Cycle 1
Health 2025-07-24 · Fire 2025-07-24
2 health deficiencies
Top issue: Infection Control (1 deficiency)
1 fire-safety deficiencies
Top issue: Smoke (1 deficiency)
Manchester, NH
Mount Carmel Rehabilitation And Nursing Center
4-star overall rating with 4-star inspections with 2 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
235 Myrtle Street, Manchester, NH
(603) 627-3811
Overall
4 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
122
Certified beds
Average residents
111
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
Catholic Charities New Hampshire
Operator or chain grouping
Approved since
1996-04-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
6 facilities
Chain averages 4 overall / 4 health / 4 staffing / 3 quality stars
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
0.66
Registered nurse staffing · state 0.74 · national 0.68
LPN hours / resident day
1.02
Licensed practical nurse staffing · state 0.76 · national 0.87
Aide hours / resident day
2.58
Nurse aide staffing · state 2.39 · national 2.35
Total nurse hours
4.26
All reported nurse hours · state 3.88 · national 3.89
Licensed hours
1.68
RN + LPN hours · state 1.49 · national 1.54
Weekend hours
3.90
Weekend nurse staffing · state 3.44 · national 3.43
Weekend RN hours
0.46
Weekend registered nurse coverage · state 0.51 · national 0.47
Physical therapist
0.06
Reported PT staffing · state 0.06 · national 0.07
Adjusted RN hours
0.77
CMS adjusted RN staffing hours
Adjusted total hours
4.95
CMS adjusted total nurse staffing hours
Case-mix index
1.18
Higher values indicate more complex resident acuity
RN turnover
33%
Annual RN turnover · state 45% · national 45%
Total nurse turnover
49%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
7,880
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
28.52
Composite VBP score used to determine payment impact.
Payment multiplier
0.9850
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0
Baseline 18.76% · Performance 24.54% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
3.70
Baseline 5.54% · Performance 6.73% · Measure score 3.70 · Achievement 3.70 · Improvement 0
Total nurse turnover
3.53
Baseline 53.79% · Performance 49.24% · Measure score 3.53 · Achievement 3.53 · Improvement 1.07
Adjusted total nurse staffing
4.17
Baseline 4.70 hours · Performance 4.27 hours · Measure score 4.17 · Achievement 4.17 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 11.6% |
10.72%
0.9 pts worse
|
No Different than the National Rate · Eligible stays 334 · Observed rate 10.78% · Lower 95% interval 8.29% |
| Discharge to community | 59.03% |
50.57%
8.5 pts better
|
Better than the National Rate · Eligible stays 318 · Observed rate 55.66% · Lower 95% interval 54.51% |
| Medicare spending per beneficiary | 0.95 |
1.02
0.1 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 158 · Denominator 158 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 158 |
| Discharge self-care score | 70.5% |
53.69%
16.8 pts better
|
Numerator 98 · Denominator 139 |
| Discharge mobility score | 73.38% |
50.94%
22.4 pts better
|
Numerator 102 · Denominator 139 |
| Pressure ulcers or injuries, new or worsened | 1.27% |
2.29%
1 pts better
|
Numerator 2 · Denominator 158 · Adjusted rate 1.52% |
| Healthcare-associated infections requiring hospitalization | 6.73% |
7.12%
0.4 pts better
|
No Different than the National Rate · Eligible stays 231 · Observed rate 5.63% · Lower 95% interval 4.81% |
| Staff COVID-19 vaccination coverage | 5.48% |
8.2%
2.7 pts worse
|
Numerator 8 · Denominator 146 |
| Staff flu vaccination coverage | 57.29% |
42%
15.3 pts better
|
Numerator 114 · Denominator 199 |
| Discharge function score | 73.38% |
56.45%
16.9 pts better
|
Numerator 102 · Denominator 139 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 31 · Denominator 31 |
| Transfer of health information to patient | 97.62% |
96.28%
1.3 pts better
|
Numerator 82 · Denominator 84 |
| Resident COVID-19 vaccinations up to date | 28.95% |
25.2%
3.8 pts better
|
Numerator 22 · Denominator 76 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.2 |
1.6
0.6 pts worse
|
1.9
0.3 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.2 · Observed 2.0 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.6 |
1.9
0.3 pts better
|
1.8
0.2 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.6 · Observed 1.5 · Expected 1.5 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 93.9% |
96.4%
2.5 pts worse
|
93.4%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 96.9% · Q2 95.8% · Q3 87.8% · Q4 94.7% · 4Q avg 93.9% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
98.0%
2 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 4.0% |
4.5%
0.5 pts better
|
3.3%
0.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.1% · Q2 3.2% · Q3 3.3% · Q4 6.3% · 4Q avg 4.0% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.0% |
9.7%
9.7 pts better
|
11.4%
11.4 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 who lose too much weight | 4.3% |
5.5%
1.2 pts better
|
5.4%
1.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.5% · Q2 10.1% · Q3 2.6% · Q4 1.2% · 4Q avg 4.3% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 20.2% |
18.9%
1.3 pts worse
|
19.6%
0.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.1% · Q2 19.5% · Q3 18.5% · Q4 21.7% · 4Q avg 20.2% |
| Percentage of long-stay residents who received an antipsychotic medication | 8.5% |
18.7%
10.2 pts better
|
16.7%
8.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 7.7% · Q2 5.1% · Q3 9.8% · Q4 11.1% · 4Q avg 8.5% · 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 | 18.2% |
19.2%
1 pts better
|
16.3%
1.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 15.1% · Q2 21.6% · Q3 16.2% · Q4 20.4% · 4Q avg 18.2% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 23.2% |
21.9%
1.3 pts worse
|
14.9%
