Federal inspection record · CMS data as of October 1, 2026
The Elms Center
71 Elm Street, Milford, NH · (603) 673-2907
- Certified beds
- 52
- Residents per day
- 46
- Ownership
- For-Profit
- Chain
- 603 Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- August 1, 1996
1
How this home got 3 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 New Hampshire.
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Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
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
★★★★★3 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among New Hampshire homes
The Elms Center carries 21 inspection points. That is fewer than 50% of New Hampshire's 72 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in New Hampshire: 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★ 0–6 pts
- 4★ 6–15 pts
- 3★ 15–23 pts
- 2★ 23–40 pts
- 1★ over 40 pts
Bars show every rated home in New Hampshire 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
19 health citations on record since 2024. 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
Resident Assessment and Care Planning4D
- D
Provide doctor's orders for the resident's immediate care at the time the resident was 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.
- B
Assess the resident when there is a significant change in condition
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Pharmacy Service3D
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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.
- D
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.
Resident Rights3D
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- D
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.
- C
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Infection Control2F
- F
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Nutrition and Dietary2D
- D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
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.
Administration2D
- D
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
- C
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.
Nursing and Physician Services2F
- C
Post nurse staffing information every day.
- F
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Inspection history
2026-02-24
2 health deficiencies · 3 fire-safety deficiencies
Top issue: Pharmacy Service (1 deficiency)
2025-01-10
10 health deficiencies · 3 fire-safety deficiencies
Top issue: Administration (2 deficiencies)
2024-01-25
7 health deficiencies · 3 fire-safety deficiencies
Top issue: Infection Control (1 deficiency)
4
Nursing time per resident, per day
Each resident here gets about 3 h 6 min of nursing staff time a day, 49 min of it from a registered nurse.
This home
3 h 6 min
New Hampshire average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 63% of nursing staff and 67% of registered nurses left in the past year, along with 1 administrator.
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
$9,770 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2024-01-25 | Fine | $9,770 |
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 days2.5 pts worse | 4.2 | 1.7 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.5 pts worse | 2.4 | 1.9 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3.3 pts worse | 94.4% | 97.7% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine0.1 pts worse | 97.7% | 97.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2.4 pts worse | 6.9% | 4.5% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms27 pts worse | 42.8% | 15.8% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.2 pts worse | 6.4% | 5.2% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication5.9 pts worse | 25.0% | 19.1% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication0.8 pts worse | 18.7% | 17.9% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.5 pts worse | 0.6% | 0.1% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened10.5 pts worse | 26.3% | 15.8% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased8.1 pts worse | 30.4% | 22.3% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.9 pts better | 0.0% | 0.9% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.5 pts better | 0.7% | 2.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.2 pts worse | 25.6% | 25.4% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.9 pts worse | 5.2% | 4.3% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine19.2 pts worse | 67.9% | 87.1% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit7.1 pts better | 5.9% | 13.0% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.2 pts better | 0.0% | 1.2% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine6.9 pts worse | 78.8% | 85.7% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission19.6 pts worse | 41.4% | 21.8% | 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 |
|---|---|---|---|
| Pr Nh Holdings LLC | 5% Or Greater Direct Ownership Interest · Organization | 48% | 11 facilities |
| Rr Nh Holdings LLC | 5% Or Greater Direct Ownership Interest · Organization | 48% | 11 facilities |
| 603 Healthcare LLC | Operational/Managerial Control · Organization | 0% | 11 facilities |
| 603 Healthcare LLC | Adp Of The SNF · Organization | 0% | 11 facilities |
| Manchin, Crystal | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Manchin, Crystal | Adp Of The SNF · Individual | 0% | 1 facilities |
| Ojutalayo, Ayobami | Operational/Managerial Control · Individual | 0% | 5 facilities |
| Ojutalayo, Ayobami | Adp Of The SNF · Individual | 0% | 5 facilities |
| Rausman, Philip | Indirect Ownership Interest · Individual | 0% | 7 facilities |
| Rausman, Robert | Indirect Ownership Interest · Individual | 0% | 8 facilities |
| Stevenson, Sean | Direct Ownership Interest · Individual | 0% | 10 facilities |
| Stevenson, Sean | Operational/Managerial Control · Individual | 0% | 10 facilities |
·
Fire safety
9 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Egress4F
- B
Install emergency lighting that can last at least 1 1/2 hours.
- F
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
Install emergency lighting that can last at least 1 1/2 hours.
- C
Install emergency lighting that can last at least 1 1/2 hours.
Smoke3E
- D
Properly select, install, inspect, or maintain portable fire extinguishes.
- C
Provide properly protected cooking facilities.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Gas, Vacuum, and Electrical Systems2D
- D
Have generator or other power source capable of supplying service within 10 seconds.
- D
Have generator or other power source capable of supplying service within 10 seconds.
·
Other homes nearby
-
Crestwood Center
Milford, NH · Genesis Healthcare
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 24 min
- Fines
- $15,646
-
Courville at Nashua
Nashua, NH
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 3 h 46 min
- Fines
- $0
-
Nashua Post Acute Care
Nashua, NH · Marquis Health Services
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 4 min
- Fines
- $0