The Elms Center
Nursing Home, Memory Care & Respite Care · Milford, NH
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.

The Elms Center

Nursing Home, Memory Care & Respite Care · Milford, NH
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
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The Elms Center accepts Medicaid, Medicare, and private pay.

Inspection History

In New Hampshire, the Department of Health and Human Services, Health Facilities Administration is responsible for the unannounced inspection and licensing of all residential care and nursing facilities.

Since 2023 · 3 years of data 23 deficiencies

Inspection Scorecard Info This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the New Hampshire state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Since 2023 vs. New Hampshire state average
Overall vs. NH average 2 Worse Metrics worse than New Hampshire average:
• Total deficiencies (35% above)
• Deficiencies per year (35% above)
0 Better No metrics in this bucket.
Latest Inspection January 10, 2025 Routine

Deficiencies Info Deficiencies are formal regulatory issues recorded during state inspections.

This FacilityNH Averagevs. NH Avg
Total deficiencies Info Formal regulatory issues recorded by inspectors across all inspection types. 2317 This facility has 35% more total deficiencies than a typical New Hampshire assisted living residence (23 vs. NH avg 17).↑ 35% worse
Deficiencies per year Info Average deficiencies per year since 2023. 7.75.7 This facility has 35% more deficiencies per year than a typical New Hampshire assisted living residence (7.7 vs. NH avg 5.7).↑ 35% worse

Inspection Reports Summary Info An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

  • January 10, 2025 inspection found 10 deficiencies including failure to inform residents in their language, advance directive violations, medication and kitchen issues, and incomplete staffing assessments.
  • January 25, 2024 complaint investigation confirmed a resident fall causing serious fractures due to lack of assessment after wheelchair change without seatbelt.
  • January 25, 2024 routine inspection cited 8 deficiencies including insufficient nursing staff causing delayed care, late medications, poor supervision, and infection control lapses.

Health Inspection History

Inspections since 2023
Total health inspections 3

State average N/A


Last Health inspection on Jan 2025

Total health citations
21 Rank #51 / 66Health citations — State benchmarkedThis home is ranked 51st out of 66 homes in New Hampshire. Shows this facility's total health deficiency citations benchmarked to the New Hampshire State average, with a ranking across all 66 NH facilities. Lower citation counts earn a better rank.Rankings are based only on facilities in New Hampshire that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A

Citations per inspection
7 Rank #63 / 66Citations per inspection — State benchmarkedThis home is ranked 63rd out of 66 homes in New Hampshire. Shows average deficiency citations per CMS inspection for this facility versus the New Hampshire mean across 66 facilities with citation data. Lower is better.Rankings are based only on facilities in New Hampshire that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

State average N/A


Health citations are formal notices following inspections when they fail to comply with safety and care standards.

20 of 21 citations resulted from standard inspections; and 1 of 21 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 3 years)
Critical health citations
0
In line with State average

State average: N/A


Serious health citations
1
In line with State average

State average: N/A

0 critical citations State average: N/A

1 serious citation State average: N/A

15 moderate citations State average: N/A

5 minor citations State average: N/A
Citations history (last 3 years)
Administration minor citation Jan 10, 2025
Corrected

Administration moderate citation Jan 10, 2025
Corrected

Infection Control moderate citation Jan 10, 2025
Corrected

Nursing Services minor citation Jan 10, 2025
Corrected

Staffing Data

Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.

Total staff 66
Employees 49
Contractors 17
Staff to resident ratio 1.40 : 1
0% compared with State average

State average ratio: 0 : 0

Avg staff/day 21
Average shift 7.8 hours
0% compared with State average

State average: 0 hours

Total staff hours (quarter) 15,103

Nursing staff breakdown

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse

Manages medical care and health needs.

RN Staff Info 11 total: 9 full-time employees and 2 contractors. 11
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.8 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info All 6 LPN Staff are full-time employees. No contractors work on this role. 6
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.5 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info All 21 CNA Staff are full-time employees. No contractors work on this role. 21
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.8 hours

Contractor staffing

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.

