New Hampshire Nursing Home
Administrators Board
Certification Practice Exam
Part 0: Table of Contents
*(#part-i-the-preview) *(#the-introduction) *(#the-critical-axioms-cheat-sheet)
*(#new-hampshire-fee-structure-and-record-retention-matrices) *(#part-ii-the-elite-test-bank)
*(#tier-1-questions-115-foundational-syntax--application)
*(#tier-2-questions-1635-complex-application--simulation)
*(#tier-3-questions-3660-grandmaster-synthesis)
Part I: The Preview
The Introduction
Achieving board certification as a licensed Nursing Home Administrator (NHA) in New
Hampshire demands a flawless command of both state-specific administrative rules (He-P 803)
and statutory requirements (RSA 151 and RSA 151-A). This elite practice exam is engineered to
transform basic regulatory knowledge into advanced operational competence, ensuring
candidates are fully prepared for federal and state licensing standards.
The Critical Axioms Cheat Sheet
● Clinical Record Retention Standard: Adult clinical records must be preserved for at
least 7 years post-discharge, whereas Medicaid resident records must be held for a
minimum of 6 years from the date of service or until all pending litigation is resolved.
Minor clinical records must be retained for at least 7 years post-discharge or up to 1 year
past the age of majority, whichever is longer.
● Emergency Permit Supervision Standard: Under rule Nuh 305, an acting administrator
operating under an emergency permit must receive at least 8 hours of direct, onsite
supervision per week from an approved preceptor with at least 5 years of experience.
● Incident Reporting Windows: Allegations of abuse, neglect, mistreatment, or
misappropriation of resident property must be faxed to the department within 24 hours of
discovery, followed by a completed written investigation report within 5 calendar days.
● Continuing Education Mandates: Administrators must complete 40 clock hours of
, approved continuing education during the 2 years preceding their biennial renewal,
retaining all certificates of attendance for a minimum of 3 years.
New Hampshire Fee Structure and Record Retention Matrices
Table 1 outlines the licensing and administrative fees established by the Office of Professional
Licensure and Certification (OPLC) :
Category of License or Duration of Validity Associated Fee Rule Reference
Permit
Nursing Home 2 Years $300 Plc 1002.34
Administrator Initial
License / Renewal /
Reinstatement
NHA Temporary 6 Months $300 Plc 1002.34
License
NHA Temporary 6 Months $300 Plc 1002.34
Emergency Permit
Double-space
Table 2 outlines the clinical record retention standards across resident categories :
Resident Demographic Minimum Retention Administrative Baseline Rule Reference
Duration
Standard Adult 7 Years Post-Discharge date He-P 803.19(g)
Resident
Medicaid-Recipient 6 Years Date of Service (or until He-P 803.19(g)
Resident litigation is resolved)
Minor Resident (Under 7 Years, or 1 Year past Post-Discharge date / He-P 803.19(g)
18 Years) age 18 (whichever is Majority age
longer)
Closed Facility Records 7 Years Closure storage He-P 803.19(h)
agreement date
Part II: The Elite Test Bank
Tier 1: Questions 1–15 (Foundational Syntax & Application)
Q1: A resident is discharged from a New Hampshire nursing home to a private residence.
Based on the principles of New Hampshire Administrative Code He-P 803.19(g), which record
retention timeline is the MOST ACCURATE? A) The facility must retain the original clinical
records for a minimum of 5 years. B) The facility must retain the original clinical records for a
minimum of 6 years. C) The facility must retain the original clinical records for a minimum of 7
years. D) The facility must retain the original clinical records for a minimum of 10 years.
● The Answer: C (The facility must retain the original clinical records for a minimum of 7
years.)
● Distractor Analysis:
○ A is incorrect: A 5-year retention timeline represents a common federal baseline but
is non-compliant with New Hampshire's stricter state regulations.
○ B is incorrect: A 6-year retention timeline is specifically designated for Medicaid
, residents based on the date of service, not the general post-discharge baseline.
