Cycle 1
Health 2025-01-10 · Fire 2025-01-10
10 health deficiencies
Top issue: Administration (2 deficiencies)
3 fire-safety deficiencies
Top issue: Egress (2 deficiencies)
Milford, NH
The Elms Center
1-star overall rating with 1-star inspections with $9,770 in total fines with 10 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
71 Elm Street, Milford, NH
(603) 673-2907
Overall
1 / 5
CMS overall stars
Health inspections
1 / 5
Survey and complaint cycles
Staffing
1 / 5
RN + nurse staffing
Quality measures
2 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
52
Certified beds
Average residents
47
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
603 Healthcare
Operator or chain grouping
Approved since
1996-08-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
7 facilities
Chain averages 2 overall / 3 health / 2 staffing / 2 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
0.64
Registered nurse staffing · state 0.74 · national 0.68
LPN hours / resident day
0.67
Licensed practical nurse staffing · state 0.76 · national 0.87
Aide hours / resident day
1.68
Nurse aide staffing · state 2.39 · national 2.35
Total nurse hours
3.00
All reported nurse hours · state 3.88 · national 3.89
Licensed hours
1.32
RN + LPN hours · state 1.49 · national 1.54
Weekend hours
2.38
Weekend nurse staffing · state 3.44 · national 3.43
Weekend RN hours
0.27
Weekend registered nurse coverage · state 0.51 · national 0.47
Physical therapist
0.01
Reported PT staffing · state 0.06 · national 0.07
Adjusted RN hours
0.64
CMS adjusted RN staffing hours
Adjusted total hours
2.98
CMS adjusted total nurse staffing hours
Case-mix index
1.38
Higher values indicate more complex resident acuity
RN turnover
88%
Annual RN turnover · state 45% · national 45%
Total nurse turnover
58%
Annual nurse turnover · state 49% · national 46%
SNF VBP
Value-based purchasing
Program rank
11,414
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
16.82
Composite VBP score used to determine payment impact.
Payment multiplier
0.9817
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.38
Baseline 20.11% · Performance 19.86% · Measure score 3.38 · Achievement 3.38 · Improvement 0.30
Healthcare-associated infections
0
Baseline 7.75% · Performance 7.97% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
3.35
Baseline 42.22% · Performance 50.00% · Measure score 3.35 · Achievement 3.35 · Improvement 0
Adjusted total nurse staffing
0
Baseline 3.45 hours · Performance 2.89 hours · Measure score 0 · Achievement 0 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.85% |
10.72%
0.9 pts better
|
No Different than the National Rate · Eligible stays 60 · Observed rate 8.33% · Lower 95% interval 5.92% |
| Discharge to community | Not Available |
50.57%
|
Not Available · Eligible stays 24 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Medicare spending per beneficiary | 0.81 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 88.57% |
95.27%
6.7 pts worse
|
Numerator 31 · Denominator 35 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 35 |
| Discharge self-care score | 41.67% |
53.69%
12 pts worse
|
Numerator 10 · Denominator 24 |
| Discharge mobility score | 45.83% |
50.94%
5.1 pts worse
|
Numerator 11 · Denominator 24 |
| Pressure ulcers or injuries, new or worsened | 5.71% |
2.29%
3.4 pts worse
|
Numerator 2 · Denominator 35 · Adjusted rate 5.91% |
| Healthcare-associated infections requiring hospitalization | 7.97% |
7.12%
0.8 pts worse
|
No Different than the National Rate · Eligible stays 36 · Observed rate 11.11% · Lower 95% interval 4.44% |
| Staff COVID-19 vaccination coverage | 7.5% |
8.2%
0.7 pts worse
|
Numerator 3 · Denominator 40 |
| Staff flu vaccination coverage | 60.32% |
42%
18.3 pts better
|
Numerator 38 · Denominator 63 |
| Discharge function score | 58.33% |
56.45%
1.9 pts better
|
Numerator 14 · Denominator 24 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 16 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 4 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 16 · Too few residents or stays to report publicly. |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.0 |
1.6
0.4 pts worse
|
1.9
0.1 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.0 · Observed 1.7 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.4 |
1.9
0.5 pts better
|
1.8
0.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.4 · Observed 1.3 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 96.3% |
