Buckingham‘s Choice
Nursing Home, Assisted Living, Memory Care, Respite Care & Skilled Nursing · Adamstown, MD
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.

Buckingham‘s Choice

Nursing Home, Assisted Living, Memory Care, Respite Care & Skilled Nursing · Adamstown, MD
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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Buckingham‘s Choice accepts Medicare and private pay.

Overview of Buckingham‘s Choice

Buckingham’s Choice provides exceptional service for seniors of independent living, assisted, and memory care living. The nurturing environment empowers and enhances the quality of life for residents by tailored care to each unique individual. Personalized care caters to each individual’s needs while maintaining independence and individuality. Buckingham’s Choice offers a vibrant lifestyle for a graceful senior living experience.

They pride themselves on their unmatched level of care thanks to their remarkable staff who offer compassionate service. Community features include 24-hour care, delicious meals served three times daily, social activities, engaging events, housekeeping and laundry services, and optimum security provided.

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
▲ 64.4% Above MD avg. ▲ 64.4% Above MD avg.MD average: 3.0Click the badge to see the full State ranking.Click here to see the full State ranking.
Health Inspection Info Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
▲ 77.5% Above MD avg. ▲ 77.5% Above MD avg.MD average: 2.8Click the badge to see the full State ranking.Click here to see the full State ranking.
Staffing Info Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
▲ 64.2% Above MD avg. ▲ 64.2% Above MD avg.MD average: 3.0Click the badge to see the full State ranking.Click here to see the full State ranking.
Quality Measures Info Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
▲ 35.3% Above MD avg. ▲ 35.3% Above MD avg.MD average: 3.7Click the badge to see the full State ranking.Click here to see the full State ranking.

Staffing hours Info Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.

Hours per resident per day vs Maryland averages

Rank #16 / 120Nurse hours — State benchmarkedThis home is ranked 16th out of 120 homes we track in Maryland for nurse hours. Shows adjusted nurse hours per resident per day benchmarked to the Maryland average, with a ranking across 120 Maryland facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Total nursing care Info This home is ranked 16th out of 120 homes we track in Maryland for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.

5h 3m

34% above state avg
Staff type
Hours / day / resident
vs state avg
Registered Nurse (RN) Info RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
1h 48m
+115% State avg: 50m per day · National avg: 42m per day
LPN / LVN Info Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
41m
−24% State avg: 54m per day · National avg: 52m per day
Nurse Aide Info Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
2h 35m
+23% State avg: 2h 6m per day · National avg: 2h 24m per day
Weekend Total Nursing Info Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
4h 29m
+31% State avg: 3h 26m per day · National avg: 3h 30m per day
Physical Therapist Info Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
12m
+94% State avg: 6m per day · National avg: 4m per day
Weekend RN Info Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
1h 16m
+102% State avg: 38m per day · National avg: 29m per day

1 of 6 metrics below state avg

Capacity and availability

This home usually has availability

Lower occupancy than the Maryland average: 82.2%
Occupancy rate
59% Rank #82 / 91Occupancy rate — State benchmarkedThis home is ranked 82nd out of 91 homes we track in Maryland for occupancy. Shows this facility's occupancy rate versus the Maryland average, with its Statewide rank out of 91. Higher occupancy signals strong local demand and financial stability.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Residents per day (avg)
25
Avg. Length of Stay Info Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
85 days
Bed community size
42-bed community Rank #222 / 684Bed count — State benchmarkedThis home is ranked 222nd out of 684 homes we track in Maryland for bed count. Shows this facility's certified or reported bed count compared to other Maryland facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A moderately sized community that may balance personal attention with shared amenities and social activities.
Years in operation
31 years in operation Rank #39 / 210Years in operation — State benchmarkedThis home is ranked 39th out of 210 homes we track in Maryland for years in operation. Shows how long this facility has been in operation compared to other Maryland facilities. Longer operating histories may benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care.
Walk Score
Walk Score: 3 / 100 Rank #930 / 953Walk Score — State benchmarkedThis home is ranked 930th out of 953 homes we track in Maryland for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Maryland facilities. Higher scores benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Car-dependent. Most errands require a car, with limited nearby walkable options.

