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New Hampshire Nursing Home Administrator — Requirements & Free Practice

US-NH · License preparation

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Nursing Home Administrator License

License to practice nursing home administration in New Hampshire.

Licensing authority: New Hampshire Board of Examiners of Nursing Home Administrators · Application information

Initial licensure by examination
Age
At least 21 years old.
Background
Criminal history record release and fingerprints.
Character
Good moral character and suitability, references and application documents.
Education
Accredited bachelor of science or arts degree and prescribed core coursework.
Training
One year of administrator-in-training experience or Board-approved equivalent or waiver.
Licensure by reciprocity
Background
Submit criminal history record release and fingerprints.
Character
Submit references and required application documents.
Equivalence
Original state standards were equivalent and the state recognizes New Hampshire licenses.
Experience
Document one year of related administrator work experience.
National score
Submit documentation of NAB nursing home administrator examination scores.
Other license
Hold a valid nursing home administrator license from another state.
Reactivation after registration expiry
No examination is required for this applicant pathway.
Application
Comply with registration requirements and file an affidavit of the facts explaining the expired registration.
Eligibility
Prior license must not have been revoked or suspended.

Official no-examination sources

Effective from 2026-09-22.

Biennial registration renewal
No examination is required for this applicant pathway.
Application
Submit renewal form and renewal fee before registration ends.
Continuing education
Document required continuing education for the preceding two years.

Official no-examination sources

Effective from 2026-09-22.

Restoration after revocation
No examination is required for this applicant pathway.
Background
Reinstatement applicants submit a criminal history record release and fingerprints.
Discretion
Board may reissue revoked license or registration in its discretion.
Pardon
If applicable, submit evidence of pardon or certificate of good conduct.

Official no-examination sources

Effective from 2026-09-22.

Temporary Permit to Work as an Administrator

Six-month temporary permit for an otherwise qualified reciprocity candidate awaiting the state examination.

Licensing authority: New Hampshire Board of Examiners of Nursing Home Administrators · Application information

Temporary permit for qualified reciprocity applicant
Examination on New Hampshire Law
Duration
Permit lasts at most six months and cannot be renewed or reissued to the same candidate.
Reciprocity
Meet all reciprocity requirements except sitting for the state examination.
Urgent need
Demonstrate an urgent need for a licensed administrator.

NAB National Nursing Home Administrators Line of Service Exam (NHA)