Total hours from contractors

7.5%

1,131 contractor hours this quarter

Speech Language Pathologist: 3 Respiratory Therapy Technician: 3 Qualified Social Worker: 3 Registered Nurse: 2 Physical Therapy Assistant: 2 Physical Therapy Aide: 2 Nurse Practitioner: 1 Medical Director: 1

Staff by category

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Certified Nursing Assistant210215,36992100%7.8
Medication Aide/Technician5051,8457480%10
Licensed Practical Nurse6061,80992100%8.5
Registered Nurse92111,75492100%7.8
RN Director of Nursing1015285863%9.1
Administrator1015286672%8
Mental Health Service Worker1015286672%8
Dietitian1014846267%7.8
Other Dietary Services Staff1014816065%8
Clinical Nurse Specialist1014265560%7.7
Nurse Practitioner2134145661%7.4
Physical Therapy Assistant0223225257%6.1
Speech Language Pathologist0332495155%4.7
Physical Therapy Aide0222464043%5.2
Respiratory Therapy Technician033542628%1.9
Qualified Social Worker033401718%2.3
Medical Director011261314%2
21 Certified Nursing Assistant
% of Days 100%
5 Medication Aide/Technician
% of Days 80%
6 Licensed Practical Nurse
% of Days 100%
11 Registered Nurse
% of Days 100%
1 RN Director of Nursing
% of Days 63%
1 Administrator
% of Days 72%
1 Mental Health Service Worker
% of Days 72%
1 Dietitian
% of Days 67%
1 Other Dietary Services Staff
% of Days 65%
1 Clinical Nurse Specialist
% of Days 60%
3 Nurse Practitioner
% of Days 61%
2 Physical Therapy Assistant
% of Days 57%
3 Speech Language Pathologist
% of Days 55%
2 Physical Therapy Aide
% of Days 43%
3 Respiratory Therapy Technician
% of Days 28%
3 Qualified Social Worker
% of Days 18%
1 Medical Director
% of Days 14%

Penalties and fines

Includes penalties issued in 2024

Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.

Source: CMS Penalties Database (Data as of Jan 2026)

Total fines amount $13K Rank #52 / 66Federal fines — State benchmarkedThis home is ranked 52nd out of 66 homes in New Hampshire. Shows this facility's cumulative CMS federal fine dollars versus the New Hampshire average among facilities with fines, and where it ranks among 66 facilities in the pool. Lower total dollars mean a better rank.Rankings are based only on facilities in New Hampshire that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
61% lower than State average

State average: $33K

Number of fines 2
In line with State average

State average: 1.9

Payment Denials Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. 0
100% fewer payment denials than State average

State average: 0.1

Fines amount comparison
Fines amount comparison
This facility $13K
State average $33K
Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

1 penalty in the past 3 years

Jan 25, 2024 · $10K

Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Jan 25, 2024
$10K

Last updated: Jan 2026

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 13.4
18% worse than State average

State average: 11.4

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 26.8
16% worse than State average

State average: 23.2

Long-stay resident measures
Significantly below average State avg: 2.7 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 25.2%
15% worse than State average

State average: 21.9%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 24.3%
20% worse than State average

State average: 20.3%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 30.9%
14% worse than State average

State average: 27.1%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 4.1%
11% better than State average

State average: 4.6%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 7.8%
73% worse than State average

State average: 4.5%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 4.3%
71% worse than State average

State average: 2.5%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 5.8%
In line with State average

State average: 5.6%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 17.9%
117% worse than State average

State average: 8.3%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 15.8%
9% better than State average

State average: 17.4%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 95.4%
In line with State average

State average: 96.0%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 93.0%
5% worse than State average

State average: 98.0%

Hospitalizations per 1,000 days Info Number of hospitalizations per 1,000 long-stay resident days. 1.96
19% worse than State average