About this community

License Details

CMS Certification Number215329

Payment & Insurance

1 service
Accept Medicare

Therapy & Rehabilitation

3 services
Rehabilitation Services
Respite Care
Short-Term Rehab

Staffing & Medical

1 service
24-Hour Staffing

Additional Services

1 service
Rehabilitation Therapy

Amenities & Lifestyle

Fitness Center
Dining
Nature Trails
Operating Hours24/7

Contact Buckingham‘s Choice

CMS Health Inspection History

Inspections Since 2018 · 8 years of data
Total health inspections 3

Maryland average 3.9


Last Health inspection on Nov 2024

Total health citations
29 Rank #27 / 123Health citations — State benchmarkedThis home is ranked 27th out of 123 homes we track in Maryland for health citations. Shows this facility's total health deficiency citations benchmarked to the Maryland State average, with a ranking across all 123 MD facilities. Lower citation counts earn a better rank.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Maryland average 49.9

Citations per inspection
9.67 Rank #46 / 123Citations per inspection — State benchmarkedThis home is ranked 46th out of 123 homes we track in Maryland for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Maryland mean across 123 facilities with citation data. Lower is better.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Maryland average 12.81


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

28 of 29 citations resulted from standard inspections; and 1 of 29 resulted from complaint investigations.

Breakdown of citation severity (last 8 years)
Critical health citations
0
100% better than Maryland average

Maryland average: 0.5


Serious health citations
0
100% better than Maryland average

Maryland average: 0.6

0 critical citations Maryland average: 0.5

0 serious citations Maryland average: 0.6

25 moderate citations Maryland average: 47.2

4 minor citations Maryland average: 1.7
Citations history (last 8 years)
Nutrition moderate citation Nov 22, 2024
Corrected

Nutrition moderate citation Nov 22, 2024
Corrected

Quality of Care moderate citation Nov 22, 2024
Corrected

Care Planning moderate citation Nov 22, 2024
Corrected

Staffing Data

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

Total staff 62
Employees 60
Contractors 2
Staff to resident ratio 2.21 : 1
22% more staff per resident than Maryland average
Maryland average ratio: 1.81 : 1 Maryland average ratio: 1.81 : 1See full Maryland ranking
Avg staff/day 20
Average shift 7.1 hours
11% worse than Maryland average
Maryland average: 8 hours Maryland average shift: 8 hoursSee full Maryland ranking
Total staff hours (quarter) 13,105

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 All 14 RN Staff are full-time employees. No contractors work on this role. 14
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.4 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info All 4 LPN Staff are full-time employees. No contractors work on this role. 4
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 11.2 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info All 20 CNA Staff are full-time employees. No contractors work on this role. 20
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7 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

1.2%

158 contractor hours this quarter

Occupational Therapy Assistant: 1 Occupational Therapy Aide: 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 Assistant200204,97792100%7
Registered Nurse140142,50592100%8.4
Licensed Practical Nurse4041,0607480%11.2
Physical Therapy Assistant4045877076%4.6
Other Dietary Services Staff1015336571%8.2
Clinical Nurse Specialist1015236470%8.2
Administrator1015126470%8
Nurse Practitioner1015126470%8
Mental Health Service Worker1014466166%7.3
Dietitian1014385863%7.6
Respiratory Therapy Technician4043046267%4.1
Speech Language Pathologist3032705964%4.5
Physical Therapy Aide1011805459%3.3
Occupational Therapy Aide0111442426%6
Qualified Social Worker202801718%4.7
Occupational Therapy Assistant1122178%3
Medical Director101141415%1
20 Certified Nursing Assistant
% of Days 100%
14 Registered Nurse
% of Days 100%
4 Licensed Practical Nurse
% of Days 80%
4 Physical Therapy Assistant
% of Days 76%

Penalties and fines

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

No penalties in the past 3 years

No civil money penalties or payment denials were reported in the last 3 years.

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. 11.0
15% better than Maryland average

Maryland average: 12.9

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 21.2
18% better than Maryland average

Maryland average: 25.7

Long-stay resident measures
Significantly above average 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 22.2%
6% better than Maryland average

Maryland average: 23.7%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 20.1%
23% better than Maryland average

Maryland average: 25.9%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 2.5%
11% worse than Maryland average

Maryland average: 2.3%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 14.7%
126% worse than Maryland average

Maryland average: 6.5%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 0.0%
100% better than Maryland average

Maryland average: 1.6%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 4.4%
23% better than Maryland average

Maryland average: 5.8%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 0.0%
100% better than Maryland average

Maryland average: 20.2%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 11.4%
12% better than Maryland average

Maryland average: 12.9%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
9% better than Maryland average

Maryland average: 92.0%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
In line with Maryland average

Maryland average: 96.6%

Short-stay resident measures
Above average 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 100.0%
27% better than Maryland average

Maryland average: 78.4%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 2.7%
94% worse than Maryland average

Maryland average: 1.4%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
24% better than Maryland average

Maryland average: 80.6%

Breakdown by payment type

Medicare

71% of new residents, usually for short-term rehab.

Typical stay 28 days

Private pay

29% of new residents, often for short stays.