Provider
Pearson VUE
Format
Objective multiple-choice items with four response options, one correct; delivered by Pearson VUE
Exam questions
75 (60 scored, 15 non-scored pretest)
Time limit
90 minutes seat time; 1 hour and 10 minutes to answer questions
Passing score
Scaled score of 113 on a 50-150 scale
Exam fee
NHA only $190; CORE and NHA combo $480 (effective 2/1/2026)
Examination outline
  • Care, Services, and Supports (45%)
    • Quality of Care: Medical and Nursing Care Practices
    • Quality of Care: Medication Management and Administration
    • Quality of Care: Nutrition and Hydration (e.g., specialized diets)
    • Quality of Care: Rehabilitation and Restorative Programs
    • Quality of Care: Care Recipient Assessment and Interdisciplinary Care Planning
    • Quality of Care: Clinical and Medical Records and Documentation Requirements (e.g., storage, retention, destruction)
    • Quality of Care: Medical Director
    • Quality of Care: Emergency Medical Services (e.g., CPR, first aid, Heimlich maneuver, AED)
    • Quality of Care: Transition of Care (e.g., admission, move-in, transfer, discharge, and move-out)
    • Quality of Life: Psychosocial Needs (e.g., social, spiritual, community, cultural)
    • Quality of Life: Person-Centered Care and Comprehensive Care Planning
    • Quality of Life: Care Recipient Bill of Rights and Responsibilities
    • Quality of Life: Care Recipient Safety (e.g., fall prevention, elopement prevention, adverse events)
    • Quality of Life: Care Recipient (and Representative) Grievance, Conflict, and Dispute Resolution
    • Quality of Life: Care Recipient Advocacy (e.g., Ombudsman, resident and family council)
    • Quality of Life: Care Recipient Decision-Making (e.g., capacity, power of attorney, guardianship, conservatorship, code status, advance directives, ethical decision-making)
    • Quality of Life: Recognition of Maltreatment (e.g., abuse, neglect, exploitation)
    • Quality of Life: Mental and Behavioral Health (e.g., cognitive impairment, depression, social support systems)
    • Quality of Life: Trauma-Informed Care (e.g., PTSD)
    • Quality of Life: Pain Management
    • Quality of Life: Death, Dying, and Grief
    • Quality of Life: Restraint Usage and Reduction
    • Quality of Life: Foodservice (e.g., choice and menu planning, dietary management, food storage and handling, dining services)
    • Quality of Life: Social Services Programs
    • Quality of Life: Therapeutic Recreation and Activity Programs
    • Ancillary Services: Hospice and Palliative Care
    • Ancillary Services: Transportation for Care Recipients
    • Ancillary Services: Diagnostic Services (e.g., radiology, lab services)
    • Ancillary Services: Dental and Oral Care Services
    • Ancillary Services: Healthcare Partners and Clinical Providers (e.g., MD/DO, Nurse Practitioner, Psychiatrist, Podiatrist, Dentist)
    • Ancillary Services: Volunteer Programs
  • Operations (28%)
    • Financial Management: Revenue and Reimbursement (e.g., PDPM, PDGM, ACOs, HMOs, Medicaid, private payors)
    • Financial Management: Financial Reporting Requirements (e.g., requirements for not-for-profit, for-profit, and governmental providers)
    • Financial Management: Integration of Clinical and Financial Systems (e.g., EMR/EHR, MDS)
    • Financial Management: Resident Trust Accounts for Personal Funds
    • Risk Management: OSHA Rules and Regulations
    • Risk Management: Compliance Programs
    • Risk Management: Scope of Practice and Legal Liability
    • Risk Management: Internal Investigation Protocols and Techniques (e.g., incidents, adverse events)
    • Risk Management: Mandatory Reporting Requirements (e.g., incidents, adverse events, abuse, neglect, financial exploitation, fraud)
    • Risk Management: Healthcare Record Requirements (e.g., confidentiality, disclosure, safeguarding, HIPAA, HITECH)
    • Risk Management: Security (e.g., cameras, monitoring systems, locks, staff location reporting)
    • Risk Management: Contracted Services (e.g., roles, responsibilities, oversight, background checks)
    • Human Resources: Organizational Staffing Requirements and Reporting (e.g., PBJ)
    • Human Resources: Staff Certification and Licensure Requirements
    • Human Resources: Professional Development (e.g., maintenance of credentials, continuing education)
    • Human Resources: Employee Training and Orientation
    • Human Resources: Performance Evaluation
    • Human Resources: Employee Record-Keeping Requirements
    • Human Resources: Cultural Competence and Diversity Awareness
  • Environment and Quality (27%)
    • Care Setting: Federal Codes and Regulations for Building, Equipment, Maintenance, and Grounds
    • Care Setting: Person-Centered Environment (e.g., home-like environment)
    • Care Setting: Safety and Accessibility (e.g., ADA, safety data sheets)
    • Care Setting: Facility Management and Environmental Services
    • Care Setting: Preventative and Routine Maintenance Programs (e.g., pest control, equipment, mechanical systems)
    • Care Setting: Infection Control and Sanitation (e.g., linens, kitchen, hand washing, healthcare-acquired infections, hazardous materials)
    • Care Setting: Disaster and Emergency Planning, Preparedness, Response, and Recovery (e.g., Appendix Z)
    • Regulatory Compliance: Federal Healthcare Laws, Rules, and Regulations
    • Regulatory Compliance: Government Programs and Entities (e.g., Medicare, Medicaid, waivers)
    • Regulatory Compliance: Certification and Licensure Requirements for the Organization
    • Regulatory Compliance: Regulatory Survey and Inspection Process
    • Regulatory Compliance: Procedures for Informal Dispute Resolution (IDR)
    • Regulatory Compliance: Centers for Medicare and Medicaid Services (CMS) Quality Measures
    • Regulatory Compliance: Quality Assurance and Performance Improvement (QAPI)
    • Regulatory Compliance: Bed-Hold Requirements
    • Regulatory Compliance: Pre-Admission Screening Annual Review (PASRR)
    • Regulatory Compliance: Facility Assessment
Examination sources

Examination on New Hampshire Law

Passing score
75 percent correct answers on the specific state part
Examination outline
  • RSA 151 — Residential Care and Health Facility Licensing
  • RSA 151-A — Nursing Home Administrators
  • Ph 705 — Disposal and Destruction of Controlled Drugs
  • He-P 803 — New Hampshire Nursing Home Rules
  • Nuh 200 — Practice and Procedure
  • Nuh 300 — Application Procedure
  • Nuh 400 — Continued Status and Discipline
  • Nuh 500 — Code of Ethics
Examination sources