Cycle 1
Health 2025-05-22 · Fire 2025-05-22
12 health deficiencies
Top issue: Resident Assessment and Care Planning (4 deficiencies)
9 fire-safety deficiencies
Top issue: Egress (3 deficiencies)
Houlton, ME
Madigan Estates
5-star overall rating with 4-star inspections with $11,450 in total fines with 12 recent health deficiencies with 9 fire-safety deficiencies in the latest cycle
93 Military Street, Houlton, ME
(207) 532-6593
Overall
5 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
5 / 5
RN + nurse staffing
Quality measures
2 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
99
Certified beds
Average residents
94
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1993-01-01
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
0.89
Registered nurse staffing · state 1.03 · national 0.68
LPN hours / resident day
0.37
Licensed practical nurse staffing · state 0.47 · national 0.87
Aide hours / resident day
3.17
Nurse aide staffing · state 2.86 · national 2.35
Total nurse hours
4.43
All reported nurse hours · state 4.35 · national 3.89
Licensed hours
1.26
RN + LPN hours · state 1.49 · national 1.54
Weekend hours
3.72
Weekend nurse staffing · state 3.91 · national 3.43
Weekend RN hours
0.36
Weekend registered nurse coverage · state 0.73 · national 0.47
Physical therapist
0.06
Reported PT staffing · state 0.07 · national 0.07
Adjusted RN hours
0.95
CMS adjusted RN staffing hours
Adjusted total hours
4.77
CMS adjusted total nurse staffing hours
Case-mix index
1.27
Higher values indicate more complex resident acuity
RN turnover
29%
Annual RN turnover · state 45% · national 45%
Total nurse turnover
33%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
2,807
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
47.62
Composite VBP score used to determine payment impact.
Payment multiplier
1.0012
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
2.95
Baseline 15.96% · Performance 20.07% · Measure score 2.95 · Achievement 2.95 · Improvement 0
Healthcare-associated infections
5.72
Baseline 4.94% · Performance 6.12% · Measure score 5.72 · Achievement 5.72 · Improvement 0
Total nurse turnover
5.76
Baseline 30.00% · Performance 40.16% · Measure score 5.76 · Achievement 5.76 · Improvement 0
Adjusted total nurse staffing
4.62
Baseline 3.81 hours · Performance 4.39 hours · Measure score 4.62 · Achievement 4.62 · Improvement 2.45
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.47% |
10.72%
1.2 pts better
|
No Different than the National Rate · Eligible stays 68 · Observed rate 2.94% · Lower 95% interval 6.14% |
| Discharge to community | 42.76% |
50.57%
7.8 pts worse
|
No Different than the National Rate · Eligible stays 64 · Observed rate 40.63% · Lower 95% interval 32.95% |
| Medicare spending per beneficiary | 1.21 |
1.02
0.2 pts worse
|
|
| Drug regimen review with follow-up | 97.87% |
95.27%
2.6 pts better
|
Numerator 46 · Denominator 47 |
| Falls with major injury | 6.38% |
0.77%
5.6 pts worse
|
Numerator 3 · Denominator 47 |
| Discharge self-care score | 40% |
53.69%
13.7 pts worse
|
Numerator 14 · Denominator 35 |
| Discharge mobility score | 34.29% |
50.94%
16.6 pts worse
|
Numerator 12 · Denominator 35 |
| Pressure ulcers or injuries, new or worsened | 2.13% |
2.29%
0.2 pts better
|
Numerator 1 · Denominator 47 · Adjusted rate 2.67% |
| Healthcare-associated infections requiring hospitalization | 6.12% |
7.12%
1 pts better
|
No Different than the National Rate · Eligible stays 40 · Observed rate 0% · Lower 95% interval 3.19% |
| Staff COVID-19 vaccination coverage | 2.06% |
8.2%
6.1 pts worse
|
Numerator 4 · Denominator 194 |
| Staff flu vaccination coverage | 30.32% |
42%
11.7 pts worse
|
Numerator 57 · Denominator 188 |
| Discharge function score | 37.14% |
56.45%
19.3 pts worse
|
Numerator 13 · Denominator 35 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 16 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 40.74% |
25.2%
15.5 pts better
|
Numerator 11 · Denominator 27 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.6 |
1.4
0.8 pts better
|
1.9
1.3 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.6 · Observed 0.5 · Expected 1.6 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 3.3 |
2.1
1.2 pts worse
|
1.8
1.5 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 3.3 · Observed 3.2 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 89.3% |
90.7%
1.4 pts worse
|
93.4%
4.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 92.0% · Q2 86.2% · Q3 87.5% · Q4 91.6% · 4Q avg 89.3% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 78.5% |
95.5%
17 pts worse
|
95.5%
17 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 78.5% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 5.5% |