○ D is incorrect: A 10-year retention timeline is an over-extended standard
recommended by some liability carriers but is not the minimum statutory
requirement under state rule.
The Mentor's Analysis: Administrative compliance requires strict adherence to state-specific
record retention rules. When managing resident discharges, the immediate priority is to
preserve clinical records to protect the facility against liability and ensure regulatory compliance.
By utilizing He-P 803.19(g), the administrator bypasses the common trap of relying on more
lenient federal guidelines. Professional/Academic Intuition: Standard adult clinical records
in New Hampshire must be retained for at least 7 years post-discharge.
Double-space
Q2: A Medicaid-recipient resident is discharged from a New Hampshire nursing facility. Based
on the principles of New Hampshire Administrative Code He-P 803.19(g), which retention
timeline is the MOST ACCURATE? A) The record must be kept for 7 years post-discharge
regardless of any active legal disputes. B) The record must be kept for a minimum of 6 years
from the date of service, or until the resolution of any legal actions commenced during that
period, whichever is longer. C) The record must be kept for 5 years past the age of majority. D)
The record must be kept for 3 years, after which it may be destroyed with department approval.
● The Answer: B (The record must be kept for a minimum of 6 years from the date of
service, or until the resolution of any legal actions commenced during that period,
whichever is longer.)
● Distractor Analysis:
○ A is incorrect: Although 7 years is the standard post-discharge timeline for
non-Medicaid adult residents, Medicaid records are subject to specific audit rules
tied to the date of service.
○ C is incorrect: This option describes a variation of the rule for minor residents, not
adult Medicaid recipients.
○ D is incorrect: A 3-year retention timeline violates both state and federal nursing
home clinical record standards.
The Mentor's Analysis: Medicaid record retention is designed to align with state and federal
financial audit windows. When facing potential retrospective audits, the immediate priority is
preserving clinical and billing documentation. By utilizing the date of service plus litigation
resolution clause, the administrator bypasses the trap of prematurely destroying records that
could be requested during a Medicaid recovery action. Professional/Academic Intuition:
Medicaid resident records must be held for 6 years from the date of service or until any
active legal disputes are fully resolved.
Double-space
Q3: A minor resident is discharged from a New Hampshire nursing home. Based on the
principles of New Hampshire Administrative Code He-P 803.19(g), which record retention
timeline is the MOST ACCURATE? A) Records must be retained for 7 years after the discharge
date, with no exceptions for age. B) Records must be retained until 1 year after the resident
reaches the age of 18, but in no case for less than 7 years after discharge. C) Records must be
retained for 10 years following the minor's 18th birthday. D) Records must be retained for 5
years after discharge, matching federal pediatric standards.
● The Answer: B (Records must be retained until 1 year after the resident reaches the age
of 18, but in no case for less than 7 years after discharge.)
● Distractor Analysis:
○ A is incorrect: Applying the standard adult 7-year rule without considering the age of
, majority violates state regulations for minor residents.
○ C is incorrect: A 10-year post-majority rule is an over-extended standard that is not
required by New Hampshire state regulations.
○ D is incorrect: A 5-year retention timeline is non-compliant with New Hampshire's
minimum statutory protections for minor records.
The Mentor's Analysis: Minor residents are afforded extended legal protection because the
statute of limitations for malpractice claims may not begin until they reach the age of majority.
When managing minor records, the immediate priority is to calculate the retention period based
on both the majority age and the minimum 7-year baseline. By utilizing this dual-metric
approach, the administrator bypasses the risk of premature record destruction.
Professional/Academic Intuition: Minor clinical records must be kept for at least 7 years
post-discharge or until 1 year after the resident reaches age 18, whichever is longer.
Double-space
Q4: A New Hampshire nursing facility is closing down. Based on the principles of New
Hampshire Administrative Code He-P 803.19(h), which action regarding clinical records is the
MOST ACCURATE? A) The facility may destroy all records immediately upon closure to protect
resident privacy. B) The facility must arrange for the storage of, and access to, clinical records
for a period of 7 years in the event the nursing home ceases operation. C) The facility must
transfer all records to the local county registry of deeds for storage. D) The facility must submit
all paper records to the New Hampshire Department of Safety for secure incineration.
