The Elms Center

Nursing Home, Memory Care & Respite Care · Milford, NH

CMS overall rating

71 Elm Street, Milford, NH 03055 View map

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The Elms Center accepts Medicaid, Medicare, and private pay.

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The Elms Center accepts Medicaid, Medicare, and private pay.

Overview of The Elms Center

Located in Milford, New Hampshire, the Elms Center is a nursing home focused on short-term rehabilitation and skilled nursing care. The 52-bed community operates at full capacity, with most residents staying an average of 170 days. The facility accepts Medicaid, Medicare, and private-pay residents.

Most families that choose this setting are looking for post-acute rehab or ongoing skilled nursing support. The center’s staffing model reflects that clinical focus, with total nursing care averaging 3 hours and 5 minutes per resident each day, supported by a doctor on staff and 24-hour staffing coverage.

The facility focuses on rehabilitation, including respite care and short-stay programs. Residents can access on-site medical services and comprehensive discharge planning. Their daily lives are supported by a full-service dining program with meal options tailored to individual preferences. There are also amenities like a salon and spa, recreational programming, and wellness check-in calls. Housekeeping and laundry services are also available.

State inspections identified recurring issues in staffing adequacy, clinical documentation and medication management, and communication with residents. These are areas that should be carefully reviewed with ongoing oversight. Families considering the home should ask how the facility addresses these concerns and what specific improvements were implemented.

Milford is a car-dependent community with minimal walkable options. Visiting families should plan transportation accordingly. Those seeking a focused rehabilitation setting with on-site medical services should take a tour to understand current operations and assess whether the community fits their one’s clinical and personal needs.

Facility Direct Line (603) 673-2907

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Staffing hours breakdown

Hours per resident per day — compared to state averages

Total nursing care / resident

3h 5m per day

vs avg

6 of 6 metrics below state avg

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.	37m per day	▼ 16% 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.	33m per day	▼ 28% 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 43m per day	▼ 28% 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 35m per day	▼ 25% 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	▼ 81% 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.	23m per day	▼ 27% State avg: 31m per day · National avg: 28m per day

Capacity and availability

170 days

52-bed community

A moderately sized community that may balance personal attention with shared amenities and social activities.

Walk Score: 0 / 100

Car-dependent. Most errands require a car, with limited nearby walkable options.

About this community

Occupancy

Occupancy rate

100%

Higher than the New Hampshire average: 81.1%

Occupied beds

52 / 52

Average occupied beds in New Hampshire homes 80 beds

Facility TypeNursing Home

StatusActive

IssuanceSeptember 1, 2025

CountyHillsborough

License Number04769

CMS Certification Number305068

AccreditationsAHCA Bronze Quality Award Winner

The Elms Center is administered by Austin J Cole.

Accept Medicaid

Accept Medicare

Rehabilitation Services

Respite Care

Short-Term Rehab

Doctor on Staff

24-Hour Staffing

Comprehensive Discharge Plans

Safe Individualized Care

Covid-19 Safety & Prevention

Premier Rehabilitation & Medical Services

Innovative Technology

On-Site Services

Stay Connected

Recreational Services & Entertainment

Full-Service Dining

Salon & Spa

In-Room Comfort

Relaxation Spaces

Housekeeping & Laundry

Routine Wellness Calls

Since 2023 · 3 years of data 23 deficiencies

Inspection Scorecard This scorecard compares key inspection, deficiency, 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.

Since 2023 vs. New Hampshire state average

Overall vs. NH average

Latest Inspection January 10, 2025 Routine

Deficiencies Deficiencies are formal regulatory issues recorded during state inspections.	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 assisted living residence (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 assisted living residence (7.7 vs. NH avg 5.7).↑ 35% worse

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

January 10, 2025 inspection found 10 deficiencies including failure to inform residents in their language, advance directive violations, medication and kitchen issues, and incomplete staffing assessments.
January 25, 2024 complaint investigation confirmed a resident fall causing serious fractures due to lack of assessment after wheelchair change without seatbelt.
January 25, 2024 routine inspection cited 8 deficiencies including insufficient nursing staff causing delayed care, late medications, poor supervision, and infection control lapses.

