Cycle 1
Health 2025-06-05 · Fire 2025-06-05
3 health deficiencies
Top issue: Infection Control (1 deficiency)
6 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (3 deficiencies)
Portsmouth, NH
Edgewood Centre (The)
3-star overall rating with 3-star inspections with 3 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
928 South Street, Portsmouth, NH
(603) 436-0099
Overall
3 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
156
Certified beds
Average residents
136
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1972-06-13
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.61
Registered nurse staffing · state 0.74 · national 0.68
LPN hours / resident day
0.75
Licensed practical nurse staffing · state 0.76 · national 0.87
Aide hours / resident day
2.15
Nurse aide staffing · state 2.39 · national 2.35
Total nurse hours
3.51
All reported nurse hours · state 3.88 · national 3.89
Licensed hours
1.36
RN + LPN hours · state 1.49 · national 1.54
Weekend hours
3.25
Weekend nurse staffing · state 3.44 · national 3.43
Weekend RN hours
0.38
Weekend registered nurse coverage · state 0.51 · national 0.47
Physical therapist
0.05
Reported PT staffing · state 0.06 · national 0.07
Adjusted RN hours
0.60
CMS adjusted RN staffing hours
Adjusted total hours
3.44
CMS adjusted total nurse staffing hours
Case-mix index
1.39
Higher values indicate more complex resident acuity
RN turnover
33%
Annual RN turnover · state 45% · national 45%
Total nurse turnover
51%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
7,836
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
28.65
Composite VBP score used to determine payment impact.
Payment multiplier
0.9851
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0
Baseline 19.73% · Performance 21.24% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
5.77
Baseline 6.69% · Performance 6.11% · Measure score 5.77 · Achievement 5.77 · Improvement 2.93
Total nurse turnover
3.43
Performance 49.64% · Measure score 3.43 · Achievement 3.43 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
2.25
Baseline 3.57 hours · Performance 3.72 hours · Measure score 2.25 · Achievement 2.25 · Improvement 0.16
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.39% |
10.72%
0.3 pts better
|
No Different than the National Rate · Eligible stays 321 · Observed rate 8.72% · Lower 95% interval 7.83% |
| Discharge to community | 57.32% |
50.57%
6.8 pts better
|
Better than the National Rate · Eligible stays 321 · Observed rate 54.52% · Lower 95% interval 52.52% |
| Medicare spending per beneficiary | 0.85 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 214 · Denominator 214 |
| Falls with major injury | 0.47% |
0.77%
0.3 pts better
|
Numerator 1 · Denominator 214 |
| Discharge self-care score | 71.05% |
53.69%
17.4 pts better
|
Numerator 108 · Denominator 152 |
| Discharge mobility score | 67.76% |
50.94%
16.8 pts better
|
Numerator 103 · Denominator 152 |
| Pressure ulcers or injuries, new or worsened | 3.27% |
2.29%
1 pts worse
|
Numerator 7 · Denominator 214 · Adjusted rate 3.53% |
| Healthcare-associated infections requiring hospitalization | 6.11% |
7.12%
1 pts better
|
No Different than the National Rate · Eligible stays 209 · Observed rate 4.31% · Lower 95% interval 3.7% |
| Staff COVID-19 vaccination coverage | 4.07% |
8.2%
4.1 pts worse
|
Numerator 7 · Denominator 172 |
| Staff flu vaccination coverage | 26.1% |
42%
15.9 pts worse
|
Numerator 77 · Denominator 295 |
| Discharge function score | 80.92% |
56.45%
24.5 pts better
|
Numerator 123 · Denominator 152 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 56 · Denominator 56 |
| Transfer of health information to patient | 98.13% |
96.28%
1.8 pts better
|
Numerator 105 · Denominator 107 |
| Resident COVID-19 vaccinations up to date | 51.38% |
25.2%
26.2 pts better
|
Numerator 56 · Denominator 109 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.3 |
1.6
0.3 pts better
|
1.9
0.6 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.3 · Observed 1.2 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.2 |
1.9
0.7 pts better
|
1.8
0.6 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.2 · Observed 1.2 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 95.6% |
96.4%
0.8 pts worse
|
93.4%
2.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 91.3% · Q2 96.4% · Q3 99.1% · Q4 95.8% · 4Q avg 95.6% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 96.7% |
98.0%
1.3 pts worse
|
95.5%
1.2 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 96.7% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 6.6% |
4.5%
2.1 pts worse
|
3.3%
3.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.1% · Q2 6.2% · Q3 7.3% · Q4 6.8% · 4Q avg 6.6% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 4.5% |
9.7%
5.2 pts better
|
11.4%
6.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.0% · Q2 7.1% · Q3 1.0% · Q4 9.1% · 4Q avg 4.5% |
| Percentage of long-stay residents who lose too much weight | 5.2% |
5.5%
0.3 pts better
|
5.4%
0.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.4% · Q2 5.5% · Q3 6.7% · Q4 4.1% · 4Q avg 5.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 24.5% |
18.9%
5.6 pts worse
|
19.6%
4.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 22.3% · Q2 30.4% · Q3 25.3% · Q4 20.2% · 4Q avg 24.5% |
| Percentage of long-stay residents who received an antipsychotic medication | 6.8% |
18.7%
11.9 pts better
|
16.7%
9.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.3% · Q2 7.5% · Q3 5.9% · Q4 5.6% · 4Q avg 6.8% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.2%
0.2 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 15.4% |
19.2%
3.8 pts better
|
16.3%
0.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 17.6% · Q2 12.8% · Q3 13.3% · Q4 17.9% · 4Q avg 15.4% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 23.8% |
21.9%
1.9 pts worse
|
14.9%
8.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 24.1% · Q2 13.0% · Q3 21.8% · Q4 34.9% · 4Q avg 23.8% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.8% |
1.3%
0.5 pts better
|
1.0%
0.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.6% · Q2 0.0% · Q3 1.7% · Q4 0.0% · 4Q avg 0.8% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.1% |
2.4%
1.3 pts better
|
1.7%
0.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.8% · Q2 1.8% · Q3 0.9% · Q4 0.0% · 4Q avg 1.1% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 25.9% |
26.7%
0.8 pts better
|
19.8%
