5/5
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.
5/5
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 provides assisted living, memory care, respite care, and skilled nursing in Adamstown, MD. Assisted living supports residents with daily tasks, while memory care provides a secured setting with supervision for someone at risk of wandering. Skilled nursing offers nursing care, and respite care provides a short stay for someone whose usual caregiver needs to travel or recover.
Because the community offers several care levels, a resident whose needs change may be able to move to a different level without leaving the community. Buckingham‘s Choice has 42 beds, making it a smaller community where staff and residents can get to know one another. Private rooms give residents a single private living space.
Rehabilitation services and short-term rehabilitation are available for residents who need temporary recovery support. A fitness center gives residents a place for exercise, while nature trails and outdoor areas provide spaces to spend time outside; gourmet dining and social spaces are also available. Medicare and private pay are accepted, and total nurse staffing is 4h 48m per resident per day, representing the daily hands-on nursing time allocated to each resident.
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.
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.
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.
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.
Data period: Q4 2025 (October 1 – December 31, 2025).
This nursing home is ranked 15th out of 118 nursing 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.
4h 48mStandout metric: Registered nurse (RN) is +97% above Maryland average
1 of 6 metrics below Maryland average
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. All 14 are the facility's own employees; no agency contractors work in this role.
14 staff · 8.4-hour shifts
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. All 4 are the facility's own employees; no agency contractors work in this role.
4 staff · 11.2-hour shifts
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. All 20 are the facility's own employees; no agency contractors work in this role.
20 staff · 7-hour shifts
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.
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.
RN + LPN + aide · Sat–Sun
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.
Sat–Sun
Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
62
60 employees · 2 contractors · 20 on an average day
62 total staff / 22 residents. Residents: CMS Long-Term Care Facility Characteristics (data as of Jun 2026); staff: CMS Payroll-Based Journal (Q4 2025).Residents and staff come from two different CMS releases, so the two counts can be a few months apart.
2.82 : 1
↑ 59% · MD 1.77This facility: 2.82 staff per resident, 59% above the Maryland average of 1.77 (among Maryland facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
62 staff ÷ 22 residents
See full Maryland ranking →
Average hours one staff member works on a day they are on shift, across every role.
7.1 h
↓ 11% · MD 8 hThis facility: 7.1 h, 11% below the Maryland average of 8 h (among Maryland facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
13,105 staff hours this quarter
See full Maryland ranking →98.8% of staff hours were worked by the facility's own employees
Maryland average: 87.8% · Contractors this quarter: Occupational Therapy Assistant (1), Occupational Therapy Aide (1)
Why it matters: employees work here week after week and get to know each resident's routines and needs. Agency contractors often rotate between facilities, so a higher employee share usually means more consistent care.
A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions.
42
Rank #114 / 139Bed count — State benchmarked This nursing home is ranked 114th out of 139 nursing 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 compare like with like: every nursing home we track in Maryland that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Smaller home · May offer a more intimate, personalized care environment.
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care. This is the number of years in operation under current management.
Rank #14 / 41Years in operation — State benchmarked This nursing home is ranked 14th out of 41 nursing 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 compare like with like: every nursing home we track in Maryland that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Car-dependent. Most errands require a car, with limited nearby walkable options.
Rank #158 / 160Walk Score — State benchmarked This nursing home is ranked 158th out of 160 nursing 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 compare like with like: every nursing home we track in Maryland that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Occupancy lower than 85% suggests more openings may be available.
Rank #82 / 90Occupancy rate — State benchmarked This nursing home is ranked 82nd out of 90 nursing homes we track in Maryland for occupancy. Shows this facility's occupancy rate versus the Maryland average, with its Statewide rank out of 90. Higher occupancy signals strong local demand and financial stability. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Maryland that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Based on residents per day and 42 beds.
Lower than the Maryland average: 83.2%
The average number of residents living at this facility on a given day. CMS calculates this figure from the facility's Minimum Data Set (MDS) assessments and uses this value for other measures like Hours Per Resident Per Day (HPRD) and 5-Star Staffing rating.
Source: CMS Provider Information, average daily residents
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.
100% corrected
23 of 23 citations corrected Latest inspection: Feb 17, 2026 · 4 citations, all corrected
Most cited category: Resident Assessment & Care Planning, 12 of 23 citations · 7 categories in total
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Health citations are formal notices following inspections when they fail to comply with safety and care standards.
22 of 23 citations resulted from standard inspections; and 1 of 23 resulted from complaint investigations.