Show Inspection Reports

Inspections since 2023

Total health inspections 3

State average N/A

Last Health inspection on Jan 2025

Total health citations

State average N/A

Citations per inspection

State average N/A

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).

Breakdown of citation severity (last 3 years)

Critical health citations

In line with State average

State average: N/A

Serious health citations

In line with State average

State average: N/A

0 critical citations State average: N/A

1 serious citation State average: N/A

15 moderate citations State average: N/A

5 minor citations State average: N/A

Citations history (last 3 years)

Administration minor citation Jan 10, 2025

Corrected

Administration moderate citation Jan 10, 2025

Corrected

Infection Control moderate citation Jan 10, 2025

Corrected

Nursing Services minor citation Jan 10, 2025

Corrected

Total staff 66

Employees 49

Contractors 17

Staff to resident ratio 1.40 : 1

0% compared with State average

State average ratio: 0 : 0

Avg staff/day 21

Average shift 7.8 hours

0% compared with State average

State average: 0 hours

Total staff hours (quarter) 15,103

Nursing staff breakdown

7.8 hours

8.5 hours

7.8 hours

Contractor staffing

1,131 contractor hours this quarter

Speech Language Pathologist: 3 Respiratory Therapy Technician: 3 Qualified Social Worker: 3 Registered Nurse: 2 Physical Therapy Assistant: 2 Physical Therapy Aide: 2 Nurse Practitioner: 1 Medical Director: 1