● The Answer: B (The facility must arrange for the storage of, and access to, clinical
records for a period of 7 years in the event the nursing home ceases operation.)
● Distractor Analysis:
○ A is incorrect: Destroying records immediately upon closure violates
state-mandated post-closure storage and access requirements.
○ C is incorrect: The registry of deeds has no legal authority or facilities to store
clinical healthcare records.
○ D is incorrect: The Department of Safety handles criminal records, not the
post-closure storage of clinical healthcare files.
The Mentor's Analysis: A facility's closure does not relieve the licensee of their legal
record-keeping responsibilities. When planning a facility closure, the immediate priority is to
secure a contract with a medical records custodian to ensure safe storage and access for 7
years. By utilizing a certified custodian, the administrator bypasses the risk of state penalties for
non-compliance. Professional/Academic Intuition: Nursing home licensees must arrange
secure storage and access for clinical records for 7 years following a facility's closure.
Double-space
Q5: A family member requests copies of their relative's clinical records. Based on the principles
of New Hampshire Revised Statutes Annotated RSA 332-I:1, which fee structure is the MOST
ACCURATE? A) The facility may charge a flat fee of $100 for any copy request. B) The facility
may charge up to $15 for the first 30 pages, or $0.50 per page, whichever is greater, plus the
actual cost of duplication for filmed records. C) The facility must provide all records free of
charge, regardless of page count. D) The facility may charge $1.00 per page for the first 50
pages and $0.10 per page thereafter.
● The Answer: B (The facility may charge up to $15 for the first 30 pages, or $0.50 per
page, whichever is greater, plus the actual cost of duplication for filmed records.)
● Distractor Analysis:
○ A is incorrect: Charging a flat $100 fee is non-compliant and violates the
state-mandated copy fee caps.
Administrators Board
Certification Practice Exam
Part 0: Table of Contents
*(#part-i-the-preview) *(#the-introduction) *(#the-critical-axioms-cheat-sheet)
*(#new-hampshire-fee-structure-and-record-retention-matrices) *(#part-ii-the-elite-test-bank)
*(#tier-1-questions-115-foundational-syntax--application)
*(#tier-2-questions-1635-complex-application--simulation)
*(#tier-3-questions-3660-grandmaster-synthesis)
Part I: The Preview
The Introduction
Achieving board certification as a licensed Nursing Home Administrator (NHA) in New
Hampshire demands a flawless command of both state-specific administrative rules (He-P 803)
and statutory requirements (RSA 151 and RSA 151-A). This elite practice exam is engineered to
transform basic regulatory knowledge into advanced operational competence, ensuring
candidates are fully prepared for federal and state licensing standards.
The Critical Axioms Cheat Sheet
● Clinical Record Retention Standard: Adult clinical records must be preserved for at
least 7 years post-discharge, whereas Medicaid resident records must be held for a
minimum of 6 years from the date of service or until all pending litigation is resolved.
Minor clinical records must be retained for at least 7 years post-discharge or up to 1 year
past the age of majority, whichever is longer.
● Emergency Permit Supervision Standard: Under rule Nuh 305, an acting administrator
operating under an emergency permit must receive at least 8 hours of direct, onsite
supervision per week from an approved preceptor with at least 5 years of experience.
● Incident Reporting Windows: Allegations of abuse, neglect, mistreatment, or
misappropriation of resident property must be faxed to the department within 24 hours of
discovery, followed by a completed written investigation report within 5 calendar days.
● Continuing Education Mandates: Administrators must complete 40 clock hours of
, approved continuing education during the 2 years preceding their biennial renewal,
retaining all certificates of attendance for a minimum of 3 years.