Includes all CMS health inspection records for this property, which could include management/ownership changes.
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
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 Aug 2026
No penalties in the past 3 years
No civil money penalties or payment denials on record since Aug 2023.
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
How residents at this home fare on health outcomes and preventive care, compared with the Maryland average.
CMS star rating for the care of long-stay residents, who live at the home for 100 days or more. It is built from the long-stay quality measures below. 5 stars is the best.
5
/ 5
Significantly above average
CMS star rating for the care of short-stay residents, mostly people recovering after a hospital stay for under 100 days. It is built from the short-stay quality measures below. 5 stars is the best.
5
/ 5
Significantly above average
Average of five long-stay measures: pressure ulcers, falls with major injury, unplanned weight loss, worsening ability to walk, and needing more help with daily activities. Each is the % of residents affected, so lower is better.
7.6
Score · lower is better
↓ 31% · MD 11.0This facility: 7.6, 31% below the MD average of 11.0 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of three long-stay measures: needing more help with daily activities, worsening ability to walk, and loss of bowel or bladder control. Each is the % of residents affected, so lower is better.
6.0
Score · lower is better
↓ 73% · MD 22.4This facility: 6.0, 73% below the MD average of 22.4 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.10 long-stay measures: 7 better, 1 worse, 2 near MD average
3 short-stay measures: 3 better
People who live at the home · 10 measures
Percent of long-stay residents whose need for help with daily activities has increased
8.2%
↓ 60% · MD 20.4This facility: 8.2, 60% below the MD average of 20.4 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of low risk long-stay residents who lose control of their bowels or bladder
3.8%
↓ 85% · MD 25.0This facility: 3.8, 85% below the MD average of 25.0 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents with a urinary tract infection
1.3%
↓ 10% · MD 1.5This facility: 1.3, 10% below the MD average of 1.5 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents experiencing one or more falls with major injury
1.3%
↓ 46% · MD 2.4This facility: 1.3, 46% below the MD average of 2.4 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay high risk residents with pressure ulcers
15.2%
↑ 157% · MD 5.9This facility: 15.2, 157% above the MD average of 5.9 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who lose too much weight
5.6%
↑ 3% · MD 5.4This facility: 5.6, 3% above the MD average of 5.4 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who have depressive symptoms
0.0%
↓ 100% · MD 22.8This facility: 0.0, 100% below the MD average of 22.8 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who received an antipsychotic medication
2.9%
↓ 79% · MD 13.8This facility: 2.9, 79% below the MD average of 13.8 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
↑ 8% · MD 92.6This facility: 100.0, 8% above the MD average of 92.6 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
↑ 3% · MD 96.6This facility: 100.0, 3% above the MD average of 96.6 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Rehab and recovery after a hospital stay · 3 measures
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
↓ 100% · MD 1.1This facility: 0.0, 100% below the MD average of 1.1 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
↑ 26% · MD 79.1This facility: 100.0, 26% above the MD average of 79.1 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
↑ 24% · MD 80.6This facility: 100.0, 24% above the MD average of 80.6 (among MD facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Arrows show whether a figure is above or below the average. Green is better for residents, red is worse, and yellow means within 5% of the average. The line on each bar marks the average.
Quality measures are calculated by CMS from Minimum Data Set (MDS) resident assessments and Medicare claims.
57% of new residents, usually for short-term rehab.
43% of new residents, often for short stays.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jun 2026)
Total residents
22Residents meet regularly to discuss policies, care quality, and activities
Part of a Continuing Care Retirement Community offering multiple care levels
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Buckingham‘s Choice’s finances from its CMS cost report for the fiscal year ending December 2024, compared with 116 Maryland nursing homes that filed a recent report. Includes all financial data for this property, which could include management/ownership changes.
Is it financially stable?
Profitable on care
17.5% operating margin
+3.9 pts vs prior year
Positive margin in 4 of the last 8 reported years. Net income $5.5M after other income.
Does it invest in staff?
Payroll in line with Maryland homes
46.8% payroll share of revenue
MD average 47.0%Rank #35 / 116Payroll % of net patient revenue — State benchmarked This nursing home is ranked 35th out of 116 nursing homes we track in Maryland for payroll % of net patient revenue. 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 compare like with like: every nursing home we track in Maryland that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Payroll rose $0.6M while revenue rose $2.4M. Check hours per resident in the staffing section to confirm it reaches the floor.
FY 2024 scorecard
Each row shows the FY 2024 figure, the change since the prior report, the trend, and how it compares with Maryland homes.