6.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 25.9% · Q2 25.1% · Q3 26.4% · Q4 26.3% · 4Q avg 25.9% |
| Percentage of long-stay residents with pressure ulcers | 3.4% |
4.4%
1 pts better
|
5.1%
1.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.4% · Q2 3.7% · Q3 3.6% · Q4 3.0% · 4Q avg 3.4% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 74.2% |
85.6%
11.4 pts worse
|
81.7%
7.5 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 59.7% · Q2 76.7% · Q3 89.7% · Q4 70.1% · 4Q avg 74.2% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 15.4% |
14.1%
1.3 pts worse
|
12.0%
3.4 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 15.4% · Observed 15.4% · Expected 11.2% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.3% |
1.7%
1.4 pts better
|
1.6%
1.3 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 1.2% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.3% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 85.9% |
83.0%
2.9 pts better
|
79.7%
6.2 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 85.9% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 26.7% |
22.1%
4.6 pts worse
|
23.9%
2.8 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 26.7% · Observed 25.8% · Expected 23.1% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-03-14 · Fire 2024-03-14
9 health deficiencies
Top issue: Pharmacy Service (3 deficiencies)
5 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Cycle 3
Health 2023-02-17 · Fire 2023-02-17
2 health deficiencies
Top issue: Pharmacy Service (1 deficiency)
1 fire-safety deficiencies
Top issue: Miscellaneous (1 deficiency)
Fire safety
Fire-safety citations
E · Potential for more than minimal harm
2025-06-05
K913 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure operating rooms are properly protected and written records are maintained and available for inspection.
Corrected 2025-07-25
D · Potential for more than minimal harm
2025-06-05
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2025-07-25
D · Potential for more than minimal harm
2025-06-05
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2025-07-25
C · Minimal harm
2025-06-05
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2025-07-25
C · Minimal harm
2025-06-05
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2025-07-25
C · Minimal harm
2025-06-05
K923 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2025-07-25
F · Potential for more than minimal harm
2024-03-14
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-04-30
D · Potential for more than minimal harm
2024-03-14
K223 · Egress Deficiencies
Fire Safety
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Corrected 2024-04-30
C · Minimal harm
2024-03-14
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2024-04-30
C · Minimal harm
2024-03-14
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2024-04-30
C · Minimal harm
2024-03-14
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-04-30
C · Minimal harm
2023-02-17
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-03-14
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-06-05
F578 · Resident Rights Deficiencies
Health
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected 2025-07-23
D · Potential for more than minimal harm
2025-06-05
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2025-07-23
D · Potential for more than minimal harm
2025-06-05
F887 · Infection Control Deficiencies
Health
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Corrected 2025-07-23
E · Potential for more than minimal harm
2024-03-14
F761 · Pharmacy Service Deficiencies
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2024-04-05
D · Potential for more than minimal harm
2024-03-14
F644 · Resident Assessment and Care Planning Deficiencies
Health
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2024-04-26
D · Potential for more than minimal harm
2024-03-14
F645 · Resident Assessment and Care Planning Deficiencies
Health
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected 2024-04-26
D · Potential for more than minimal harm
2024-03-14
F725 · Nursing and Physician Services Deficiencies
Health
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected 2024-04-01
D · Potential for more than minimal harm
2024-03-14
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2024-03-14
D · Potential for more than minimal harm
2024-03-14
F757 · Pharmacy Service Deficiencies
Health
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected 2024-03-14
D · Potential for more than minimal harm
2024-03-14
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-04-15
D · Potential for more than minimal harm
2024-03-14
F883 · Infection Control Deficiencies
Health
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected 2024-04-15
C · Minimal harm
2024-03-14
F732 · Nursing and Physician Services Deficiencies
Health
Post nurse staffing information every day.
Corrected 2024-04-15
E · Potential for more than minimal harm
2023-02-17
F761 · Pharmacy Service Deficiencies
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2023-03-01
D · Potential for more than minimal harm
2023-02-17
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-03-01
Penalties and ownership
What sits behind the stars
Ownership
Edgewood Nh Opco Holdco LLC
5% Or Greater Direct Ownership Interest · Organization
Ads Capital Trust
5% Or Greater Indirect Ownership Interest · Organization
Dasay 2019 Trust
5% Or Greater Indirect Ownership Interest · Organization
Fischer, Elazar
5% Or Greater Indirect Ownership Interest · Individual
Gamta 2020 Trust
5% Or Greater Indirect Ownership Interest · Organization
Pc8 Capital Group LLC
5% Or Greater Indirect Ownership Interest · Organization
Robillard, Patricia
W-2 Managing Employee · Individual
Sj Family Trust
5% Or Greater Indirect Ownership Interest · Organization
Sj Healthcare Capital LLC
5% Or Greater Indirect Ownership Interest · Organization
Stern, Aharon
Corporate Officer · Individual
Nearby options
Other facilities in reach
#1
Cedar Healthcare Center
Portsmouth, NH
5-star overall rating with 5-star inspections with 1 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
#2
Webster At Rye
Rye, NH
4-star overall rating with 4-star inspections with 2 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
#3
Durgin Pines
Kittery, ME
5-star overall rating with 5-star inspections with $14,434 in total fines with 4 recent health deficiencies with 10 fire-safety deficiencies in the latest cycle
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