New Hampshire Fee Structure and Record Retention Matrices
Table 1 outlines the licensing and administrative fees established by the Office of Professional
Licensure and Certification (OPLC) :
Category of License or Duration of Validity Associated Fee Rule Reference
Permit
Nursing Home 2 Years $300 Plc 1002.34
Administrator Initial
License / Renewal /
Reinstatement
NHA Temporary 6 Months $300 Plc 1002.34
License
NHA Temporary 6 Months $300 Plc 1002.34
Emergency Permit
Double-space
Table 2 outlines the clinical record retention standards across resident categories :
Resident Demographic Minimum Retention Administrative Baseline Rule Reference
Duration
Standard Adult 7 Years Post-Discharge date He-P 803.19(g)
Resident
Medicaid-Recipient 6 Years Date of Service (or until He-P 803.19(g)
Resident litigation is resolved)
Minor Resident (Under 7 Years, or 1 Year past Post-Discharge date / He-P 803.19(g)
18 Years) age 18 (whichever is Majority age
longer)
Closed Facility Records 7 Years Closure storage He-P 803.19(h)
agreement date
Part II: The Elite Test Bank
Tier 1: Questions 1–15 (Foundational Syntax & Application)
Q1: A resident is discharged from a New Hampshire nursing home to a private residence.
Based on the principles of New Hampshire Administrative Code He-P 803.19(g), which record
retention timeline is the MOST ACCURATE? A) The facility must retain the original clinical
records for a minimum of 5 years. B) The facility must retain the original clinical records for a
minimum of 6 years. C) The facility must retain the original clinical records for a minimum of 7
years. D) The facility must retain the original clinical records for a minimum of 10 years.
● The Answer: C (The facility must retain the original clinical records for a minimum of 7
years.)
● Distractor Analysis:
○ A is incorrect: A 5-year retention timeline represents a common federal baseline but
is non-compliant with New Hampshire's stricter state regulations.
○ B is incorrect: A 6-year retention timeline is specifically designated for Medicaid
, residents based on the date of service, not the general post-discharge baseline.
○ D is incorrect: A 10-year retention timeline is an over-extended standard
recommended by some liability carriers but is not the minimum statutory
requirement under state rule.
The Mentor's Analysis: Administrative compliance requires strict adherence to state-specific
record retention rules. When managing resident discharges, the immediate priority is to
preserve clinical records to protect the facility against liability and ensure regulatory compliance.
By utilizing He-P 803.19(g), the administrator bypasses the common trap of relying on more
lenient federal guidelines. Professional/Academic Intuition: Standard adult clinical records
in New Hampshire must be retained for at least 7 years post-discharge.
Double-space
Q2: A Medicaid-recipient resident is discharged from a New Hampshire nursing facility. Based
on the principles of New Hampshire Administrative Code He-P 803.19(g), which retention
timeline is the MOST ACCURATE? A) The record must be kept for 7 years post-discharge
regardless of any active legal disputes. B) The record must be kept for a minimum of 6 years
from the date of service, or until the resolution of any legal actions commenced during that
period, whichever is longer. C) The record must be kept for 5 years past the age of majority. D)
The record must be kept for 3 years, after which it may be destroyed with department approval.
● The Answer: B (The record must be kept for a minimum of 6 years from the date of
service, or until the resolution of any legal actions commenced during that period,
whichever is longer.)
● Distractor Analysis:
○ A is incorrect: Although 7 years is the standard post-discharge timeline for
non-Medicaid adult residents, Medicaid records are subject to specific audit rules
tied to the date of service.
○ C is incorrect: This option describes a variation of the rule for minor residents, not
adult Medicaid recipients.
○ D is incorrect: A 3-year retention timeline violates both state and federal nursing
home clinical record standards.
The Mentor's Analysis: Medicaid record retention is designed to align with state and federal
financial audit windows. When facing potential retrospective audits, the immediate priority is
preserving clinical and billing documentation. By utilizing the date of service plus litigation
resolution clause, the administrator bypasses the trap of prematurely destroying records that
could be requested during a Medicaid recovery action. Professional/Academic Intuition:
Medicaid resident records must be held for 6 years from the date of service or until any
active legal disputes are fully resolved.