Profitable on care
| Metric | FY 2024 | vs prior year | Trend 2016 → 2024Trend | MD median | Compared with MD homesRank in MD | In short |
|---|---|---|---|---|---|---|
| Net patient revenue What the home earns from resident care, after discounts and bad debt. | $22.4M | +$2.4M | Trend 20162024 | MD median $17.7M | Rank in MD Rank #30 / 116Net patient revenue — State benchmarked This nursing home is ranked 30th out of 116 nursing homes we track in Maryland for net patient revenue. 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 compare like with like: every nursing home we track in Maryland that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 75% of homes | Above MD median Higher net patient revenue than 75% of MD homes that filed a recent report. Revenue mostly follows how big a home is. |
| Operating expenses Everything it costs to run the home: staff, supplies, rent, admin. | $18.5M | +$1.2M | Trend 20162024 | MD median — | Rank in MD Not ranked | Within revenue Operating expenses are lower than net patient revenue, so resident care covers its costs. |
| Net patient income Revenue minus operating expenses. Negative means care loses money. | $3.9M | +$1.2M | Trend 20162024 | MD median — | Rank in MD Not ranked | Profit, growing Resident care made money this year, more than in the prior report. |
| Operating margin Net patient income as a share of revenue. The clearest health signal. | 17.5% | +3.9 pts | Trend 20162024 | MD median — | Rank in MD Not ranked | Healthy margin More than 5% of revenue is left after operating expenses. |
| Other income Money not from resident care: investments, grants, services. | $1.6M | — | Trend — | MD median — | Rank in MD Not ranked | Adds to profit Income from outside resident care, on top of the profit from care. |
| Net income The bottom line after other income. | $5.5M | +$1.4M | Trend — | MD median — | Rank in MD Not ranked | Profit The bottom line is above zero after other income. |
Staff spending in line with Maryland homes
| Metric | FY 2024 | vs prior year | Trend 2016 → 2024Trend | MD median | Compared with MD homesRank in MD | In short |
|---|---|---|---|---|---|---|
| Payroll costs Salaries and wage-related benefits, not counting contract labor. | $10.5M | +$0.6M | Trend 20162024 | MD median $6.3M | Rank in MD Rank #24 / 116Payroll costs — State benchmarked This nursing home is ranked 24th out of 116 nursing homes we track in Maryland for payroll costs. 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 compare like with like: every nursing home we track in Maryland that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 80% of homes | Above MD median Higher payroll than 80% of MD homes. Payroll in dollars mostly follows how big a home is, so this compares size, not staffing levels. |
| Payroll share of revenue Payroll divided by revenue. Higher usually means more staff per resident. | 46.8% | −2.7 pts | Trend 20162024 | MD median 40.5% | Rank in MD Rank #35 / 116Payroll % of net patient revenue — State benchmarked This nursing home is ranked 35th out of 116 nursing homes we track in Maryland for payroll % of net patient revenue. 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 compare like with like: every nursing home we track in Maryland that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 70% of homes | Near MD average The MD average is 47.0% of revenue. Within 3 points of it reads as near the average. |
What the home earned from resident care (net patient revenue), what it cost to run (operating expenses) and the difference between the two (net patient income), for each fiscal year it filed a CMS cost report.
USD, millions
Net patient revenue Operating expenses Net patient income No report
Both lines are a share of net patient revenue. Payroll share is what goes to salaries and wage-related benefits; operating margin is what is left after every operating cost (below 0%, resident care lost money). The dashed line is the Maryland payroll average.
