New Hampshire doesn't issue a separate memory care license. Dementia care is delivered inside a licensed Assisted Living Residence or other licensed setting, and what the state requires on top of that is dementia-specific staff training. This guide explains how that works, what to verify on a visit, what it costs, and who pays.
In This Guide
- Key Takeaways
- How New Hampshire Regulates Memory Care
- What the Training Mandate Means for You
- What It Costs and Who Pays
- How to Vet a Memory-Care Setting
- Frequently Asked Questions
How New Hampshire Regulates Memory Care
When you start calling around, "memory care" gets used as if it were a single licensed thing you could shop for and line up side by side. In New Hampshire it isn't, and knowing that before you tour a single place changes what you ask. The state never created a separate memory-care license. Dementia care is delivered inside a setting that's already licensed for something else, usually an Assisted Living Residence, and some of those residences run a secured or specialized memory-care program within that license. So the question isn't "is this place a licensed memory care facility." It's "how is this place licensed, and what does it do for dementia residents."
That residence license comes from the New Hampshire DHHS Health Facilities Administration, the state office that licenses and monitors health-care facilities. An Assisted Living Residence-Residential Care is licensed under the administrative rule He-P 804 and RSA 151:9, and a residence has to hold that license to operate as assisted living. A higher-acuity residential category, the Supported Residential Health Care Facility, is licensed separately under He-P 805 for people who need more support. If your loved one's dementia comes with heavy medical needs, the license type matters, because an assisted living residence may not be set up to provide the level of skilled nursing a person eventually requires.
What New Hampshire does impose on top of the license, statewide, is a training requirement. Under RSA 151:47 through 151:52, any facility or program that serves residents with Alzheimer's disease or other dementia, including any program that advertises specialty memory care, has to train its direct-care staff in dementia care. The training comes in two parts: initial dementia training after a worker is hired, and ongoing continuing education each year. The law doesn't make memory care a new kind of building you license. It makes dementia-care competence a standing obligation for the people who actually provide the care, whatever setting they work in. That's where the real protection lives, and it's what you can ask a residence to show you.
What the Training Mandate Means for You
Here's why that training rule matters to your family in practice. The hardest part of dementia care isn't the building, it's how the staff respond when your loved one is confused, frightened, or trying to leave. A worker trained to understand what's happening, and to redirect rather than restrain, is the difference between a resident who feels safe and one who's in constant distress. New Hampshire decided that competence shouldn't be optional, so it wrote the requirement into statute rather than leaving it to each facility's discretion.
Because the mandate is set in law, you can ask about it directly, and you have a right to clear answers. The statute frames the requirement as initial training after hire plus annual continuing education, so a fair set of questions is who on the staff completes the dementia training, what it covers, whether new hires finish it before they work alone with residents, and how the residence keeps its staff current year to year. A residence that can answer those plainly is showing you the rule is real on the floor, not just on file. One that gets vague is telling you something too. The exact number of training hours and the specifics of any secured unit vary by setting and aren't fixed by a single statewide standard you can quote, so don't anchor on a precise hour count you read somewhere. Ask the residence what its own training and staffing actually look like, and tour any secured unit before you choose it.
What It Costs and Who Pays
Cost is usually what families brace for, and New Hampshire is an expensive state to receive care in. There's no clean single number for memory care specifically, because the state doesn't license or survey it as a separate category, so the industry surveys that track senior-care prices don't break it out the way they break out assisted living. What you do have is a solid anchor for the base.
Per the Genworth/CareScout 2024 Cost of Care Survey, the most recent state-level data, assisted living in New Hampshire runs a median of about $7,431 a month (roughly $89,175 a year), well above the national median of about $70,800 a year. Memory care costs more than that base, here as everywhere, because dementia care means more staff time, the dementia-specific training the state requires, and often a secured setting. How much more depends on the residence, its size, and how much care your loved one needs. Treat memory care as a premium on top of that assisted-living figure, and be wary of any source quoting one precise statewide memory-care number.
| Care setting | New Hampshire median | National median |
|---|---|---|
| Assisted living | $7,431/mo ($89,175/yr) | $70,800/yr |
| Nursing home, semi-private room | $149,650/yr | $111,325/yr |
| Nursing home, private room | $157,680/yr | $127,750/yr |
| Home health aide (44 hrs/wk) | $89,232/yr | n/a |
Those are industry-survey medians, not government figures, and prices vary across the state and climb as care needs grow. Use them to set expectations, then get a specific written quote from any place you're serious about. The advertised figure is almost always a base rate. Ask what it includes, how the residence charges as care needs grow, how it reassesses care as dementia progresses, and how often rates rise.
