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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 51st out of 58 homes in New Hampshire. 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.
| Staff type | Hours / Day / Resident | 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 |
|
Weekend Total Nursing
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 |
|
Weekend RN
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 |
Higher than the New Hampshire average: 81.1%The Elms Center is administrated by Austin J Cole.
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.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the New Hampshire state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | NH Average | vs. NH Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 23 | 17 | This facility has 35% more total deficiencies than a typical New Hampshire nursing home (23 vs. NH avg 17).↑ 35% worse |
|
Deficiencies per year
Average deficiencies per year since 2023.
| 7.7 | 5.7 | This facility has 35% more deficiencies per year than a typical New Hampshire nursing home (7.7 vs. NH avg 5.7).↑ 35% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 7.7 | 4.3 | This facility has 79% more deficiencies per inspection than a typical New Hampshire nursing home (7.7 vs. NH avg 4.3).↑ 79% worse |
Inspections
| This Facility | NH Average | vs. NH Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 3 | 4 | This facility has 25% fewer total inspections than a typical New Hampshire nursing home (3 vs. NH avg 4).↓ 25% better |
Read the full inspection reports for this facility, including detailed findings and corrective actions.
Show Inspection ReportsNew 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
900% worse than New Hampshire averageNew Hampshire average: 0.1
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
24% worse than New Hampshire average
0% compared with New Hampshire average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.8 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.
8.5 hoursNo contractors work on this role.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.8 hoursNo contractors work on this role.
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
1,131 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 21 | 0 | 21 | 5,369 | 92 | 100% | 7.8 |
| Medication Aide/Technician | 5 | 0 | 5 | 1,845 | 74 | 80% | 10 |
| Licensed Practical Nurse | 6 | 0 | 6 | 1,809 | 92 | 100% | 8.5 |
| Registered Nurse | 9 | 2 | 11 | 1,754 | 92 | 100% | 7.8 |
| RN Director of Nursing | 1 | 0 | 1 | 528 | 58 | 63% | 9.1 |
| Administrator | 1 | 0 | 1 | 528 | 66 | 72% | 8 |
| Mental Health Service Worker | 1 | 0 | 1 | 528 | 66 | 72% | 8 |
| Dietitian | 1 | 0 | 1 | 484 | 62 | 67% | 7.8 |
| Other Dietary Services Staff | 1 | 0 | 1 | 481 | 60 | 65% | 8 |
| Clinical Nurse Specialist | 1 | 0 | 1 | 426 | 55 | 60% | 7.7 |
| Nurse Practitioner | 2 | 1 | 3 | 414 | 56 | 61% | 7.4 |
| Physical Therapy Assistant | 0 | 2 | 2 | 322 | 52 | 57% | 6.1 |
| Speech Language Pathologist | 0 | 3 | 3 | 249 | 51 | 55% | 4.7 |
| Physical Therapy Aide | 0 | 2 | 2 | 246 | 40 | 43% | 5.2 |
| Respiratory Therapy Technician | 0 | 3 | 3 | 54 | 26 | 28% | 1.9 |
| Qualified Social Worker | 0 | 3 | 3 | 40 | 17 | 18% | 2.3 |
| Medical Director | 0 | 1 | 1 | 26 | 13 | 14% | 2 |
Includes penalties issued in 2024
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
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
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.
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.
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.
Historical financial and operational data for The Elms Center based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #51 / 58Payroll — State benchmarkedThis home is ranked 51st out of 58 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.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Most residents stay for extended periods and receive ongoing daily care.
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.
Add your location
The Elms Center is located in Milford, New Hampshire.
Here are the financial assistance programs available to residents in New Hampshire.
The information below is reported by the New Hampshire Department of Health and Human Services, Health Facilities Administration.
| Havenwood |
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.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk.
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision. | Concord | 159 | 68.9% | -15% | 5.73 | +8% | +34% | $0 | 6 | 2.0 | - | 67 | A+ | 23 | Tracy Judd | $31.5M | $15.7M | 49.8% | 305016 | ||||
| Presidential Oaks |
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.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Concord | 52 | 52.1% | -36% | 4.85 | -8% | +13% | $46.1k | 16 | 5.3 | - | 69 | - | 43 | Joyce Higgins | $11.1M | $7.6M | 68.8% | 305063 | ||||
| Exeter 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.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Exeter (Hampton Road) | 81 | 30.9% | -62% | 3.34 | -19% | -22% | $28.9k | 12 | 3.0 | 1 | 25 | - | 28 | Sunbridge Goodwin Nursing Home LLC | $11.2M | $5.2M | 46.3% | 305064 | ||||
| Hanover Hill Health Care 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. | Manchester (Hanover Hill) | 124 | 93.5% | +15% | 3.46 | +23% | -19% | $8.5k | 10 | 3.3 | 1 | 116 | A+ | 59 | Theodore Lee | $21.1M | $10.8M | 51.1% | 305009 | ||||
| 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 | 100.0% | +23% | 3.08 | +31% | -28% | $13.0k | 21 | 7.0 | 1 | 44 | - | 0 | - | $7.9M | $4.2M | 53.3% | 305068 |
According to NH state health department records, The Elms Center's license number is 04769.
The Elms Center's occupancy is 100%.
Austin J Cole is the administrator of The Elms Center.
The Elms Center has 52 beds.
The Elms Center is located at 71 ELM STREET.
(603) 673-2907 will put you in contact with the team at The Elms Center.
The Elms Center is in Hillsborough County.
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