% of net patient revenue
Payroll share Operating margin MD payroll average No report
| Metric | 2016 | 2017 | 2018 | 2019 | 2020no report | 2021 | 2022 | 2023 | 2024 |
|---|---|---|---|---|---|---|---|---|---|
| Net patient revenue | $17.9M | $18.4M | $18.7M | $17.8M | $17.8M | $18.6M | $19.9M | $22.4M | |
| Operating expenses | $20.3M | $20.9M | $20.9M | $17.9M | $15.3M | $16.2M | $17.2M | $18.5M | |
| Net patient income | −$2.4M | −$2.4M | −$2.1M | −$0.1M | $2.5M | $2.4M | $2.7M | $3.9M | |
| Operating margin | −13.2% | −13.2% | −11.4% | −0.3% | 13.9% | 12.8% | 13.6% | 17.5% | |
| Net income | −$0.7M | −$0.9M | −$1.5M | $1.3M | $3.5M | $3.7M | $4.1M | $5.5M | |
| Payroll costs | $7.5M | $7.4M | $7.1M | $6.5M | $8.9M | $9.4M | $9.9M | $10.5M | |
| Payroll share of revenue | 41.8% | 40.2% | 37.8% | 36.2% | 50.0% | 50.6% | 49.5% | 46.8% | |
| Beds | 42 | 42 | 42 | 42 | 42 | 42 | 42 | 39 | |
| Gross revenue | $19.3M | $19.8M | $20.1M | $18.5M | $18.3M | $19.0M | $20.9M | $23.5M | |
| Salaries | $6.6M | $6.3M | $6.2M | $5.5M | $7.5M | $8.1M | $8.5M | $9.1M | |
| Wage-related costs | $0.9M | $1.1M | $0.9M | $0.9M | $1.4M | $1.3M | $1.3M | $1.4M | |
| Contract labor | $0.6M | $0.6M | $0.5M | $0.5M | $0.0M | — | — | — | |
| Other operating costs | $12.8M | $13.5M | $13.8M | $11.4M | $6.4M | $6.8M | $7.4M | $8.0M | |
| Net patient revenue per day | $1,414 | $1,480 | $1,515 | $1,728 | $2,205 | $2,161 | $2,289 | $2,613 | |
| Cost per day | $1,601 | $1,676 | $1,688 | $1,734 | $1,898 | $1,884 | $1,978 | $2,157 | |
| Average length of stay | 67.5 days | 63.6 days | 55.7 days | 65.7 days | 76.1 days | 106.4 days | 85.3 days | 31.3 days |
Showing 2024–2022 · scroll sideways for 6 earlier years
Earlier and partial years are in the download. Download CSV
Most residents typically stay for a few weeks or months before returning home or moving on.
Most new residents arrive under Medicare (57% of admissions), and a typical Medicare stay runs around 1 - 2 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
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.
2.8 miles from city center
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)
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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-ranked to lowest-ranked based on our methodology.
The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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: 47.0% 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.
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CMS Certification Number: the unique federal identifier for this skilled nursing provider.
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Citizens Nursing Home | NH HOS MC RC SNF | Frederick | 170
Facility
170
MD AVG
104
Rank
#19 / 139 |
91.5%
Facility
91.5%
MD AVG
83.2%
Rank
#23 / 90 | +10% | 3.66
Facility
3.66
MD AVG
3.92
Rank
#42 / 118 | -21% | -7% | $0
Facility
$0
MD AVG
$53.4k
Rank
#1 / 120 | 33
Facility
33
MD AVG
52.0
Rank
#30 / 120 | 8.3
Facility
8.3
MD AVG
11.8
Rank
#29 / 120 | 1 | 156 | - |
41
Facility
41
MD AVG
45
Rank
#88 / 160 | Frederick County Maryland | $26.2MFiscal year ending 06/2025
Facility
$26.2MFiscal year ending 06/2025
MD AVG
$19.5M
Rank
#18 / 116 | $13.9MFiscal year ending 06/2025
Facility
$13.9MFiscal year ending 06/2025
MD AVG
$8.2M
Rank
#17 / 116 | 53%Fiscal year ending 06/2025
Facility
53%Fiscal year ending 06/2025
MD AVG
47%
Rank
#24 / 116 | 215105 | ||||
| Homewood Living Frederick | NH AL IL MC SNF | Frederick | 120
Facility
120
MD AVG
104
Rank
#55 / 139 |
69.3%
Facility
69.3%
MD AVG
83.2%
Rank
#77 / 90 | -17% | 4.62
Facility
4.62
MD AVG
3.92
Rank
#18 / 118 | +3% | +18% | $0
Facility
$0
MD AVG
$53.4k
Rank
#1 / 120 | 19
Facility
19
MD AVG
52.0
Rank
