Merrimack County Nursing Home

At 325 Daniel Webster Hwy in rural Boscawen, Merrimack County Nursing Home operates 290 licensed beds under county governance, administered by Heather M Moquin. The facility ranked third in New Hampshire by capacity serves residents through Medicare (average stay one month, 24% of admissions), Medicaid (three years typical, 35% of admissions), and private payment (eight months, 41% of admissions). Current residents number 254 across the 290-bed community; a 78% occupancy rate. The setting is heavily car-dependent (Walk Score 0), situated 14.3 miles from downtown Boscawen and 6.2 miles from the nearest hospital.

Financially, Merrimack County reported a $6.6M operating deficit in 2023, despite occupancy recovery from 65.4% in 2022 to 77.5% in 2023. Payroll consumed 95.4% of the facility’s $27.6M revenue (the highest allocation statewide).

Staff totals 491 (313 employees, 178 contractors), with an overall resident-to-staff ratio of 1.93:1. Nursing care averages 5 hours 25 minutes/resident/day (29% above average), ranking the facility 10th among 58 New Hampshire SNFs. Certified nursing aides deliver 3 hours 25 minutes of daily care/resident; 43% above norms. However, weekend RN coverage dropped to 22 minutes/resident (29% below average), and physical therapist hours totaled only 2 minutes/resident/day(50% below average).

CMS ratings reflect strengths in three areas: overall 4-star rating 36.5% above average, staffing 4-star rating 57.7% above average, and quality measures 4-star rating 29.9% above average. Health inspection ratings were 4 stars, marginally above state (6% higher). Yet quality measures reveal concerns: falls with major injury at 5.6% (24% worse than state), and antipsychotic medication use at 21.3% (22% worse than state).

Long-stay residents showed functional improvements in some areas (urinary tract infection rate 70% better, weight loss 25% better, ED visits 61% better) but struggled with short-stay outcomes (influenza vaccination only 56.1%, ability to care for self at discharge 16% worse, successful return to community 27% worse).

March 2023 inspections cited psychotropic medication ordering without proper documentation, medication refrigerator temperature control gaps with expired insulin on hand, and paid feeding assistants assigned to residents with complicated feeding needs.

A substantiated complaint investigation in March 2024 documented a critical resident safety breach: during a fire alarm, the facility allowed a resident to elope. The resident was discovered hours later with severe hypothermia, requiring hospitalization. The same inspection identified infection control failures.

February 2025 routine inspection again cited medication management deficiencies, inaccurate resident assessments, and failure to implement proper barrier precautions for a catheterized resident.

A $16K federal fine was assessed in March 2024.

No immediate jeopardy findings, license suspensions, or payment denials appeared in regulatory records.

Merrimack County Nursing Home facility fits long-term Medicaid-eligible residents and families seeking skilled nursing care in a large county setting with strong staffing presence.

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