4.3%
1.2 pts worse
|
3.3%
2.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.6% · Q2 5.7% · Q3 5.7% · Q4 6.0% · 4Q avg 5.5% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 16.4% |
10.7%
5.7 pts worse
|
11.4%
5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 14.3% · Q2 16.5% · Q3 21.2% · Q4 13.6% · 4Q avg 16.4% |
| Percentage of long-stay residents who lose too much weight | 8.4% |
5.5%
2.9 pts worse
|
5.4%
3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 13.9% · Q2 10.4% · Q3 5.5% · Q4 3.1% · 4Q avg 8.4% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 24.7% |
17.0%
7.7 pts worse
|
19.6%
5.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 24.3% · Q2 28.0% · Q3 24.4% · Q4 21.2% · 4Q avg 24.7% |
| Percentage of long-stay residents who received an antipsychotic medication | 23.7% |
21.0%
2.7 pts worse
|
16.7%
7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.2% · Q2 27.9% · Q3 23.8% · Q4 22.0% · 4Q avg 23.7% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.0%
About the same
|
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 | 28.8% |
29.6%
0.8 pts better
|
16.3%
12.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 22.4% · Q2 28.9% · Q3 32.9% · Q4 30.2% · 4Q avg 28.8% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 37.7% |
25.7%
12 pts worse
|
14.9%
22.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 43.3% · Q2 46.6% · Q3 33.8% · Q4 25.0% · 4Q avg 37.7% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.6% |
1.3%
1.3 pts worse
|
1.0%
1.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.0% · Q2 2.3% · Q3 4.8% · Q4 1.2% · 4Q avg 2.6% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 3.9% |
2.7%
1.2 pts worse
|
1.7%
2.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.9% · Q2 6.1% · Q3 1.2% · Q4 2.5% · 4Q avg 3.9% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 35.2% |
29.8%
5.4 pts worse
|
19.8%
15.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 29.1% · Q2 33.6% · Q3 44.0% · Q4 34.8% · 4Q avg 35.2% |
| Percentage of long-stay residents with pressure ulcers | 2.8% |
4.4%
1.6 pts better
|
5.1%
2.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.4% · Q2 0.0% · Q3 3.5% · Q4 6.5% · 4Q avg 2.8% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 68.7% |
71.2%
2.5 pts worse
|
81.7%
13 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 65.8% · Q2 69.0% · Q3 73.9% · Q4 66.1% · 4Q avg 68.7% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 30.1% |
15.6%
14.5 pts worse
|
12.0%
18.1 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 30.1% · Observed 25.0% · Expected 9.3% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.4%
1.4 pts better
|
1.6%
1.6 pts better
|
Short Stay · 2024Q4-2025Q3 · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 77.3% |
74.5%
2.8 pts better
|
79.7%
2.4 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 77.3% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 18.7% |
20.5%
1.8 pts better
|
23.9%
5.2 pts better
|
Short Stay · 20240701-20250630 · Adjusted 18.7% · Observed 13.6% · Expected 17.4% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-03-21 · Fire 2024-03-21
7 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2023-05-24 · Fire 2023-05-24
6 health deficiencies
Top issue: Infection Control (2 deficiencies)
4 fire-safety deficiencies
Top issue: Egress (2 deficiencies)
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2025-05-22
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-22
K222 · Egress Deficiencies
Fire Safety
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-22
K293 · Egress Deficiencies
Fire Safety
Have properly located and lighted "Exit" signs.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-22
K351 · Smoke Deficiencies
Fire Safety
Install an approved automatic sprinkler system.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-22
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-22
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-22
K911 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Meet requirements for the installation and maintenance of electrical systems.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-22
K914 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Corrected 2025-06-30
D · Potential for more than minimal harm
2025-05-22
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2025-06-30
D · Potential for more than minimal harm
2023-05-24
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2023-06-05
D · Potential for more than minimal harm
2023-05-24
K271 · Egress Deficiencies
Fire Safety
Have exits that are accessible at all times.