96.4%
0.1 pts worse
|
93.4%
2.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 95.3% · Q2 92.7% · Q3 97.5% · Q4 100.0% · 4Q avg 96.3% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 93.0% |
98.0%
5 pts worse
|
95.5%
2.5 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 93.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 3.7% |
4.5%
0.8 pts better
|
3.3%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.7% · Q2 4.9% · Q3 2.5% · Q4 2.5% · 4Q avg 3.7% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 27.7% |
9.7%
18 pts worse
|
11.4%
16.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 31.2% · Q3 41.2% · Q4 39.4% · 4Q avg 27.7% |
| Percentage of long-stay residents who lose too much weight | 4.6% |
5.5%
0.9 pts better
|
5.4%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.3% · Q2 0.0% · Q3 6.5% · Q4 3.4% · 4Q avg 4.6% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 36.7% |
18.9%
17.8 pts worse
|
19.6%
17.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 41.0% · Q2 40.0% · Q3 32.4% · Q4 32.3% · 4Q avg 36.7% |
| Percentage of long-stay residents who received an antipsychotic medication | 16.0% |
18.7%
2.7 pts better
|
16.7%
0.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 17.9% · Q2 17.4% · Q3 15.4% · Q4 13.0% · 4Q avg 16.0% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.6% |
0.2%
0.4 pts worse
|
0.1%
0.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 2.5% · 4Q avg 0.6% |
| Percentage of long-stay residents whose ability to walk independently worsened | 26.2% |
19.2%
7 pts worse
|
16.3%
9.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 26.0% · Q2 30.6% · 4Q avg 26.2% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 25.6% |
21.9%
3.7 pts worse
|
14.9%
10.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 38.9% · Q2 18.2% · Q3 12.9% · Q4 31.0% · 4Q avg 25.6% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.5% |
1.3%
1.2 pts worse
|
1.0%
1.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.5% · Q2 3.4% · Q3 3.9% · Q4 0.0% · 4Q avg 2.5% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 3.2% |
2.4%
0.8 pts worse
|
1.7%
1.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.9% · Q2 2.4% · Q3 5.3% · Q4 0.0% · 4Q avg 3.2% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 28.5% |
26.7%
1.8 pts worse
|
19.8%
8.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 23.6% · Q2 44.2% · Q3 19.1% · Q4 27.2% · 4Q avg 28.5% |
| Percentage of long-stay residents with pressure ulcers | 7.8% |
4.4%
3.4 pts worse
|
5.1%
2.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.4% · Q2 7.8% · Q3 7.7% · Q4 6.0% · 4Q avg 7.8% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 68.8% |
85.6%
16.8 pts worse
|
81.7%
12.9 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 67.9% · Q2 73.5% · Q3 68.4% · Q4 65.8% · 4Q avg 68.8% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 8.5% |
14.1%
5.6 pts better
|
12.0%
3.5 pts better
|
Short Stay · 20240701-20250630 · Adjusted 8.5% · Observed 11.5% · Expected 15.1% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.7%
1.7 pts better
|
1.6%
1.6 pts better
|
Short Stay · 2024Q4-2025Q3 · Q2 0.0% · Q3 0.0% · 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 | 57.1% |
83.0%
25.9 pts worse
|
79.7%
22.6 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 57.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 31.8% |
22.1%
9.7 pts worse
|
23.9%
7.9 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 31.8% · Observed 42.3% · Expected 31.8% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-01-25 · Fire 2024-01-25
7 health deficiencies
Top issue: Infection Control (1 deficiency)
3 fire-safety deficiencies
Top issue: Egress (1 deficiency)
Cycle 3
Health 2023-01-20 · Fire 2023-01-20
4 health deficiencies
Top issue: Infection Control (2 deficiencies)
1 fire-safety deficiencies
Top issue: Miscellaneous (1 deficiency)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-01-10
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2025-03-07
E · Potential for more than minimal harm
2025-01-10
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2025-03-07
C · Minimal harm
2025-01-10
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2025-03-07
E · Potential for more than minimal harm
2024-01-25
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2024-02-16
D · Potential for more than minimal harm
2024-01-25
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-02-16
