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The Overall CMS Rating is scored from 1 to 5 stars and 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.
The Overall CMS Rating is scored from 1 to 5 stars and 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.
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.
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.
This home is ranked 55th out of 62 homes in New Hampshire.| Staff type | Hours / day | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
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.
| 39m per day | ▼ 11% State avg: 44m per day · National avg: 41m per day |
|
LPN / LVN
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.
| 40m per day | ▼ 13% State avg: 46m per day · National avg: 52m per day |
|
Nurse Aide
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.
| 1h 41m per day | ▼ 29% State avg: 2h 23m per day · National avg: 2h 20m per day |
|
Total Nursing (Weekend)
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.
| 2h 41m per day | ▼ 22% State avg: 3h 26m per day · National avg: 3h 26m per day |
|
Physical Therapist
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.
| 1m per day | ▼ 75% State avg: 4m per day · National avg: 4m per day |
|
RN (Weekend)
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.
| 16m per day | ▼ 48% State avg: 31m per day · National avg: 28m per day |
Most residents stay for extended periods and receive ongoing daily care.
35% of new residents, usually for short-term rehab.
37% of new residents, often for short stays.
28% of new residents, often for long-term daily care.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #52 / 60Payroll — state benchmarkedThis home is ranked 52nd out of 60 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.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Higher than the New Hampshire average: 81.1%The Elms Center is administrated by Austin J Cole.
Ways to qualify for care at this community, including accepted programs.
This facility is certified for eligible Medicaid services.
This facility is certified for eligible Medicare services.
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.
New Hampshire average 3.5
Last Health inspection on Jan 2025
New Hampshire average 14.4
New Hampshire average 3.99
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).
100% better than New Hampshire averageNew Hampshire average: 0.2
1
900% worse than New Hampshire averageNew Hampshire average: 0.1
Issues related to how the facility is managed, including policies, procedures, and compliance with regulations.
Jan 10, 2025
Corrected
Issues related to how the facility is managed, including policies, procedures, and compliance with regulations.
Jan 10, 2025
Corrected
Issues related to preventing and controlling infections, including hygiene practices and safety protocols.
Jan 10, 2025
Corrected
Issues related to the availability and quality of nursing staff and the care they provide.
Jan 10, 2025
Corrected
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.
The Elms Center is located in Milford, New Hampshire.
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2.4 miles from city center
Estimated distance in miles from Milford's city center to The Elms Center's address, calculated via Google Maps.
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This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
30% worse than New Hampshire averageNew Hampshire average ratio: 1.87:1
6% better than New Hampshire averageNew Hampshire average: 7.8 hours
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.3 hoursThis role is partially covered by contractors.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.1 hoursThis role is partially covered by contractors.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.7 hoursNo contractors work on this role.
Total hours from contractors
1,436 contractor hours this quarter
| Certified Nursing Assistant | 21 | 0 | 21 | 4,029 | 91 | 100% | 7.7 |
| Medication Aide/Technician | 6 | 0 | 6 | 3,369 | 91 | 100% | 10.3 |
| Licensed Practical Nurse | 10 | 4 | 14 | 2,864 | 91 | 100% | 8.1 |
| Registered Nurse | 7 | 2 | 9 | 1,208 | 86 | 95% | 8.3 |
| Nurse Practitioner | 3 | 0 | 3 | 648 | 65 | 71% | 8 |
| Administrator | 2 | 0 | 2 | 600 | 65 | 71% | 8 |
| Mental Health Service Worker | 1 | 0 | 1 | 520 | 65 | 71% | 8 |
| Other Dietary Services Staff | 1 | 0 | 1 | 511 | 64 | 70% | 8 |
| RN Director of Nursing | 1 | 0 | 1 | 495 | 62 | 68% | 8 |
| Dietitian | 1 | 0 | 1 | 442 | 56 | 62% | 7.9 |
| Clinical Nurse Specialist | 2 | 0 | 2 | 344 | 43 | 47% | 8 |
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
47Residents meet regularly to discuss policies, care quality, and activities
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.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
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 New Hampshire averageNew Hampshire average: 11.4
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
26.8
16% worse than New Hampshire averageNew Hampshire average: 23.2
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
25.2%
15% worse than New Hampshire averageNew Hampshire average: 21.9%
Percent of long-stay residents whose ability to move independently worsened
24.3%
20% worse than New Hampshire averageNew Hampshire average: 20.3%
Percent of low risk long-stay residents who lose control of their bowels or bladder
30.9%
14% worse than New Hampshire averageNew Hampshire average: 27.1%
Percent of long-stay residents experiencing one or more falls with major injury
4.1%
11% better than New Hampshire averageNew Hampshire average: 4.6%
Percent of long-stay high risk residents with pressure ulcers
7.8%
73% worse than New Hampshire averageNew Hampshire average: 4.5%
Percent of long-stay residents with a urinary tract infection
4.3%
71% worse than New Hampshire averageNew Hampshire average: 2.5%
Percent of long-stay residents who lose too much weight
5.8%
In line with New Hampshire averageNew Hampshire average: 5.6%
Percent of long-stay residents who have depressive symptoms
17.9%
117% worse than New Hampshire averageNew Hampshire average: 8.3%
Percent of long-stay residents who received an antipsychotic medication
15.8%
9% better than New Hampshire averageNew Hampshire average: 17.4%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
95.4%
In line with New Hampshire averageNew Hampshire average: 96.0%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
93.0%
5% worse than New Hampshire averageNew Hampshire average: 98.0%
Number of hospitalizations per 1,000 long-stay resident days.
1.96
19% worse than New Hampshire averageNew Hampshire average: 1.65
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.36
28% better than New Hampshire averageNew Hampshire average: 1.90
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
70.2%
16% worse than New Hampshire averageNew Hampshire average: 83.8%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than New Hampshire averageNew Hampshire average: 1.6%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
57.1%
31% worse than New Hampshire averageNew Hampshire average: 83.0%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
31.8%
44% worse than New Hampshire averageNew Hampshire average: 22.1%
Percentage of short-stay residents who had an outpatient emergency department visit.
8.5%
40% better than New Hampshire averageNew Hampshire average: 14.1%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than New Hampshire averageNew Hampshire average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
41.7%
22% worse than New Hampshire averageNew Hampshire average: 53.7%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
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)
61% lower than New Hampshire averageNew Hampshire average: $33K
In line with New Hampshire averageNew Hampshire average: 1.9
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than New Hampshire averageNew Hampshire average: 0.1
Penalties are imposed by CMS for violations of federal nursing home regulations.
1 penalty in the past 3 years
Jan 25, 2024 · $10K
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jan 25, 2024Last updated: Jan 2026
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AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Keene | 85 | 84.4% | +4% | 3.21 | -52% | -25% | 0 | 17 | 5.7 | 0 | 73 | - | White Mountain Peak Healthcare Llc | $8.5M | $3.8M | 44.8% | 305062 | ||||
| The Elms Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Milford | 52 | 96.1% | +18% | 3.08 | +18% | -28% | 2 | 21 | 7.0 | 1 | 44 | - | - | $7.9M | $3.0M | 37.3% | 305068 | ||||
| Brookdale Spruce Wood | - |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
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Historical financial and operational data for The Elms Center based on CMS SNF Cost Reports.
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