Occupational Safety and Health 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 14: What is the purpose of regular health assessments for residents?

To satisfy paperwork requirements
To determine eligibility for insurance
To monitor and adjust care as needed (Correct answer)
To reduce staffing needs

Correct answer: To monitor and adjust care as needed

Health assessments help track changes in residents’ conditions and guide necessary updates to their care plans.

Question 15: A CALA administrator notices accounts receivable aging past 90 days. What is the most appropriate first action?

Contact the responsible party to arrange payment or a payment plan (Correct answer)
Reduce resident services
Write off the debt immediately
Discharge the resident

Correct answer: Contact the responsible party to arrange payment or a payment plan

The administrator should first contact the responsible party to discuss outstanding balances and arrange payment or a structured payment plan.

Question 16: Under fair housing laws, an assisted living facility may NOT refuse admission based on which of the following?

A diagnosis that exceeds the facility's licensed care level
A condition the facility cannot safely manage
Race, color, national origin, religion, sex, familial status, or disability (Correct answer)
Inability to pay the required fees

Correct answer: Race, color, national origin, religion, sex, familial status, or disability

The Fair Housing Act prohibits discrimination in housing based on race, color, national origin, religion, sex, familial status, or disability.

Question 17: What is the primary purpose of maintaining a facility's asset inventory for equipment and furnishings?

To support budgeting, maintenance scheduling, insurance claims, and replacement planning (Correct answer)
To impress state surveyors during inspections
To track items that residents have borrowed from the facility
To comply with IRS requirements for non-profit facilities only

Correct answer: To support budgeting, maintenance scheduling, insurance claims, and replacement planning

An asset inventory supports multiple operational needs including budget forecasting, preventive maintenance scheduling, insurance documentation, and capital replacement planning.

Question 18: Under the Americans with Disabilities Act (ADA), what is an employer required to provide to a qualified employee with a disability?

A separate workspace
Promotion priority over non-disabled employees
Reasonable accommodation unless it causes undue hardship (Correct answer)
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 19: Which federal agency regulates the registration of assisted living facilities that store and dispense controlled substances?

Food and Drug Administration (FDA)
Drug Enforcement Administration (DEA) (Correct answer)
State Board of Pharmacy
Centers for Medicare & Medicaid Services (CMS)

Correct answer: Drug Enforcement Administration (DEA)

The DEA enforces the Controlled Substances Act and requires facilities that handle controlled substances to register and comply with federal regulations.

Question 20: What information is a CALA administrator legally prohibited from requesting on an employment application under most US state laws?

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

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 21: Under US law, what is the administrator's responsibility when a resident's personal funds held by the facility are used incorrectly?

Transfer the responsibility to the resident's family
Report to the marketing department
Acknowledge that it is solely an accounting error
Report to the appropriate state agency and ensure funds are restored (Correct answer)

Correct answer: Report to the appropriate state agency and ensure funds are restored

Misuse of resident personal funds is a serious violation; the administrator must report the incident to the appropriate state regulatory agency and ensure the funds are promptly restored to the resident.

Question 22: What is one way to resolve conflicts effectively in a facility setting?

Blame the staff
Ignore the issue
Involve unrelated departments
Listen actively and seek resolution (Correct answer)

Correct answer: Listen actively and seek resolution

Listening actively and working toward collaborative solutions helps maintain team morale and resident satisfaction.

Question 23: What is the primary source of revenue for most US assisted living facilities?

Medicaid waiver payments
Long-term care insurance
Medicare reimbursements
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 24: Which federal law prohibits employment discrimination based on race, color, religion, sex, or national origin for employers with 15 or more employees?

Americans with Disabilities Act (ADA)
Family and Medical Leave Act (FMLA)
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 25: Which staffing metric measures the cost of losing and replacing one employee in an assisted living facility?

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

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 26: What does 'business continuity planning' address in the context of an assisted living emergency preparedness program?

How the facility will maintain essential operations and services during and after a disaster (Correct answer)
Marketing and census growth strategies
Annual financial audits
Daily staffing schedules

Correct answer: How the facility will maintain essential operations and services during and after a disaster

Business continuity planning ensures the facility can maintain critical resident care services, staffing, supply chains, and communications during and after a disruptive event.

Question 27: A facility's state license is set to expire. The administrator submits the renewal application late. What is the MOST LIKELY regulatory consequence?

The state must grant an extension if services continue
The facility may continue operating without penalty
The facility receives an automatic 30-day extension
The facility risks operating without a valid license and may face fines (Correct answer)

Correct answer: The facility risks operating without a valid license and may face fines

Operating with an expired license exposes a facility to civil penalties, citations, and possible closure depending on state law.

Question 28: In assisted living financial management, what does 'census' refer to?

Staff headcount
Monthly expense total
Number of occupied resident beds (Correct answer)
Government inspection count

Correct answer: Number of occupied resident beds

Census refers to the number of occupied resident beds or units at a given time, directly impacting revenue calculations.

Question 29: If a resident with dementia is found to be a potential danger to themselves and others, the administrator must balance safety with which key regulatory principle?

Resident autonomy and least restrictive environment (Correct answer)
Cost containment
Physician orders
Staff safety protocols

Correct answer: Resident autonomy and least restrictive environment

Regulations require facilities to use the least restrictive approach possible, balancing safety with respect for resident autonomy.

Question 30: What is required during a regulatory inspection?

Access to care plans, records, and operations (Correct answer)
Only financial statements
Archived marketing materials
Copies of employee tax records

Correct answer: Access to care plans, records, and operations

Inspectors require access to records, interviews with staff and residents, and observation of daily operations.

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

35 min

Time Limit

75%

To Pass

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