In New Hampshire, the license families see for assisted living is "Assisted Living Residence (ALR)", issued by the New Hampshire Department of Health and Human Services, Health Facilities Administration (Health Facility Licensing Unit). At the residential care level, each resident needs a licensed practitioner's health examination within 30 days before or 72 hours after admission, then every 12 months, plus the state's CARES Tool needs assessment within 30 days before or 24 hours after admission. At least 30 days' written notice is required before an involuntary discharge, allowed only for medical reasons, the welfare of the resident or others, nonpayment or closure, and not because the resident becomes eligible for Medicaid.
Key facts
- The median monthly cost of assisted living in New Hampshire was $8,025 in CareScout's 2025 Cost of Care Survey, or $96,300 a year, $1,825 above the national median of $6,200 a month. (CareScout, 2026)
- New Hampshire's Choices for Independence Medicaid waiver covers services in licensed residential care and supported residential health care facilities, paid as a daily rate. (N.H. Code Admin. R. He-E 801.26, 2022)
- New Hampshire's assisted living residence rules do not require a TB test for new residents. (N.H. Code Admin. R. He-P 804.18, 2022)
- Staff who are not nurses may remind residents, watch them take their own medicine, or physically help residents who direct their own care, but that help does not include injections or filling insulin syringes. (N.H. Code Admin. R. He-P 804.17, 2022)
- Assisted living staff must complete dementia training: at least 6 hours for administrators and direct care staff when they start, and at least 4 hours every calendar year. (N.H. RSA ch. 151, sections 47 to 50, 2025)
New Hampshire licenses assisted living residences at two levels under RSA 151:9 and the Department of Health and Human Services rules in He-P 800: residential care (ALR-RC, He-P 804) for residents who are mobile and can get out on their own in an emergency, and supported residential health care (SRHCF, He-P 805), which adds health services, including short-term medical care. The facts below are for residential care (He-P 804), and He-P 805 differs on some points, such as requiring the health assessment within 30 days before admission.
Rules change and communities can set stricter policies. Before you sign, confirm the details with the community and the New Hampshire Department of Health and Human Services, Health Facilities Administration (Health Facility Licensing Unit). This page is general information, not legal advice.
The rules at a glance
| Medical assessment before move-in | At the residential care level, each resident needs a licensed practitioner's health examination within 30 days before or 72 hours after admission, then every 12 months, plus the state's CARES Tool needs assessment within 30 days before or 24 hours after admission. Supported residential health care facilities allow only the 30 days before admission for both. [4][5] More on this |
|---|---|
| TB test | New Hampshire's assisted living residence rules do not require a TB test for new residents. They do require staff to give the facility results of a 2-step TB test, taken within 12 months before hire, before they have contact with residents. [6][4] More on this |
| Notice before a move-out | At least 30 days' written notice is required before an involuntary discharge, allowed only for medical reasons, the welfare of the resident or others, nonpayment or closure, and not because the resident becomes eligible for Medicaid. Shorter notice is allowed for an emergency, danger to others, improved health, or a stay under 30 days. [7][8] More on this |
| Who may give medications | Staff who are not nurses may remind residents, watch them take their own medicine, or physically help residents who direct their own care, but that help does not include injections or filling insulin syringes. Other medication may be given only by someone authorized by law, including a nurse's delegate, and staff who help need a 4-hour medication assistance course first. [9] More on this |
| Memory care and dementia | Assisted living staff must complete dementia training: at least 6 hours for administrators and direct care staff when they start, and at least 4 hours every calendar year. A residential care facility may use locked or secured units, as the state fire code allows. [10][3] |
| Long-term care ombudsman | New Hampshire's Office of the Long-Term Care Ombudsman takes complaints from residents of assisted living and other long-term care facilities and can be reached at 1-800-442-5640 or (603) 271-4375. [11][12] Official page More on this |
| Medicaid help | New Hampshire's Choices for Independence Medicaid waiver covers services in licensed residential care and supported residential health care facilities, paid as a daily rate. Payment for waiver services excludes room and board. [13][14] Official page More on this |
What assisted living costs in New Hampshire
The median monthly cost of assisted living in New Hampshire was $8,025 in CareScout's 2025 Cost of Care Survey, or $96,300 a year, $1,825 above the national median of $6,200 a month. [16]
A median is the middle of the rates communities reported, so many charge more or less. Rates differ between regions and by the care a resident needs, so ask each community for its full fee list in writing. More: assisted living costs in every state, a monthly budget and the costs that aren't in the base rate.
How to check a community in New Hampshire
The Health Facilities Administration links to a Health Facilities License Search for checking a facility's license. Residential care facilities must also post their license and the last 12 months of inspection reports where residents and visitors can see them, and complaints go to the Health Facility Licensing Unit at (603) 271-9039. Search New Hampshire's records. [1][3][2]
The licensing agency: New Hampshire Department of Health and Human Services, Health Facilities Administration (Health Facility Licensing Unit). [1][15] Our guide on how to read an inspection report explains what to look for.
