Federal inspection record · CMS data as of October 1, 2026
Madigan Estates
93 Military Street, Houlton, ME · (207) 532-6593
- Certified beds
- 99
- Residents per day
- 96
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- January 1, 1993
1
How this home got 4 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Maine.
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Staffing
★★★★★+1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★4 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Maine homes
Madigan Estates carries 58 inspection points. That is fewer than 62% of Maine's 77 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Maine: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–24 pts
- 4★ 24–55 pts
- 3★ 55–78 pts
- 2★ 78–115.5 pts
- 1★ over 115.5 pts
Bars show every rated home in Maine by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
26 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (1)
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Quality of Life and Care6E
- E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Resident Assessment and Care Planning6E
- D
Ensure each resident receives an accurate assessment.
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Freedom from Abuse, Neglect, and Exploitation5D
- D
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- B
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Nutrition and Dietary3E
- D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control3D
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- C
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Nursing and Physician Services1D
- D
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Pharmacy Service1E
- E
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.
Inspection history
2025-05-22
13 health deficiencies · 9 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (4 deficiencies)
2024-03-21
7 health deficiencies · 0 fire-safety deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
2023-05-24
6 health deficiencies · 4 fire-safety deficiencies
Top issue: Infection Control (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 4 h 8 min of nursing staff time a day, 50 min of it from a registered nurse.
This home
4 h 8 min
Maine average
4 h 23 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 43% of nursing staff and 26% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$11,450 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2023-11-14 | Fine | $11,450 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.1 pts better | 1.2 | 1.3 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.8 pts worse | 2.5 | 1.7 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine1.5 pts better | 94.6% | 93.1% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2 pts better | 97.9% | 95.9% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury3.6 pts worse | 7.6% | 4.0% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms5.6 pts worse | 17.3% | 11.7% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.3 pts worse | 6.4% | 5.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication2.6 pts worse | 20.2% | 17.6% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication3.6 pts worse | 23.1% | 19.5% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened2.3 pts better | 21.6% | 23.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased4.8 pts worse | 29.1% | 24.3% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.6 pts worse | 1.5% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection2 pts worse | 4.1% | 2.1% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence3 pts worse | 31.2% | 28.2% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.7 pts worse | 5.1% | 4.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine1.1 pts worse | 71.6% | 72.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit2.6 pts better | 12.8% | 15.4% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.5 pts better | 0.0% | 1.5% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine19.9 pts better | 97.1% | 77.2% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission7.7 pts better | 12.9% | 20.6% | 23.4% |
·
Who owns and runs it
12 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Brown, James | 5% Or Greater Direct Ownership Interest · Individual | 100% | 4 facilities |
| Abouleish, Hassan | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Abouleish, Hassan | Adp Of The SNF · Individual | 0% | 1 facilities |
| Brown, Dana | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Brown, Dana | Adp Of The SNF · Individual | 0% | 1 facilities |
| Brown, James | Indirect Ownership Interest · Individual | 0% | 4 facilities |
| Brown, James | Corporate Director · Individual | 0% | 4 facilities |
| Brown, James | Operational/Managerial Control · Individual | 0% | 4 facilities |
| Brown, James | Trustee Of The SNF · Individual | 0% | 4 facilities |
| Brown, James | Adp Of The SNF · Individual | 0% | 4 facilities |
| Russell, Ashley | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Russell, Ashley | Adp Of The SNF · Individual | 0% | 1 facilities |
·
Fire safety
13 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Egress5D
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
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.
- D
Have properly located and lighted "Exit" signs.
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
Have exits that are accessible at all times.
Gas, Vacuum, and Electrical Systems4D
- D
Meet requirements for the installation and maintenance of electrical systems.
- D
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- D
Ensure proper usage of power strips and extension cords.
- D
Ensure proper usage of power strips and extension cords.
Smoke3D
- D
Install an approved automatic sprinkler system.
- D
Properly select, install, inspect, or maintain portable fire extinguishes.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Miscellaneous1D
- D
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
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Other homes nearby
-
Presque Isle Healthcare Center
Presque Isle, ME
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 4 h 41 min
- Fines
- $0
-
Maine Veterans Home - Caribou
Caribou, ME · Maine Veterans' Home
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 5 h 20 min
- Fines
- $27,508
-
Caribou Healthcare Center, LLC
Caribou, ME · First Atlantic Healthcare
★★★★★- Worst citation, 3 yrs
- H
- Nursing / resident / day
- 4 h 35 min
- Fines
- $0