Paying for it is where families often get caught off guard. Assisted living in New Hampshire is largely private-pay, and New Hampshire Medicaid doesn't pay an assisted living resident's room and board. What Medicaid can help with is services, not rent: the state's Choices for Independence waiver can cover personal-care and support services for eligible residents, though it doesn't pay the room-and-board portion of the bill. Dementia care runs for years and the cost is steep, so it's worth checking eligibility and planning early rather than assuming the whole bill is yours alone to carry.
How to Vet a Memory-Care Setting
You don't have to become an expert in dementia care to make a sound decision. You have to confirm how the place is licensed, press on how its staff are trained, and check what's promised against what you actually see.
- Confirm how the residence is licensed. Because there's no separate memory-care license, ask which license the place holds, usually an Assisted Living Residence under He-P 804, and verify it with the New Hampshire DHHS Health Facilities Administration rather than taking the facility's word. Remember an assisted living residence may not be licensed for skilled nursing care.
- Ask exactly how the dementia staff are trained. State law requires initial dementia training after hire and continuing education each year, so ask who completes it, what it covers, and whether new hires finish before working alone with residents. Specific answers are a good sign; vague reassurance isn't.
- Tour any secured or specialized unit in person. Memory-care programs in New Hampshire are run within a licensed residence, not under a separate standard, so what a "memory care" unit actually offers varies place to place. Walk it, see how exits are managed, and check whether the design truly supports a resident who may wander.
- Pin down screening and discharge. Ask exactly what would trigger a move or discharge, so a later transfer doesn't blindside your family months in, at the worst possible moment.
- Get the costs in writing. Ask for a written breakdown of the base rate, what memory care adds, how care levels get reassessed as dementia progresses, and what triggers an increase. Bring the contract home and read the refund and discharge terms without a salesperson in the room.
Tour at least a couple of places. The goal isn't a flawless one. It's a residence whose license you've verified with the state, whose dementia training you've asked about in detail, and whose promises you've checked against what's actually happening inside the building.
Frequently Asked Questions
No. New Hampshire doesn't issue a separate memory care license. Dementia care is delivered inside an already-licensed setting, most often an Assisted Living Residence (He-P 804), and some residences run a secured or specialized memory-care program within that license. The license itself is issued by the New Hampshire DHHS Health Facilities Administration.
Under RSA 151:47 through 151:52, any facility or program serving residents with Alzheimer's or other dementia, including programs that advertise specialty memory care, must train its direct-care staff in dementia care. The requirement has two parts: initial training after a worker is hired, and continuing education each year. The exact hour counts and any secured-unit specifics vary by setting, so ask the residence what its own training looks like rather than relying on a number you read elsewhere.
Ask which license the residence holds and verify it with the New Hampshire DHHS Health Facilities Administration, not just the facility's marketing. Then ask in detail how the dementia-care staff are trained, since that's what state law actually requires, and tour any secured unit in person before you choose it.
There's no reliable single statewide figure for memory care alone. Use the assisted-living base as your anchor, about $7,431 a month per the Genworth/CareScout 2024 survey, and expect memory care to run higher because of the added staff time, dementia training, and secured setting it requires. The advertised rate is usually a base that rises as care needs grow, so get a written breakdown from any place you're considering.
Largely, assisted living in New Hampshire is private-pay, and New Hampshire Medicaid doesn't pay an assisted living resident's room and board. The state's Choices for Independence waiver can cover personal-care and support services for eligible residents, but it doesn't pay the room-and-board portion of the bill. Because an assisted living residence may not provide skilled nursing care, a resident with heavier medical needs may eventually move to a nursing home, where Medicaid's nursing-facility coverage can apply for those who qualify. It's worth checking eligibility early rather than assuming the entire bill is private-pay.
Learn More
Find personalized help asking the right questions about a New Hampshire residence's dementia staffing and training at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.