Put New Hampshire's paperwork on a date
Parent Move Plan counts every task back from the move-in day, including the medical assessment and TB screening the community will ask for, so nothing lands in the last week.
Get your first 3 days freeFrequently asked questions
How much does assisted living cost in New Hampshire?
The median monthly cost of assisted living in New Hampshire was $8,025 in CareScout's 2025 Cost of Care Survey, or $96,300 a year, $1,825 above the national median of $6,200 a month. A median is the middle of the rates communities reported, so many charge more or less, and rates differ between regions and by the care a resident needs.
What medical assessment does New Hampshire require before moving into assisted living?
At the residential care level, each resident needs a licensed practitioner's health examination within 30 days before or 72 hours after admission, then every 12 months, plus the state's CARES Tool needs assessment within 30 days before or 24 hours after admission. Supported residential health care facilities allow only the 30 days before admission for both.
Does New Hampshire require a TB test for assisted living?
New Hampshire's assisted living residence rules do not require a TB test for new residents. They do require staff to give the facility results of a 2-step TB test, taken within 12 months before hire, before they have contact with residents.
How much notice must an assisted living community in New Hampshire give before a move-out?
At least 30 days' written notice is required before an involuntary discharge, allowed only for medical reasons, the welfare of the resident or others, nonpayment or closure, and not because the resident becomes eligible for Medicaid. Shorter notice is allowed for an emergency, danger to others, improved health, or a stay under 30 days.
Who can give medications in assisted living in New Hampshire?
Staff who are not nurses may remind residents, watch them take their own medicine, or physically help residents who direct their own care, but that help does not include injections or filling insulin syringes. Other medication may be given only by someone authorized by law, including a nurse's delegate, and staff who help need a 4-hour medication assistance course first.
Who can help with a complaint about assisted living in New Hampshire?
New Hampshire's Office of the Long-Term Care Ombudsman takes complaints from residents of assisted living and other long-term care facilities and can be reached at 1-800-442-5640 or (603) 271-4375.
Does Medicaid pay for assisted living in New Hampshire?
New Hampshire's Choices for Independence Medicaid waiver covers services in licensed residential care and supported residential health care facilities, paid as a daily rate. Payment for waiver services excludes room and board.
Sources
- New Hampshire Department of Health and Human Services: Health Facilities Administration (2025) (checked October 22, 2026)
- New Hampshire Department of Health and Human Services: File a Complaint Against a Health Facility in NH (2025) (checked October 22, 2026)
- N.H. Code Admin. R. He-P 804.14, Duties and Responsibilities of the Licensee, assisted living residence-residential care (New Hampshire DHHS certified copy), 2022 (checked October 22, 2026)
- N.H. Code Admin. R. He-P 804.16, Required Services, assisted living residence-residential care (New Hampshire DHHS certified copy), 2022 (checked October 22, 2026)
- N.H. Code Admin. R. He-P 805.16, Required Services, supported residential health care facility (New Hampshire DHHS certified copy), 2025 (checked October 22, 2026)
- N.H. Code Admin. R. He-P 804.18, Personnel, assisted living residence-residential care (New Hampshire DHHS certified copy), 2022 (checked October 22, 2026)
- N.H. RSA ch. 151, section 26, Transfer or Discharge of Patients (official General Court text), 2014 (checked October 22, 2026)
- N.H. RSA ch. 151, section 21, Patients' Bill of Rights (official General Court text), 2025 (checked October 22, 2026)
- N.H. Code Admin. R. He-P 804.17, Medication Services, assisted living residence-residential care (New Hampshire DHHS certified copy), 2022 (checked October 22, 2026)
- N.H. RSA ch. 151, sections 47 to 50, Dementia training for staff of facilities and programs (official General Court text), 2025 (checked October 22, 2026)
- N.H. Code Admin. R. Omb 403.01, Complaint Process, Office of the Long-Term Care Ombudsman (via Cornell LII), 2017 (checked October 22, 2026)
- N.H. Code Admin. R. Omb 401.02, Scope, Office of the Long-Term Care Ombudsman (via Cornell LII), 2017 (checked October 22, 2026)
- N.H. Code Admin. R. He-E 801.26, Residential Care Facility Services, Choices for Independence Program (via Cornell LII), 2022 (checked October 22, 2026)
- N.H. Code Admin. R. He-E 801.12, Non-Covered Services, Choices for Independence Program (via Cornell LII), 2022 (checked October 22, 2026)
- N.H. RSA ch. 151, section 9, Rules, residential care licensure levels (official General Court text), 2023 (checked October 22, 2026)
- CareScout: Cost of Care Survey 2025, Ranked Median Costs by State (2026) (checked October 22, 2026)