Corrected 2023-06-05
D · Potential for more than minimal harm
2023-05-24
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 2023-06-05
D · Potential for more than minimal harm
2023-05-24
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2023-06-05
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-05-22
F605 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Corrected 2025-07-06
D · Potential for more than minimal harm
2025-05-22
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2025-07-06
D · Potential for more than minimal harm
2025-05-22
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2025-06-27
D · Potential for more than minimal harm
2025-05-22
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2025-06-27
D · Potential for more than minimal harm
2025-05-22
F655 · Resident Assessment and Care Planning Deficiencies
Health
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2025-06-27
D · Potential for more than minimal harm
2025-05-22
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2025-06-27
D · Potential for more than minimal harm
2025-05-22
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2025-07-06
D · Potential for more than minimal harm
2025-05-22
F690 · Quality of Life and Care Deficiencies
Health
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected 2025-06-27
D · Potential for more than minimal harm
2025-05-22
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-07-06
D · Potential for more than minimal harm
2025-05-22
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 2025-06-27
D · Potential for more than minimal harm
2025-05-22
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-07-14
D · Potential for more than minimal harm
2025-05-22
F947 · Nursing and Physician Services Deficiencies
Health
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Corrected 2025-06-17
D · Potential for more than minimal harm
2025-01-22
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2025-03-08
E · Potential for more than minimal harm
2024-03-21
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2024-04-11
E · Potential for more than minimal harm
2024-03-21
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2024-04-11
E · Potential for more than minimal harm
2024-03-21
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 2024-04-11
E · Potential for more than minimal harm
2024-03-21
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 2024-03-29
D · Potential for more than minimal harm
2024-03-21
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 2024-04-09
D · Potential for more than minimal harm
2024-03-21
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-04-05
G · Actual harm
2023-11-14
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2023-11-03
B · Minimal harm
2023-11-14
F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Not marked corrected
E · Potential for more than minimal harm
2023-05-24
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-07-24
E · Potential for more than minimal harm
2023-05-24
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-06-12
D · Potential for more than minimal harm
2023-05-24
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-06-12
C · Minimal harm
2023-05-24
F883 · Infection Control Deficiencies
Health
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected 2023-06-15
Penalties and ownership
What sits behind the stars
$11,450
2023-11-14
Fine
Fine · fine $11,450
Fine
Ownership
Brown, James
5% Or Greater Direct Ownership Interest · Individual
Abouleish, Hassan
Operational/Managerial Control · Individual
Brown, Dana
Operational/Managerial Control · Individual
Brown, James
Operational/Managerial Control · Individual
Brown, James
Corporate Director · Individual
Russell, Ashley
Operational/Managerial Control · Individual
Nearby options
Other facilities in reach
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Aroostook Health Center
Mars Hill, ME
5-star overall rating with 4-star inspections with 9 recent health deficiencies
#2
Maine Veterans Home - Caribou
Caribou, ME
5-star overall rating with 4-star inspections with $7,901 in total fines with 5 recent health deficiencies
#3
Caribou Rehab and Nursing Center
Caribou, ME
2-star overall rating with 2-star inspections with 11 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
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