Staff by category


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

21 Certified Nursing Assistant

% of Days 100%

5 Medication Aide/Technician

% of Days 80%

6 Licensed Practical Nurse

% of Days 100%

11 Registered Nurse

% of Days 100%

1 RN Director of Nursing

% of Days 63%

1 Administrator

% of Days 72%

1 Mental Health Service Worker

% of Days 72%

1 Dietitian

% of Days 67%

1 Other Dietary Services Staff

% of Days 65%

1 Clinical Nurse Specialist

% of Days 60%

3 Nurse Practitioner

% of Days 61%

2 Physical Therapy Assistant

% of Days 57%

3 Speech Language Pathologist

% of Days 55%

2 Physical Therapy Aide

% of Days 43%

3 Respiratory Therapy Technician

% of Days 28%

3 Qualified Social Worker

% of Days 18%

1 Medical Director

% of Days 14%

View All Staffing Data

Total fines amount $13K

61% lower than State average

State average: $33K

Number of fines 2

In line with State average

State average: 1.9

Payment Denials 0

100% fewer payment denials than State average

State average: 0.1

Fines amount comparison

This facility $13K

State average $33K

Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

1 penalty in the past 3 years

Jan 25, 2024 · $10K

Civil Money Penalty Jan 25, 2024

$10K

Last updated: Jan 2026

High-risk clinical events score 13.4

18% worse than State average

State average: 11.4

Functional decline score 26.8

16% worse than State average

State average: 23.2

Long-stay resident measures

Significantly below average State avg: 2.7

Need for Help with Daily Activities Increased 25.2%

15% worse than State average

State average: 21.9%

Walking Ability Worsened 24.3%

20% worse than State average

State average: 20.3%

Low Risk Residents with Bowel/Bladder Incontinence 30.9%

14% worse than State average

State average: 27.1%

Falls with Major Injury 4.1%

11% better than State average

State average: 4.6%

High Risk Residents with Pressure Ulcers 7.8%

73% worse than State average

State average: 4.5%

Urinary Tract Infection 4.3%

71% worse than State average

State average: 2.5%

Lost Too Much Weight 5.8%

In line with State average

State average: 5.6%

Depressive Symptoms 17.9%

117% worse than State average

State average: 8.3%

Antipsychotic Use 15.8%

9% better than State average

State average: 17.4%

Pneumococcal Vaccine 95.4%

In line with State average

State average: 96.0%

Influenza Vaccine 93.0%

5% worse than State average

State average: 98.0%

Hospitalizations per 1,000 days 1.96

19% worse than State average

State average: 1.65

ED visits per 1,000 days 1.36

28% better than State average

State average: 1.90

Short-stay resident measures

Average State avg: 2.9

Pneumococcal Vaccine 70.2%

16% worse than State average

State average: 83.8%

Antipsychotic medication increase 0.0%

100% better than State average

State average: 1.6%

Influenza Vaccine 57.1%

31% worse than State average

State average: 83.0%

Re-hospitalized after SNF stay 31.8%

44% worse than State average

State average: 22.1%

Emergency department visits 8.5%

40% better than State average

State average: 14.1%

Falls with major injury 0.0%

100% better than State average

State average: 0.8%

Ability to care for self at discharge 41.7%

22% worse than State average

State average: 53.7%

Breakdown by payment type

Medicare

35% of new residents, usually for short-term rehab.

Typical stay 28 days

Private pay

37% of new residents, often for short stays.

Typical stay 1 - 2 months

Medicaid

28% of new residents, often for long-term daily care.

Typical stay 1 - 2 years

Total residents 47

Medicare

8.5% of residents

Medicaid

83% of residents

Private pay or other

8.5% of residents

Programs & Services

Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Financial Trends

Historical financial and operational data for The Elms Center from 2011–2023, based on CMS SNF Cost Reports.

Occupancy Rate 96.1% ↑ 1.8pp vs 2022

Net Patient Income -$279.8K ↑ ~$811.4K vs 2022

Payroll Costs $3.3M ↑ ~$592.7K vs 2022

Operating Margin -4.7% ↑ 16.1pp vs 2022

Metric	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023
Occupancy %	90.2%	94.0%	92.7%	94.7%	92.3%	92.3%	92.1%	95.5%	93.3%	89.1%	85.0%	94.3%	96.1%
Beds	52	52	52	52	52	52	52	52	52	52	52	52	52
Net Income	$103,169	-$169,838	-$80,122	$266,259	$198,910	$340,337	$43,076	-$972,923	-$2,704,380	-$1,340,318	-$1,972,745	-$1,019,989	-$257,175
Gross Revenue	$6,271,449	$6,414,219	$6,850,649	$6,776,250	$6,766,979	$6,606,204	$6,983,627	$7,412,801	$7,282,958	$6,936,417	$6,595,025	$7,444,456	$7,904,642
Operating Expenses	$4,249,448	$4,055,120	$4,369,171	$4,415,729	$4,322,030	$4,052,547	$4,456,709	$5,525,350	$7,408,170	$6,525,202	$6,635,977	$6,357,558	$6,287,852
Net Patient Income	$84,925	-$176,556	-$81,589	$260,701	$193,578	$335,445	$38,076	-$977,882	-$2,707,542	-$1,341,160	-$2,067,360	-$1,091,188	-$279,809
Net Patient Revenue	$4,334,373	$3,878,564	$4,287,582	$4,676,430	$4,515,608	$4,387,992	$4,494,785	$4,547,468	$4,700,628	$5,184,042	$4,568,617	$5,266,370	$6,008,043
Payroll Costs	$1,969,157	$2,052,382	$2,180,508	$2,248,287	$2,271,573	$2,104,734	$1,964,221	$2,068,718	$2,103,964	$2,084,804	$2,643,369	$2,740,030	$3,332,754
Operating Margin %	2.0%	-4.6%	-1.9%	5.6%	4.3%	7.6%	0.9%	-21.5%	-57.6%	-25.9%	-45.3%	-20.7%	-4.7%
Medicare %	15.0%	11.2%	13.6%	10.4%	12.3%	8.5%	8.1%	9.6%	7.3%	10.2%	9.3%	9.8%	5.8%
Medicaid %	74.0%	72.2%	81.8%	77.1%	79.3%	80.2%	80.9%	83.0%	83.6%	82.9%	76.3%	80.1%	82.5%
Private %	11.0%	16.6%	4.7%	12.5%	8.5%	11.3%	10.9%	7.4%	9.1%	7.0%	14.4%	10.2%	11.7%
Net Patient Revenue/Day	$253	$217	$244	$260	$258	$250	$257	$251	$265	$306	$283	$294	$329
Cost/Day	$248	$227	$248	$246	$247	$231	$255	$305	$418	$385	$411	$355	$345
Avg Length of Stay	112.6 days	188.2 days	133.2 days	164.9 days	162.2 days	148.9 days	140.9 days	140.5 days	168.6 days	134.6 days	145.3 days	179.0 days	170.5 days