Typical stay 7 - 8 months

Facility Characteristics

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

Total residents 28
Medicare
6
21.4% of residents
Medicaid
1
3.6% of residents
Private pay or other
21
75% of residents
Programs & Services
CCRC

Part of a Continuing Care Retirement Community offering multiple care levels

Finances and operations

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

Nonprofit
Nonprofit Corporation
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."
$19.9M
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."
$2.7M
Nonprofit Nonprofit Corporation
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."
$19.9M Rank #34 / 105Net patient revenue — State benchmarkedThis home is ranked 34th out of 105 homes we track in Maryland. Shows this facility's net patient revenue compared to the Maryland average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
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."
$2.7M
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.
$1.4M
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 #28 / 105Payroll costs — State benchmarkedThis home is ranked 28th out of 105 homes we track in Maryland. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Maryland average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
$9.9M 49.5% 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 #34 / 105Payroll % of net patient revenue — State benchmarkedThis home is ranked 34th out of 105 homes we track in Maryland. Shows payroll as a percentage of net patient revenue versus the Maryland average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Maryland that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
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).
$7.4M
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).
$17.2M

What does this home offer?

Pets allowed icon
Pets allowed icon

No pets allowed

Housing options icon
Housing options icon

Housing Options: Private Rooms

Building type icon
Building type icon

Building Type: 3-story

Transportation services icon
Transportation services icon

Transportation Services

Fitness and recreation icon
Fitness and recreation icon

Fitness and Recreation

Who this home usually serves

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

Most new residents arrive under Medicare (71% of admissions), and a typical Medicare stay runs around 28 days.

Admissions
98 total

Coverage residents most often arrive under.

Medicare 71%
Private pay 29%
Discharges
102 total

Coverage residents most often leave under.

Medicare 65%
Private pay 34%
Medicaid 1%

Managed by Jonathan D. Grant

Executive Vice President and Chief Operating Officer

Over 35 years of experience

Jonathan D. Grant serves as Executive Vice President and Chief Operating Officer at Acts Retirement-Life Communities. With over 35 years in retirement and health care, he has held leadership roles including Administrator and Executive Director at other communities. He holds a bachelor's in communications and an MBA from Florida Atlantic University and is a Fellow of the LeadingAge Leadership Program.

Places of interest near Buckingham‘s Choice

Address 2.8 miles from city center Info Estimated distance in miles from Adamstown's city center to Buckingham‘s Choice's address, calculated via Google Maps. — 14.15 miles to nearest hospital (Frederick Health Mt Airy)

Calculate Travel Distance to Buckingham‘s Choice

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Address

Compare Nursing Homes around Frederick

Info below is compiled from CMS reports & the MD Dept. of Health (OHCQ), senior community websites & trusted data sources such as Walk Score & BBB.

Communities are listed from highest to lowest based on our ranking methodology.