Double-space
Q3: A minor resident is discharged from a New Hampshire nursing home. Based on the
principles of New Hampshire Administrative Code He-P 803.19(g), which record retention
timeline is the MOST ACCURATE? A) Records must be retained for 7 years after the discharge
date, with no exceptions for age. B) Records must be retained until 1 year after the resident
reaches the age of 18, but in no case for less than 7 years after discharge. C) Records must be
retained for 10 years following the minor's 18th birthday. D) Records must be retained for 5
years after discharge, matching federal pediatric standards.
● The Answer: B (Records must be retained until 1 year after the resident reaches the age
of 18, but in no case for less than 7 years after discharge.)
● Distractor Analysis:
○ A is incorrect: Applying the standard adult 7-year rule without considering the age of
, majority violates state regulations for minor residents.
○ C is incorrect: A 10-year post-majority rule is an over-extended standard that is not
required by New Hampshire state regulations.
○ D is incorrect: A 5-year retention timeline is non-compliant with New Hampshire's
minimum statutory protections for minor records.
The Mentor's Analysis: Minor residents are afforded extended legal protection because the
statute of limitations for malpractice claims may not begin until they reach the age of majority.
When managing minor records, the immediate priority is to calculate the retention period based
on both the majority age and the minimum 7-year baseline. By utilizing this dual-metric
approach, the administrator bypasses the risk of premature record destruction.
Professional/Academic Intuition: Minor clinical records must be kept for at least 7 years
post-discharge or until 1 year after the resident reaches age 18, whichever is longer.
Double-space
Q4: A New Hampshire nursing facility is closing down. Based on the principles of New
Hampshire Administrative Code He-P 803.19(h), which action regarding clinical records is the
MOST ACCURATE? A) The facility may destroy all records immediately upon closure to protect
resident privacy. B) The facility must arrange for the storage of, and access to, clinical records
for a period of 7 years in the event the nursing home ceases operation. C) The facility must
transfer all records to the local county registry of deeds for storage. D) The facility must submit
all paper records to the New Hampshire Department of Safety for secure incineration.
● The Answer: B (The facility must arrange for the storage of, and access to, clinical
records for a period of 7 years in the event the nursing home ceases operation.)
● Distractor Analysis:
○ A is incorrect: Destroying records immediately upon closure violates
state-mandated post-closure storage and access requirements.
○ C is incorrect: The registry of deeds has no legal authority or facilities to store
clinical healthcare records.
○ D is incorrect: The Department of Safety handles criminal records, not the
post-closure storage of clinical healthcare files.
The Mentor's Analysis: A facility's closure does not relieve the licensee of their legal
record-keeping responsibilities. When planning a facility closure, the immediate priority is to
secure a contract with a medical records custodian to ensure safe storage and access for 7
years. By utilizing a certified custodian, the administrator bypasses the risk of state penalties for
non-compliance. Professional/Academic Intuition: Nursing home licensees must arrange
secure storage and access for clinical records for 7 years following a facility's closure.
Double-space
Q5: A family member requests copies of their relative's clinical records. Based on the principles
of New Hampshire Revised Statutes Annotated RSA 332-I:1, which fee structure is the MOST
ACCURATE? A) The facility may charge a flat fee of $100 for any copy request. B) The facility
may charge up to $15 for the first 30 pages, or $0.50 per page, whichever is greater, plus the
actual cost of duplication for filmed records. C) The facility must provide all records free of
charge, regardless of page count. D) The facility may charge $1.00 per page for the first 50
pages and $0.10 per page thereafter.
● The Answer: B (The facility may charge up to $15 for the first 30 pages, or $0.50 per
page, whichever is greater, plus the actual cost of duplication for filmed records.)
● Distractor Analysis:
○ A is incorrect: Charging a flat $100 fee is non-compliant and violates the
state-mandated copy fee caps.