Finances and operations

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

Net patient revenue

$6.0M

Net patient income

-$279.8K

For-profit Operated by a single business entity.

Net patient revenue

$6.0M

Net patient income

-$279.8K

Other income

$22.6K

Payroll costs

$3.3M 55.5% of net patient revenue

Other operating costs

$3.0M

Total costs

$6.3M

TYPE OF STAY

Mostly long-term care residents

Most residents stay for extended periods and receive ongoing daily care.

New residents most often arrive under private pay (37% of admissions), and a typical private pay stay runs around 1 - 2 months.

Coverage residents most often arrive under.

Medicare 35%

Private pay 37%

Medicaid 28%

Coverage residents most often leave under.

Medicare 20%

Private pay 34%

Medicaid 47%

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The information below is reported by the New Hampshire Department of Health and Human Services, Health Facilities Administration.


The Elms Center	NH MC RC	Milford	-	52	-	0	-
RiverWoods Exeter	NH AL IL MC NC	Exeter (Perkins Hill)	-	66	-	0	-
Pleasant Valley Nursing and Rehab Center	NH HC RC	Derry	-	112	-	65	-
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Nursing Home Explorer

What is the license number of The Elms Center?

According to NH state health department records, The Elms Center's license number is 04769.

What is the occupancy rate at The Elms Center?

The Elms Center's occupancy is 100%.

Does The Elms Center operate as a for-profit or non-profit?

The Elms Center is registered as a for-profit in NH.

Who is the administrator of The Elms Center?

Austin J Cole is the administrator of The Elms Center.

How many beds does The Elms Center have?

The Elms Center has 52 beds.

What is the address of The Elms Center?

The Elms Center is located at 71 Elm Street, Milford, NH 03055.

What is the phone number of The Elms Center?

(603) 673-2907 will put you in contact with the team at The Elms Center.

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The Elms Center

Overview of The Elms Center

Quality ratings

Staffing hours breakdown

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Payment & Insurance

Therapy & Rehabilitation

Staffing & Medical

Amenities & Lifestyle

Contact The Elms Center

Inspection History

Inspection Scorecard This scorecard compares key inspection, deficiency, 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 Deficiencies are formal regulatory issues recorded during state inspections.

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

Health Inspection History

Inspections since 2023

Breakdown of citation severity (last 3 years)

Citations history (last 3 years)

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

21 Certified Nursing Assistant

5 Medication Aide/Technician

6 Licensed Practical Nurse

11 Registered Nurse

1 RN Director of Nursing

1 Administrator

1 Mental Health Service Worker

1 Dietitian

1 Other Dietary Services Staff

1 Clinical Nurse Specialist

3 Nurse Practitioner

2 Physical Therapy Assistant

3 Speech Language Pathologist

2 Physical Therapy Aide

3 Respiratory Therapy Technician

3 Qualified Social Worker

1 Medical Director

Penalties and fines

Fines amount comparison

Fines amount comparison

Penalty History

Quality of care over time

Long-stay resident measures

Short-stay resident measures

Breakdown by payment type

Medicare

Private pay

Medicaid

Facility Characteristics

Programs & Services

Residents Group

Active Resident Council

Financial Trends

Financial Performance

Payroll & Labor Costs

Payer Mix (percentage)

Finances and operations

Who this home usually serves

Mostly long-term care residents

Admissions

Discharges

Places of interest near The Elms Center

Calculate Travel Distance to The Elms Center

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