#9 / 120 | 6.3
Facility
6.3
MD AVG
11.8
Rank
#13 / 120 | - | 83 | - |
14
Facility
14
MD AVG
45
Rank
#142 / 160 | Phillip Bowers | $23.7MFiscal year ending 12/2024
Facility
$23.7MFiscal year ending 12/2024
MD AVG
$19.5M
Rank
#27 / 116 | $16.5MFiscal year ending 12/2024
Facility
$16.5MFiscal year ending 12/2024
MD AVG
$8.2M
Rank
#11 / 116 | 69.7%Fiscal year ending 12/2024
Facility
69.7%Fiscal year ending 12/2024
MD AVG
47%
Rank
#9 / 116 | 215245 | ||||
| Buckingham‘s Choice | NH AL MC RC SNF | Adamstown | 42
Facility
42
MD AVG
104
Rank
#114 / 139 |
63.6%
Facility
63.6%
MD AVG
83.2%
Rank
#82 / 90 | -24% | 4.80
Facility
4.80
MD AVG
3.92
Rank
#15 / 118 | +64% | +22% | $0
Facility
$0
MD AVG
$53.4k
Rank
#1 / 120 | 23
Facility
23
MD AVG
52.0
Rank
#15 / 120 | 7.7
Facility
7.7
MD AVG
11.8
Rank
#26 / 120 | - | 27 | - |
3
Facility
3
MD AVG
45
Rank
#158 / 160 | - | $22.4MFiscal year ending 12/2024
Facility
$22.4MFiscal year ending 12/2024
MD AVG
$19.5M
Rank
#30 / 116 | $10.5MFiscal year ending 12/2024
Facility
$10.5MFiscal year ending 12/2024
MD AVG
$8.2M
Rank
#24 / 116 | 46.8%Fiscal year ending 12/2024
Facility
46.8%Fiscal year ending 12/2024
MD AVG
47%
Rank
#35 / 116 | 215329 | ||||
| Autumn Lake Healthcare at Braddock Heights | NH HOS RC SNF | Frederick (Braddock Estates) | 65
Facility
65
MD AVG
104
Rank
#101 / 139 |
87.4%
Facility
87.4%
MD AVG
83.2%
Rank
#47 / 90 | +5% | 3.23
Facility
3.23
MD AVG
3.92
Rank
#62 / 118 | -24% | -18% | $0
Facility
$0
MD AVG
$53.4k
Rank
#1 / 120 | 40
Facility
40
MD AVG
52.0
Rank
#49 / 120 | 13.3
Facility
13.3
MD AVG
11.8
Rank
#81 / 120 | - | 57 | - | - | As Family Vb Holdings LLC | $8.4MFiscal year ending 12/2024
Facility
$8.4MFiscal year ending 12/2024
MD AVG
$19.5M
Rank
#109 / 116 | $1.3MFiscal year ending 12/2024
Facility
$1.3MFiscal year ending 12/2024
MD AVG
$8.2M
Rank
#110 / 116 | 15.5%Fiscal year ending 12/2024
Facility
15.5%Fiscal year ending 12/2024
MD AVG
47%
Rank
#81 / 116 | 215199 | ||||
| Frederick Health & Rehabilitation Center | NH HOS MC RC SNF | Frederick (Wyngate) | 120
Facility
120
MD AVG
104
Rank
#55 / 139 |
94.3%
Facility
94.3%
MD AVG
83.2%
Rank
#19 / 90 | +13% | 3.02
Facility
3.02
MD AVG
3.92
Rank
#74 / 118 | -50% | -23% | $13.5k
Facility
$13.5k
MD AVG
$53.4k
Rank
#89 / 120 | 83
Facility
83
MD AVG
52.0
Rank
#107 / 120 | 10.4
Facility
10.4
MD AVG
11.8
Rank
#57 / 120 | 1 | 113 | - |
55
Facility
55
MD AVG
45
Rank
#59 / 160 | - | $13.5MFiscal year ending 12/2024
Facility
$13.5MFiscal year ending 12/2024
MD AVG
$19.5M
Rank
#92 / 116 | $6.9MFiscal year ending 12/2024
Facility
$6.9MFiscal year ending 12/2024
MD AVG
$8.2M
Rank
#51 / 116 | 50.9%Fiscal year ending 12/2024
Facility
50.9%Fiscal year ending 12/2024
MD AVG
47%
Rank
#26 / 116 | 215184 |
Rank badges are statewide and care-type specific: each nursing home is ranked against every other MD nursing home we track that reports that metric, not just the 5 on this page. See how we rank facilities
Buckingham‘s Choice is located in Adamstown, Maryland.
Here are the financial assistance programs available to residents in Maryland.
Buckingham‘s Choice has a walk score of 3. Car-dependent. Most errands require a car, with limited nearby walkable options.
Buckingham‘s Choice's occupancy is 63.6%.
Buckingham‘s Choice has been operating for approximately 31 years, based on available licensing and registration records.
No, Buckingham‘s Choice has a no-pet policy.
Buckingham‘s Choice is registered as a non-profit in MD.
Buckingham‘s Choice received a 5-star overall rating from the CMS (Centers for Medicare and Medicaid Services). This score combines results from staffing levels, quality measures, and health inspections.
Buckingham‘s Choice has 42 beds.
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