The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
Care Types in This Table AL (Assisted Living): Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing. NH (Nursing Home): 24/7 skilled nursing care for residents with complex, ongoing medical needs. SNF (Skilled Nursing Facility): Round-the-clock nursing care, often for recovery after surgery, injury, or illness. MC (Memory Care): Secured, specialized care for people living with Alzheimer's or dementia. RC (Respite Care): Short-term temporary care that gives family caregivers a break. IL (Independent Living): Community living with dining, activities, and transportation for active seniors who need little personal care. HOS (Hospice Care): Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Maryland average is: 50.3% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
CMS Certification Number: the unique federal identifier for this skilled nursing provider.
Homewood Living Frederick
NH
AL
IL
MC
SNF
Frederick
120
Facility 120
MD AVG 42
Rank #72 / 684
68.4%
Facility 68.4%
MD AVG 82.2
Rank #76 / 91
-17%
4.83
Facility 4.83
MD AVG 3.77
Rank #19 / 120
+3%+28%
$0
Facility $0
MD AVG $65.0k
Rank #1 / 123
19
Facility 19
MD AVG 49.9
Rank #12 / 123
6.3
Facility 6.3
MD AVG 12.8
Rank #12 / 123
-82- 14 Phillip Bowers
$21.8MFiscal year ending 12/2023
Facility $21.8MFiscal year ending 12/2023
MD AVG $18.4M
Rank #29 / 105
$15.3MFiscal year ending 12/2023
Facility $15.3MFiscal year ending 12/2023
MD AVG $8.4M
Rank #10 / 105
70.1%Fiscal year ending 12/2023
Facility 70.1%Fiscal year ending 12/2023
MD AVG 50.3%
Rank #11 / 105
215245
Buckingham‘s Choice
NH
AL
MC
RC
SNF
Adamstown
42
Facility 42
MD AVG 42
Rank #222 / 684
59.0%
Facility 59.0%
MD AVG 82.2
Rank #82 / 91
-28%
5.05
Facility 5.05
MD AVG 3.77
Rank #16 / 120
+64%+34%
$0
Facility $0
MD AVG $65.0k
Rank #1 / 123
29
Facility 29
MD AVG 49.9
Rank #27 / 123
9.7
Facility 9.7
MD AVG 12.8
Rank #46 / 123
-25-
3
Facility 3
MD AVG 66
Rank #930 / 953
-
$19.9MFiscal year ending 12/2023
Facility $19.9MFiscal year ending 12/2023
MD AVG $18.4M
Rank #34 / 105
$9.9MFiscal year ending 12/2023
Facility $9.9MFiscal year ending 12/2023
MD AVG $8.4M
Rank #28 / 105
49.5%Fiscal year ending 12/2023
Facility 49.5%Fiscal year ending 12/2023
MD AVG 50.3%
Rank #34 / 105
215329
Citizens Nursing Home
NH
HOS
MC
RC
SNF
Frederick
170
Facility 170
MD AVG 42
Rank #22 / 684
93.5%
Facility 93.5%
MD AVG 82.2
Rank #22 / 91
+14%
3.80
Facility 3.80
MD AVG 3.77
Rank #45 / 120
-21%+1%
$0
Facility $0
MD AVG $65.0k
Rank #1 / 123
41
Facility 41
MD AVG 49.9
Rank #60 / 123
10.3
Facility 10.3
MD AVG 12.8
Rank #50 / 123
1159- 41 Frederick County Maryland
$25.8MFiscal year ending 06/2024
Facility $25.8MFiscal year ending 06/2024
MD AVG $18.4M
Rank #15 / 105
$14.1MFiscal year ending 06/2024
Facility $14.1MFiscal year ending 06/2024
MD AVG $8.4M
Rank #14 / 105
54.6%Fiscal year ending 06/2024
Facility 54.6%Fiscal year ending 06/2024
MD AVG 50.3%
Rank #22 / 105
215105
Autumn Lake Healthcare at Braddock Heights
NH
HOS
RC
SNF
Frederick (Braddock Estates)
65
Facility 65
MD AVG 42
Rank #189 / 684
87.8%
Facility 87.8%
MD AVG 82.2
Rank #46 / 91
+7%
3.36
Facility 3.36
MD AVG 3.77
Rank #65 / 120
-24%-11%
$0
Facility $0
MD AVG $65.0k
Rank #1 / 123
54
Facility 54
MD AVG 49.9
Rank #81 / 123
18.0
Facility 18.0
MD AVG 12.8
Rank #103 / 123
-57--As Family Vb Holdings LLC
$7.1MFiscal year ending 12/2023
Facility $7.1MFiscal year ending 12/2023
MD AVG $18.4M
Rank #98 / 105
$1.2MFiscal year ending 12/2023
Facility $1.2MFiscal year ending 12/2023
MD AVG $8.4M
Rank #100 / 105
16.8%Fiscal year ending 12/2023
Facility 16.8%Fiscal year ending 12/2023
MD AVG 50.3%
Rank #73 / 105
215199
Frederick Health & Rehabilitation Center
NH
HOS
MC
RC
SNF
Frederick (Wyngate)
120
Facility 120
MD AVG 42
Rank #72 / 684
94.0%
Facility 94.0%
MD AVG 82.2
Rank #18 / 91
+14%
3.29
Facility 3.29
MD AVG 3.77
Rank #77 / 120
-50%-13%
$13.5k
Facility $13.5k
MD AVG $65.0k
Rank #90 / 123
109
Facility 109
MD AVG 49.9
Rank #119 / 123
27.3
Facility 27.3
MD AVG 12.8
Rank #119 / 123
3113- 55 -
$13.4MFiscal year ending 12/2023
Facility $13.4MFiscal year ending 12/2023
MD AVG $18.4M
Rank #77 / 105
$6.6MFiscal year ending 12/2023
Facility $6.6MFiscal year ending 12/2023
MD AVG $8.4M
Rank #52 / 105
49.7%Fiscal year ending 12/2023
Facility 49.7%Fiscal year ending 12/2023
MD AVG 50.3%
Rank #32 / 105
215184

Financial Assistance for
Nursing Home in Maryland

Buckingham‘s Choice is located in Adamstown, Maryland.
Here are the financial assistance programs available to residents in Maryland.