C · Minimal harm
2024-01-25
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2024-02-16
C · Minimal harm
2023-01-20
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-02-08
Inspection history
Recent health citations
F · Potential for more than minimal harm
2025-01-10
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-02-07
D · Potential for more than minimal harm
2025-01-10
F552 · Resident Rights Deficiencies
Health
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected 2025-02-07
D · Potential for more than minimal harm
2025-01-10
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 2025-02-07
D · Potential for more than minimal harm
2025-01-10
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 2025-02-21
D · Potential for more than minimal harm
2025-01-10
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 2025-02-25
D · Potential for more than minimal harm
2025-01-10
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 2025-01-27
D · Potential for more than minimal harm
2025-01-10
F868 · Administration Deficiencies
Health
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Corrected 2025-02-06
C · Minimal harm
2025-01-10
F732 · Nursing and Physician Services Deficiencies
Health
Post nurse staffing information every day.
Corrected 2025-02-07
C · Minimal harm
2025-01-10
F838 · Administration Deficiencies
Health
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Corrected 2025-01-30
B · Minimal harm
2025-01-10
F637 · Resident Assessment and Care Planning Deficiencies
Health
Assess the resident when there is a significant change in condition
Corrected 2025-02-02
G · Actual harm
2024-01-25
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 2024-02-22
F · Potential for more than minimal harm
2024-01-25
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 2024-03-01
D · Potential for more than minimal harm
2024-01-25
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-02-26
D · Potential for more than minimal harm
2024-01-25
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 2024-02-23
D · Potential for more than minimal harm
2024-01-25
F811 · Nutrition and Dietary Deficiencies
Health
Ensure that residents are assessed for appropriateness for a feeding assistant program, receive services as per their plan of care, and feeding assistants are trained and supervised.
Corrected 2024-02-23
D · Potential for more than minimal harm
2024-01-25
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-02-22
C · Minimal harm
2024-01-25
F553 · Resident Rights Deficiencies
Health
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Corrected 2024-03-01
D · Potential for more than minimal harm
2023-01-20
F645 · Resident Assessment and Care Planning Deficiencies
Health
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected 2023-02-10
D · Potential for more than minimal harm
2023-01-20
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-02-10
D · Potential for more than minimal harm
2023-01-20
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-02-13
C · Minimal harm
2023-01-20
F885 · Infection Control Deficiencies
Health
Report COVID19 data to residents and families.
Corrected 2023-01-31
Penalties and ownership
What sits behind the stars
$9,770
2024-01-25
Fine
Fine · fine $9,770
Fine
Ownership
Pr Nh Holdings LLC
5% Or Greater Direct Ownership Interest · Organization
Rausman, Philip
5% Or Greater Indirect Ownership Interest · Individual
Rausman, Robert
5% Or Greater Indirect Ownership Interest · Individual
Rr Nh Holdings LLC
5% Or Greater Direct Ownership Interest · Organization
Stevenson, Sean
5% Or Greater Direct Ownership Interest · Individual
603 Healthcare LLC
Operational/Managerial Control · Organization
Manchin, Crystal
Operational/Managerial Control · Individual
Ojutalayo, Ayobami
Operational/Managerial Control · Individual
Stevenson, Sean
Operational/Managerial Control · Individual
Nearby options
Other facilities in reach
#1
Crestwood Center
Milford, NH
4-star overall rating with 3-star inspections with $15,646 in total fines with 3 recent health deficiencies
#2
Courville at Nashua
Nashua, NH
4-star overall rating with 3-star inspections with 2 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
#3
Southern New Hampshire Rehabilitation & Healthcare
Nashua, NH
1-star overall rating with 1-star inspections with 8 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
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