8.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.6% · Q2 26.0% · Q3 26.3% · Q4 19.2% · 4Q avg 23.2% · 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 5.0% · Q2 2.2% · Q3 1.2% · Q4 1.9% · 4Q avg 2.6% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 2.5% |
2.4%
0.1 pts worse
|
1.7%
0.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.2% · Q2 0.0% · Q3 2.3% · Q4 5.3% · 4Q avg 2.5% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 29.5% |
26.7%
2.8 pts worse
|
19.8%
9.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 37.0% · Q2 31.3% · Q3 25.0% · Q4 24.5% · 4Q avg 29.5% |
| Percentage of long-stay residents with pressure ulcers | 4.4% |
4.4%
About the same
|
5.1%
0.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.7% · Q2 4.1% · Q3 4.7% · Q4 3.9% · 4Q avg 4.4% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 93.2% |
85.6%
7.6 pts better
|
81.7%
11.5 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 94.0% · Q2 92.5% · Q3 91.8% · Q4 94.7% · 4Q avg 93.2% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 12.5% |
14.1%
1.6 pts better
|
12.0%
0.5 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 12.5% · Observed 11.2% · Expected 10.0% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.1% |
1.7%
0.6 pts better
|
1.6%
0.5 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 1.9% · Q2 1.9% · Q3 0.8% · Q4 0.0% · 4Q avg 1.1% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 91.6% |
83.0%
8.6 pts better
|
79.7%
11.9 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 91.6% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 33.7% |
22.1%
11.6 pts worse
|
23.9%
9.8 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 33.7% · Observed 29.4% · Expected 20.8% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-05-22 · Fire 2024-05-22
5 health deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
4 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Cycle 3
Health 2023-04-27 · Fire 2023-04-27
3 health deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (1 deficiency)
1 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-07-24
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2025-08-15
F · Potential for more than minimal harm
2024-05-22
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2024-06-14
E · Potential for more than minimal harm
2024-05-22
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2024-06-14
D · Potential for more than minimal harm
2024-05-22
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 2024-06-14
D · Potential for more than minimal harm
2024-05-22
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2024-06-14
D · Potential for more than minimal harm
2023-04-27
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-06-22
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-07-24
F552 · Resident Rights Deficiencies
Health
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected 2025-09-09
D · Potential for more than minimal harm
2025-07-24
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 2025-09-09
D · Potential for more than minimal harm
2024-05-22
F554 · Resident Rights Deficiencies
Health
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected 2024-06-06
D · Potential for more than minimal harm
2024-05-22
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 2024-06-10
D · Potential for more than minimal harm
2024-05-22
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-06-10
D · Potential for more than minimal harm
2024-05-22
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 2024-06-10
B · Minimal harm
2024-05-22
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2024-06-12
D · Potential for more than minimal harm
2023-04-27
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2023-05-26
D · Potential for more than minimal harm
2023-04-27
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-05-24
D · Potential for more than minimal harm
2023-04-27
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 2023-05-26
Penalties and ownership
What sits behind the stars
Ownership
Nh Catholic Charities Inc
5% Or Greater Direct Ownership Interest · Organization
Barrett, Kevin
Corporate Director · Individual
Bernard, Alain
W-2 Managing Employee · Individual
Blonski, Thomas
Corporate Officer · Individual
Blonski, Thomas
W-2 Managing Employee · Individual
Bohunicky, Joseph
W-2 Managing Employee · Individual
Coughlin, Adam
Corporate Director · Individual
Demers, Kate
Corporate Director · Individual
Desrosiers, Kevin
Corporate Director · Individual
Ford, Patrick
Corporate Director · Individual
Hildenbrand, David
Corporate Officer · Individual
Hilton, Richard
Corporate Director · Individual
Huard, Susan
Corporate Director · Individual
Jalbert, Jason
Corporate Director · Individual
Legere, Tina
Corporate Director · Individual
Libasci, Peter
Corporate Director · Individual
Mclean, Jeffrey
Corporate Director · Individual
Mirable, Catherine
Corporate Director · Individual
Mullikin, Anu
Corporate Director · Individual
Nh Catholic Charities Inc
Operational/Managerial Control · Organization
Ouellette, Russ
Corporate Director · Individual
Patenaude, John
Corporate Director · Individual
Powers, Edward
Corporate Director · Individual
Richardson, Sarah
W-2 Managing Employee · Individual
Zirkle, Karen
W-2 Managing Employee · Individual
Nearby options
Other facilities in reach
#1
Maple Leaf Health Care Center
Manchester, NH
4-star overall rating with 4-star inspections with 4 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
#2
Saint Teresa Rehabilitation & Nursing Center
Manchester, NH
4-star overall rating with 4-star inspections with 2 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#3
Courville At Manchester
Manchester, NH
2-star overall rating with 2-star inspections with 9 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
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