Get Financial aid guidance

Community Options Waiver

Maryland Medicaid Community Options Waiver

Age 65+ or disabled
General Maryland resident, Medicaid- eligible, nursing home-level care need.
Income Limits (2025) ~$2,829/month 300% FBR, individual
Asset Limits $2,000 (individual), $3,000 (couple) (excludes home, car).
MD

High urban demand; rural outreach efforts.

Benefits
Personal care (5-7 hours/day, e.g., bathing, dressing) Respite care (up to 240 hours/year) Adult day care ($70/day) Home modifications ($1,500 avg.)

Senior Care Program

Maryland Senior Care

Age 65+
General Maryland resident, at risk of nursing home placement.
Income Limits ~$2,000/month individual, varies by county
Asset Limits $11,000 individual
MD

Limited funding; waitlists common in high-demand areas.

Benefits
In-home care (3-5 hours/week) Respite care (up to 10 days/year) Meals (~$6/meal) Transportation (~5 trips/month) Case management

Maryland Nursing Home Medicaid

Maryland Medical Assistance (Medicaid) Nursing Home Program

Age 65+
General Maryland resident, Medicaid-eligible, requires nursing home-level care.
Income Limits (2025) $943/month (individual); most income applied to care costs.
Asset Limits $2,500 (individual), $3,000 (couple); spousal protections up to $155,356.
MD

Home equity limit $636,000; estate recovery applies post-55.

Benefits
24/7 nursing care Meals Therapy Medications (unlimited per medical need)

Senior Assisted Living Subsidy Program

Maryland Senior Assisted Living Group Home Subsidy

Age 62+
General Maryland resident, in or moving to approved assisted living, low/moderate income.
Income Limits (2025) ~$34,000/year individual, varies by county
Asset Limits Not strict; prioritizes low-income.
MD

Not available statewide; facility must be licensed by MDH.

Benefits
Personal care Meals 24-hour supervision (up to $1,500/month subsidy typical)

Veterans Aid and Attendance (A&A) Benefit

Maryland VA Aid and Attendance

Age
General Wartime veteran/spouse, age 65+ or disabled, needs ADL help, Maryland resident.
Income Limits (2025) Net income minus medical expenses < $1,984/month individual with A&A
Asset Limits $155,356 net worth limit
MD

High veteran population in suburban/rural areas.

Benefits
Cash benefit ($1,478-$2,471/month, varies by status) for care costs

Senior Prescription Drug Assistance Program (SPDAP)

Maryland Senior Prescription Drug Assistance Program

Age 65+
General Maryland resident (6+ months), Medicare Part D enrolled.
Income Limits (2025) $48,560/year individual, 300% FPL
Asset Limits None specified.
MD

Supplements Medicare Part D; annual enrollment required.

Benefits
Up to $40/month premium subsidy Reducing drug costs

Medicare Savings Programs (MSP)

Maryland Medicare Savings Programs

Age 65+
General Maryland resident, Medicare Part A/B enrollee.
Income Limits (2025) $2,014/month (QMB), $2,706/month (SLMB/QI, individual).
Asset Limits $9,090 (individual), $13,630 (couple).
MD

Includes QMB, SLMB, QI categories.

Benefits
Covers premiums (up to $174.70/month Part B) Co-pays Deductibles

Community Personal Assistance Services (CPAS)

Maryland Medicaid Community Personal Assistance Services

Age 65+
General Maryland resident, Medicaid-eligible, needs ADL assistance.
Income Limits (2025) $943/month (individual); spend-down available.
Asset Limits $2,500 (individual), $3,000 (couple).
MD

Consumer-directed option allows hiring family caregivers.

Benefits
Personal care (hours vary, typically 20-30/week) Chores Nurse supervision

Frequently Asked Questions about Buckingham‘s Choice

Is Buckingham‘s Choice in a walkable area?

Buckingham‘s Choice has a walk score of 3. Car-dependent. Most errands require a car, with limited nearby walkable options.

What is the occupancy rate at Buckingham‘s Choice?

Buckingham‘s Choice's occupancy is 56.8%.

How long has Buckingham‘s Choice been in business?

Buckingham‘s Choice has been operating for approximately 31 years, based on available licensing and registration records.

Are pets allowed at Buckingham‘s Choice?

No, Buckingham‘s Choice has a no-pet policy.

Does Buckingham‘s Choice operate as a for-profit or non-profit?

Buckingham‘s Choice is registered as a non-profit in MD.

Are there photos of Buckingham‘s Choice?

Yes — there are 6 photos of Buckingham‘s Choice in the photo gallery on this page.

What is the address of Buckingham‘s Choice?

Buckingham‘s Choice is located at 3200 Baker Cir, Adamstown, MD 21710.

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