State average: 1.65

ED visits per 1,000 days Info Number of outpatient emergency department visits per 1,000 long-stay resident days. 1.36
28% better than State average

State average: 1.90

Short-stay resident measures
Average State avg: 2.9 Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 70.2%
16% worse than State average

State average: 83.8%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 0.0%
100% better than State average

State average: 1.6%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 57.1%
31% worse than State average

State average: 83.0%

Re-hospitalized after SNF stay Info Percentage of short-stay residents who were re-hospitalized after their nursing home admission. 31.8%
44% worse than State average

State average: 22.1%

Emergency department visits Info Percentage of short-stay residents who had an outpatient emergency department visit. 8.5%
40% better than State average

State average: 14.1%

Falls with major injury Info Percentage of SNF residents who experience falls with major injury during their stay. 0.0%
100% better than State average

State average: 0.8%

Ability to care for self at discharge Info Percentage of residents at or above expected ability to care for themselves at discharge. 41.7%
22% worse than State average

State average: 53.7%

Breakdown by payment type

Medicare

35% of new residents, usually for short-term rehab.

Typical stay 28 days

Private pay

37% of new residents, often for short stays.

Typical stay 1 - 2 months

Medicaid

28% of new residents, often for long-term daily care.

Typical stay 1 - 2 years

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 47
Medicare
4
8.5% of residents
Medicaid
39
83% of residents
Private pay or other
4
8.5% of residents
Programs & Services
Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

For-profit
Operated by a single business entity.
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$6.0M
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
-$279.8K
For-profit Operated by a single business entity.
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$6.0M Rank #54 / 65Revenue — State benchmarkedThis home is ranked 54th out of 65 homes in New Hampshire. Shows this facility's annual revenue compared to the New Hampshire average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Rankings are based only on facilities in New Hampshire that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
-$279.8K
Other income Info Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
$22.6K
Payroll costs Info Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs. Rank #58 / 65Payroll — State benchmarkedThis home is ranked 58th out of 65 homes in New Hampshire. Shows total annual staff payroll benchmarked to the New Hampshire average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Rankings are based only on facilities in New Hampshire that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
$3.3M 55.5% of net patient revenue Info Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay. Rank #35 / 65Payroll % — State benchmarkedThis home is ranked 35th out of 65 homes in New Hampshire. Shows payroll as a percentage of revenue versus the New Hampshire average. Well-run New Hampshire facilities typically land around 59–80% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Rankings are based only on facilities in New Hampshire that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Other operating costs Info Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
$3.0M
Total costs Info The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$6.3M

Who this home usually serves

TYPE OF STAY

Mostly long-term care residents

Most residents stay for extended periods and receive ongoing daily care.

New residents most often arrive under private pay (37% of admissions), and a typical private pay stay runs around 1 - 2 months.

Admissions
106 total

Coverage residents most often arrive under.

Medicare 35%
Private pay 37%
Medicaid 28%
Discharges
107 total

Coverage residents most often leave under.

Medicare 20%
Private pay 34%
Medicaid 47%

Places of interest near The Elms Center

Address 2.4 miles from city center Info Estimated distance in miles from Milford's city center to The Elms Center's address, calculated via Google Maps.

Calculate Travel Distance to The Elms Center

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Frequently Asked Questions about The Elms Center

What is the license number of The Elms Center?

According to NH state health department records, The Elms Center's license number is 04769.

What is the occupancy rate at The Elms Center?

The Elms Center's occupancy is 100%.

Does The Elms Center operate as a for-profit or non-profit?

The Elms Center is registered as a for-profit in NH.

Who is the administrator of The Elms Center?

Austin J Cole is the administrator of The Elms Center.

How many beds does The Elms Center have?

The Elms Center has 52 beds.

What is the address of The Elms Center?

The Elms Center is located at 71 Elm Street, Milford, NH 03055.

What is the phone number of The Elms Center?

(603) 673-2907 will put you in contact with the team at The Elms Center.

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